The use of psychotropic drugs in the treatment of compulsive opiate abusers: the rationale for their use.

Psychotropic agents are most helpful to opiate addicts when used to treat co-existing psychopathology. While such agents may not impact directly on the addiction itself, they might help keep patients available for rehabilitation efforts since concomitant severe psychopathology has been associated with poorer outcome. Neuroleptics for schizophrenia and lithium for manic disorders are generally agreed upon. Minor tranquilizers for anxiety and MAO inhibitors for depression may be too risky for this population. Tricyclic antidepressants clearly have a role in treating major depression in addicts but the lability of the syndrome over time argues against their routine use until the depression has persisted at least 3 months.