Pharmacological and psychological interventions for antisocial personality disorder - Results of two cochrane reviews

Abstract

Antisocial Personality Disorder (AsPD) is a relatively common condition. It is associated with a high number of adverse outcomes for the people affected, their families and society. Little is known about the best way to treat this condition. This paper summarises the results of two separate but complementary Cochrane systematic reviews: one looking at the effectiveness of psychological interventions and the other into the effectiveness of pharmacological interventions. Only a small number of randomised controlled trials were identified for inclusion in the reviews (11 for psychological, eight for pharmacological interventions). The majority of these studies did not focus solely on AsPD but selected participants for other conditions, most commonly substance misuse disorders. Most trials tested a different psychological or pharmacological intervention, so very few conclusions can be drawn. Among the pharmacological approaches tested, nortriptyline and bromocriptine had some effect in men with alcohol dependency. Both drugs reduced anxiety levels, nortriptyline also had a positive effect on substance use related outcomes. Phenytoin was reported as superior to placebo on frequency and intensity of aggressive acts in male prisoners. Psychological interventions, that proved superior to the control condition, included cognitive behaviour therapy (CBT) and contingency management in men with AsPD and cocaine dependency. © Touch Briefings 2011.