Dependent Personality Disorder Biological Therapies

Four studies have explored the use of medications in the treatment of dependent personality disorder, and two studies have investigated their use in the treatment of dependent traits. Diagnostic and other limitations of the studies prevent firm conclusions about the efficacy of medications.

Klein and colleagues compared placebo with either imipramine or chlorpromazine in hospitalized patients with passive-aggressive and passive-dependent personality disorders that had been diagnosed according to DSM criteria. None of the patients showed a positive drug response.

Lauer (1976) gave tricyclic antidepressants to patients who had passive-dependent traits in addition to their primary diagnoses. On follow-up questionnaires, patients who had received active drugs reported less anxiety, along with increases in available energy, assertiveness, and outgoing behavior in day-to-day life. The results suggested that some patients with dependent personality disorder respond to antidepressants in the presence of an Axis I disorder, but, in any event, the benefits were not very striking.

As reported earlier in this chapter, patients with major depressive disorder and an anxious-cluster personality disorder, many with dependent personality disorder, showed significant improvement in depression with imipramine or psychotherapeutic treatment. Fewer patients with Cluster C disorders fully recovered, however, and social adjustment problems remained.

Tyrer et al. drew a similar conclusion after studying patients with "general neurotic syndrome," which includes mixed anxiety-depression and dependent or obsessive personality. Although such patients initially appeared to be as responsive as others to 10-week treatments, including dothiepin (an antidepressant), diazepam, placebo, cognitive-behavioral therapy, or self-help, at 2-year follow-up, they had greater symptom levels and did significantly worse than other outpatients.