The Effects of Sertraline on Psychopathic Traits

• Type of Material: Article
• Authors: Boadie W Dunlop, Emory University; Jared DeFife, Emory University; Lauren Marx, Emory University; Steven Garlow, Emory University; Charles B. Nemeroff, University of Miami Miller School of Medicine; Scott O Lilienfeld, Emory University
• Language: English
• Date: 2011-11
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 Lippincott Williams & Wilkins, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1097%2FYIC.0b013e32834b80df
• Title of Journal or Parent Work: International Clinical Psychopharmacology
• ISSN: 0268-1315
• Volume: 26
• Issue: 6
• Start Page: 329
• End Page: 337
• Grant/Funding Information: This research was funded by the National Institutes of Mental Health grants R01 MH56946 and K23 MH086690 (BWD).
• Research Categories: Psychology, Psychobiology; Health Sciences, Pharmacology

Abstract

Objective To evaluate whether antidepressants alter expression of psychopathic personality traits in patients with major depressive disorder (MDD). Methods Data were collected from a double-blind, placebo-controlled 8-week trial evaluating the efficacy of sertraline (50-200 mg/d) combined with either tri-iodothyronine (T3) or matching placebo in adult outpatients with MDD. Administration of sertraline was open-label; T3/placebo was double-blind. At the baseline and week 8 visits, patients completed the short form of the Psychopathic Personality Inventory (PPI), a well-validated self-report measure assessing two major factors of psychopathy: Fearless Dominance (PPI-1) and Self-centered Impulsivity (PPI-2). Change in PPI scores were assessed using paired t-tests for all subjects who completed a baseline and post-randomization PPI. Results Ninety patients (84 completers and 6 who terminated the trial early) were eligible for the analysis. Both PPI factors changed significantly from baseline to endpoint, but in opposing directions. The mean score on PPI-1 increased significantly during treatment; this change was weakly correlated with change in depression scores. In contrast, the mean score on PPI-2 decreased significantly, but these changes were not correlated with changes in depression scores. Conclusion Independent of their effects on depression, antidepressants increase adaptive traits traditionally observed in psychopathic individuals, such as social charm and interpersonal and physical boldness. Antidepressants reduce other, more maladaptive, traits associated with psychopathy, including dysregulated impulsivity and externalization.