Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough?

Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough? Expert Opin Pharmacother. 2019 Nov 06;:1-15 Authors: Bozzatello P, Rocca P, De Rosa ML, Bellino S Abstract Introduction: The treatment of borderline personality disorder (BPD) remains an open question for clinicians. There is scarce evidence available and the guidelines' conclusions diverge. Together with these factors, the complexity of BPD generates uncertainty in day-to-day practice. This narrative review aims to provide an overview of advances in BPD treatment and posit a critical opinion based on clinical evidence and practice.Areas covered: The authors review the clinical trials concerning the efficacy of the main classes of drugs in BPD: antidepressants, mood stabilizers, first-, second-, and third-generation antipsychotics, and other agents (opiate antagonists, clonidine, oxytocin, omega-3 fatty acids). They also include in this review studies on combinations of drugs and psychotherapies.Expert opinion: An individualized, tailored pharmacotherapy for BPD that targets the prominent symptom clusters can improve relevant aspects of the clinical picture. However, no medication is indicated to treat the global psychopathology of BPD. Polypharmacy should be avoided or strictly limited. To date, pharmacotherapy alone does not suffice to manage the complexity of BPD. Combining medication with psychotherapy may improve specific BPD symptom dimensions. In ...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

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Authors: Kaess M, Herpertz SC, Plener PL, Schmahl C Abstract Borderline Personality Disorders Abstract. Within the framework of the German task force "Transitional Psychiatry" (DGKJP and DGPPN), a group of experts discussed the significance of adolescence for the mental healthcare of Borderline Personality Disorder (BPD) in Germany. They identified particular gaps and problems within the following areas: early detection, access to specific outpatient psychotherapy, prolonged inpatient treatment, and polypharmacy. The authors then describe various recommendations and demands regarding the generation and di...
Source: Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie - Category: Child Development Tags: Z Kinder Jugendpsychiatr Psychother Source Type: research
ConclusionThe study identified a continuum of dysfunctions in intersubjective relatedness which can become a frame of reference to understand the interpersonal dynamics of a client in Music Therapy. This will help music therapists to be better prepared musically when working with BPD clients.
Source: Arts in Psychotherapy - Category: Psychiatry & Psychology Source Type: research
ConclusionsAdolescent females with borderline personality traits had lower social cognitive performance compared to healthy adolescent females. The intensity of this social cognitive deficit was evident to be related to impulsivity, emptiness, pattern of relationships, and quasi ‐psychotic states.
Source: Psychology and Psychotherapy: Theory, Research and Practice - Category: Psychiatry & Psychology Authors: Tags: Original article Source Type: research
ConclusionsA naturalistic integration of EBTs for BPD may benefit both BPD and PTSD symptoms even in the absence of PTSD-oriented intervention. Additionally, the attenuation of BPD symptoms may have positive impact on PTSD symptoms.
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research
Journal of Personality Disorders, Ahead of Print.
Source: Journal of Personality Disorders - Category: Psychiatry Authors: Source Type: research
ConclusionsThe conclusions seem promising for specific effectiveness of responsive treatments in particular in the interpersonal problem area of BPD. Identifying social interaction patterns early in treatment may be a crucial pathway to change for BPD.Practitioner points Responsive therapy activating social interaction patterns may be crucial for better outcome. Future research should focus on mechanisms of change in early treatment phases for BPD. New scale for assessing social interaction patterns specific to borderline personality disorder.
Source: Psychology and Psychotherapy: Theory, Research and Practice - Category: Psychiatry & Psychology Authors: Tags: Research Paper Source Type: research
There is growing recognition that borderline personality disorder emerges in adolescence and reaches increasing stability in early adulthood. Although the efficacy of psychotherapy in adults with borderline personality disorder is well-established, it is unclear whether psychotherapy is effective for adolescents with borderline personality disorder symptomatology. Here, the authors conduct a systematic review and meta-analysis of RCTs to assess the efficacy of psychotherapies in adolescents with borderline personality disorder symptomatology.
Source: Journal of the American Academy of Child and Adolescent Psychiatry - Category: Psychiatry Authors: Source Type: research
CONCLUSIONS: Depressive symptoms are present in the majority of people with BPD. To address the difficulty differentiating clinically distinct MDD from depressive symptoms that are integral to BPD psychopathology, it is suggested that depressive symptoms arising from a primary diagnosis of BPD (i) may exhibit transience and be stress reactive, (ii) lack a robust clinical response to antidepressant medication and/or electroconvulsive treatment and (iii) are responsive to BPD-appropriate psychotherapy. PMID: 31573324 [PubMed - as supplied by publisher]
Source: Australasian Psychiatry - Category: Psychiatry Authors: Tags: Australas Psychiatry Source Type: research
BACKGROUND: Evidence regarding the efficacy of psychotherapy in adolescents with borderline personality disorder (BPD) symptomatology has not been previously synthesized. OBJECTIVE: To conduct a systematic review and meta-analysis of the randomized...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
CONCLUSIONS: There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up-particularly for frequency of suicide attempts. PMID: 31558033 [PubMed - as supplied by publisher]
Source: Canadian Journal of Psychiatry - Category: Psychiatry Authors: Tags: Can J Psychiatry Source Type: research
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