Medication

Medications are appropriate for some children, adolescents and adults in combination with other forms of therapy. Medication should not be a first-line treatment.
Medications are usually recommended only for patients who do not respond to other interventions. Your clinician should not prescribe medication for psychopathy without trying other approaches first (or sometimes simultaneously).

No medications have been developed specifically to treat psychopathy, so medications initially developed to treat ADHD, mood and anxiety disorders, or thought disorders are used instead.

Medications are not a cure. But medications may reduce symptoms of psychopathy. They will not help everybody, and often several medications and dosages must be tried to determine if any of them will have an effect. All medications have side effects, which may outweigh their benefits for managing symptoms.

You should also know that most of the medications described below have only been tested for short periods of time in small numbers of children and adolescents, most of whom were not assessed for psychopathy. Larger, longer-term studies are needed to develop better treatment protocols. In addition, more studies need to be done that specifically test the effects of these medications on both children and adults with psychopathy. 

With this in mind, medications that may be effective for symptoms of psychopathy include:

Psychostimulants

Psychostimulant medications (for example, methylphenidate and dextroamphetamine, which are sold under brand names like Concerta™ and Adderall™ are used to treat symptoms of ADHD, like impulsiveness, hyperactivity, and restlessness. Scientific studies show they can also be effective in reducing aggression and other disruptive behaviors in children and adolescents with psychopathy.

Antipsychotics

Antipsychotic medications (for example, risperidone) were developed to manage symptoms of thought disorders, like schizophrenia and bipolar disorder. However, they are often used clinically to reduce aggression in children and adults who do not have these disorders. Scientific studies show they can be effective in reducing aggression and improving social competencies in children and adolescents. They may also enhance the effects of psychostimulants in some children.

Mood Stabilizers

Mood stabilizing medications (for example, lithium and divalproate) were developed to manage symptoms of bipolar disorder. Scientific studies show they may also be effective in reducing aggression, bullying, and outbursts in children and adolescents.