The chapter pays specific attention to the role of antiandrogen and hormonal medications and the increasing use of selective serotonin reuptake inhibitors in managing intense and recurring sexual preoccupations. Psychopharmacological treatments should never be used as an exclusive treatment for deviant sexual behaviors and are generally reserved for treatment of the more severe adult sex offenders. The chapter focuses on psychopharmacological treatment possibilities as one aspect of a comprehensive treatment plan for adolescent and adult sex offenders. Sexual deviance often develops during adolescence; this supports the need for early treatment. However, none of the psychopharmacological interventions has been well studied in that age group. Of the available treatment options, the selective serotonin reuptake inhibitors have been widely used in adolescents and adults with sexual obsessions or compulsions, coexisting depressive disorders, and paraphilias. These medications are relatively safe and their side-effect profiles are well known. Decreasing the production or blocking the effect of testosterone is not commonly used in adolescents because of the effects on sexual maturation and growth. Table, references