Treatment of Histrionic Personality Disorder

Pharmacotherapy Role

• Pharmacotherapy is not a primary treatment for histrionic personality disorder itself, but should be considered only for comorbid conditions, such as depression or anxiety disorders, with SSRIs or cognitive-behavioral therapy initiated following established depression treatment protocols (moderate strength of evidence) 1
• For comorbid anxiety disorders, SSRIs or SNRIs may be appropriate based on the specific anxiety disorder present (moderate strength of evidence) 1
• The American Psychiatric Association recommends avoiding antidepressants or benzodiazepines for initial treatment of depressive symptoms in the absence of a current or prior depressive episode 2
• Benzodiazepines should be avoided for impulsivity in Cluster B personality disorders as they may increase disinhibition, according to the American Medical Association 3

Common Pitfalls

• The National Institute of Mental Health advises against premature medication use, as medication should never substitute for psychotherapy, which remains the cornerstone of treatment 3