Nortriptyline Reduces Drinking in Alcoholics with Antisocial Personality Disorder

Previously we reported that the antidepressant citalopram has negligible effects on drinking behavior in alcoholics (see JW for Psychiatry, vol. 1, p. 5) and suggested that antidepressants may be more effective in alcoholics with comorbid depression. This randomized placebo-controlled study compared the effects of the antidepressant nortriptyline and bromocriptine (a dopamine agonist with both antidepressant activity and possible effects on craving) in 216 alcoholic patients.

The patients were subtyped as pure alcoholism, alcoholism with anxiety and depression or both, and alcoholism with antisocial personality disorder (a group not expected to respond to medication), 60% of whom also had comorbid anxiety or depression. After six months, onl…