Medline Research on the Borderline Personality Disorder - BPD Medications

Written by Dr. Leland Heller

Psychotherapy with BPD patients: Aust N Z J Psychiatry 1999 Aug
Psychotherapy can help patients with the BPD.

Clozapine in BPD: Clin Psychol Rev 1999 Aug
Clozapine helped with severe self-mutilation, aggression and violence. (unfortunately clozapine is a very dangerous medication that requires very close follow up)

Substance abuse in hospitalized BPD patients: Compr Psychiatry 1999 Jul-Aug
This study from Greece showed that 76% of hospitalized BPD patients had a substance abuse problem.

Lamotrigine for treating BPD: J Affect Disorder 1998 Dec
75% of those with BPD showed improvement with lamotrigine (Lamictil). The authors argue that depression in BPD dysphoria is a different phenomenon than "unipolar depression."

Abnormal frontal brain lobes in BPD: J Affect Disord 1998 Sept
This study from South Korea showed smaller frontal lobe volume on brain MRI's.

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Spinal fluid chemicals in BPD: Neuropsychobiology 1998 Nov
This study from Sweden showed no difference from controls in some neurotransmitter metabolites.

2000-2002

Behav Res Ther 2000 Sep Dept of Psychiatry, University of Freiburg, Germany
"Evaluation of inpatient dialectical-behavioral therapy for borderline personality disorder - a prospective study."
Three month inpatient DBT treatment of 24 women with BPD were compared at admission and one month after discharge. Significant improvements in ratings of depression, dissociation, anxiety and overall stress. Significant reduction in parasuicidal acts (primarily cutting).

Br J Med Psychol 2000 Jun Kings College, London, UK
"Effectiveness of time-limited cognitive analytic therapy of borderline personality disorder: factors associated with outcome."
This study showed psychotherapy can help and could cease fitting DSM BPD criteria. Poorer outcome associated with stronger BPD symptoms, cutting, alcohol abuse and unemployment.

J Clin Psychiatry 2000 Jun Eating Disorders Clinic, Douglas Hospital, Verdun, Quebec, Canada
"Childhood abuse and platelet tritiated-paroxetine binding in bulimia nervosa - implications of borderline personality disorder."
Strong similar causes of bulimia and BPD, which frequently are comorbid. Serotonin function, including transporter malfunction, may be a part of both disorders.

Med Hypotheses 2000 Apr Argyll and Bute Hospital, Lochgilphead, UK
"The role of dysregulated amygdalic emotion in borderline personality disorder."
The authors propose that the disorder arises from impaired modulation of subcortical inputs to consciousness. "We hypothesize that the amygdaloid complex, and it's connections with thalamus, cingulate cortex and insular cortex are critical in the development and maintenance of the disorder. If this is the case, peptides such as galanin, somatostatin and cholecystokinin will be the most important neurotransmitters..."

Am J Psychiatry 2000 Apr Western Psychiatric Institute, U of Pittsburgh, PA (Soloff PH, Lynch KG)
"Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study."
"Hopelessness and impulsive aggression independently increase the risk of suicidal behavior in patients with borderline personality disorder and in patients with major depressive episode."

J Personal Disord 2000 Winter Western Psychiatric Institute and Clinic, U of Pittsburgh, Pittsburgh, PA
"Recent life events, social adjustment, and suicide attempts in patients with major depression and borderline personality disorder"
"Borderline disordered patients low on overall social adjustment were over 16 times more likely to have attempted suicide than patients diagnosed with major depression only. Recent life events may elevate suicide risk in groups already at high risk for suicide completion, whereas high levels of social adjustment may be protective against stress-related suicidal behavior."