Which medication is commonly prescribed for managing severe symptoms in cluster A personality disorders?

Risperidone, particularly in its intramuscular (IM) form, is often prescribed for managing severe symptoms associated with cluster A personality disorders. These disorders, which include paranoid, schizoid, and schizotypal personality disorders, can involve significant symptoms such as agitation, paranoia, or perceptual distortions. Risperidone, an atypical antipsychotic, has been beneficial in addressing these symptoms due to its ability to modulate dopamine and serotonin receptors, which can help reduce psychotic-like symptoms and agitation.

In contrast, while fluoxetine (an SSRI), lithium carbonate (a mood stabilizer), and citalopram (another SSRI) may have roles in the broader context of mood and anxiety disorders, they are not first-line treatments for the severe symptoms specifically tied to cluster A disorders. SSRIs are generally more effective for mood regulation and anxiety rather than the core symptoms exhibited in these personality disorders. Lithium may help with mood stabilization but is not targeted to the symptoms that are primarily present in cluster A personality disorders. Thus, risperidone IM stands out as the most appropriate choice in treating the severe manifestations found in these disorders.