[Mood stabilizer in the psychopharmacotherapy of borderline personality disorder]

Abstract

Borderline Personality Disorder (BPD) constitutes a profound instability with dysfunction in three psychopathological dimensions as cognitive-perceptual symptoms, affective dysregulation and behavioral impulsivity. Psychopharmacotherapy has a crucial role in the treatment of this complex disorder and targets the respective core symptoms. It comprises basically atypical antipsychotics, antidepressant agents and moodstabilizers, often requiring a combination of these substances in case of complex, multidimensional symptoms. Regarding the predominantly young and female patients the teratogenic risk demands critical consideration. This study focuses on the use of moodstabilizers in the treatment of BPD and gives an overview of the currently available studies on this substance class, in particular on lithium, carbamazepine, divalproex sodium, topiramate and lamotrigine. Results show significant effects on core features of BPD, but nevertheless, there are considerable limits in comparability and validity among the studies because of heterogeneities in the patient groups, study design, additive medication and outcome measures. Disregarding the off-label use in this indication the data reflect however an established clinical practice of use for these substances and underline the pivotal impact of moodstabilizers in the treatment of core symptoms of BPD.