Title:Current Clinical Psychopharmacology in Borderline Personality Disorder
Volume: 19
Issue: 10
Author(s): Antonio Del Casale*, Luca Bonanni, Paride Bargagna, Francesco Novelli, Federica Fiaschè, Marco Paolini, Francesca Forcina, Gaia Anibaldi, Francesca Natalia Cortese, Alessia Iannuccelli, Barbara Adriani, Roberto Brugnoli, Paolo Girardi, Joel Paris and Maurizio Pompili
Affiliation:
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, “Sant’Andrea” University Hospital, Rome,Italy
Keywords:
Borderline personality disorder, affective instability, drug treatment, impulsiveness, anger, atypical antipsychotics,
mood stabilizers, antidepressants.
Abstract:
Background: Patients with Borderline Personality Disorder (BPD) manifest affective and
behavioral symptoms causing personal distress, relationship difficulties, and reduced quality of life
with global functioning impairment, mainly when the disease takes an unfavorable course. A substantial
amount of healthcare costs is dedicated to addressing these issues. Many BPD patients receive
medications, mostly those who do not respond to psychological interventions.
Objective: Our aim was to assess the efficacy of the most used strategies of pharmacological interventions
in BPD with a comprehensive overview of the field.
Methods: We searched the PubMed database for papers focused on the most used psychotropic
drugs for BPD. We included randomized controlled trials and open studies in adult patients with
BPD, focusing on the efficacy and tolerability of single classes of drugs with respect to specific
clinical presentations that may occur during the course of BPD.
Results: Specific second-generation antipsychotics (SGAs) or serotonergic antidepressants can be
effective for different core symptoms of BPD, mainly including mood symptoms, anxiety, and impulse
dyscontrol. Some atypical antipsychotics can also be effective for psychotic and dissociative
symptoms. Specific antiepileptics can be useful in some cases in treating different BPD symptoms,
mainly including mood instability, impulsiveness, and anger.
Conclusion: No medication is currently approved for BPD, and clinicians should carefully assess
the benefits and risks of drug treatment. Further studies are needed to identify specific personalized
treatment strategies, also considering the clinical heterogeneity and possible comorbidities of BPD.
