Psychopharmacological Treatment of Personality Disorders

2015 ◽  
Author(s):  
M. Mercedes Perez-Rodriguez ◽  
Larry J. Siever
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Omega 3 ◽  
Psychopharmacological Treatment ◽  
Limited Effectiveness ◽  
Second Generation Antipsychotics

Despite the lack of approval by the U.S. Food & Drug Administration, drugs are used widely to treat personality disorders, particularly borderline personality disorder, based on their effects known from clinical trials in other psychiatric disorders (off-label use). The role of medications in personality disorders is limited to moderate effects on some but not all of the symptom domains. There are no medications available that improve the global severity of any personality disorder as a whole. In borderline personality disorder, evidence is strongest for second-generation antipsychotics and mood stabilizers, while dietary supplements like omega-3 fatty acids hold some promise. However, medications have limited effectiveness and are still viewed as adjunctive to other forms of treatment, particularly psychotherapy.

scholarly journals Psychopharmacologic treatment of borderline personality disorder

2013 ◽  
Vol 15 (2) ◽  
pp. 213-224 ◽  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Antipsychotic Agents ◽  
Borderline Personality ◽  
Future Research ◽  
Omega 3 ◽  
Research Strategies ◽  
Omega 3 Fatty Acid ◽  
Atypical Antipsychotic Agents

The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning.

scholarly journals Management of personality disorders in acute in-patient settings. Part 1: Borderline personality disorders

2004 ◽  
Vol 10 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Leonard Fagin
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Patient Care ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Care Plan ◽  
Borderline Personality Disorders

General principles of management of patients with personality disorders admitted in crises to the in-patient unit are discussed. The role of the acute ward in the overall plan of care, the clinical thresholds to consider in deciding whether admission is appropriate and the main elements of the in-patient care plan are outlined. The management of patients with borderline personality disorder, who constitute the majority of such admissions, is discussed in detail.

scholarly journals Pharmacotherapy of Borderline Personality Disorder: A Metaanalysis of Randomised Controlled Trials

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
J. Stoffers ◽  
B. Völlm ◽  
G. Rücker ◽  
A. Timmer ◽  
K. Lieb
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomised Controlled Trials ◽  
Second Generation ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Controlled Trials ◽  
Omega 3 ◽  
Psychotherapeutic Treatment ◽  
Randomised Controlled

Background:In Borderline Personality Disorder (BPD), pharmacotherapy is used for the treatment of specific BPD pathology facets, such as cognitive-perceptual, affective, or impulsivity symptoms. Due to the polymorphic phenomenology of the disorder, different classes of drugs are used, e.g., antipsychotics, antidepressants, or mood stabilizers.Aims:To evaluate the up-to-date evidence of drug treatment efficacy for BPD.Method:A systematic review and metaanalysis of randomised controlled trials was done. All randomised comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity and mental health status, tolerability, and adverse effects. With support of the Cochrane Collaboration, a thorough search was conducted to identify both published and unpublished trials. The findings were scrutinized by two reviewers independently.Results:Twenty-six trials were included, investigating first- and second-generation antipsychotics, mood stabilizers, antidepressants, and omega-3 fatty acids.Conclusion:Findings indicate beneficial effects for all classes of drugs investigated, and suggest mood stabilizers and second-generation antipsychotic agents as first-line treatments for BPD due to their efficacy in the treatment of different domains of BPD and associated pathology. However, psychotherapeutic treatment should clearly be targeted at predefined specific symptoms.

Pharmacotherapy of Borderline Personality Disorder: a Metaanalysis of Randomised Controlled Trials

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
J. Stoffers ◽  
B. Völlm ◽  
G. Rücker ◽  
A. Timmer ◽  
K. Lieb
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomised Controlled Trials ◽  
Second Generation ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Controlled Trials ◽  
Omega 3 ◽  
Psychotherapeutic Treatment ◽  
Randomised Controlled

Background:In Borderline Personality Disorder (BPD), pharmacotherapy is used for the treatment of specific BPD pathology facets, such as cognitive-perceptual, affective, or impulsivity symptoms. Due to the polymorphic phenomenology of the disorder, different classes of drugs are used, e.g., antipsychotics, antidepressants, or mood stabilizers.Aims:To evaluate the up-to-date evidence of drug treatment efficacy for BPD.Method:A systematic review and metaanalysis of randomised controlled trials was done. All randomised comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity and mental health status, tolerability, and adverse effects. with support of the Cochrane Collaboration, a thorough search was conducted to identify both published and unpublished trials. the findings were scrutinized by two reviewers independently.Results:Twenty-six trials were included, investigating first- and second-generation antipsychotics, mood stabilizers, antidepressants, and omega-3 fatty acids.Conclusion:Findings indicate beneficial effects for all classes of drugs investigated, and suggest mood stabilizers and second-generation antipsychotic agents as first-line treatments for BPD due to their efficacy in the treatment of different domains of BPD and associated pathology. However, psychotherapeutic treatment should clearly be targeted at predefined specific symptoms.

Treatment and management of personality disorder

2020 ◽  
pp. 1247-1254
Author(s):  
Giles Newton-Howes ◽  
Roger Mulder
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Dopamine Antagonists ◽  
Term Therapy ◽  
Short Term ◽  
Long Term Therapy

The management of personality disorders remains a complex and challenging area, in which significant advances have been made to our understanding over the last two decades. As an increasing understanding of the diagnosis of personality disorder is recognized, our ability to understand what interventions could be of value continues to develop. The diagnosis of borderline personality disorder is where the most significant understanding has occurred. It is now clear that these disorders can be recognized early in development and treatment should be primarily psychological. Cognitive, dynamic, and educational approaches have been trialled and found to be effective. Further, pharmacotherapy is best considered for short-term, symptom-focused use, as opposed to long-term therapy. The evidence suggests dopamine antagonists and mood stabilizers are the drugs of choice. Identifying the needs and developing strategies to meet these provide greater benefit than focusing on risk.

scholarly journals Pharmacotherapy of borderline personality disorder: what has changed over two decades? A retrospective evaluation of clinical practice

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Charles Timäus ◽  
Miriam Meiser ◽  
Borwin Bandelow ◽  
Kirsten R. Engel ◽  
Anne M. Paschke ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychotropic Drug ◽  
Inpatient Treatment ◽  
Medical Center ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Main Diagnosis ◽  
Tetracyclic Antidepressants ◽  
Prescription Rates

Abstract Background The purpose of this study was to assess the pharmacological treatment strategies of inpatients with borderline personality disorder between 2008 and 2012. Additionally, we compared pharmacotherapy during this period to a previous one (1996 to 2004). Methods Charts of 87 patients with the main diagnosis of borderline personality disorder receiving inpatient treatment in the University Medical Center of Goettingen, Germany, between 2008 and 2012 were evaluated retrospectively. For each inpatient treatment, psychotropic drug therapy including admission and discharge medication was documented. We compared the prescription rates of the interval 2008–2012 with the interval 1996–2004. Results 94% of all inpatients of the interval 2008–2012 were treated with at least one psychotropic drug at time of discharge. All classes of psychotropic drugs were applied. We found high prescription rates of naltrexone (35.6%), quetiapine (19.5%), mirtazapine (18.4%), sertraline (12.6%), and escitalopram (11.5%). Compared to 1996–2004, rates of low-potency antipsychotics, tri−/tetracyclic antidepressants and mood stabilizers significantly decreased while usage of naltrexone significantly increased. Conclusions In inpatient settings, pharmacotherapy is still highly prevalent in the management of BPD. Prescription strategies changed between 1996 and 2012. Quetiapine was preferred, older antidepressants and low-potency antipsychotics were avoided. Opioid antagonists are increasingly used and should be considered for further investigation.

scholarly journals Experiences of Compassion in Adults With a Diagnosis of Borderline Personality Disorder: An Interpretative Phenomenological Analysis

2021 ◽  
pp. 003329412110006
Author(s):  
Stephanie Fagan ◽  
Suzanne Hodge ◽  
Charlotte Morris
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Interpretative Phenomenological Analysis ◽  
Sense Of Self ◽  
Phenomenological Analysis ◽  
Borderline Personality ◽  
Adverse Impact ◽  
Empathic Understanding ◽  
Therapeutic Encounters

The study explored experiences of compassion in adults with a diagnosis of Borderline Personality Disorder (BPD) to further the development of the construct of compassion in relation to BPD. Interpretative Phenomenological Analysis was used to develop themes from the narratives of six adults with a diagnosis of BPD. Five themes emerged: Emotional Connection to Suffering, Empathic Understanding, Prioritisation of Needs, A Model of Genuine Compassion and Developing Acceptance and Worth. Participants described the role of compassion in their difficulties, including the adverse impact of experiences of incompassion upon their sense of self. The themes were integrated into a model that highlighted a process of recovery through therapeutic encounters with others in which genuine compassion was modelled. In addition, barriers to compassion and factors facilitating the development of compassion emerged from the analysis and have implications for clinical practice.

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