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 dis order (ASP), in a 12-week, randomized, double-blind trial using desipr amine 150 mg daily (n = 30), amantadine 300 mg daily (n = 33), and pla cebo (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 signific ant difference in the percentage of cocaine-free urines between the AS P 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 demo nstrated no significant difference in their urine toxicologies compari ng the first to the last two weeks of treatment. However, the percenta ge of cocaine-free urines increased from 15% to 32% in medicated non-A SP patients, but showed no change in medicated ASP patients. Thus, ant isocial personality disorder was a poor prognostic factor for treatmen t retention and continued cocaine abuse, and medication did not improv e treatment outcome for the ASP patients, but did for the non-ASP pati ents.