In 1990, a prison in California filed a class action lawsuit requiring better mental health services for inmates. Some researchers have contributed to the current literature by providing an overview of evidence-based interventions, clinical recommendations, and future research recommendations by critically examining current research for this population

Scripps College

As of currently, there aren't any successful treatment methods to treat ASPD directly. However, some strategies can be helpful. For example, treating conduct disorder during childhood is considered the most effective in minimizing ASPD behaviors. Additionally, medications and hospitalization can be used to treat symptoms associated with co-occurring conditions. Meanwhile, hospitalization is not worthwhile to treat ASPD directly because it is very expensive, can disrupt other patients, and is just not effective. It is also important to note that most people with ASPD are noncompliant with therapy, making managing it hard.

Treating ASPD

Green, S. (2025). Evidence-based treatments for adult violent offenders diagnosed with borderline personality disorder and/or antisocial personality disorder: A literature review [ProQuest Information & Learning]. In Dissertation Abstracts International: Section B: The Sciences and Engineering (Vol. 86, Issue 1–B). 

Treatment for adult violent offenders

- Aggressive behavior: 
    - First-line therapy: second generation antipsychotics (risperidone and quetiapine);
    - Second/third-line therapies: SSRIs, sertraline, fluoxetine, or mood stabilizers;
- Impulsivity: Anticonvulsants (oxcarbazepine and carbamazepine);
- ADHD: Bupropion and atomoxetine.

Medications used to treat co-occurring conditions in people with ASPD

For better outcomes, it is crucial for different professionals specialized in different areas to work together when treating patients with ASPD. Such professionals should include:
- Psychological specialist (physician overseeing the case);
- Nurses with psychological training;
- Pharmacist (for pharmacotherapy);
- Any other professional that the patient might need.

Interprofessional team approach for treating ASPD

A series of psycholytic (low dose) ketamine therapy sessions over the course of 3 years resulted in resolution of severe alcoholism, reduction in violent thoughts about people and the world, and a reduction in depression symptoms. With additional precautions, utilizing a ketamine-assisted psychotherapy approach led to clinical improvements in depression, alcohol abuse, and ASPD traits. 

Ketamine as treatment for ASPD

After interviewing several clinicians and clients, one study concluded that rapport building, therapeutic alliance, supervision, and consultation were especially important for treatment effectiveness and outcomes. Finally, the study also revealed that there is an interconnectedness of the carceral system with the diagnosis of ASPD, leading to possible misdiagnosis or over diagnosis.

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