A growing number of studies on pharmacotherapy of personality disorders have been performed. This article considers controlled trials conducted between 1990 and 2010, and is directed toward the treatment of personality disorders. Data on borderline personality disorder (BPD), antisocial personality disorder and schizotypal personality disorder (STPD) were collected and discussed, in order to provide indications for clinical practice. Concerning antisocial personality disorder and STPD, available evidence is too sparse to propose treatment recommendations. As for BPD, there is some evidence that mood stabilizers (topiramate, valproate, and lamotrigine), second-generation antipsychotics (olanzapine, aripiprazole), and omegaâ3 fatty acids can be useful to treat affective symptoms and impulsive-behavioral dyscontrol. Antipsychotics showed positive effects on cognitive symptoms both in patients with BPD and STPD. Selective serotonin reuptake inhibitors were found effective in decreasing depressed mood, anxiety and anger in BPD patients, mainly in subjects with a concomitant affective disorder. Effects of antidepressants on impulsive behaviors are uncertain. Further studies are needed to improve methods of trials and confirm these findings.