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Cited by 83Personality Disorders and PsychopathologyPersonality Traits and PsychologySchizophrenia research and treatment

Evidence-based pharmacotherapy for personality disorders

Ripoll, Luis H., Triebwasser, Joseph, Siever, Larry J.·2011·The International Journal of Neuropsychopharmacology
DOI 10.1017/s1461145711000071
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Abstract

Patients with personality disorders are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. Prescribing practices in these populations are often based on anecdotal evidence rather than rigorous data. Although evidence-based psychotherapy remains an integral part of treatment, Axis II psychopathology is increasingly conceptualized according to neurobiological substrates that correspond to specific psychopharmacological strategies. We summarize the best available evidence regarding medication treatment of personality disordered patients and provide optimal strategies for evidence-based practice. Most available evidence is concentrated around borderline and schizotypal personality disorders, with some additional evidence concerning the treatment of avoidant and antisocial personality disorders. Although maladaptive personality symptoms respond to antidepressants, antipsychotics, mood stabilizers, and other medications, evidence-based pharmacotherapy is most useful in treating circumscribed symptom domains and induces only partial improvement. Most available evidence supports use of medication in reducing impulsivity and aggression, characteristic of borderline and antisocial psychopathology. Efforts have also begun to reduce psychotic-like symptoms and improve cognitive deficits characteristic of schizotypy. Indirect evidence is also provided for psychopharmacological reduction of social anxiety central to avoidant personality disorder. Evidence-based practice requires attention to domains of expected clinical improvement associated with a medication, relative to the potential risks. The development of future rational pharmacotherapy will require increased understanding of the neurobiological underpinnings of personality disorders and their component dimensions. Increasing efforts to translate personality theory and social cognitive neuroscience into increasingly specific neurobiological substrates may provide more effective targets for pharmacotherapy.

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Crossref · 10.1017/s1461145711000071

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  • Evidence points to a deficiency of serotonin in BPD, while the partial efficacy of antipsychotic agents suggest hyperactivity of dopamine.

    “Evidence points to a deficiency of serotonin, while the partial efficacy of antipsychotic agents suggest hyperactivity of dopamine (Bandelow et al., 2010Ripoll, 2011).”

    From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Ripoll, 2011

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Authors
Ripoll, L. H., Triebwasser, J., & Siever, L. J.
Affiliations
James J. Peters VA Medical Center (US)
Corresponding author
Ripoll, Luis H.
Venue
The International Journal of Neuropsychopharmacology
Publisher
Oxford University Press (OUP)
Published
2011-02-15
Volume
14
Issue
09
Pages
1257-1288
ISSN
  • 1461-1457 (ISSN-L)
  • 1469-5111
DOI
10.1017/s1461145711000071
OpenAlex
W1998023387
Cited by
83
References
196
Citations by year
2026: 3 · 2025: 4 · 2024: 6 · 2023: 2 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 10 · 2015: 7 · 2014: 4 · 2013: 7 · 2012: 3
FWCI
0.69
Type
journal article
Language
en
Open access
closed
Locations
  • The International Journal of Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
personality disorders, pharmacotherapy, borderline personality disorder, schizotypal personality disorder, avoidant personality disorder, antisocial personality disorder, antidepressants, antipsychotic drugs, mood stabilizers, impulsivity, aggression, psychotic-like symptoms, cognitive impairment, social anxiety, neural correlates, evidence-based practice
MeSH terms
Female, Humans, Male, Personality Disorders, Psychotropic Drugs, Evidence-Based Medicine

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