Ripoll Luis H
Assistant Professor, Dept of Psychiatry, The Mount Sinai School of Medicine, New York, New York, USA.
Dialogues Clin Neurosci. 2013 Jun;15(2):213-24. doi: 10.31887/DCNS.2013.15.2/lripoll.
The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning.
本文概述了边缘型人格障碍(BPD)心理药物治疗的现有最佳证据。BPD的定义是身份认同和人际功能障碍,患者报告了潜在的药物治疗靶点,如冲动、攻击、短暂的精神病性和分离症状,以及难治性情感不稳定。最近很少有关于BPD心理药物治疗的随机对照试验发表,尽管多项综述一致认为特定的抗惊厥药、非典型抗精神病药和ω-3脂肪酸补充剂有效。与情感或其他人际症状相比,药物在改善冲动攻击性方面有更有力的证据。未来的研究策略将集中在神经肽药物和对5-羟色胺2A受体具有更高特异性的药物的潜在作用,以及优化循证心理治疗和心理药理学的联合应用,以改善BPD患者的整体功能。