PDF herunterladen
Pharmacopsychiatry 2005; 38(5): 201-205
DOI: 10.1055/s-2005-873154
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Pharmacotherapy of Personality Disorders in German Speaking Countries: State and Changes in the Last Decade

M. Heinze1 , D. Andreae2 , R. Grohmann3
  • 1Department of Psychiatry and Psychotherapy, Klinikum Bremen-Ost, Bremen, Germany
  • 2Department of Psychiatry and Psychotherapy, Landesklinik Teupitz, Teupitz, Germany
  • 3Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany
Weitere Informationen

Publikationsverlauf

Received: 20.9.2004 Revised: 20.1.2005

Accepted: 18.5.2005

Publikationsdatum:
27. September 2005 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Background: In many cases, patients with personality disorders currently receive psychopharmacological treatment as well as psychotherapy. Empirically oriented studies of outcome and efficacy are still rare, and clinical practice is still dominated by a symptomatic and rather pragmatic approach. Aim: This study provides empirical insight into the reality of psychopharmacological practice in psychiatric institutions in German speaking countries. Method: The use of psychotropic drugs in patients with personality disorders is demonstrated using the data base of the AMSP drug safety program. Recent changes are shown by comparing results from 1996 and 2003. Results: Our data show a symptom-driven, polypragmatic, and often off-label use of psychotropic drugs in personality disorders.

References

  • 1 American Psychiatric A ssociation. Practice guideline for the treatment of patients with borderline personality disorder.  Am J Psychiatry. 2001;  158 (Suppl) 1-52
    CrossrefPubMedSuche in Google Scholar
  • 2 Benjamin L S. Special feature: personality disorders: models for treatment and strategies for treatment development.  J Personal Disord. 1997;  11 307-324
    PubMedSuche in Google Scholar
  • 3 Cowdry R W, Gardner D L. Pharmacotherapy of borderline personality disorder: alprazolam, carbamazepine, trifluoperazine and tranylcyclopromine.  Arch Gen Psychiatry. 1988;  45 111-119
    PubMedSuche in Google Scholar
  • 4 Cowdry R W. Psychopharmacology of borderline personality disorder.  J Clin Psychiatry. 1987;  48 15-25
    PubMedSuche in Google Scholar
  • 5 Dulz B. Pharmakotherapie bei Borderlinestörungen. Eine Literaturübersicht.  Nervenarzt. 1994;  65 755-761
    PubMedSuche in Google Scholar
  • 6 Frankenburg F R, Zanarini M C. Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder: a double-blind placebo-controlled pilot study.  J Clin Psychiatry. 2002;  63 442-446
    CrossrefPubMedSuche in Google Scholar
  • 7 Grohmann R, Engel R R, Geissler K H, Ruether E. Psychotropic drug use in psychiatric Impatiens: recent trends and changes over time - data from the AMSP study.  Pharmacopsychiatry. 2004;  37 (Suppl 1) S27-S38
    Thieme ConnectPubMedSuche in Google Scholar
  • 8 Grohmann R, Engel R R, Ruether E, Hippius H. The AMSP drug safety program: methods and global results.  Pharmacopsychiatry . 2004;  37 (Suppl 1) S4-S11
    Thieme ConnectPubMedSuche in Google Scholar
  • 9 Grohmann R, Hippius H, Helmchen H, Ruether E, Schmidt L G. The AMÜP study for drug surveillance in psychiatry - a summary of impatient data.  Pharmacopsychiatry. 2004;  37 (Suppl 1) S16-S26
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Hollander E, Swann A C, Coccaro E F, Jiang P, Smith T B. Impact of trait impulsivity and state aggression on divalproex versus placebo response in borderline personality disorder.  Am J Psychiatry. 2005;  162 621-624
    CrossrefPubMedSuche in Google Scholar
  • 11 Kampfhammer H P, Hippius H. Special feature: pharmacotherapy in personality disorders.  J Personal Disord. 1998;  12 277-288
    PubMedSuche in Google Scholar
  • 12 Links P S, Boggild A, Sarin N. Modeling the relationship between affective liability, Impulsivity, and suicidal behavior.  J Psychiatr Pract. 2000;  6 247-255
    PubMedSuche in Google Scholar
  • 13 Links P S, Boggild A, Sarin N. Psychopharmacology of personality disorders: review and emerging issues.  Curr Psychiatry Rep. 2001;  3 70-76
    CrossrefPubMedSuche in Google Scholar
  • 14 Links P S, Heslegrave R, Villella J. Psychopharmacological management of personality disorders: an outcome-focused model. In Silk KR, editor Biology of Personality Disorders. Washington; American Psychiatric Press 1998: p 93-127
    Suche in Google Scholar
  • 15 Markovitz P J. Recent trends in the pharmacotherapy of personality disorders.  J Personal Disord. 2004;  18 90-101
    CrossrefPubMedSuche in Google Scholar
  • 16 Montgomery S A. The psychopharmacology of borderline personality disorders.  Acta Psychiatr Belg. 2001;  87 260-266
    PubMedSuche in Google Scholar
  • 17 Oldham J M, Bender D S, Skodol A E, Dyck I R, Sanislow C A, Yen S, Grilo C M, Shea M T, Zanarini M C, Gunderson E J, McGlashan T H. Testing an APA practice guideline: symptom-targeted medication utilization for patients with borderline personality disorder.  J Psychiatr Pract. 2004;  10 156-161
    PubMedSuche in Google Scholar
  • 18 Pelissolo A, Lepine J P. Pharmacotherapy in personality disorders: methodological issues and resulte.  Encephale. 1999;  25 496-507
    PubMedSuche in Google Scholar
  • 19 Soloff P H. Algorithms for psychopharmacological treatment of personality dimensions: symptom-specific treatments for cognitive-perceptual, affective, and impulsive-behavioral dysregulation.  Bull Menninger Clin. 1998;  62 195-214
    PubMedSuche in Google Scholar
  • 20 Soloff P H. Psychopharmacology of borderline personality disorder.  Psychiatr Clin North Am. 2000;  23 169-192
    CrossrefPubMedSuche in Google Scholar
  • 21 Synder S. The interaction of psychopharmacology and psychoanalysis in the borderline patient.  Psychiatr Q. 1980;  52 240-250
    CrossrefPubMedSuche in Google Scholar
  • 22 Villalba R, Harrington C J. Repetitive self-injurious behaviour: a neuropsychiatric perspective and review of pharmacologic treatments.  Semin Clin Neuropsychiatry. 2000;  5 214-226
    CrossrefPubMedSuche in Google Scholar
  • 23 Zanarini M C, Frankenburg F R, Parachini E A. A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder.  J Clin Psychiatry. 2004;  65 903-907
    CrossrefPubMedSuche in Google Scholar
  • 24 Zanarini M C, Frankenburg F R. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study.  J Clin Psychiatry. 2001;  62 849-854
    CrossrefPubMedSuche in Google Scholar
  • 25 Zanarini M C. Update on pharmacotherapy of borderline personality disorder.  Curr Psychiatry Rep. 2004;  6 66-70
    PubMedSuche in Google Scholar
  • 26 Zisook S, Ricketts J E. Psychopharmacologic approaches to the borderline patient.  Hillside J Clin Psychiatry. 1988;  10 55-70
    PubMedSuche in Google Scholar

Dr. Martin Heinze

Department of Psychiatry and Psychotherapy

Klinikum Bremen-Ost

Züricher Str. 40

 28325 Bremen

eMail: martin.heinze@klinikum-bremen-ost.de