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Antisocial Personality Disorder

Current Drug Treatment Recommendations

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Abstract

Summary

The use of drug treatments in patients with personality disorders remains controversial. The target for treatment is symptoms that arise from underlying biological vulnerabilities rather than the personality disorder itself.

In antisocial personality disorder (ASPD). the trait symptoms that may respond to drugs are impulsive and violent behaviour. As there have been no specific placebo-controlled treatment studies of patients with ASPD, no specific drug treatment recommendations can be made. However. there is limited evidence based on trials of patients with antisocial behaviours that anti psychotics, mood stabilisers and antidepressants may sometimes be helpful in patients with ASPD. Well designed drug treatment studies are urgently needed.

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References

  1. Soloff PH. What’s new in personality disorder?: an update on pharmacologic treatment. J Pers Disorders 1990; 4 (3): 233–43

    Article  Google Scholar 

  2. Bluglass R. Who’s psychopathic now [abstract 1]? BMJ 1994; 309: 826

    Article  PubMed  CAS  Google Scholar 

  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington. DC: American Psychiatric Association. 1994

    Google Scholar 

  4. World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization 1992

    Google Scholar 

  5. Widiger TA. Antisocial personality disorder. Hosp Community Psychiatry 1992; 43 (1): 6–8

    PubMed  CAS  Google Scholar 

  6. Dolan M. Psychopathy — a neurobiological perspective. Br J Psychiatry 1994; 165: 151–9

    Article  PubMed  CAS  Google Scholar 

  7. McGuttin P, Gotteman I. Genetic influences on nom1al and abnormal development. In: Rutter M, Hersov L, editors. Child psychiatry modem approaches. 2nd ed. London: Blackwell. 1984: 17–33

    Google Scholar 

  8. Howard RL. The clinical EEG and personality in mentally abnormal offenders. Psychol Med 1984; 14: 569–80

    Article  PubMed  CAS  Google Scholar 

  9. Monroe RR. The medical model in psychopathy and dyscontrol syndromes. In: Reid WH. editor. The psychopath. New York: Brunner/Mazel. 1978: 198–208

    Google Scholar 

  10. Hare RD. Psychopathy and electrodermal responses to nonsignal stimulation. Bioi Psychiatry 1978; 6: 237–46

    CAS  Google Scholar 

  11. Hare RD, Quinn MJ. Psychopathy and autonomic conditioning. J Abnorm Psvchol 1991; 77: 223–35

    Article  Google Scholar 

  12. Schalling D. Psychopathy related personality variables and the psychophysiology of socialisation. In: Hare RD, Schalling D. editors. Psychopathic behaviour: approaches to research. Chichester: Wiley. 1978: 1–21

    Google Scholar 

  13. Robinson TN, Zhan TP. Psychotism and arousal: possible evidence for a linkage of P and psychopathy. Pers Individ Diff 1985; 6: 47–66

    Article  Google Scholar 

  14. Mulder R. The biology of personality. Aust NZ J Psychiatry 1992; 26: 364–76

    Article  CAS  Google Scholar 

  15. Galvin M, Shekhar A, Simon J, et al. Low dopamine-betahydroxylase: a biological se4uela of abuse and neglect. Psychiatrv Res 1991; 39: 1–11

    Article  CAS  Google Scholar 

  16. Siever LJ, Coccaro EF, Zemishlanv EF, et al. Psychobiology of personality disorders: pharmacologic implications. Psychopharmacol Bull 1987; 23: 333–6

    PubMed  CAS  Google Scholar 

  17. Schulz CS, Cornelius J, Barrell DB, et al. Pharmacodvnamic probes in personality disorders. Psychopharmacol Bull 1987; 23: 337–41

    PubMed  CAS  Google Scholar 

  18. Siever U, Steinberg BJ, Trestman RC. et al. Personality disorders. In: Oldham JM, Riba MB. Review of Psvchiam. V0l. 13. Washington, DC: American Psychiatric Press. 1994: 253–90

    Google Scholar 

  19. Rohins LN, Tipp J, Przybeck T. Antisocial personality. In: Robins LN, Regier DA, editors. Psychiatric disorders in America. New York: The Free Press. 1991

    Google Scholar 

  20. Tyrer P, Seivewright N. Pharmacological treatment of personality disorders. Clin Neuropharmacol 1988; 11 (6): 493–9

    Article  PubMed  CAS  Google Scholar 

  21. Goldberg SC, Schulz SC, Schulz PM, et al. Borderline and schiwtypal personality disorders treated with low dose thiothixene vs placebo. Arch Gen Psychiatry 1986; 43: 680–6

    Article  PubMed  CAS  Google Scholar 

  22. Cowdrey R, Gardner DL. Pharmacotherapy of borderline personality disorder. Arch Gen Psychiatry 1998; 45: 111–9

    Article  Google Scholar 

  23. Soloff PH, George A, Nathan RS, et al. Progress in pharmacotherapy of borderline disorders: a double-blind study of amitriptyline, haloperidol and placebo. Arch Gen Psychiatry 1986; 43: 691–7

    Article  PubMed  CAS  Google Scholar 

  24. Stein G. Drug treatment of the personality disorders. Br J Psychiatry 1992; 161: 167–84

    Article  PubMed  CAS  Google Scholar 

  25. Tupin JP, Smith DB, Clanon TL, et al. The long-tenn use of lithium in aggressive prisoners. Compr Psychiatry 1973; 14: 311–7

    Article  PubMed  CAS  Google Scholar 

  26. Sheard MH, Marini JL, Bridges CI, et al. The effect of lithium on unipolar aggressive behaviour in man. Am J Psychiatry 1976; 133: 1409–13

    PubMed  CAS  Google Scholar 

  27. Kalina RK. Diazepam: its role in a prison setting. Dis Nerv Sys 1964; 25: 101–7

    CAS  Google Scholar 

  28. Hakola HP, Laulumaa VAO. Carbamazepine in the treatment of violent schizophrenics [abstract]. Lancet 1982; 1: 1358

    Article  PubMed  CAS  Google Scholar 

  29. Malles J. Comparative effectiveness of carbamazepine and propranolol for rage outbursts. J Neuropsychiatry Clin Neurosci 1990; 2: 159–64

    Google Scholar 

  30. Neppe VW. Carbamazepine as an adjunctive treatment in nonepileptic chronic inpatients with EEG temporal lobe abnormalities. J Clin Psvchiatrv 1983; 44: 326–31

    CAS  Google Scholar 

  31. Luchens OJ. Carbamazepine in violent non-epileptic schizophrenics. Psychopharmacol Bull 1984; 20: 569–71

    Google Scholar 

  32. Wender PH, Reimherr FW, Wood DR. Attention deficit disorder (minimal brain dysfunction) in adults. Arch Gen Psychiatry 1981; 38: 449–56

    Article  PubMed  CAS  Google Scholar 

  33. Norden MJ. Fluoxetine in borderline personality disorder. Prog Neuropsychopharmacol Biol Psychiatry 1989; 13: 885–93

    Article  PubMed  CAS  Google Scholar 

  34. Markovitz PJ. Drug treatment of personality disorders [letter]. Br J Psychiatry 1993; 162: 122

    Article  PubMed  CAS  Google Scholar 

  35. Salzman C, Wolfson AN, Schatzberg A, et al. Effect of tluoxetine on anger in symptomatic volunteers with borderline personality disorder. J Clin Psychopharmacol 1995; 15: 23–9

    Article  PubMed  CAS  Google Scholar 

  36. Kavoussi RJ, Liu J, Coccaro EF. An open trial of sertraline in personality disordered patients with impulsive aggression. J Clin Psychiatry 1994; 55: 137–41

    PubMed  CAS  Google Scholar 

  37. Buck OD. Senraline for reduction of violent behaviour [letter]. Am J Psychiatry 1995; 152: 6

    Google Scholar 

  38. Mulder RT, Wells JE, Joyce PR, et al. Antisocial women. J Pers Disorders 1994; 8: 279–87

    Article  Google Scholar 

  39. Lewis CE. Neurochemical mechanisms of chronic antisocial behavior I psychopathy): a literature review. J Nerv Ment Dis 1991; 179: 720–7

    Article  PubMed  CAS  Google Scholar 

  40. Garton G, Akhtar S. The literature on personality disorders 1985-88: trends, issues and controversies. Hosp Community Psychiatry 1990; 41: 39–51

    Google Scholar 

  41. Gitlin MJ. Pharmacotherapy of personality disorder: conceptual framework and clinical strategies. J Clin Psychopharmacol 1993; 13: 343–53

    PubMed  CAS  Google Scholar 

Download references

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Mulder, R.T. Antisocial Personality Disorder. CNS Drugs 5, 257–263 (1996). https://doi.org/10.2165/00023210-199605040-00004

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