Clinical Outcome of Psychopharmacologic Treatment of Borderline and Schizotypal Personality Disordered Subjects
Emil F. Coccaro, M.D.
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This paper reviews the biological and psychopharmacologic nature of personality disordered subjects,
specifically those with borderline (BPD) and schizotypal (ScPD) personality disorder. Generally
speaking, there is no agent of choice for the treatment of either BPD or ScPD. Many agents of different
classes appear to offer some benefit to selected subjects depending upon their symptom presentation.
For example, ScPD or BPD subjects with prominent cognitive/perceptual distortion may respond
to neuroleptic agents, while some BPD subjects with depressed mood may respond best to antidepressants.
The hypothesis that biological and behavioral dimensions underlie the psychopharmacologic
response to treatment in personality disordered subjects, proposed over the past decade, is now being
tested. The most salient example of this is the testing of serotonin-specific agents (e.g., fluoxetine) for
potential antiaggressive efficacy in personality disordered subjects with prominent histories of impulsive
aggressive behavior and putative reduced serotonin system function.
J Clin Psychiatry 1998;59(suppl 1):30–35
© Copyright 1998 Physicians Postgraduate Press, Inc.
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