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    ABSTRACT: Background: Personality disordered individuals, especially those with severe cluster B disorders, are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. However, prescribing practices in this population often are based on hunches or anecdotal evidence rather than on rigorous or widely replicated data. Aims: We have attempted to provide a comprehensive review of randomized trials of the pharmacotherapy of personality disorders. Method: Pubmed searches using various combinations of the terms “pharmacotherapy”“psychopharmacology”“medication,”“personality disorder” and “Axis II.” Results: Approximately 40 published randomized trials were found and summarized. The vast majority concern borderline personality disorder (BPD); these studies cover almost every known class of psychotropic medications. Most published BPD studies show efficacy for at least one target symptom, with some studies identifying multiple areas of drug response. Medications seem most useful in treating circumscribed symptom areas and to induce only partial improvements. Conclusions: Much work remains to be done in finding wholly effective pharmacological strategies for treating personality disorders. The development of rational pharmacotherapy will require increasing our knowledge of the neurobiological underpinnings of the disorders themselves and of their component dimensions.Declaration of interest: None.
    Journal of Mental Health 07/2009; 16(1). · 1.40 Impact Factor
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    ABSTRACT: The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning.
    Dialogues in clinical neuroscience. 06/2013; 15(2):213-24.
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    ABSTRACT: Trichotillomania is a psychiatric condition characterised by chronic hair pulling, which is often associated with considerable comorbidity. Typically striking during critical developmental periods in childhood or early adolescence. the disorder tends to follow a chronic course. Trichotillomania is currently classified in DSM-IV as an impulse control disorder. However, phenomenological observations, neurobiological investigations and pharmacological responsivity have suggested similarities between hair pulling and affective states, compulsions, tics, and displacement activities involving excessive grooming. These findings indicate that the classification and theories of the aetiology of trichotillomania may need to be reconsidered. Few pharmacological treatment studies have been conducted for trichoti 110- mania. and among those that have been published several discrepant results have been noted. Nonetheless, certain clinical guidelines can be offered. The usual recommended pharmacological approach is to initiate treatment with an antidepressant that has serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibiting properties. This should be administered for 8 to 12 weeks. Depending on the clinical context. augmentation with anxiolytics. thymoleptics. antipsychotics.topical corticosteroids and other agents may be useful. Behavioural treatment is also an important treatment approach and should be considered either as the initial intervention or in concert with medication. Although rational options for the treatment of trichotillomania can be recommended based on the currently available literature. further controlled studies of pharmacological and nonpharmacological interventions are clearly needed.
    CNS Drugs 07/1996; 6(1). · 4.38 Impact Factor