I heard it had a 50% suicide attempt rate. If true, the depression rate is probably more than 15%.
Ok, ok, it may be unethical (don't you miss the days when researches could do whatever they wanted?) but still, if these people don't feel depression or anxiety but can through a lot work, and that is the goal of treatment, then why wouldn't inducing it pharmacologically work? Even if reserpine wouldn't work, certainly there is something out there that would cause the symptoms needed for treating the disorder.
So do you think that the 50% suicide rate (if correct) is solely due to the drug? Or could it be a function of the types of patients who received it? I think the later is more parsimonious until research suggests otherwise. Keep in mind that resperine was formerly used to treat patients with psychosis and sever mania who happen to have a base rate suicide occurrence of almost 30%.
A couple of things: One, I don't think it's correct to say that these people "
don't feel depression or anxiety." I think this is somewhat of a stretch. Several methods, including Galvanic skin response, and other psychophysiological methods have demonstrated decreased autonomic arousal. Decreased is the key word here, meaning that the threshold for these responses maybe maybe lower,
on average. I don't think this translates into an inability to experience depression or anxiety. Empathy, especially in those who qualify for psychopathy, maybe be a different story however. In fact, the only time you are likely to see a person with ASP voluntarily walk into your clinic is when they are experiencing other axis I conditions (depression or anxiety) that are troubling them.
Second, keep in mind that mood induction is just one of many proposed treatments for ASP, and none of these have been shown to be particularly effective. Inducing a second problematic issue (ie., depression) into patients that are already notoriously difficult to treat would only complicate matters significantly. I think inducing transient mood states through experimental paradigms such as priming would accomplish the state necessary for this proposed therapy, without subjecting patients to prolonged depressed mood, or the risks associated with pharmacological therapy. As I mentioned before, techniques aimed at empathy induction are common place in therapy with ASP patients, but I am not sure how artificially inducing depressed mood states would increase insight, because they often have difficulty with empathy, which is necessary for insight into how others experience emotion. I'd like to know the efficacy and treatment size effects of this therapy when compared to other methods.
Third, yes, certain drugs, like resperine can cause depressive symptoms as a side effect. However, assuming that this mimics true clinical depression is a reductionist view of the multifactorial causes of depression and how it is truly experienced in depressed patients. There is no way to mimic the negative cognitive schematas (which are widely accepted and supported by experimental research) that contribute to, and exacerbate, the experience of negative emotions in depressed patients There is also no way to mimic the psychosocial environments/situations and stresses that are often part of the depressed patient's world. So basically, i don't think there is a way to reliably induce a true depressive state pharmacologically, and even if you could, there are other experimental methods that can that serve as less dangerous alternatives for this proposed therapy.