Hostname: page-component-84b7d79bbc-7nlkj Total loading time: 0 Render date: 2024-07-25T14:05:18.556Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharmacotherapeutical treatment of personality disorders*

Published online by Cambridge University Press:  18 September 2015

J.M. Keppel Hesselink
Get access Rights & Permissions [Opens in a new window]

Summary

Since some years it has become evident that objective disturbances can be found in patients suffering from personality disorders. Research findings from earlier date already demonstrated low levels of 5-hydroxyindoleacetic acid in the cerebrospinal fluid, especially in patients with personality disorders, under exclusion of depressive features. Furthermore, data have been collected on the correlation between a hyposerotonergic state and disturbances in aggression and impulse control in a variety of syndromes such as automutilation, bulimia nervosa, suicide attempts and various states of drug abuse.

However, psychopharmacological research in personality disorders is rare and to date mainly patients with borderline and schizotypical personality disorders have been studied. It is quite remarkable for this area to find more review articles than original contributions based on the results of clinical trials. A great variety of recommendations for pharmacotherapy in these patients exists in literature, among which treatment with carbamazepine, lithium, low-dose neuroleptics, tricyclic antidepressants and serotonin uptake inhibitors. In this article we will analyze the research methodology and the results of clinical trials forming the base for pharmacotherapeutic treatment recommendations.

Only the results of well-controlled studies will be reviewed.

Keywords

clinical trialsdouble-blindplaceboreviewpersonality disorderspsychopharmacologytreatmentimpulse controlserotoninazapironesklinisch geneesmiddelenonderzoekdubbel-blindplacebopersoonlijkheidsstoornissenoverzichtpsychofarmacologiebehandelingimpuls-stoornissenSerotonineazapironen
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 7 , Issue 3 , September 1995 , pp. 80 - 83
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Dit artikel is een uitbreiding van een voordracht gehouden in het Vincent van Gogh Instituut op 18-11-1994: ‘De farmacotherapeutische behandeling van persoonlijkheidsstoornissen; mogelijke rol van serotonerge farmaca in het algemeen en de azapironen in het bijzonder.’

References

Literatuur

1.Keppel Hesselink, JM. Beeiden in de mist. De geschiedenis van de neurologie in capita selecta. Rotterdam: Erasmus Publishing, 1994.Google Scholar
2.Task force on Nomenclature and Statistics. Diagnostic and statistical manual of mental disorders, 3rd edition. (DSM-III). Washington: APA, 1980.Google Scholar
3.Stein, G. Drug treatment of the personality disorders. Br J Psychiat 1992; 161: 167–84.CrossRefGoogle ScholarPubMed
4.Cowdry, RW, Gardner, DL. Pharmacotherapy of borderline personality disorder. Alprazolam, carbamazepine, trifluoperazine, and tranylcypromine. Arch gen Psychiat 1988; 45: 111–9.CrossRefGoogle ScholarPubMed
5.Nestadt, G, Romanoski, AJ, Samuels, JF, Folstein, MF, McHugh, PR. The relationship between personality and DSM-III axis I disorders in the population: results from an epidemiological survey. Am J Psychiat 1992; 149: 1228–33.Google ScholarPubMed
6.Gunderson, JG, Elliot, GR. The interface between borderline personality disorder and affective disorder. Am J Psychiat 1985; 142: 277–88.Google ScholarPubMed
7.Parsons, B, Quitkin, FM, McGrath, PJ, Stewart, JW, Tricamo, RN, Ocepek Welkinson, K, Harrison, W, Rabkin, JG, Wager, SG, Nunes, E. Phenelzine, imipramine, and placebo in borderline patients meeting criteria for atypical depression. Psychopharm Bull 1989; 25: 524–34.Google ScholarPubMed
8.Waldinger, RJ, Gunderson, JG. Completed psychotherapies with borderline patients. Am J Psychother 1984; 38: 190–202.CrossRefGoogle ScholarPubMed
9.Hoch, PH, Cattell, JP, Pennes, HH. Effects of mescaline and lysergic acid. Am J Psychiat 1952; 108: 579–84.CrossRefGoogle ScholarPubMed
10.Hoch, PH, Catell, JP, Pennes, HH. Effects of drugs. Theoretical considerations from a psychological viewpoint. Am J Psychiat 1952; 108: 585–9.CrossRefGoogle ScholarPubMed
11.Soloff, PH, George, A, Swami Nathan, R, Schultz, PM, Ulrich, RF, Perel, JM. Progress in pharmacotherapy of borderline disorders: a double-blind study of amitriptyline, haloperidol and placebo. Arch gen Psychiat 1986; 43: 691–7.CrossRefGoogle ScholarPubMed
12.Goldberg, SC, Schultz, C, Schultz, PM, Resnick, RJ, Hamer, RM, Friedel, RO. Borderline and schizotypal personality disorders treated with low-dose thiothixene vs placebo. Arch gen Psychiat 1986; 43: 680–6.CrossRefGoogle ScholarPubMed
13. Editorial. Management of borderline personality disorders. The Lancet 1986; ii: 864–5.Google Scholar
14.Baron, M, Asnis, L, Gruen, R. Schedule of interviewing schizotypal personalities: A diagnostic interview for schizotypal features. Psychiat Res 1981; 4: 213–28.CrossRefGoogle ScholarPubMed
15.Soloff, PH, George, A, Nathan, S, Schulz, PM, Ulrich, RF, Perel, JM. Progress in pharmacotherapy of borderline disorders. Arch gen Psychiat 1986; 43: 691–7.CrossRefGoogle ScholarPubMed
16.Soloff, PH, George, A, Nathan, S, Schulz, PM, Cornelius, JR, Herring, J, Perel, JM. Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. J clin Psychopharm 1989; 9: 238–46.CrossRefGoogle ScholarPubMed
17.Soloff, PH, George, A, Nathan, S, Schulz, PM, Perel, JM. Paradoxical effects of amitriptyline on borderline patients. Am J Psychiat 1986; : 1603–5.Google ScholarPubMed
18.Soloff, PH, Cornelius, J, George, A, Nathan, S, Perel, JM, Ulrich, RF. Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch gen Psychiat 1993; 50: 377–85.CrossRefGoogle ScholarPubMed
19.Cornelius, JR, Soloff, PH, Perel, JM, Ulrich, RF. Continuation pharmacotherapy of borderline personality disorder with haloperidol and fenelzine. Am J Psychiat 1993; 150: 1843–8.Google Scholar
20.Cornelius, JR, Soloff, PH, George, A, Ulrich, RF, Perel, JM. Haloperidol vs. fenelzine in continuation therapy of borderline disorder. Psychopharm Bull 1993; 29: 333–7.Google Scholar
21.Sramek, JJ, Cutler, NR, Costa, JF, Keppel Hesselink, JM, Seifert, RD, Graham, E. Depression in the course of treatment of generalized anxiety disorder with lorazepam, ipsapirone, and placebo: results from a multicenter trial. Depression 1993; 1: 172–6.CrossRefGoogle Scholar
22.Keppel Hesselink, JM. Een nieuwe klasse farmaca: de azapironen. TGO/JDR 1993; 18: 175–9.Google Scholar
23.Stahl, SM, Gastpar, M, Keppel Hesselink, JM, Traber, J, red. Serotonin 1A receptors in depression and anxiety. New York: Raven Press, 1992.Google Scholar
24.De Vrij, JM, Schreiber, R, Glaser, T, Traber, J. Behavioral pharmacology of 5 HT-1A agonists: animal models of anxiety and depression. In: Stahl, SM, Gaspar, M, Keppel Hesselink, JM, Traber, J, eds. Serotonin 1A receptors in depression and anxiety. New York. Raven Press 1992: 55–81.Google Scholar
25.Schreiber, R, Opitz, K, Glaser, T, De Vrij, JM. Ipsapirone and 8-OH-DPAT reduce ethanol preference in rats: involvement of presynaptic 5-HT-lA receptors. Psychopharmacol 1993; 112: 100–10.CrossRefGoogle Scholar