Zanarini Mary C
Department of Psychiatry, Harvard Medical School, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Curr Psychiatry Rep. 2004 Feb;6(1):66-70. doi: 10.1007/s11920-004-0041-9.
Pharmacotherapy is a very common form of treatment for borderline personality disorder or its concomitant disorders. This paper reviews all the open-label and placebo-controlled trials of second generation medications studied in samples of well-defined borderline patients. Most of the medications studied in double-blind, placebo-controlled trials were efficacious. Most of these medications were also useful in treating symptoms of affective dysregulation and impulsive aggression, which have been suggested to be the core dimensions of psychopathology of underlying borderline personality disorder. Taken together, the results of these studies suggest that the choice of medication can be guided as much by tolerability and safety as by symptom presentation. It also suggests that the common practice of polypharmacy, which has no empiric support, may be unnecessary for most patients with borderline personality disorder.
药物治疗是边缘性人格障碍或其伴发疾病非常常见的一种治疗形式。本文回顾了在明确诊断为边缘性人格障碍患者样本中研究的第二代药物的所有开放标签试验和安慰剂对照试验。在双盲、安慰剂对照试验中研究的大多数药物都是有效的。这些药物中的大多数在治疗情感失调和冲动攻击症状方面也很有用，而这些症状被认为是潜在边缘性人格障碍精神病理学的核心维度。综合来看，这些研究结果表明，药物的选择可以像根据症状表现一样，由耐受性和安全性来指导。这也表明，对大多数边缘性人格障碍患者来说，没有经验支持的联合用药的常见做法可能是不必要的。
