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Abstract
Background: Personality disordered individuals, especially those with severe cluster B disorders, are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. However, prescribing practices in this population often are based on hunches or anecdotal evidence rather than on rigorous or widely replicated data.
Aims: We have attempted to provide a comprehensive review of randomized trials of the pharmacotherapy of personality disorders.
Method: Pubmed searches using various combinations of the terms “pharmacotherapy”“psychopharmacology”“medication,”“personality disorder” and “Axis II.”
Results: Approximately 40 published randomized trials were found and summarized. The vast majority concern borderline personality disorder (BPD); these studies cover almost every known class of psychotropic medications. Most published BPD studies show efficacy for at least one target symptom, with some studies identifying multiple areas of drug response. Medications seem most useful in treating circumscribed symptom areas and to induce only partial improvements.
Conclusions: Much work remains to be done in finding wholly effective pharmacological strategies for treating personality disorders. The development of rational pharmacotherapy will require increasing our knowledge of the neurobiological underpinnings of the disorders themselves and of their component dimensions.Declaration of interest: None.