Off-label use of atypical antipsychotics in personality disorders

Introduction: Personality disorders are among the most persistent and challenging disorders to treat within psychiatry. There is emerging evidence that some personality disorders, particularly borderline personality disorder and, to a lesser extent, schizotypal personality disorder, may benefit from treatment with atypical antipsychotics as well as mood stabilizers. This review examines the evidence for atypical antipsychotics for personality disorders and discusses strengths and limitations of this approach. Areas covered: Searches of Medline and PsycInfo yielded 57 articles related to use of atypical antipsychotics for treatment of personality disorders. Most were relatively small randomized, controlled trials examining atypical antipsychotics for borderline personality disorder; however, the search also yielded two Cochrane reviews examining pharmacotherapy for borderline personality disorder and antisocial personality disorder as well as three other meta-analyses. Expert opinion: There is some evidenc...