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J Pers Disord. 1998 Fall;12(3):277-88.

Special feature: pharmacotherapy in personality disorders.

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  • 1Department of Psychiatry, University of Munich, Germany.


Recent epidemiological and psychobiological studies indicate that psychopharmacology is promising, even for the treatment of personality disorders. Psychotropic drugs may have positive effects on personality disorders that show a close-relationship to Axis I disorders (e.g., schizotypal personality disorder--schizophrenia simplex; avoidant personality disorder--generalized social phobia; borderline personality disorder--affective disorders, etc.). In addition, psychotropic drugs may influence certain psychopathological symptom clusters (e.g., cognitive-perceptual organization, impulsivity/aggressivity, affective instability, anxiety/inhibition) present in various disorders. Psychotropic drugs may also be indicated when psychiatric comorbidity exists. The results of clinical pharmacological studies are reviewed with reference to cluster A, B, and C personality disorders. Some guidelines can be drawn from these trials. Clinically, the use of psychotropic drugs in symptomatic crises should be considered, especially when a secondary psychiatric comorbidity exists. Pharmacotherapy is well indicated for personality disorders closely associated with Axis I disorders. Usually pharmacotherapy is short term, although in some cases long-term treatment may be promising. However, pharmacotherapy must always refer to a supportive therapeutic interaction between physician and patient.

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