Abstract
Borderline personality disorder is a pervasive pattern of instability of interpersonal relationships, affects and self-image, as well as marked impulsivity. Although psychotherapy is needed to attain lasting improvements in a patient’s personality and overall functioning, practice guidelines state that pharmacotherapy is indicated to manage state symptoms and trait vulnerabilities. Three psychopathological dimensions are the main targets for pharmacotherapy of borderline personality disorder: affective dysregulation, impulsive-behavioural dyscontrol and cognitive-perceptual symptoms. Guidelines recommend the use of antidepressant agents and mood stabilizers for affective dysregulation and impulsivebehavioural dyscontrol, and antipsychotics for cognitive-perceptual symptoms.
This review aims to report and discuss data from clinical trials, reviews and meta-analyses concerning drug efficacy and tolerability in the treatment of borderline personality disorder. Investigations that considered antidepressant agents mainly focused on SSRIs, which are recommended as first-line treatments for affective instability and impulse dyscontrol. Both open-label and randomized controlled studies have been performed, predominantly concerning the efficacy of fluoxetine and fluvoxamine. Other classes of antidepressants, such as TCAs and MAOIs, were investigated as alternative treatments for borderline personality disorder, but the risk of adverse effects and toxicity is a limitation to their use in clinical practice. Increasing amounts of data have recently been collected on the use of mood stabilizers to control mood instability and impulsivity in patients with borderline personality disorder. More substantial data were derived from controlled trials of valproate semisodium, although other drugs such as lithium, carbamazepine, oxcarbazepine and lamotrigine were tested with promising results. Several first-generation antipsychotics were studied in open-label and controlled trials, with good effects on behavioural dyscontrol and psychotic-like symptoms. Selection biases and heterogeneity of drugs and methods somewhat limited the value of these results. More recent investigations have examined atypical antipsychotics, with most of these studies being open-label trials with small sample sizes; however, a few controlled studies have been performed using olanzapine, showing improvements in impulsivity, anger and hostility.
In conclusion, a large number of different drugs have been evaluated in the treatment of patients with borderline personality disorder. Initial findings are encouraging for many of these drugs. However, data need to be replicated in further controlled studies with head-to-head comparisons and long-term follow-ups. Many questions remain to be answered.
Similar content being viewed by others
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed., text revision. Washington, DC: American Psychiatric Association, 2000
Clarkin JF, Yeomans FE, Kernberg OF. Psychotherapy for borderline patients. New York: John Wiley & Sons, 1999
Livesley WJ. A practical approach to the treatment of patients with borderline personality disorder. Psychiatr Clin North Am 2000; 23: 211–32
American Psychiatric Association. Practice guidelines for the treatment of patients with borderline personality disorder. Washington, DC: American Psychiatric Association, 2001
Siever LJ, Davis KL. A psychobiological perspective on the personality disorders. Am J Psychiatry 1991; 148: 1647–58
Siever LJ, Trestman R. The serotonin system and aggressive personality disorder. Int Clin Psychopharmacol 1993; 8: 33–9
Cowdry RW, Gardner DL. Pharmacotherapy of borderline personality disorder: alprazolam, carbamazepine, trifluoperazine, and tranylcipromine. Arch Gen Psychiatry 1988; 45: 111–9
Parsons B, Quitkin FM, McGrath PJ, et al. Phenelzine, imipramine, and placebo in borderline patients meeting criteria for atypical depression. Psychopharmacol Bull 1989; 25: 524–34
Soloff PH, Cornelius J, George A, et al. Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch Gen Psychiatry 1993; 50(5): 377–85
Soloff PH, George A, Nathan S, et al. Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. J Clin Psychopharmacol 1989; 9: 238–46
Links P, Steiner M, Boiago I, et al. Lithium therapy for borderline patients: preliminary findings. J Personal Disord 1990; 4: 173–81
Coccaro EF, Kavoussi RJ. Fluoxetine and impulsive aggressive behaviour in personality disordered subjects. Arch Gen Psychiatry 1997; 54: 1081–8
Markovitz P. Pharmacotherapy of impulsivity, aggression, and related disorders. In: Hollander E, Stein DJ, editors. Impulsivity and aggression. New York: John Wiley & Sons, 1995: 263–87
Salzman C, Wolfson AN, Schatzberg A, et al. Effect of fluoxetine on anger in symptomatic volunteers with borderline personality disorder. J Clin Psychopharmacol 1995; 15: 23–9
Rinne T, de Kloet ER, Wouters L, et al. Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse. Biol Psychiatry 2002; 52: 1102–12
Cornelius JR, Soloff PH, George A, et al. Haloperidol vs phenelzine in continuation therapy of borderline disorder. Psychopharmacol Bull 1993; 29(2): 333–7
Lavin MR, Mendelowitz A, Kronig MH. Spontaneous hypertensive reactions with monoamine oxidase inhibitors. Biol Psychiatry 1993; 34(3): 146–51
Shader RI, DiMascio A. Psychotropic drug side effects. Baltimore (MD): Williams and Wilkins, 1970
Soloff PH, George A, Nathan RS, et al. Progress in pharmacotherapy of borderline disorders: a double-blind study of amitriptyline, haloperidol, and placebo. Arch Gen Psychiatry 1986; 43: 691–7
Brown GL, Ebert MH, Goyer PF, et al. Aggression, suicide, and serotonin: relationships to CSF amine metabolites. Am J Psychiatry 1982; 139: 741–6
Coccaro EF. Central serotonin and impulsive aggression. Br J Psychiatry Suppl 1989; 155: 52–62
Coccaro EF, Siever LJ, Klar HM, et al. Serotonergic studies in patients with affective and personality disorders: correlates with suicidal and impulsive aggressive behavior. Arch Gen Psychiatry 1989; 46: 587–99
Oquendo MA, Mann JJ. The biology of impulsivity and suicidality. Psychiatr Clin North Am 2000; 23: 11–25
Soloff PH, Meltzer CC, Becker C, et al. Impulsivity and prefrontal hipometabolism in borderline personality disorder. Psychiatry Res 2003; 123: 153–63
Frankle WG, Lombardo I, New AS, et al. Brain serotonin transporter distribution in subjects with impulsive aggressivity: a positron emission study with [HC]McN 5652. Am J Psychiatry 2005; 162(5): 915–23
Soloff PH. Algorithms for pharmacological treatment of personality dimensions: symptom-specific treatments for cognitive-perceptual, affective, and impulsive-behavioral dysregulation. Bull Menninger Clin 1998; 62: 195–214
Soloff PH. Psychopharmacology of borderline personality disorder. Psychiatr Clin North Am 2000; 23: 169–92
Norden MJ. Fluoxetine in borderline personality disorder. Prog Neuropsychopharmacol Biol Psychiatry 1989; 13: 885–93
Coccaro EF, Astill JL, Herbert JL, et al. Fluoxetine treatment of impulsive aggression in DSM-III-R personality disorder patients. J Clin Psychopharmacol 1990; 10: 373–5
Cornelius JR, Soloff PH, Perel JM, et al. Fluoxetine trial in borderline personality disorder. Psychopharmacol Bull 1990; 26: 151–4
Cornelius J, Soloff PH, Perel J, et al. A preliminary trial of fluoxetine in refractory borderline patients. J Clin Psychopharmacol 1991; 11: 116–20
Markovitz PJ, Calabrese JR, Charles SC, et al. Fluoxetine in the treatment of borderline and schizotypal personality disorders. Am J Psychiatry 1991; 148: 1064–7
Teicher MH, Glod CA, Cole JO. Emergence of intense suicidal preoccupation during fluoxetine treatment. Am J Psychiatry 1990; 147: 207–10
Kavoussi RJ, Liu J, Coccaro EF. An open trial of sertraline in personality disordered patients with impulsive aggression. J Clin Psychiatry 1994; 55: 137–41
Silva H, Jerez S, Paredes A, et al. Fluoxetine in the treatment of borderline personality disorder. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1997; 25(6): 391–5
Simpson EB, Yen S, Costello E, et al. Combined dialectical behavior therapy and fluoxetine in the treatment of borderline personality disorder. J Clin Psychiatry 2004 Mar; 65(3): 379–85
Zanarini MC, Frankenburg FR, Parachini EA. A preliminary randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. J Clin Psychiatry 2004; 65: 903–7
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd. ed., revised. Washington, DC: American Psychiatric Association, 1987
Anderson IM. Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 2000; 58(1): 19–36
Westenberg HG, Sandner C. Tolerability and safety of fluvoxamine and other antidepressants. Int J Clin Pract. 2006; 60(4): 482–91
Sachs GS. Bipolar mood disorder: practical strategies for acute and maintenance phase treatment. J Clin Psychopharmacol 1996; 16: 32–47S
Keck Jr PE, McElroy SL, Richt N, et al. What makes a drug a primary mood stabilizer? Mol Psychiatry 2002; 7Suppl. 1: S8–14
Ketter TA, Calabrese JR. Stabilization of mood from below versus above baseline in bipolar disorder: a new nomenclature. J Clin Psychiatry 2002; 63: 146–51
Grof P. Mood-stabilizers: the archeology of the concept [commentary]. Bipolar Disord 2003; 5: 453–5
Harris M, Chandran S, Chakraborty N, et al. Mood stabilizers: the archeology of the concept. Bipolar Disord 2003; 5: 446–52
Keck Jr PE, McElroy SL. Redefining mood stabilization. J Affect Disord 2003; 73: 163–9
Vieta E. Mood stabilization in the treatment of bipolar disorder: focus on quetiapine. Hum Psychopharmacol 2005; 20: 225–36
Mackinnon DF, Pies R. Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders. Bipolar Disord 2006; 8: 1–14
Gardner DL, Cowdry RW. Positive effects of carbamazepine on behavioural dyscontrol in borderline personality disorder. Am J Psychiatry 1986; 143: 519–22
Hollander E, Allen A, Lopez RP, et al. A preliminary double-blind, placebo-controlled trial of divalproex sodium in borderline personality disorder. J Clin Psychiatry 2001; 62: 199–203
Hollander E, Swann AC, Coccaro EF, et al. Impact of trait impulsivity and state aggression on divalproex versus placebo response in borderline personality disorder. Am J Psychiatry 2005; 162: 621–4
Frankenburg FR, Zanarini MC. Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder: a double-blind placebo-controlled pilot study. J Clin Psychiatry 2002; 63: 442–6
Tritt K, Nickel C, Lahmann C, et al. Lamotrigine treatment of aggression in female borderline-patients: a randomized, double-blind, placebo-controlled study. J Psychopharmacol 2005; 19: 287–91
Zanarini MC, Frankenburg FR, Gunderson JG. Pharmacotherapy of borderline outpatients. Compr Psychiatry 1988; 29: 372–8
Gardner DL, Cowdry RW. Pharmacotherapy of borderline personality disorder: a review. Psychopharmacol Bull 1989; 25: 515–23
Goldberg SC. Prediction of change in borderline personality disorder. Psychopharmacol Bull 1989; 25: 550–5
Jope RS. Anti-bipolar therapy: mechanism of action of lithium. Mol Psychiatry 1999; 4: 117–28
Stein DJ. Drug treatment of the personality disorders. Br J Psychiatry 1992; 161: 167–84
Delva NJ, Hawken ER. Preventing lithium intoxication: guide for physicians. Can Fam Physician 2001; 47: 1595–600
Fagiolini A, Kupfer DJ, Scott J, et al. Hypothyroidism in patients with bipolar I disorder treated primarily with lithium. Epidemiol Psychiatr Soc 2006; 15(2): 123–7
Van Gerven HA, Boer WH. Chronic renal function disorders during lithium use. Ned Tijdschr Geneeskd 2006; 150(31): 1715–8
Tang SW. Using lithium [letter]. Hong Kong Med J 2006; 12(4): 253
Ghaemi SN, Ko JY. Oxcarbazepine treatment of bipolar disorder: a review of the literature. Prim Psychiatry 2002; 9: 55–9
Denicoff KD, Meglathery SB, Post RM, et al. Efficacy of carbamazepine compared with other agents: a clinical practice survey. J Clin Psychiatry 1994; 55: 70–6
Hori A. Pharmacotherapy for personality disorders. Psychiatry Clin Neurosci 1998; 52: 13–9
Mattes J. Comparative effectiveness of carbamazepine and propranolol for rage outbursts. J Neuropsychiatry Clin Neurosci 1990; 2: 159–64
Kravitz HM, Fawcett J. Carbamazepine in the treatment of affective disorders. Med Sci Res 1987; 15: 1–8
Blumer D, Heibronn M, Himmelhoch J. Indications for carbamazepine in mental illness: atypical psychiatric disorder or temporal lobe syndrome? Compr Psychiatry 1988; 29: 108–22
Hachad H, Ragueneau-Majlessi I, Levy RH. New antiepileptic drugs: review on drug interactions. Ther Drug Monit 2002; 24(1): 91–103
Zubcevic S, Gavranovic M, Katica V, et al. Efficacy and tolerability of carbamazepine as the initial drug used in the treatment of epilepsy. Med Arch 2002; 56(3 Suppl. 1): 26–9
Emrich H. Studies with oxcarbazepine (Trileptal) in acute mania. Int Clin Psychopharmacol 1990; 5Suppl. 1: 83–8
Hellewell JS. Oxcarbazepine (Trileptal) in the treatment of bipolar disorders: a review of efficacy and tolerability. J Affect Disord 2002; 72Suppl. 1: S23–34
Hummel B, Waiden J, Stampfer R, et al. Acute antimanic efficacy and safety of oxcarbazepine in an open trial with an on-off-on design. Bipolar Disord 2002; 4: 412–7
Dietrich DE, Kropp S, Emrich HM. Oxcarbazepine in the treatment of affective and schizoaffective disorders. Fortschr Neurol Psychiatr 2003; 71: 255–64
Evins AE. Efficacy of newer anticonvulsant medications in bipolar spectrum mood disorders. J Clin Psychiatry 2003; 64Suppl. 8: 9–14
Ghaemi SN, Berv DA, Klugman J, et al. Oxcarbazepine treatment of bipolar disorder. J Clin Psychiatry 2003; 64: 943–5
Perugi G, Toni C, Frare F, et al. An open case study in Italy of oxcarbazepine, an effective mood stabilizer, in patients with drug resistant/intolerant bipolar I disorders [poster]. XVI Congress of European College of Neuropsychopharmacology; 2003 Sep 20–24; Prague
Raja M, Azzoni A. Oxcarbazepine versus valproate in mood and schizoaffective disorders. Int J Neuropsychopharm 2003; 6: 409–14
Benedetti A, Lattanzi L, Pini S, et al. Oxcarbazepine as add-on treatment in patients with bipolar manic, mixed or depressive episode. J Affect Disord 2004; 79: 273–7
Spina E, Perugi G. Antiepileptic drugs: indications other than epilepsy. Epileptic Disord 2004; 6: 57–75
Stahl SM. Anticonvulsants as mood stabilizers and adjuncts to antipsychotics: valproate, lamotrigine, carbamazepine, ad oxcarbazepine and actions at voltage-gated sodium channels. J Clin Psychiatry 2004; 65: 738–9
Yatham LN. Newer anticonvulsants in the treatment of bipolar disorder. J Clin Psychiatry 2004; 65Suppl. 10: 28–35
Gentry JR, Hill C, Malcolm R. New anticonvulsants: a review of applications for the management of substance abuse disorders. Ann Clin Psychiatry 2002; 14: 233–45
Leweke FM, Gerth CW, Koethe D, et al. Oxcarbazepine as an adjunct for schizophrenia. Am J Psychiatry 2004; 161: 1130–1
Bellino S, Paradiso E, Bogetto F. Oxcarbazepine in the treatment of borderline personality disorder: a pilot study. J Clin Psychiatry 2005; 66: 1111–5
Martinez W, Ingenito A, Blakeslee M, et al. Efficacy, safety, and tolerability of oxcarbazepine monotherapy. Epilepsy Behav 2006; 9(3): 448–56
McAuley JW, Biederman TS, Smith JC, et al. Newer therapies in the drug treatment of epilepsy. Ann Pharmacother 2002; 36(1): 119–29
Pol P. Enhancement of GABAergic inhibition: a mechanism of action of benzodiazepines, phenobarbital, valproate and L-cycloserine in the cat spinal cord. Electroencephalogr Clin Neurophysiol 1982; 36 Suppl.: 188–98
Wilcox JA. Divalproex sodium in the treatment of aggressive behaviour. Ann Clin Psychiatry 1994; 6: 17–20
Wilcox JA. Divalproex sodium as a treatment for borderline personality disorder. Ann Clin Psychiatry 1995; 7: 33–7
Stein DJ, Simeon D, Frenkel M, et al. An open trial of valproate in borderline personality disorder. J Clin Psychiatry 1995; 56: 506–10
Kavoussi RJ, Coccaro EF. Divalproex sodium for impulsive aggressive behavior in patients with personality disorder. J Clin Psychiatry 1998; 59: 676–80
Landy SH, McGinnis J. Divalproex sodium: review of prophylactic migraine efficacy, safety and dosage, with recommendations. Tenn Med 1999; 92: 135–6
Walia KS, Khan EA, Ko DH, et al. Side effects of antiepileptics: a review. Pain Pract 2004; 4(3): 194–203
Xie X, Hagan RM. Cellular and molecular actions of lamotrigine: possible mechanisms of efficacy in bipolar disorder. Neuropsychobiology 1998; 38: 119–30
Pinto OC, Akiskal HS. Lamotrigine as a promising approach to borderline personality: an open case series without concurrent DSM-IV major mood disorder. J Affect Disord 1998; 51: 333–43
Green B. Lamotrigine in mood disorders. Curr Med Res Opin 2003; 19: 272–7
Preston GA, Marchant BK, Reimherr FW, et al. Borderline personality disorder in patients with bipolar disorder and response to lamotrigine. J Affect Disord 2004; 79: 297–303
Faught E, Matsuo FU, Schachter S, et al. Long-term tolerability of lamotrigine: data from a 6-year continuation study. Epilepsy Behav 2004; 5(1): 31–6
Bowden CL, Brugger AM, Swann AC, et al. Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. JAMA 1994; 271(12): 918–24
Hirsch LJ, Weintraub D, Du Y, et al. Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy. Neurology 2004; 63(6): 1022–6
Teicher M, Glod C, Aaronson S, et al. Open assessment of the safety and efficacy of thioridazine in the treatment of patients with borderline personality disorder. Psychopharmacol Bull 1989; 25: 535–49
Kutcher S, Papatheodorou G, Reiter S, et al. The successful pharmacological treatment of adolescents and young adults with borderline personality disorder: a preliminary open trial of flupenthixol. J Psychiatry Neurosci 1995; 20: 113–8
Leone N. Response of borderline patients to loxapine and chlorpromazine. J Clin Psychiatry 1982; 43: 148–50
Serban G, Siegel S. Response of borderline and schizotypal patients to small doses of thiothixene and haloperidol. Am J Psychiatry 1984; 141(11): 1455–8
Goldberg SC, Schulz SC, Schulz PM, et al. Borderline and schizotypal personality disorder treated with low-dose thiothixene vs placebo. Arch Gen Psychiatry 1986; 43: 680–6
Montgomery SA, Montgomery D. Pharmacological prevention of suicidal behaviour. J Affect Disord 1982; 4(4): 291–8
Quieffin J, Brochet E, Gamerman G, et al. Ventricular arrhythmia following thioridazine poisoning. Ann Cardiol Angiol 1991; 40(4): 199–201
Lingjaerde O. Electrocardiographic changes, disturbances of cardiac rhythm, and sudden deaths during treatment with phenothiazine drugs. Tidsskr Nor Laegeforen 1967; 87(2): 90–4
Jarema M, Sartorius N. Treatment of bipolar disorders with second generation antipsychotic medications. Neuro Endocrinol Lett 2005; 26Suppl. 1: 5–7
Malhi GS, Berk M, Bourin M, et al. Atypical mood stabilizers: a typical role for atypical antipsychotics. Acta Psychiatr Scand Suppl 2005; 111(426): 29–38
Muzina DJ, Calabrese JR. Maintenance therapies in bipolar disorder: focus on randomized controlled trials. Aust N Z J Psychiatry 2005; 39: 652–61
Vieta E, Goikolea JM. Atypical antipsychotics: newer options for mania and maintenance therapy. Bipolar Disord 2005; 7Suppl. 4: 21–33
Conus P, Berk M, McGorry PD. Pharmacological treatment in the early phase of bipolar disorders: what stage are we at? Aust N Z J Psychiatry 2006; 40: 199–207
Frankenburg FR, Zanarini MC. Clozapine treatment of borderline patients: a preliminary study. Compr Psychiatry 1993; 34: 402–5
Benedetti F, Sforzini L, Colombo C, et al. Low dose clozapine in acute and continuation treatment of severe borderline personality disorder. J Clin Psychiatry 1998; 59: 103–7
Chengappa KN, Ebeling T, Kang JS, et al. Clozapine reduces severe self-mutilation and aggression in psychotic patients with borderline personality disorder. J Clin Psychiatry 1999; 60: 477–84
Kouzam HR, Donnelly NJ. Remission of selfmutilation in a patient with borderline personality during risperidone therapy. J Nerv Ment Dis 1997; 185: 348–9
Szighethy EM, Schulz SC. Risperidone in comorbid borderline personality disorder and dysthymia. J Clin Psychopharmacol 1997; 17: 326–7
Schulz SC, Camlin KL, Berry SA, et al. Olanzapine safety and efficacy in patients with borderline personality disorder and comorbid dysthymia. Biol Psychiatry 1999; 46: 1429–35
Hirose S. Effective treatment of aggression and impulsivity in antisocial personality disorder with risperidone. Psych Clin Neurosci 2001; 55: 161–2
Rocca P, Marchiaro L, Cocuzza E, et al. Treatment of borderline personality disorder with risperidone. J Clin Psychiatry 2002; 63: 241–4
Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study. J Clin Psychiatry 2001; 62: 849–54
Bogenschutz MP, Nurnberg HG. Olanzapine versus placebo in the treatment of borderline personality disorder. J Clin Psychiatry 2004; 65: 104–9
Soler J, Pascual JC, Barrachina J, et al. Double-blind, placebo-controlled study of dialectical behavior therapy plus olanzapine for borderline personality disorder. Am J Psychiatry 2005; 162: 1221–4
Nickel MK, Muehlbacher M, Nickel C, et al. Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study. Am J Psychiatry 2006; 163(5): 833–8
Bhana N, Foster RH, Olney R, et al. Olanzapine: an updated review of its use in the management of schizophrenia. Drugs 2001; 61: 111–61
Kufferle B, Tauscher J, Asenbaum S, et al. IBZM SPECT imaging of striatal dopamine-2 receptors in psychotic patients treated with the novel antipsychotic substance quetiapine in comparison to clozapine and haloperidol. Psychopharmacology 1997; 133: 323–8
Brecher M, Rak IW, Melvin K, et al. The longterm effect of quetiapine (‘Seroquel’) monotherapy on weight in patients with schizophrenia. Int J Psychiatry Clin Pract 2000; 4: 287–91
Kapur S, Zipursky R, Jones C, et al. A positron emission tomography study of quetiapine in schizophrenia: a preliminary finding of an antipsychotic effect with only transient high dopamine D2 receptor occupancy. Arch Gen Psychiatry 2000; 57: 553–9
Hilger E, Barnas C, Kasper S. Quetiapine in the treatment of borderline personality disorder. World J Biol Psychiatry 2003; 4: 42–4
Adityanjee A, Schulz SC. Clinical use of quetiapine in disease states other than schizophrenia. J Clin Psychiatry 2002; 63Suppl. 13: 32–8
Villeneuve E, Lemelin S. Open-label study of atypical neuroleptic quetiapine for treatment of borderline personality disorder: impulsivity as main target. J Clin Psychiatry 2005; 66: 1298–303
Perrella C, Carrus D, Costa E, et al. Quetiapine for the treatment of borderline personality disorder; an open-label study. Prog Neuropsychopharmacol Biol Psychiatry 2006; 31(1): 158–63
Bellino S, Paradiso E, Bogetto F. Efficacy and tolerability of quetiapine in the treatment of borderline personality disorder: a pilot study. J Clin Psychiatry 2006; 67(7): 1042–6
Kasper S, Lerman MN, McQuade RD, et al. Efficacy and safety of aripiprazole vs haloperidol for long-term maintenance treatment following acute relapse of schizophrenia. Int J Neuropsychopharmacol 2003; 6: 325–37
Potkin SG, Saha AR, Kujawa MJ, et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 2003; 60: 681–90
Chengappa KN, Suppes T, Berk M. Treatment of bipolar mania with atypical antipsychotics. Expert Rev Neurother 2004; 4Suppl. 2: 17–25
Centorrino F, Fogarty KV, Cimbolli P, et al. Aripiprazole: initial clinical experience with 142 hospitalized psychiatric patients. J Psychiatr Pract 2005; 11(4): 241–7
Fleischhacker WW. Aripiprazole. Expert Opin Pharmacother 2005; 6(12): 2091–101
Simon JS, Nemeroff CB. Aripiprazole augmentation for the treatment of partially responding and non responding patients with major depressive disorder. J Clin Psychiatry 2005; 66: 1216–20
Patkar AA, Peindl K, Mago R, et al. An open-label, raterblinded, augmentation study of aripiprazole in treatment-resistant depression. Prim Care Companion J Clin Psychiatry 2006; 8(2): 82–7
Mobascher A, Mobascher J, Schlemper V, et al. Aripiprazole pharmacotherapy of borderline personality disorder. Pharmacopsychiatry 2006; 39(3): 111–2
Nickel MK, Loew TH, Gil FP. Aripiprazole in the treatment of borderline patients: II. An 18-month follow-up. Psychopharmacology 2007; 191(4): 1023–6
Lambertenghi Deliliers G. Blood dyscrasias in clozapine-treated patients in Italy. Haematologica 2000; 85(3): 233–7
Weiden PJ. EPS profiles: the atypical antipsychotics are not all the same. J Psychiatr Pract 2007; 13(1): 13–24
Murashita M, Inoue T, Kusumi I, et al. Glucose and lipid metabolism of long-term risperidone monotherapy in patients with schizophrenia. Psychiatry Clin Neurosci 2007; 61(1): 54–8
Conley RR, Kelly DL, Nelson MW, et al. Risperidone, quetiapine, and fluphenazine in the treatment of patients with therapy-refractory schizophrenia. Clin Neuropharmacol 2005; 28: 163–8
Dunner DL. Safety and tolerability of emerging pharmacological treatments for bipolar disorder. Bipolar Disord 2005; 7: 307–25
Keck Jr PE, Marcus R, Tourkodimitris S, et al. A placebo-controlled, double-blind study of the efficacy and safety of aripiprazole in patients with acute bipolar mania. Aripiprazole Study Group. Am J Psychiatry 2003; 160: 1651–8
Nosè M, Cipriani A, Biancosino B, et al. Efficacy of pharmacotherapy against core traits of borderline personality disorder: meta-analysis of randomized controlled trials. Int Clin Psychopharmacol 2006; 21(6): 345–53
Binks CA, Fenton M, McCarthy L, et al. Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev 2006; (1): CD005653
Acknowledgements
No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review. All persons who made substantial contributions to this review met the criteria for authorship.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bellino, S., Paradiso, E. & Bogetto, F. Efficacy and Tolerability of Pharmacotherapies for Borderline Personality Disorder. CNS Drugs 22, 671–692 (2008). https://doi.org/10.2165/00023210-200822080-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00023210-200822080-00005