Pharmacotherapy for Borderline Personality Disorder: an Update of Published, Unpublished and Ongoing Studies

Abstract

Purpose of the review: We aim to identify the most recent evidence of randomised controlled trials evaluating continued drug treatments in people with a diagnosis of BPD, review the most recent findings, highlight trends in terms of currently ongoing studies and comment on the overall body of evidence.

Recent findings: We identified seven new RCTs, plus newly available data for an older RCT. Only three of these RCTs have been published in full text, while we found study data posted at trial registry platforms for the others. The new findings do not support fluoxetine as a treatment option for suicide and self-harm prevention. A large effectiveness study did not detect beneficial effects of lamotrigine in routine care. The prevalent use of medications in BPD is still not reflected or supported by the current evidence. More research is needed regarding the most commonly used substances and substance classes, i.e. SSRIs, and quetiapine, but also with respect to people presenting with distinct comorbid conditions.

Keywords: Anticonvulsants; Antidepressants; Antipsychotics; Borderline personality disorder; Drug treatment; Review.

Fig. 1

Randomised and quasi-randomised controlled trials of drug treatments in people with personality disorders. Publications per year, 1980 to current; CENTRAL search 29 March 2020 (MeSH descriptor [borderline personality disorder] AND qualifier “drug therapy”)