Pharmacotherapy of borderline personality disorder: Replacing confusion with prudent pragmatism

Vladan Starcevic, Aleksandar Janca

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)69-73
Number of pages5
JournalCurrent Opinion in Psychiatry
Volume31
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint

Borderline Personality Disorder
Drug Therapy
Polypharmacy
Pharmacology
Psychotropic Drugs
Psychotherapy
Antidepressive Agents
Antipsychotic Agents

Cite this

@article{77baa59802ce48209c3113cf4bdc218c,
title = "Pharmacotherapy of borderline personality disorder: Replacing confusion with prudent pragmatism",
abstract = "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.",
keywords = "Borderline personality disorder, Clinical practice guidelines, Pharmacological treatment, Polypharmacy",
author = "Vladan Starcevic and Aleksandar Janca",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/YCO.0000000000000373",
language = "English",
volume = "31",
pages = "69--73",
journal = "Current Opinion in Psychiatry",
issn = "0951-7367",
publisher = "Lippincott Williams & Wilkins",
number = "1",

}

Pharmacotherapy of borderline personality disorder : Replacing confusion with prudent pragmatism. / Starcevic, Vladan; Janca, Aleksandar.

In: Current Opinion in Psychiatry, Vol. 31, No. 1, 01.01.2018, p. 69-73.

Research output: Contribution to journalReview article

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

VL - 31

SP - 69

EP - 73

JO - Current Opinion in Psychiatry

JF - Current Opinion in Psychiatry

SN - 0951-7367

IS - 1

ER -