Is there any drug treatment of choice for the borderline patient?
Psychotropic medication is used extensively in the borderline patient in an effort to treat the cognitive, affective, impulsive-behavioral and anxious-fearful symptoms which comprise the state symptoms and trait vulnerabilities of BPD. This paper reviews the efficacy of neuroleptics, antidepressants (TCA, MAOI and SSRI), lithium carbonate, carbamazepine and benzodiazepines against these 4 symptom domains. There is currently no single drug treatment of choice in BPD. Current research supports acute treatment. Maintenance trials are generally lacking or show limited efficacy. A dimensional approach is recommended for clinical practice and future research trials, targeting specific symptom domains with selective medication. Pharmacotherapy should be viewed as a useful adjunct to psychotherapy in the long-term treatment of the borderline patient.
Soloff
P H
PH
Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213.
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001883:Borderline Personality Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000627:therapeutic use; D006801:Humans; D007175:Impulsive Behavior / Q000188:drug therapy; D016651:Lithium Carbonate / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000929:Antidepressive Agents, Tricyclic; D001569:Benzodiazepines; D002220:Carbamazepine; D016651:Lithium Carbonate; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors