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Cited by 4Personality Disorders and PsychopathologyBipolar Disorder and TreatmentPersonality Traits and Psychology

Pharmacological management of personality disorders: from evidence to practice

Open access
Völlm, Birgit, Cerci, Deniz·2025·BJPsych Advances
DOI 10.1192/bja.2024.30
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Abstract

SUMMARY Clinical guidelines recommend avoiding the use of medications to manage personality disorder. In clinical practice, however, substantial amounts of medication are used. In this article, we summarise the recommendations of guidelines published in various countries in the past 15 years. We review the evidence from randomised controlled trials and recent reviews, discuss the discordance between guidance and clinical practice and give recommendations on what a clinician should consider if they choose to prescribe in cases of severe disturbances in mood or behaviour despite the lack of evidence.

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Crossref · 10.1192/bja.2024.30

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27 of 27 references verified0 citation errors · 0 not checkable

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  • There is no strong empirical evidence supporting pharmacotherapy for PN, with medications primarily used to target comorbid symptoms such as mood instability, impulsivity, and aggression rather than core narcissistic traits.

    “To date, there is no strong empirical evidence supporting pharmacotherapy for PN, with medications primarily used to target comorbid symptoms such as mood instability, impulsivity, and aggression rather than core narcissistic traits (77).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [77]

    The paper says there is almost no evidence for pharmacotherapy in personality disorders other than those chiefly studied, and its ‘Identify target symptoms’ discussion lists mood instability, impulsivity and anger/hostility as possible medication targets (sections labelled References in our copy; no page numbers supplied). It does not specifically assess pathological narcissism (PN) or core narcissistic traits. Its discussion of prescribing practice also says clinicians often prescribed for personality-disorder symptoms rather than comorbid conditions, so the claim's description of these targets as primarily comorbid symptoms is not supported. (LLM, conf=0.84)

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Cites

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1 of the 28 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Tyrer, P, Mulder, R (2022) Personality Disorder: From Evidence to Understanding. Cambridge University Press.CrossRefGoogle Scholar

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Authors
Völlm, B., & Cerci, D.
Affiliations
Queen Mary University of London (GB)
Corresponding author
Cerci, Deniz
ORCID
Venue
BJPsych Advances
Publisher
Royal College of Psychiatrists
Published
2024-08-01
Volume
31
Issue
4
Pages
214-222
ISSN
  • 2056-4678 (ISSN-L)
  • 2056-4686
DOI
10.1192/bja.2024.30
OpenAlex
W4401219906
Cited by
4
References
28
Citations by year
2026: 1 · 2025: 3
FWCI
2.01
Type
journal article
Language
en
Open access
Licence
Locations
BJPsych Advances (publishedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Keywords
personality disorders, pharmacological management, psychotropic drugs, guideline adherence, knowledge-practice gap, mood disturbance, behavioral problems, prescribing decisions

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