Drug treatment for personality disorders

Tyrer, Peter; Bateman, Anthony

doi:10.1192/apt.10.5.389

Cited by 99 publications

(40 citation statements)

References 51 publications

(38 reference statements)

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“…Fourth, and related, the diagnoses have limited clinical utility, not helping practitioners to choose between pharmacological or psychotherapeutic interventions (Sanderson 2002;Tyrer 2004).…”

Section: Critique Of Categorical Systemsmentioning

confidence: 99%

Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

Sarkar¹,

Duggan²

2010

Adv. psychiatr. treat

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SummaryThere are many difficulties associated with the diagnostic guidelines for personality disorder in the current international classificatory systems such as ICD–10 and DSM–IV. These lead not only to significant overlap with DSM Axis I disorders, resulting in high rates of diagnoses of comorbidities and multiple personality disorders, but also to lack of adequate capture of core personality pathology. The current classifications are also unhelpful in treatment selection, presumably the prime reason for assessing individuals in the first place. In this article we highlight various deficits and inadequacies related to the nosology of the current systems and suggest some strategies for dealing with these. We offer an integrated model of assessing and diagnosing personality disorders. We attempt to demonstrate how using a more integrated approach minimises or even eliminates some of the key problems highlighted in the current systems.

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Section: Critique Of Categorical Systemsmentioning

confidence: 99%

Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

Sarkar¹,

Duggan²

2010

Adv. psychiatr. treat

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“…Positive effects of psychotherapy on the brain is well established (Gabbard, 2005). Medication may also be of value, and antidepressants, mood stabilizers, and/or antipsychotics may facilitate psychotherapy of certain personality disorders such as borderline personality disorder (Tyrer and Bateman, 2004;Paris, 2011). However, it should also be noted that medication may also have negative effects on the brain structure/physiology in patients with personality disorders and may result in acute and/or chronic side effects or dependency (Herpertz et al, 2007).…”

Section: Resistance To Treatment Due To Neurobiological Mechanismsmentioning

confidence: 99%

“…Those changes can be achieved through long-term treatment including psychotherapy, like cognitive-behavioral therapy, which is thought to be particularly beneficial. The APA recommends a combination of psychotherapy and medication as the optimal approach to treat personality disorders (Tyrer and Bateman, 2004). Positive effects of psychotherapy on the brain is well established (Gabbard, 2005).…”

Section: Resistance To Treatment Due To Neurobiological Mechanismsmentioning

confidence: 99%

The Neural Mechanisms Underlying Personality Disorders

Gawda

Bernacka

Gawda³

2016

Neuroquantology

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This article reviews recent research on the neural mechanisms of personality disorders. Functional imaging studies have confirmed a neurobiological basis for personality traits. These types of studies also showed strong evidence for neurobiological foundations for personality pathology. Different types of personality disorders are discussed: borderline, antisocial, schizotypal, and avoidant disorders in terms of their neural correlates. A neuropsychological basis is shown as forming a stable foundation for impaired behavior, affectivity, and relevant cognitive function in subjects with personality disorders. This results in difficulties in the treatment of personality disorders. The presented neuropsychological findings suggest that personality disorders are best understood and treated when neurobiological and psychological findings are considered, just as Gabbard (2005) stated, without dichotomies between the 'mind and brain.'

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“…Majority of research attention has focused on BPD and the accumulation of evidence base led to the official treatment guidelines which state that pharmacotherapy is an important adjunct used to treat well-defined target symptoms of the disorder which often fall within three behavioral dimensions -affective dysregulation, impulsive-behavioral dyscontrol, and cognitive-perceptual distortion [6,130]. Nevertheless, our knowledge of how pharmacology can be best applied to personality disorder is limited due to the systematic evidence base being scarce, biased toward BPD, confounded by comorbid psychopathology, limited by small sample sizes, short follow-up, and lack of consensus on core outcome measures [9][10][11]. Consequently, despite the growing evidences to support the use of pharmacotherapy in personality disorders, there are no Food and Drug Administration (FDA) or European Medicines Agency (EMA) -approved medications for treating this disorder and therefore pharmacotherapy for personality disorders remains off-label.…”

Section: Introductionmentioning

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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Drug treatment for personality disorders

Cited by 99 publications

References 51 publications

Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

The Neural Mechanisms Underlying Personality Disorders

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

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