The purpose of this chapter is to review the literature concerning the psychopharmacology of personality disorders. We first review the double-blind placebo-controlled pharmacologic studies of all the personality disorders, except for borderline personality disorder (BPD). Attention is then focused on BPD. While there have been many open-labeled studies, there are fewer than 30 randomized-controlled trials even for this personality disorder. The section on borderline personality disorder will conclude with guidance as to how to think about the management of the actual pharmacologic treatment of this disorder, including matters such as dosage, lethality, augmentation, and avoiding polypharmacy. We conclude with a discussion of the obstacles hampering the development of a more substantial database that could provide guidance and direction.
