LONGECITY

I've been researching the possible mechanisms behind Psychopathy, which is one of the few mental disorders currently regarded as ''untreatable'' or at least with a poor prognosis in the long term.
My findings have generally suggested an imbalance between the stress (HPA) system and the gonadal (HPG) axis.

J Abnorm Psychol. 2010 Dec 6. [Epub ahead of print]

Increased testosterone-to-cortisol ratio in psychopathy.
Glenn AL, Raine A, Schug RA, Gao Y, Granger DA.

Abstract
Only a few studies have examined hormones in psychopathy, and results have been mixed. It has been suggested that because hormone systems are highly interconnected, it may be important to examine multiple systems simultaneously to gain a clearer picture of how hormones work together to predispose for a certain construct. In the present study, we attempt to clarify the role of the hormones cortisol and testosterone in psychopathy by examining both hormones in a community sample of 178 adults demonstrating a wide range of psychopathy scores. Results showed that psychopathy scores were associated with an increased ratio of testosterone (baseline) to cortisol responsivity to a stressor. Psychopathy was not associated with either of these measures independently or with baseline cortisol levels. These findings suggest that these highly interconnected hormone systems may work in concert to predispose to psychopathy. (PsycINFO Database Record © 2010 APA, all rights reserved).

PMID: 21133509 [PubMed - as supplied by publisher]

Also refer to pages 251-265 of the book 'The Handbook of Psychopathy':

http://books.google.co.uk/books?id=OuNdrmHcJlgC&printsec=frontcover&dq=handbook+of+psychopathy&hl=en&ei=WSOfTZvKIePR4waDkZmHAw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDMQ6AEwAA#v=onepage&q&f=false

I have found information that suggests that 'Panax Ginseng' and 'Eleutherococcus Senticosus' may reverse this imbalance to a degree:

Med Hypotheses. 2001 May;56(5):567-72.

Panax ginseng and Eleutherococcus senticosus may exaggerate an already existing biphasic response to stress via inhibition of enzymes which limit the binding of stress hormones to their receptors.
Gaffney BT, Hügel HM, Rich PA.

Department of Human Biology and Movement Science, Faculty of Biomedical and Health Sciences and Nursing, Royal Melbourne Institute of Technology Bundoora Campus, Melbourne, Australia. bengaffney68@hotmail.com

Abstract
A mechanism of action for Panax ginseng (PG) and Eleutherococcus senticosus (ES) is proposed which explains how they could produce the paradoxical effect of sometimes increasing and sometimes decreasing the stress response. The mechanism suggests that this biphasic effect results from increased occupancy of positive and negative feedback stress hormone receptors by their natural ligands due to inhibition of specific enzymes which function to limit receptor occupancy. Specifically, it is suggested that PG inhibits 11-beta hydroxysteroid dehydrogenase one and ES inhibits catechol- O -methyl transferase, both of which reside in close proximity to stress hormone receptors and catalyse the degradation of stress hormones into inactive compounds. In addition, it is suggested that the increased energy said to result from PG and ES may be a consequence of their increasing the occupancy of stress hormone receptors which function to redistribute the body's energy reserves from regeneration to activity.

Copyright 2001 Harcourt Publishers Ltd.
PMID: 11388770 [PubMed - indexed for MEDLINE]

Also:

Life Sci. 2001 Dec 14;70(4):431-42.

The effects of Eleutherococcus senticosus and Panax ginseng on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes.
Gaffney BT, Hügel HM, Rich PA.

School of Nursing. Faculty of Nursing and Health, Griffith University, Meadowbrook, Queensland, Australia. B.Gaffney@mailbox.gu.edu.au

Abstract
A clinical trial was undertaken to investigate the effects of Eleutherococcus senticosus (ES) and Panax ginseng (PG) on competitive club-level endurance athletes engaged in their normal in-season training. Participants were matched for training stress and received a 33% ethanolic extract (8 mL/day) containing either ES, PG (equivalent to 4 g and 2 g/day of dried root, respectively), or a placebo. A pre-test and post-test were used to evaluate the effects of six weeks of supplementation on cortisol, testosterone, and testosterone to cortisol ratio (TCR) as well as circulating numbers of total T-cells, T-helper cells (CD4), T-suppressor cells (CD8), CD4 to CD8 ratio, natural killer cells, and B lymphocytes. None of the immune system variables changed significantly nor showed any clear trend from pre to post test in any of the treatment groups. No significant change in testosterone, cortisol or TCR was observed in the PG group. In the ES group, however, TCR decreased by 28.7% from 0.0464 to 0.0331 (P=0.03). The main contribution to this decrease appeared to be a non-significant (P= 0.07) 31% trend towards increased cortisol rather than a very small non-significant (P = 0.36) 7% decrease in the calculated mean for testosterone. This result suggested that contrary to initial expectation, ES increased rather than decreased hormonal indices of stress, which may be consistent with animal research suggesting a threshold of stress below which ES increases the stress response and above which ES decreases the stress response.

PMID: 11798012 [PubMed - indexed for MEDLINE]

- the limit with this study clearly being limited to athletic performance

Do you guys think this may be worth further investigation?
Edited by agwoodliffe, 08 April 2011 - 03:03 PM.

metta (compassion) meditation.

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A certain sociopath I once knew responded remarkably well to herbal remedies and avoiding toxins (the times I could get him to comply).

I have a hunch that if sociopaths pursue optimal health their "evil" genes will be silenced.

MDMA often causes a dramatic short-term reversal of psychopathy or Antisocial PD. This is exactly what would be expected from an empathogen. Of course, it's unsustainable.

A longer term solution might be the combination of a 5-HT1a agonist with an SSRI. Or perhaps the agonist with an SRA. Though it would likely need to be combined with some form of customized psychotherapy. No one will stick to the treatment unless it's more reinforcing to stay normal than it is to return to old habits. This would require behavioral interventions, social skills interventions, and perhaps contingency management with low-dose MDMA to provide powerful reinforcement in times of strong temptation to return to psychopathy.

In other words... nothing exists now that works for more than a day or so.

I'd like to make a slight change to what I said in my first post. I DO NOT recommend the use of Siberian Ginseng, as it has been shown to possess both androgenic & gonadotropic actions (whether these studies have been performed on humans I have yet to find out). Panax Ginseng, on the other hand, appears to be devoid of these side-effects.

Another thing that I wonder is whether estrogenic / anti-androgenic compounds may have any efficacy in treating the symptoms?

The part of the brain that deals with empathy do not work at all in the brains of psychopaths/sociopaths and that is why there is no cure.
People who have frontal head injury also have low empathy, while psychopaths are born that way with no empathy.
http://newmedia-eng....a.ac.il/?p=4426

To illustrate the point, think about a broken computer or laptop. It doesn't matter about the different types of CDS/DVDS you insert into the pc, you will never see what is on it because the computer is broken in the first place. You will need to fix it first.

A certain sociopath I once knew responded remarkably well to herbal remedies and avoiding toxins (the times I could get him to comply).

I have a hunch that if sociopaths pursue optimal health their "evil" genes will be silenced.

^This.

The difference between a sociopath and a CEO is that the latter has better control.

A certain sociopath I once knew responded remarkably well to herbal remedies and avoiding toxins (the times I could get him to comply).

I have a hunch that if sociopaths pursue optimal health their "evil" genes will be silenced.

^This.

The difference between a sociopath and a CEO is that the latter has better control.

There is no difference, many CEO's are sociopaths/psychopaths. Just as with any psychiatric disorder, there is a spectrum full of different types.

I would say years of therapy, especially group therapy, may the the only way to help a sociopath. It is also my understanding that many sociopaths sort of start to "grow out of" the disorder as they get into their 40s.

A certain sociopath I once knew responded remarkably well to herbal remedies and avoiding toxins (the times I could get him to comply).

I have a hunch that if sociopaths pursue optimal health their "evil" genes will be silenced.

The real reason why people with sociopath/psychopath genetic predispositons end up developing problematic behaviors is lack of proper nurture in childhood, especially during crucial years of development, 1 to 5. Let's start dealing with reality. Parents play the largest role in how we turn out, regardless of our predispositions. To me, the impact of environment and nurture on development seems blatantly clear. If more people start realizing this, the world will become a much better place.

I wonder if oxytocin would be good for psychopaths. Just a thought.

As an update, I have found a study on a herb, that is purported to actually increase MAO activity by at least 36%. Most studies on antisocial behaviour document a low-functioning variant of this gene, so this could be promising.

http://www.ncbi.nlm....pubmed/11092575

http://www.npr.org/2...-of-a-sociopath
;
NPR interview with a diagnosed sociopath who has written a memoir from the inside, so to speak. The book is titled: Inside the Mind of a Sociopath: A Life Spent Hiding in Plain Sight
Covers what it's like being a sociopath, what they feel and don't feel, and how they can adjust to society.

There seem to be differences in brain structure that are not amenable to treatment - perhaps a deficiency of mirror neurons, among other things. I have not read the book, but I would hope it will produce useful insights of the topic starter.

Maybe regenerating the part of the brain that controls empathy.

For a while I took an interest in the disorder and formed my own opinions on the disorder. I won't bother linking research, most of what I say is common knowledge on these boards and its late. I am assuming there are no substance addictions in my suggested cause of treatment which of course is rare and I believe should be tackled as much as possible 'first'. The treatment suggestions will focus on 'true' Psychopathy where inpatient admission or incarceration is likely, although a less intensive modality could be used for outpatient ASPD (which in a psychopathic form) is almost always comorbid to ADHD with a hyperactive/combined subtype.

Supplements for treating severe antisocial/narcissistic personality disorder is insane imo. I'll also quickly mention that until you increase MAO-A activity by at least 80% clinic effects aren't seen.

Psychotherapy won't be effective until they have stabilized - which in itself is hard. Using it to treat some comorbid disorders - affective and psychotic disorders is important for improving prognosis. If you can get them to see the benefits of using psychotherapy to say 'feel' better. Its unlikely to have much effect on substance abuse as they won't see the benefit of stopping.

Psychotherapy should take three steps:
Basic reward based behavioral therapy (they don't respond to negative reinforcement)
Continued behavioral therapy with some cognitive therapy and DBT therapy both 1 2 1 and in a group
When they are stable enough a more analytic therapy style may be approachable provided they can be convinced of its benefit. CAT, IPT and the like with a focus on group therapy.

Psychopathy seems to present as three major mental disorders

ADHD either hyperactive or combined type: Impusivity, explosive violence, low arousal,

Narcissistic Personality Disorder: Grandiose self worth, lack of empathy, pathological jealousy

Affective dsyregulation: poor emotional tone, regular changes in affect, proneness to depressive disorders, co-morbidity to other cluster B traits

Research supports the use of: Clonidine, MAOIs, SSRIs, Lithium and Valporic acid. There is some evidence for stimulants but I don't feel they are best prescribed to those at high risk of abuse. Atypical antipsychotics may play a part, especially when combined with acute or sub-clinical psychotic symptoms so often seen.

I believe a combination of Meclobremide, Atomoxatine and Valporic acid to be a good combination with a PRN of either an antipsychotic or antihistamine for acute behavioral dsycontrol.

Meclobremide: its effect on serotonin will reduce aggression and increase empathy as well as improve mood and its effects on noradrenaline and dopamine will help with ADHD like symptomolgy. Atamoxatine is effective in cases of hyperactive/impulsive ADHD and in controlling those symptoms. It also acts as an NMDA anatgonist which may bring about a more stable mood. Finally I choose Valporic acid over Lithium because the latter decreases the amount of noradrenaine potentially worsening impusive behavior. Valporic acid acts of GABA to decrease excitability, stabilizes mood and has some evidence in controlling impulsive/aggressive behavior. A low dose antipsychotic could be added to the mix - olanzapine or quetiapine are sedating and stabilizes dopamine to serotonin normalizing mood.

My other idea was to hit the serotoninergic system and hit it hard. Nortriptyline or Clomipramine, combined with high dose L-Tryptophan thoughout the day and Lithium.

Another option is hitting home on the mood stabilization, Lithium, Valporic acid and Aripiprazole/Quetiapine/Olanzapine. With the possibility of L-Tryptophan as well.

I don't think disorders like that can be cured. Expecting herbs to cure them seems particularly unrealistic, not that drugs would. What do you mean you are "researching" this? What are your findings based on?

I don't think the OP was suggesting the likelihood of remission. More symptom reduction, possibly to a manageable level.

I agree supplements seems the least effective way to go about it.

However for AsPD there long term prognosis isn't that poor, by early 40's most no longer clinical symptomatic.

On my two cent - there is some evidence for certain mood stabilizers, SSRI's, MAOI's and some of the underlying pathophysiology has been elucidated. Nobody is going to cure a psychopath and from the case reports rather than pure AsPD this disorder has a longer and more persistent course. However that doesn't mean you can't reduce symptoms and with the right combination maybe make a real difference - prehaps even enough to make anything more than basic behavioral therapy a realistic goal.

I forgot to mention, drug that reduce cortisol (cortisol should be the primary target) and testosterone functioning, and increasing thyroid functiong MIGHT play a role. However in general there is little convincing evidence playing with endocrinology has any impact of neuropsychiatric syndromes apart from mood disorders (cortisol inhibitors being experimented with for melancholia/psychosis and T3 being a valuable adjunctive). So I would suggest treatment via psychotropic meds to be the best bet.

I have a theory, in its infancy - but don't see it mentioned here so thought I'd suggest the beginnings that I have and let you consider it (or pull it apart). It builds out of the dissociation experience.

I think l-dopa if that intensity is required, otherwise dexamphetamine (dexedrine in US), PLUS an NDRI - such as wellbutrin in the US, Zyban elsewhere I believe (it is here).

Hit the dopamine/norephinephrine systems not the serotonin. Like you're treating ADHD.

Also - add naloxone/naltrexone - opioid inhibiting stuff. Like you're treating a heroin addict.


SSRI's do two things, increase serotonin, allowing for sleep and mood (at basic levels) improvement, and also they dampen dopamine. I don't think of dopamine as a 'reward' thing, personally. My own assessment is that 'reward' systems are far more opioid based.

So opioids make us feel good - they are feeling good as they are.
Serotonin improves mood - they are happy enough with the way they are, they certainly don't seem cut up about it.
Norepinephrine makes us CHOOSE good - it motivates us, gets us seeing the value/worth in certain things. This they don't see beyond 'feeding the opioid' or 'toying with people and things for fun' basically.
Dopamine is what makes us good people - it encourages altruistic tendencies for example.

So I say hit the NE and the dopamine levels. Hard. Add a breaker to the opioid based decision system.

That's my theory in a nutshell. It's working for dissociation.

SSRI's and antipsychotics reduce dopamine, and increase serotonin - leading to happier and MORE detached people - it's sort of the point, in regard to SSRI's - detach from the emotions until you can process/deal with whatever is making you sad/depressed etc, and feel more positive about life in general while you do that.

Don't think this will help a psychopath, considering they are happy enough - or have methods of improving mood - and are detached by nature of not relating to other people and their feelings.

So opioids make us feel good - they are feeling good as they are.
Serotonin improves mood - they are happy enough with the way they are, they certainly don't seem cut up about it.
Norepinephrine makes us CHOOSE good - it motivates us, gets us seeing the value/worth in certain things. This they don't see beyond 'feeding the opioid' or 'toying with people and things for fun' basically.
Dopamine is what makes us good people - it encourages altruistic tendencies for example.

I thought I read somewhere that dopamine lead to selfish tendencies. For example, when people are given a position of power they tend to fuck over the people beneath them while favoring themselves. Not everyone, of course, but many people.

i agree with tom and alyaah

MDMA often causes a dramatic short-term reversal of psychopathy or Antisocial PD. This is exactly what would be expected from an empathogen. Of course, it's unsustainable.

A longer term solution might be the combination of a 5-HT1a agonist with an SSRI. Or perhaps the agonist with an SRA. Though it would likely need to be combined with some form of customized psychotherapy. No one will stick to the treatment unless it's more reinforcing to stay normal than it is to return to old habits. This would require behavioral interventions, social skills interventions, and perhaps contingency management with low-dose MDMA to provide powerful reinforcement in times of strong temptation to return to psychopathy.

In other words... nothing exists now that works for more than a day or so.

If mdma works then its simple, long term treatment with MDAI would be the solution, I used mdai as a antidepressant myself for several weeks, its fucking excellent not like useless ssris.

MDMA wouldn't work. Not in the least. It increases behavioural disinhibition, is as addictive as shit (nearly all of these guys abuse drugs), causes cognitive dsystortion and chronic use can lead to psychosis and depression (both disorders psychopaths are prone to), it can paradoxically (not all that paradoxically) cause anger, rage and violence and is not a medical psychotropic drug for a good reason.

 

Taking a MDAI is increadably reckless when trying to treat depression, you are lucky you didn't make yourself worse.

Explain why? its a ton more effective then ssris and in therapeutic doses poses no risks or withdrawal at all, you must be talking about daily recreational doses.

I am not replying to anyone. I agree with Aylaah the most..and a lot of what Tom wrote, and others have made some excellent points. Also, some interesting points. L-Tyrosine and L-Phenylalinine, not sure if I spelled them right,  are supplements you can buy in a health food store in the states that raise dopamine levels. I know there can be a short term cure for sociopathy because I have seen it with gabapentin. I have also seen short term cures for anxiety. I am not talking feel better. I am talking ''cured''', but they were short term..only a few hours in one case..so there are potentials for therapies. I realize this question is off topic but how old were most of you when you realized there were sociopaths in the world and doesn't that fact scare you for them and for yourselves? Does this revelation move you to question our existence? There is no question in my mind that they were born this way and has nothing to do with environment. There are sociopaths everywhere and they possess purely underhanded mentalities..at least..from the layman's research I have conducted.  They are said to be incapable of possessing  altruism, yet I have seen them exhibit good intentions and actions..at least..initially or are they just faking these emotions? But, why fake them when they don't really care what others think of them? Maybe, they feel an instantaneous goodness or goodwill which 'morphs'  into ill will due to imbalances in their brain's neurotransmission? What imbalances would cause this surge?  Only they can tell us if this is true, but they can't because their brain chemistry prevents them from being honest and they probably don't even know it is happening. I wish I knew how they thought. After all these years and talk of sociopathy from college on up I still, we still, don't know how they truly feel. If they ever feel love..warmth, real compassion..etc. Do they fill instances of it that quickly dissipate? How do they really feel? That is not as important as finding a cure for them, but it could help in finding a cure if we could 'read their minds' so to speak.

When I spoke of the surge I meant that I feel there may be a depletion of one of the neurotransmitters. It does not 'coat' or protect the brain from the intensity of the other neurotransmitters. My take is that they do not produce enough dopamine and have too much serotonin and gaba. The noradrenaline is not affected too much but from what I understand dopamine creates noradrenaline. I also wonder if t3 would be better to give them since I read that t3 tends to create serotonin and t4 creates dopamine and norepinephrine. 

and now all this crazy talk of yo yoing brains has got me crazy. Time to sleep it all away.

medievil, of course MDMA carries a risk of withdrawal and unlike SSRI's it also carries a risk of addiction. Both of which are much much worse than SSRI's.

 

It does appear to potentially have some effiacy in treating PTSD when used in psychotherapy (funnily enough almost the exact opposite of ASPD/Psychopathy).

 

The biggest reason it shouldn't be used for depression/anxiety et al is because its 'hangover' which often presents with significant depression and anxiety. Suicide Tuesday and Suicide Monday are recongonised as increases in suicide after consumption of E. While the less you take, of course the less the effect, chronic use is particually dangerous.

 

None13, there is no 'short-term' cure for psychopathy or even its milder ASPD. What ever you've seen, is not true. Furthermore a short term cure is actually an oxymoron. All of your other theories I'm sad to say don't have any basis in science. ASPD and psychopathy do have strong enviromental factors, almost everyone that can be clased as a psychopath will have had some serious shit happen to them. There is also a strong element of biology, in particular a certain Allele of the MAO-A gene is a major predictor of anti-social behavior. Check out James Fallon as an example of nature/nurture debate. Most of the people you label as psychopaths are not. The majority even don't have ASPD. Some will have Narcissistic, borderline and Schizoid disorders and the majority of people you consider to be psychopaths just have personality disordered traits, anger and drug issues and mood disorders.

 

A true psychopath if in deed they do exist which is a matter of contention. Is incapable of empathy or sympathy, they have a slightly blunted affect, a strong need for excitement and poor emotional regulation, are Narcissistic almost to the point of delusion, often sexually deviant and can rationalize all of there unacceptable behavior and as such feel no remouse and are callous - without regard for others. There are often elements of sadism in their personality as well. See the dark triad or dark tetrad

 

 

 

Can psychopathy onset later in life? I have lost all emotion & empathy for others. I can interact with a person with zero regard for them or what they think of me.

But i try to act "normal" incase i get all my feelings back. I dont know if this is depression, or ive become a psycho.

it wasn't always like this. I was so empathetic and full of emotion through my mid 20s. this all kinda hit me as i approached 30.

 

I fear i'll lose the memories of my empathy and turn into a full on selfish monster 

Jaiho, this isn't psychopathy. There are isolated case studies of similar symptoms developing after brain injury (tramatic or infective encephalopathy) but with other typical symptoms of brain damage. No it can't develop otherwise.

 

A psychopath wouldn't be bothered by there change in feelings towards people, there wouldn't be the undertones of guilt you seem to have and they would rarely if ever use the word fear.

 

Some symptoms of antisocial personality: failure to conform to soical norms in regards to the law; lying, manipulating; impusivity and failure to plan; lack of remose or guilt; irritability and aggressiveness as indicated by repreated physical conforntation; irrsponability such as not paying debts or borrowing more money than they can manage.

 

You have described an insidious onset of reduced emotional tone, feeling less connected to people and vague unsubstantiated fear. This is almost certainly a depressive disorder called dysthymia. Symptoms must have lasted for two years (although more than 6 months is enough for a mild depressive diagnosis and the 2 years isn't strictly needed, just a good deal of time). You have likely noticed a reduction in drive and motivation, generally feeling dull or uncomftable or slightly sad, you are somewhat anhedonic (you feel less pleasure than you used to), you may have put on some weight or lost some and your sleep might not be great. You mind find yourself doing a lot of armchair philosophizing about life and meaning. Its reasonably likely that one or more people in your close family have had some kind of mild-moderate mental health problem.

 

Dysthymia symptom wise is much less severe than a full blown major depressive disorder. However its been shown to have just as big an impact on functioning and can easily lead to what is called double depression (dysthymia with superimposed major depression), anxiety disorders and generally really suck. Although you probs don't feel like it often the best first line treatment is very simple behavioural activation: Spending time with friends and family, doing what you enjoy/used to, following sleep hyegine reasonably well, looking after yourself and taking some exercise. Practicing mindfulness regually can also help a lot. If this doesn't help (after a few months) then its time to go to the doctor and think about more intensive treatments like cognitive behavioual therapy, interpersonal therapy and antidepressant medication (after therapy has failed either to make impovements or only got 'half way' better. However Dysthymia is highly treatable.

Can psychopathy onset later in life? I have lost all emotion & empathy for others. I can interact with a person with zero regard for them or what they think of me.

But i try to act "normal" incase i get all my feelings back. I dont know if this is depression, or ive become a psycho.

it wasn't always like this. I was so empathetic and full of emotion through my mid 20s. this all kinda hit me as i approached 30.

 

I fear i'll lose the memories of my empathy and turn into a full on selfish monster 

 

What happened ?

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medievil, of course MDMA carries a risk of withdrawal and unlike SSRI's it also carries a risk of addiction. Both of which are much much worse than SSRI's.

 

It does appear to potentially have some effiacy in treating PTSD when used in psychotherapy (funnily enough almost the exact opposite of ASPD/Psychopathy).

 

The biggest reason it shouldn't be used for depression/anxiety et al is because its 'hangover' which often presents with significant depression and anxiety. Suicide Tuesday and Suicide Monday are recongonised as increases in suicide after consumption of E. While the less you take, of course the less the effect, chronic use is particually dangerous.

 

None13, there is no 'short-term' cure for psychopathy or even its milder ASPD. What ever you've seen, is not true. Furthermore a short term cure is actually an oxymoron. All of your other theories I'm sad to say don't have any basis in science. ASPD and psychopathy do have strong enviromental factors, almost everyone that can be clased as a psychopath will have had some serious shit happen to them. There is also a strong element of biology, in particular a certain Allele of the MAO-A gene is a major predictor of anti-social behavior. Check out James Fallon as an example of nature/nurture debate. Most of the people you label as psychopaths are not. The majority even don't have ASPD. Some will have Narcissistic, borderline and Schizoid disorders and the majority of people you consider to be psychopaths just have personality disordered traits, anger and drug issues and mood disorders.

 

A true psychopath if in deed they do exist which is a matter of contention. Is incapable of empathy or sympathy, they have a slightly blunted affect, a strong need for excitement and poor emotional regulation, are Narcissistic almost to the point of delusion, often sexually deviant and can rationalize all of there unacceptable behavior and as such feel no remouse and are callous - without regard for others. There are often elements of sadism in their personality as well. See the dark triad or dark tetrad

 

 

 

I was talking about therapeutic use of MDAI, i tried therapeutic doses of mdma (like 30mg) it gives a weird body orgasm feeling and is indeed addictive and urges you to take more, never said mdma itself can be used therapeutically.