Pharmacotherapy of Personality Disorders

Abstract

Personality disorders (PD) represent a group of more than 10 disorders, depending on the diagnostic classification used, but most research on pharmacological treatments deals with borderline PD. International guidelines consider the evidence for the usefulness of psychopharmacotherapy for PD limited and therefore, their major recommendation is to center this therapeutic approach for the treatment of the frequent psychiatric comorbidities. Indeed, current evidence favors psychotherapy compared to psychopharmacotherapy in the treatment of personality disorders (PD). However, antipsychotic drugs, antidepressants, anticonvulsants, and other psychotropic drugs are widely used, very frequently as combination treatments, despite not any of them has been introduced by national drug authorities for this indication. Previous studies are based on the use of diagnostic systems which changed over the past decades, and this explains the difficulty to compare pharmacological studies. The present situation is characterized by a transition from a categorical to a more dimensional classification, and to a hybrid model. Future research in this field will have to consider the new classification of PD and hopefully, yield evidence for efficacity of both old and new drugs in development.