Narcissists and Medication: Psychopharmacology of Narcissistic Personality Disorder (NPD)

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The Narcissistic Personality Disorder (NPD) per se is not treated with medication. The underlying disorder is treated by one of the long-term psychodynamic or cognitive-behavioural therapies. Other Personality Disorders (NPD is usually comorbid - diagnosed with other PDs) are treated separately and according to their own characteristics.

But phenomena, which are often associated with NPD, such as depression or OCD (obsessive-compulsive disorder), are treated with medication. Rumour has it that SSRI's (such as Fluoxetine, known as Prozac) might have adverse effects if the primary disorder is NPD. They sometimes lead to the Serotonin syndrome, which includes agitation and exacerbates the rage attacks typical of a narcissist. The use of SSRI's is associated at times with delirium and the emergence of a manic phase and even with psychotic microepisodes.

This is not the case with the heterocyclics, MAO and mood stabilisers, such as lithium. Blockers and inhibitors are regularly applied without discernible adverse side effects (as far as NPD is concerned).

Additionally, cognitive-behavioural therapies are often used to treat the attendant OCD and depression.

(From the book "Malignant SelfloveNarcissism Revisited" by Sam Vaknin Click on this link to purchase the print book, or 16 ebooks, or 2 DVDs with 12 hours of video lectures on narcissists, psychopaths, and abuse in relationships)