Antisocial personality disorder as a prognostic factor for pharmacotherapy of cocaine dependence.
Pharmacotherapy response was compared in 94 cocaine-abusing methadone patients with (n = 75) and without (n = 19) antisocial personality disorder (ASP), in a 12-week, randomized, double-blind trial using desipramine 150 mg daily (n = 30), amantadine 300 mg daily (n = 33), and placebo (n = 31). Retention was lower for the ASP group (ASP 9.6 weeks vs. non-ASP 11.2 weeks). During the first 2 weeks, there was no significant difference in the percentage of cocaine-free urines between the ASP vs. non-ASP patients (9% vs. 18%), but during the last 2 weeks, the non-ASP patients showed a significantly greater percentage of cocaine-free urines (30% vs. 7%). Placebo-treated patients in both groups demonstrated no significant difference in their urine toxicologies comparing the first to the last two weeks of treatment. However, the percentage of cocaine-free urines increased from 15% to 32% in medicated non-ASP patients, but showed no change in medicated ASP patients. Thus, antisocial personality disorder was a poor prognostic factor for treatment retention and continued cocaine abuse, and medication did not improve treatment outcome for the ASP patients, but did for the non-ASP patients.
Leal
J
J
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Ziedonis
D
D
Kosten
T
T
D000328:Adult; D000547:Amantadine / Q000627:therapeutic use*; D000987:Antisocial Personality Disorder / Q000523:psychology / Q000534:rehabilitation*; D003042:Cocaine; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology / Q000534:rehabilitation; D003891:Desipramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D010352:Patient Dropouts / Q000523:psychology; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*
D000547:Amantadine; D003042:Cocaine; D003891:Desipramine; D008691:Methadone