Traynor Jenna M, Roberts Daniel E, Ross Stephen, Zeifman Richard, Choi-Kain Lois
Gunderson Personality Disorders Research Institute, McLean Hospital, Belmont, Massachusetts (Traynor, Choi-Kain); Faculty of Medicine, Harvard Medical School, Boston (Traynor, Choi-Kain); Langone Center for Psychedelic Medicine, Department of Psychiatry, New York University Grossman School of Medicine, New York (Roberts, Ross); Department of Psychology, Ryerson University, Toronto (Zeifman); Centre for Psychedelic Research, Imperial College London, London (Zeifman).
Focus (Am Psychiatr Publ). 2022 Oct;20(4):358-367. doi: 10.1176/appi.focus.20220056. Epub 2022 Oct 25.
Borderline personality disorder is a complex psychiatric disorder with limited treatment options that are associated with large heterogeneity in treatment response and high rates of dropout. New or complementary treatments for borderline personality disorder are needed that may be able to bolster treatment outcomes. In this review, the authors comment on the plausibility for research on 3,4-methylenedioxymethamphetamine (MDMA) used in conjunction with psychotherapy for borderline personality disorder (i.e., MDMA-assisted psychotherapy [MDMA-AP]). On the basis of the promise of MDMA-AP in treating disorders overlapping with borderline personality disorder (e.g., posttraumatic stress disorder), the authors speculate on initial treatment targets and hypothesized mechanisms of change that are grounded in prior literature and theory. Initial considerations for designing MDMA-AP clinical trials to investigate the safety, feasibility, and preliminary effects of MDMA-AP for borderline personality disorder are also presented.
边缘型人格障碍是一种复杂的精神疾病，治疗选择有限，治疗反应存在很大异质性，且脱落率很高。需要新的或补充性的边缘型人格障碍治疗方法，以改善治疗效果。在这篇综述中，作者评论了3,4-亚甲基二氧甲基苯丙胺（摇头丸）联合心理治疗用于边缘型人格障碍（即摇头丸辅助心理治疗[MDMA-AP]）研究的合理性。基于MDMA-AP在治疗与边缘型人格障碍重叠的疾病（如创伤后应激障碍）方面的前景，作者推测了基于先前文献和理论的初始治疗靶点及假定的改变机制。还介绍了设计MDMA-AP临床试验以研究其对边缘型人格障碍的安全性、可行性和初步疗效的初步考虑因素。
