* Emotional symptoms: topiramate, lamotrigine, dipropionate, haloperidol, aripiprazole, olanzapine, quetiapine sustained release, omega-3 fatty acids and amitriptyline;
* Impulse control problems: topiramate, lamotrigine, aripiprazole and omega-3 fatty acids;
* Psychotic symptoms: aripiprazole, olanzapine and quetiapine sustained release.
Borderline Personality Disorder (BPD) is a highly destructive mental disorder. Evidence shows that 15-20% of psychiatric inpatients and outpatients suffer from the disease, and the incidence of men and women is similar. At present, no drug has been approved for the treatment of BPD, however, 80% of BPD patients are regularly medication, of which more than 40% use at least three drugs.
Dr. Dimitry Francois et al. Reviewed randomized controlled trials (RCTs) of drug therapy for BPD, while open trials, case reports, case groups, and RCTs excluded from the 2010 Cochrane review were not included. The following is the main points:
* Fluoxetine: A 13-week study of 22 patients with BPD or BPD traits explored the efficacy of fluoxetine against anesthetizing patients (fluoxetine n = 13, placebo n = 9), study Drugs were starting at 20 mg / d and titrated to 60 mg / d. The results showed that the anger mood was significantly reduced in the fluoxetine group compared with the placebo group, but the improvement in depression was not significant.
In another 12-week RCT, the investigators tried to use fluoxetine to treat BPD on the basis of dialectical behavioral therapy (DBT), 9 of whom were treated with 40 mg / d fluoxetine and 11 in combination Agent. The results showed that there was no significant difference between the two groups before and after treatment.
In a double-blind, placebo-controlled study of 38 BPD female patients, subjects were treated with fluvoxamine (mean dose 150 mg / day) for 6 weeks followed by a 6-week blind Semi-cross-test period and 12-week open label follow-up. The results showed that fluvoxamine significantly improved the patient’s rapid mood change (SMD -0.646), but there was no significant difference in impulses and aggressiveness; * sertraline: a study of BPD comorbid heroin dependent patients, Compared the efficacy of sertraline 50-100 mg / d with olanzapine 5-10 mg / d in the treatment of BPD. During the 12-week treatment, both drugs improved overall depression, anxiety, interpersonal sensitivity, aggression, compulsive and somatic symptoms, with sertraline in improving depression, interpersonal sensitivity and obsessive-compulsive symptoms Has an advantage, and olanzapine in anxiety, aggressive and paranoid symptoms prevail. There were no significant differences between the two drugs in improving somatization symptoms. Olanzapine also improves the patient’s self-injurious behavior.
Tricyclic antidepressants (TCAs)
* Amitriptyline: In a five-week, double-blind RCT, the investigators examined the efficacy of amitriptyline and haloperidol in the treatment of 90 hospitalized patients with BPD. The results showed that amitriptyline significantly improved the depressive symptoms (SMD, 0.596) in BPD patients, with an average dose of 149 mg / d.
Monoamine oxidase inhibitors (MAOIs)
* Benzhydrazine: In a five-week, double-blind, placebo-controlled study, the researchers compared phenylethylhydrazine (mean dose 60 mg / d), haloperidol and placebo for 108 patients with BPD covariance atypical depression Of patients. The results show that phenylhydrazine has an advantage in improving depression, margin traits and anxiety. A comparison of Pair-wise between drugs and placebo suggests that phenylethylhydrazine can significantly improve anger and hostility in BPD patients, but is ineffective for atypical depressive symptoms.