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Related Experiment Videos

[Pharmacotherapy in personality disorders].

D Wedekind1, B Bandelow, E Rüther

  • 1Klinik für Psychiatrie und Psychotherapie der Georg-August-Universität Göttingen. dwedeki1@gwdg.de

Fortschritte Der Neurologie-Psychiatrie
|May 10, 2005
PubMed
Summary

Psychopharmacological drugs can modify personality dimensions in patients with personality disorders, but treatment is symptom-related, not disorder-specific. Psychotherapy remains foundational, but pharmacotherapy should complement it from the outset.

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Area of Science:

  • Psychiatry
  • Neurobiology
  • Pharmacology

Context:

  • Personality disorders are prevalent in psychiatric populations, often comorbid with Axis-I diagnoses.
  • These disorders present significant treatment challenges, with pharmacologic approaches frequently deviating from empirical recommendations.
  • Psychopharmacologic drugs can influence temperament-related personality dimensions, suggesting a neurobiological basis for modern treatment.

Purpose:

  • To review the current understanding of psychopharmacological interventions for personality disorders.
  • To present an overview of existing drug studies, including dosages and augmentation strategies.
  • To discuss the complementary role of pharmacotherapy alongside psychotherapy in managing personality disorders.

Summary:

  • Pharmacotherapy can modify specific personality dimensions linked to temperament but does not treat the entire personality or specific disorders.

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  • Treatment is symptom-based, with neurobiological underpinnings supported by animal and human studies.
  • Data on drug efficacy is limited, with response rates potentially lower than in non-comorbid Axis-I disorders.

    • Impact:

    • Highlights the need for integrated treatment approaches, combining psychotherapy and pharmacotherapy from the beginning.
    • Suggests a rationale for both short- and long-term pharmacologic treatment, especially for severe affective symptoms.
    • Provides a treatment algorithm to guide clinical decision-making in the pharmacotherapy of personality disorders.