TY - JOUR
T1 - Pharmacotherapy of borderline personality disorder
T2 - Replacing confusion with prudent pragmatism
AU - Starcevic, Vladan
AU - Janca, Aleksandar
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose of review: The article aims to examine trends in the pharmacological treatment of borderline personality disorder (BPD) and shed more light on the attendant controversies. Recent findings: Although specialized, BPD-centred psychotherapy is considered first-line treatment for BPD and no psychotropic drug has been licensed for BPD, medications are frequently prescribed in the management of this condition. Various classes of psychopharmacological agents are used for BPD and there is a prominent polypharmacy. Use of antidepressants for BPD has been decreasing somewhat and use of mood stabilizers and second-generation antipsychotics has been increasing. Although there is a general agreement that little evidence of efficacy of medications exists for BPD, clinicians are either advised to almost completely avoid pharmacotherapy for BPD or use a 'targeted' approach, administering specific medications for the specific symptoms of BPD. This has created some confusion in clinical practice and contributed to a variety of prescribing practices for BPD. Summary: Well designed studies of the efficacy of pharmacological agents in BPD are needed. Clinicians should use medications for BPD with caution, usually short term and mainly for symptom relief. They should frequently review a need for ongoing pharmacotherapy and make every effort to avoid polypharmacy.
AB - Purpose of review: The article aims to examine trends in the pharmacological treatment of borderline personality disorder (BPD) and shed more light on the attendant controversies. Recent findings: Although specialized, BPD-centred psychotherapy is considered first-line treatment for BPD and no psychotropic drug has been licensed for BPD, medications are frequently prescribed in the management of this condition. Various classes of psychopharmacological agents are used for BPD and there is a prominent polypharmacy. Use of antidepressants for BPD has been decreasing somewhat and use of mood stabilizers and second-generation antipsychotics has been increasing. Although there is a general agreement that little evidence of efficacy of medications exists for BPD, clinicians are either advised to almost completely avoid pharmacotherapy for BPD or use a 'targeted' approach, administering specific medications for the specific symptoms of BPD. This has created some confusion in clinical practice and contributed to a variety of prescribing practices for BPD. Summary: Well designed studies of the efficacy of pharmacological agents in BPD are needed. Clinicians should use medications for BPD with caution, usually short term and mainly for symptom relief. They should frequently review a need for ongoing pharmacotherapy and make every effort to avoid polypharmacy.
KW - Borderline personality disorder
KW - Clinical practice guidelines
KW - Pharmacological treatment
KW - Polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=85036614063&partnerID=8YFLogxK
U2 - 10.1097/YCO.0000000000000373
DO - 10.1097/YCO.0000000000000373
M3 - Review article
C2 - 29028643
AN - SCOPUS:85036614063
VL - 31
SP - 69
EP - 73
JO - Current Opinion in Psychiatry
JF - Current Opinion in Psychiatry
SN - 0951-7367
IS - 1
ER -