Effectiveness of Pharmacotherapy for Severe Personality Disorders

Ingenhoven, Theo; Lafay, Patricia; Rinne, Thomas; Passchier, Jan; Duivenvoorden, Hugo J.

doi:10.4088/jcp.08r04526gre

Cited by 142 publications

(100 citation statements)

References 22 publications

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“…As repeatedly suggested in this article and by others [70][71][72][73][74], future perspectives of research should focus on a series of core topics: large scale multicenter RCTs of mood stabilizers and new anti psychotics in order to confirm prelimi nary evidence; drugtodrug comparisons (e.g., atypical vs traditional antipsychotics, different mood stabilizers) to explore differential effects of medications; fixeddosage and longterm studies in order to determine appropriate doses and duration of treatments; identification of biological, clinical and pharmaco logical fac tors that predict response to drug treatments; assessment of results of combined therapy in comparison with single pharmaco and psychotherapy; and selection of a set of out come measures that can be retained reliable and specific to test drug efficacy and safety in BPD populations.…”

Section: Conclusion and Future Perspectivesupporting

confidence: 72%

“…Antipsychotics were found to have a medium effect on symptoms of anger and no effects on depression. Ingenhoven et al evaluated the efficacy of pharmacotherapy for borderline and schizotypal PDs on specific tar get domains: cognitiveperceptual symptoms, impulsivebehavioral dyscontrol, affective dys regulation (depressed mood, anxiety, anger and mood lability) and global functioning [73]. Mood stabilizers had positive effects on global functioning, impulsivebehavioral dyscontrol, anger and anxiety.…”

Section: Treatment Guidelines and Meta-analysesmentioning

confidence: 99%

“…Many authors retain that prescription of SSRIs should be reserved for treatment of a comorbid major depressive epi sode, rather than BPD affective dysregulation itself [65,73,75]. Effects of SSRIs on impulsive aggression have less support and may be limited to male gender.…”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

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Recent approaches to pharmacotherapy of personality disorders

Bellino

Rinaldi²,

Bozzatello³

et al. 2011

Neuropsychiatry

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Recent approaches to pharmacotherapy of personality disorders Practice pointsPharmacotherapy of personality disorders should be considered a symptom-focused treatment, targeting dimensions of affective dysregulation, impulsive-behavioral dyscontrol and cognitive-perceptual symptoms.To date, randomized controlled trials have been performed in samples of patients with antisocial personality disorder, schizotypal personality disorder and borderline personality disorder (BPD). However, the great majority of these trials have been conducted in samples with BPD.There is some evidence that mood stabilizers (topiramate, valproate and lamotrigine), second-generation antipychotics (olanzapine, aripiprazole), and omega-3 fatty acids can be useful for the treatment of affective symptoms and impulsive-behavioral dyscontrol in BPD patients.Antipsychotics produced an improvement of psychotic-like symptoms both in patients with BPD and schizotypal personality disorder.Selective serotonin reuptake inhibitors were found to be effective in decreasing depressed mood, anxiety, and anger in BPD patients, mainly with a comorbid major depressive episode. However, recent evidence no longer supports their use as first-line treatment of affective symptoms and impulsive-behavioral dyscontrol in BPD.Present studies suffer from important methodological limitations. Thus, further investigations are needed to confirm available findings. SUMMARY A growing number of studies on pharmacotherapy of personality disorders have been performed. This article considers controlled trials conducted between 1990 and 2010, and is directed toward the treatment of personality disorders. Data on borderline personality disorder (BPD), antisocial personality disorder and schizotypal personality disorder (STPD) were collected and discussed, in order to provide indications for clinical practice. Concerning antisocial personality disorder and STPD, available evidence is too sparse to propose treatment recommendations. As for BPD, there is some evidence that mood stabilizers (topiramate, valproate, and lamotrigine), second-generation antipsychotics (olanzapine, aripiprazole), and omega-3 fatty acids can be useful to treat affective symptoms For reprint orders, please contact: reprints@futuremedicine.comNeuropsychiatry (2011) 1(3) future science group 260Review Bellino, Rinaldi, Bozzatello & Bogetto Personality disorders (PDs) are defined as endur ing patterns of inner experience and behavior causing distress, which lead to maladaptive functioning in the areas of emotion, cognition, interpersonal relationships and impulse con trol [1]. Since the 1980s there has been increas ing recognition that PDs can be considered as syndromes of interacting dimensional traits that arise from psychosocial development and/or biological vulnerability [2]. Personality dimen sions acquired through social and cultural learning are termed character, whereas those believed to have a biological origin, genetically determined or acquired from overt injury to the CNS, are traditionally referr...

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Section: Conclusion and Future Perspectivesupporting

confidence: 72%

Section: Treatment Guidelines and Meta-analysesmentioning

confidence: 99%

See 1 more Smart Citation

Recent approaches to pharmacotherapy of personality disorders

Bellino

Rinaldi²,

Bozzatello³

et al. 2011

Neuropsychiatry

View full text Add to dashboard Cite

show abstract

“…9,47,48 A psicoterapia é considerada o tratamento de primeira linha. 33,47,49,50 Não há medicamentos específicos recomendados para o tratamento dos TP, assim, são indicadas medicações para controle de sintomas nucleares e tratamento de comorbidades frequentemente presentes. [51][52][53][54][55] Ambos os tratamentos devem ser considerados de longo prazo.…”

Section: Tratamentounclassified

Personality disorders

Mazer¹,

Macedo²,

Juruena³

2017

Medicina (Ribeirão Preto)

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RESUMOOs Transtornos da personalidade são padrões psicológicos de difícil diagnóstico que exigem uma avaliação criteriosa por parte do profissional da saúde mental. A relação médico-paciente também se configura como fator de extrema importância para o manejo destes quadros. Dentro deste contexto, é imprescindível orientar os alunos das áreas de graduação em saúde sobre a existência de tal categoria de transtornos. O presente artigo consiste em uma revisão descritiva, que busca elucidar a definição de transtornos da personalidade; além de discorrer sobre aspectos históricos, nosológicos e epidemiológi-cos. Nesta publicação ainda serão revisadas as particularidades referentes ao diagnóstico, as comorbidades, ao curso e tratamento destes transtornos. O enfoque maior será no manejo de indivíduos com transtorno da personalidade borderline, dada a maior procura destes por unidades de atendimento psiquiátrico. Palavras ABSTRACTPersonality disorders are psychological patterns of difficult diagnosis that require careful evaluations from mental health professionals. The physician-patient relationship is a crucial condition for the management of these disorders. On this view it must be important guide undergraduate students from health care areas through the existence of such a category of disorders. This article consists of a descriptive review aiming at clarifying the definition of personality disorders; furthermore discuss historical, physiological and epidemiological aspects. On this publication will be reviewed some particularities from diagnostic comorbidity, course and treatment of these disorders. The management of individuals with borderline personality disorder will be emphasized in this publication due to increased seek from this public for mental health care units.

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“…Ingenhoven et al [118] evaluated the available literature about pharmacotherapy for borderline and schizotypal personality disorders, following a symptom dimensions approach. Global functioning, impulsive-behavioural dyscontrol, anger, and anxiety resulted to be better improved by mood stabilizers, while antipsychotics had a moderate efficacy on cognitive-perceptual symptoms and anger.…”

Section: ) Treatment Guidelines and Meta-analysesmentioning

confidence: 99%

Pharmacotherapy of personality disorders: what we know and what we have to search for

et al. 2017

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Pharmacotherapy for personality disorders is in the early stage of development because the evidence base for effective drug treatment is insufficient, biased toward borderline personality disorder and rampant with methodological issues. In this paper, we reviewed randomized, placebo-controlled trials of drugs efficacy in patients with personality disorders published between 1990 and 2016.Overwhelming majority of studies focused on borderline personality disorder (BPD), and the accumulation of evidence resulted in 7 meta-analyses, which are interpreted into better strategies for evidence-based practice. Little research attention was given to schizotypal (SPTD) and antisocial (ASPD) personality disorders, with only indirect treatment efficacy evidence for the obsessivecompulsive (OCPD) and avoidant (AvPD) personality disorders. Some avenues for future efficacy research are indicated.

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Effectiveness of Pharmacotherapy for Severe Personality Disorders

Cited by 142 publications

References 22 publications

Recent approaches to pharmacotherapy of personality disorders

Recent approaches to pharmacotherapy of personality disorders

Personality disorders

Pharmacotherapy of personality disorders: what we know and what we have to search for

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