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Review
. 2021;19(10):1760-1779.
doi: 10.2174/1570159X19666210610092958.

Current Clinical Psychopharmacology in Borderline Personality Disorder

Antonio Del Casale  1 , Luca Bonanni  2 , Paride Bargagna  2 , Francesco Novelli  2 , Federica Fiaschè  2 , Marco Paolini  2 , Francesca Forcina  2 , Gaia Anibaldi  2 , Francesca Natalia Cortese  2 , Alessia Iannuccelli  2 , Barbara Adriani  2 , Roberto Brugnoli  2 , Paolo Girardi  1 , Joel Paris  3 , Maurizio Pompili  2
Affiliations
Review

Current Clinical Psychopharmacology in Borderline Personality Disorder

Antonio Del Casale et al. Curr Neuropharmacol. 2021.

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.

Keywords: Borderline personality disorder; affective instability; anger; antidepressants.; atypical antipsychotics; drug treatment; impulsiveness; mood stabilizers.

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Figures

Fig. (1)
Fig. (1)
PRISMA flow diagram showing search and inclusion strategy.
See this image and copyright information in PMC

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