ABSTRACT

Personality disorders have a long history of being difficult to treat. Not many years ago it was felt that they could only be treated by skilled experts in intensive long-term psychotherapy. As our understanding of these disorders has improved with empirical research, so has our vision of what treatments can and should be. This includes our concept of psychopharmacologic treatment. At one time it was thought counterproductive to use drugs in the treatment of personality disordered patients at all as it would interfere with psychotherapy. Of course, as with any difficult patient group, clinicians will try whatever might work. This led to the realization that in at least some circumstances in some patients, drug treatment could be beneficial. We have found, however, that we do not have specific drug treatments for categorical personality disorders such as we have, for instance, for major depression or panic disorder. What we have is an array of drugs that help to some extent with certain symptoms traits commonly found in personality disorders.