The British Journal of Psychiatry (2010) 196: 4-12. doi: 10.1192/bjp.bp.108.062984
© 2010 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplement
Right arrow Submit an eLetter
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Lieb, K.
Right arrow Articles by Stoffers, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lieb, K.
Right arrow Articles by Stoffers, J. M.

REVIEW ARTICLE

Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials

Klaus Lieb, MD

Department of Psychiatry and Psychotherapy, University Medical Centre, Mainz, Germany

Birgit Völlm, MRCPsych, MD, PhD

Section of Forensic Mental Health, Division of Psychiatry, Institute of Mental Health, University of Nottingham, UK

Gerta Rücker, MSc

German Cochrane Centre, University Medical Centre Freiburg, Department of Medical Biometry and Statistics, Freiburg

Antje Timmer, MD, MSc, PhD

Institute of Epidemiology, Helmholtz Centre Munich, Neuherberg

Jutta M. Stoffers, MA

Department of Psychiatry and Psychotherapy, University Medical Centre, Mainz, and Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany

Correspondence: Correspondence: Dr Klaus Lieb, Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Untere Zahlbacher Str. 8, D–55131 Mainz, Germany. Email: Klaus.lieb{at}ukmainz.de

Declaration of interest

None.

Background

Many patients with borderline personality disorder receive pharmacological treatment, but there is uncertainty about the usefulness of such therapies.

Aims

To evaluate the evidence of effectiveness of pharmacotherapy in treating different facets of the psychopathology of borderline personality disorder.

Method

A Cochrane Collaboration systematic review and meta-analysis of randomised comparisons of drug v. placebo, drug v. drug, or single drug v. combined drug treatment in adult patients with borderline personality disorder was conducted. Primary outcomes were overall disorder severity as well as specific core symptoms. Secondary outcomes comprised associated psychiatric pathology and drug tolerability.

Results

Twenty-seven trials were included in which first- and second-generation antipsychotics, mood stabilisers, antidepressants and omega-3 fatty acids were tested. Most beneficial effects were found for the mood stabilisers topiramate, lamotrigine and valproate semisodium, and the second-generation antipsychotics aripiprazole and olanzapine. However, the robustness of findings is low, since they are based mostly on single, small studies. Selective serotonin reuptake inhibitors so far lack high-level evidence of effectiveness.

Conclusions

The current evidence from randomised controlled trials suggests that drug treatment, especially with mood stabilisers and second-generation antipsychotics, may be effective for treating a number of core symptoms and associated psychopathology, but the evidence does not currently support effectiveness for overall severity of borderline personality disorder. Pharmacotherapy should therefore be targeted at specific symptoms.


Related articles in BJP:

Highlights of this issue
Sukhwinder S. Shergill
BJP 2010 196: A2. [Full Text]  



This article has been cited by other articles:


Home page
 Br. J. PsychiatryHome page
J. Adil
Antipsychotics and borderline personality disorder
The British Journal of Psychiatry, April 1, 2010; 196(4): 332 - 332.
[Full Text] [PDF]

Home page
 Alcohol AlcoholHome page
J. Mutschler, M. Grosshans, A. Koopmann, D. Hermann, A. Diehl, K. Mann, and F. Kiefer
Supervised Disulfiram in Relapse Prevention in Alcohol-Dependent Patients Suffering From Comorbid Borderline Personality Disorder--A Case Series
Alcohol Alcohol., March 1, 2010; 45(2): 146 - 150.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. PsychiatryHome page
T. Kendall, R. Burbeck, and A. Bateman
Pharmacotherapy for borderline personality disorder: NICE guideline
The British Journal of Psychiatry, February 1, 2010; 196(2): 158 - 159.
[Full Text] [PDF]

eLetters:

Read all eLetters

Cochrane guidelines for treatment of BPD
Joel Paris
BJP Online, 10 Feb 2010 [Full text]
Untitled
Jawad Adil
BJP Online, 27 Jan 2010 [Full text]
response to Dr. Adil
Jutta Stoffers, et al.
BJP Online, 10 Feb 2010 [Full text]
Re: Cochrane guidelines for treatment of BPD
Jutta Stoffers, et al.
BJP Online, 26 Feb 2010 [Full text]
Re: Cochrane guidelines for treatment of BPD
Jutta M Stoffers, et al.
BJP Online, 2 Jun 2010 [Full text]