The Treatment of Antisocial Personality Disorder

Purpose of Review Antisocial personality disorder (ASPD) is defined by its pattern of socially irresponsible, exploitative, and guiltless behavior. The disorder is common and costly to society. ASPD starts in childhood or early adolescence when it is diagnosed as conduct disorder. If the symptoms persist past age 18, the diagnosis changes to ASPD. The disorder moderates with advancing age and many individuals will no longer meet criteria for the disorder as older adults. Recent Findings The treatment of ASPD is challenging and complicated by a dearth of research evidence. There are no medications approved by the US Food and Drug Administration for treatment of the disorder, nor are there proven psychological treatments. Medications can be prescribed to treat comorbid disorders (e.g., panic disorder, major depression), or “off-label” to target aggression and impulsivity associated with ASPD. Treatment models employing cognitive-behavioral therapy have been developed, and some reports suggest benefit. Summary Patients with ASPD should not routinely be treated with psychotropic medication. Medications may be helpful in treating comorbid psychiatric disorders such as major depression, or aggressive symptoms common in these patients. Cognitive-behavior therapy may be helpful for those with milder syndromes. © 2017, Springer International Publishing AG.