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Drug treatment for personality disorders

  • Peter Tyrer and Anthony W. Bateman
Abstract

There is some evidence that antidepressants, particularly the selective serotonin reuptake inhibitors and the monoamine oxidase inhibitors, have some benefits in the management of borderline personality disorder, and lesser evidence (partly because of limited trial data) for the benefits of antipsychotic drugs and mood stabilisers. There is not sufficient distinction between the different personality disorders to recommend that any one disorder should be treated by any one drug, and successful treatment is dependent on careful management, sensitive to the patient's expectations.

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References
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American Psychiatric Association (2001) Practice guideline for the treatment of patients with borderline personality disorder. American Journal of Psychiatry, 158 (suppl. 2–2), 152.
Bateman, A. W. & Tyrer, P. (2004a) Psychological treatments for personality disorder. Advances in Psychiatric Treatment, 10, 378388.
Bateman, A. W. & Tyrer, P. (2004b) Organisation of services for personality disorder. Advances in Psychiatric Treatment, 10, in press.
Benedetti, F., Sforzini, L., Colombo, C. et al (1998) Low dose clozapine in acute and continuation treatment of severe borderline personality disorder. Journal of Clinical Psychiatry, 59, 103107.
Bowden-Jones, O., Iqbal, M. Z., Tyrer, P. et al (2004) Prevalence of personality disorder in alcohol and drug services and associated co-morbidity. Addiction, in press.
Brinkley, J. R., Beitman, B. D. & Friedel, R. O. (1979) Low dose neuroleptic regimes in the treatment of borderline patients. Archives of General Psychiatry, 36, 319326.
Cloninger, C. R. (1987) A systematic method for clinical description and classification of personality variants. Archives of General Psychiatry, 44, 573588.
Cloninger, C. R., Svrakic, D. M. & Pryzbeck, T. R. (1993) A psychobiological model of temperament and character. Archives of General Psychiatry, 50, 975990.
Coccaro, E. F. & Kavoussi, R. J. (1997) Fluoxetine and impulsive aggressive behavior in personality-disordered subjects. Archives of General Psychiatry, 54, 10811088.
Cornelius, J. R., Soloff, P. H., Perel, J. M. et al (1993) Continuation pharmacotherapy of borderline personality disorder with haloperidol and phenelzine. American Journal of Psychiatry, 150, 18431848.
Cornelius, J. R., Salloum, I. M., Ehler, J. G. et al (1997) Fluoxetine in depressed alcoholics. A double-blind, placebo-controlled trial. Archives of General Psychiatry, 54, 700705.
Cowdry, R. & Gardner, D. L. (1988) Pharmacotherapy of borderline personality disorder: alprazolam, carbamazepine, trifluoperazine and tranylcypromine. Archives of General Psychiatry, 45, 111119.
De La Fuenta, J. M. & Lostra, F. (1994) A trial of carbamazepine in borderline personality disorder. European Neuropsychopharmacology, 4, 479486.
Ekselius, L. & Von Knorring, L. (1998) Personality disorder comorbidity with major depression and response to treatment with sertraline or citalopram. International Clinical Psychopharmacology, 13, 205211.
Frankenburg, F. R. & Zanarini, M. C. (1993) Clozapine treatment of borderline patients: a preliminary study. Comprehensive Psychiatry, 34, 402405.
Frankenburg, F. R. & Zanarini, M. C. (2002) Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder. A double-blind placebo-controlled pilot study. Journal of Clinical Psychiatry, 63, 442446.
Gardner, D. L. & Cowdry, R. W. (1986) Positive effects of carbamazepine on behavioural dyscontrol in borderline personality disorder. American Journal of Psychiatry, 143, 519522.
Goldberg, S. C., Shulz, S. C., Shulz, P. M. et al (1986) Borderline and schizotypal personality disorders treated with low dose thiothixene versus placebo. Archives of General Psychiatry, 43, 680686.
Healy, D. (2003) Lines of evidence on the risks of suicide with selective serotonin reuptake inhibitors. Psychotherapy and Psychosomatics, 72, 7179.
Hollander, E., Tracy, K. A., Swann, A. C. et al (2003) Divalproex in the treatment of impulsive aggression: efficacy in Cluster B personality disorders. Neuropsychopharmacology, 28, 11861197.
Jang, K. L., Livesley, W. J., Vernon, P. A. et al (1996) Heritability of personality disorder traits: a twin study. Acta Psychiatrica Scandinavica, 94, 438444.
Koenigsberg, H. W., Reynolds, D., Goodman, M. et al (2003) Risperidone in the treatment of schizotypal personality disorder. Journal of Clinical Psychiatry, 64, 628634.
Links, P. S., Steiner, M., Boiago, I. et al (1990) Lithium therapy for borderline patients: preliminary findings. Journal of Personality Disorders, 4, 173181.
Linnoila, M. & Virkkunen, M. (1992) Aggression, suicidality, and serotonin. Journal of Clinical Psychiatry, 53, 4651.
Livesley, W. J., Jang, K. L., Jackson, D. N. et al (1993) Genetic and environmental contributions to dimensions of personality disorder. American Journal of Psychiatry, 150, 18261831.
Markovitz, P. J. & Wagner, C. (1995) Venlafaxine in the treatment of borderline personality disorder. Psychopharmacology Bulletin, 31, 773777.
Mitropoulou, V., Trestman, R. L., New, A. S. et al (2003) Neurobiologic function and temperament in subjects with personality disorders. CNS Spectrums, 8, 725730.
Montgomery, S. A. & Montgomery, D. (1982) Pharmacological prevention of suicidal behaviour. Journal of Affective Disorders, 4, 291298.
Newton-Howes, G. & Tyrer, P. (2003) Pharmacotherapy for personality disorders. Expert Opinion on Pharmacotherapy, 4, 16431649.
Oldham, J., Phillips, K., Gabbard, G. et al (2001) Practice Guideline for the Treatment of Patients with Borderline Personality Disorder. Washington, DC: American Psychiatric Association.
Perinpanayagam, M. S. & Haig, R. A. (1977) Use of depot tranquillisers in disturbed adolescent girls. BMJ, 1, 835836.
Reich, J., Noyes, R. & Yates, W. (1980) Alprazolam treatment of avoidant personality traits in social phobic patients. Journal of Clinical Psychiatry, 50, 9195.
Rinne, T., Westenberg, H. G., den Boer, J. A. et al (2000) Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients. Biological Psychiatry, 47, 548556.
Rinne, T., de Kloet, E. R., Wouters, L. et al (2002) Hyperresponsiveness of hypothalamic–pituitary–adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse. Biological Psychiatry, 52, 11021112.
Roth, A., Ostroff, R. & Hoffman, M. (1996) Naltrexone as a treatment for repetitive self-injurious behaviour: an open label trial. Journal of Clinical Psychiatry, 57, 233237.
Salzman, C., Wolfson, A. N., Schatzberg, A. et al (1995) Effect of fluoxetine on anger in symptomatic volunteers with borderline personality disorder. Journal of Clinical Psychopharmacology, 15, 2329.
Seivewright, H., Tyrer, P., Casey, P. et al (1991) A three-year follow-up of psychiatric morbidity in urban and rural primary care. Psychological Medicine, 21, 495503.
Sheard, M. H., Martin, J. L., Bridges, C. I. et al (1976) The effect of lithium on unipolar aggressive behaviour in man. American Journal of Psychiatry, 133, 14091413.
Siever, L. J. & Davis, K. I. (1991) A psychobiologic perspective on the personality disorders. American Journal of Psychiatry, 148, 16471658.
Soloff, P. H. (1998) Algorithms for pharmacological treatment of personality dimensions. Symptom-specific treatments for cognitive–perceptual, affective, and impulsive–behavioral dysregulation. Bulletin of the Menninger Clinic, 62, 195214.
Soloff, P. H., George, A., Nathan, R. S. et al (1986) Progress in pharmacotherapy of borderline disorders: a double blind study of amitriptyline, haloperidol and placebo. Archives of General Psychiatry, 43, 691697.
Soloff, P. H., Cornelius, J. R., George, A. et al (1993) Efficacy of phenelzine and haloperidol in borderline personality disorder. Archives of General Psychiatry, 50, 377385.
Stein, G. (1993) Drug treatment of the personality disorders. In Personality Disorder Reviewed (eds Tyrer, P. & Stein, G.) pp. 262304. London: Gaskell.
Tyrer, P. (2002) Practice guideline for the treatment of personality disorders: a bridge too far. Journal of Personality Disorders, 16, 113118.
Tyrer, P. & Harrison-Read, P. (1990) New perspectives in treatment with monoamine oxidase inhibitors. International Review of Psychiatry, 2, 331340.
Tyrer, P., Seivewright, N., Ferguson, B. et al (1993) The Nottingham Study of Neurotic Disorder. Effect of personality status on response to drug treatment, cognitive therapy and self-help over two years. British Journal of Psychiatry, 162, 219226.
Tyrer, P., Gunderson, J., Lyons, M. et al (1997) Extent of comorbidity between mental state and personality disorders. Journal of Personality Disorders, 11, 242259.
Tyrer, P., Mitchard, S., Methuen, C. et al (2003) Treatment-rejecting and treatment-seeking personality disorders: Type R and Type S. Journal of Personality Disorders, 17, 265270.
Tyrer, S. P., Walsh, A., Edwards, D. E. et al (1984) Factors associated with a good response to lithium in aggressive mentally handicapped subjects. Progress in Neuropsychopharmacology and Biological Psychiatry, 8, 751755.
Van Reekum, R., Links, P. S. & Federov, C. (1994) Impulsivity in borderline personality disorder. In Biological and Neurobehavioural Studies of Borderline Personality Disorder (ed. Silk, K.) pp. 122. Washington, DC: APP.
Verkes, R. J., Van der Mast, R. C., Hengeveld, M. W. et al (1998) Reduction by paroxetine of suicidal behavior in patients with repeated suicide attempts but not major depression. American Journal of Psychiatry, 155, 543547.
Walker, C., Thomas, J. & Allen, T. S. (2003) Treating impulsivity, irritability, and aggression of antisocial personality disorder with quetiapine. International Journal of Offender Therapy, 47, 556567.
Zanarini, M. C. & Frankenburg, F. R. (2001) Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study. Journal of Clinical Psychiatry, 62, 849854.
Zanarini, M. C., Frankenburg, F. R., Hennen, J. et al (2003) The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry, 160, 274283.
Zullino, D. F., Haefliger, Q. P. & Stigler, M. (2002) Olanzapine improves social dysfunction in cluster B personality disorder. Human Psychopharmacology, 17, 247251.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
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Drug treatment for personality disorders

  • Peter Tyrer and Anthony W. Bateman
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