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Psychopharmaceuticalsby Sidney Wolfe, M.D., editor
Excellent product information on all the drugs used to treat mental health disorders.
Packaging information, interaction warnings, articles on what the manufacturer doesn't tell you.
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A great active message board for all discussion of experiences relating to psychopharmaceuticals.
Ask your questions, or just lurk for some information on what others have gone through. Responsibly owned & moderated by University of Chicago's Robert Hsiung, MD PhD, so misinformation quickly gets weeded out.
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Winds of Change 'Ask the Pharmacist' archives
A compilation of questions/answers from the Winds of Change Bipolar online support group.
Medication Discussions
American Psychiatric
Association:PSYCHOPHARMACOLOGICAL TREATMENT ALGORITHMS
for the Treatment of Patients With Borderline Personality Disorder
154th Meeting of the American Psychiatric Association
5-10 May 2001, New Orleans, Louisiana, USA
Reported by Emma Patten-Hitt
"Dr Kenneth R. Silk presented data regarding medication
choices made by physicians to treat patients with BPD. No
specific medication is indicated for the treatment of
BPD, Silk said. We have very little data with respect to
whether these medications are working, and no data about
their effectiveness over the long term, he said. Out of
114 questionnaires given to physicians, 85 were returned
(74%). Almost 50% of respondents said they would use an
SSRI as their first-choice medication if no other
medication were available, 20% would choose a
mood-stabilizer, 20% a non-SSRI antidepressant, and 10%
an antipsychotic. As their second choice, 37% of the
respondents said they would select an antipsychotic, 33%
chose mood stabilizers, 13% chose SSRIs, 9% chose
non-SSRI antidepressants, and 5% chose anxiolytics. A
total of 77% said that they selected medication because
it made valid clinical sense, and gender and age of the
clinician influenced the category of most preferred
medication."
Psychopharmacology of borderline personality disorder YP Raj, June 2004
łThis evidence-based review examines the most recent randomized controlled trials of psychopharmacology in the treatment of borderline personality disorder, with a goal of highlighting the most promising pharmacotherapy for use in current clinical practice, as well as for future large-scale research testing. The results and limitations of the randomized controlled trial data are presented along with case vignettes illustrating the complexity of the disorder and the heterogeneity of its treatment. To date, there is at least some evidence-based support for the use of antipsychotics (conventional and atypical), monoamine oxidase inhibitors, serotonin reuptake inhibitors, and omega-3 fatty acids in the treatment of borderline personality disorder.˛
IMAGES OF TREATMENT: Hope for Healing
Compelling SPECT brain scans before/after medication, from Dr. Daniel Amen's clinic.
Pharmacotherapy of borderline personality disorder
by RM Hirschfeld, 1997
"Borderline personality disorder can be classified into
four groups of symptoms: affective, impulsive,
ego-interpersonal, and psychotic. Pharmacotherapy of
borderline personality disorder should be directed at the
severity of the symptoms in each of these groups, rather
than by the presence or absence of the overall syndrome."
ACNP Focuses on Recent Treatment Advances
by Frank Ayd Jr., M.D, 1999
Pharmacotherapy for personality disorders
by Hori A., 1998
Do patients with borderline personality disorder belong to the bipolar spectrum?
by Deltito J, Martin L, Riefkohl J, Austria B, Kissilenko A, Corless C Morse P., 2001, Anxiety and Mood Disorders Program, The New York Hospital-Cornell Medical Center, Westchester Division
"Background: This report examines clinical indicators for
bipolarity in a cohort of patients suffering from
Borderline Personality Disorder (BPD). Methods: The study
was conducted in the Cornell-Westchester Hospital, famed
for its expertise in BPD. Through the use of both open
clinical interviews and standardized diagnostic
interviews (SCID), borderline patients were examined for
evidence of bipolarity by five indicators: history of
spontaneous mania, history of spontaneous hypomania,
bipolar temperaments, pharmacologic response typical of
bipolar disorder, and a positive bipolar family history.
Results: Depending on the level of bipolar disorder from
the most rigorous (mania) to the most 'soft' (bipolar
family history), between 13 and 81% of borderline
patients showed signs of bipolarity. Based on what the
emerging literature supports as rigorously defined
bipolar spectrum (bipolar I and II), we submit that at
least 44% of BPD belong to this spectrum; adding
hypomanic switches during antidepressant pharmacotherapy,
the rate of bipolarity in BPD reaches 69%. As expected
from this formulation, most responded negatively to
antidepressants (e.g. hostility and agitation) and
positively to mood stabilizers. Limitations: Small sample
size and retrospective gathering of data on treatment
response. Conclusion: Patients with BPD more often than
not exhibit clinically ascertainable evidence for
bipolarity and may benefit from known treatments for
Bipolar Spectrum Disorders. Large scale, systematic
treatment studies with mood stabilizers are indicated."
BPD: Recent Advances in Biological
Therapiesby Richard Moskovitz, MD, author of Lost in the Mirror
Symptom-focussed drug therapy in
borderline personality disorderAbstract of a recent study by Schmahl C, Bohus M (prominent German BPD researchers), 2001
Medication used to treat borderline personality disorder
by Carl Salzman, M.D., 1997
How I treat the Borderline Personality Disorder and Why
by Leland Heller, M.D.
MOOD DISORDERS: SOMATIC TREATMENT
by Robert M. Post, M.D.
This is an incredibly comprehensive, very well-done online book chapter on the pharmaceutical treatment of mood & related disorders.
Pharmacological treatment of
personality dimensions: Symptom-specific treatments for
cognitive-perceptual, affective, and impulsive-behavioral
dysregulationby Paul H. Soloff, M.D.
This excellent set of charts is invaluable for helping figure out which pharmacological treatment might be best for your BP's symptomology.
Posttraumatic Stress Disorder in
Childrenby Roy Lubit, MD, PhD, October 2001
Provides an excellent overview, as well as a detailed summary of the medications used in treating PTSD in children. Article may require registration (it's free) to read.
Medication: The Foundation of Recovery
by Edward G. Francell, Jr.
Assessing Neuropsychiatric Issues
by Thomas Croke 1998
Informative article on when to consider neurological (brain) damage as causal for BPD-like symptoms
Pregnancy, maternity and the manic depressive disorder A practical guideline for patients, partners and others
This guide is for those with Bipolar Disorder, but has solid information on the planning of pregnancy and the use of antidepressants and mood stabilizers (prozac, lithium) during pregnancy.
AFFECTIVE DISORDERS AND PREGNANCY,
Excerpts from a report on a presentationby Sylvia Simpson, M.D. Same topic as the above, an even better article.
Straight Talk About Psychiatric Medications for Kids
by Timothy Wilens. Recommended for coming to terms with the decision to medicate children.
The Texas Children's Medication Algorithm Project: Report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder
Extremely informative and helpful. November, 1999
Is electroconvulsive
therapy effective for the depressed patient with comorbid
borderline personality disorder?2001: Review of studies on BPD and ECT show that ECT does not effectively treat BPD, although it can treat comorbid depression.
Specific Medication Trials
Current Industry-Sponsored Clinical Trials
Current Government-Sponsored Clinical Trials
Learn more here about the various classes and neurological functions of antidepressants
SSRI Anti-Depressants (Selective Serotonin Reuptake
Inhibitors)
Impulsive aggression in borderline personality disorder
by Goodman M, New A., Feb 2000
Abstract of an article discussing the various serotonin-enhancing medications used for various symptoms of BPD.
A Comparison of Fluoxetine (Prozac) and Sertraline (Zoloft) in Treating Four Target Symptoms of the Borderline Personality Disorder
by Leland M. Heller, M.D.
A summary of Heller's work using SSRIs to treat BPD.
Efficacy and safety of paroxetine (Paxil) treatment for chronic PTSD: a fixed-dose, placebo-controlled study
Abstract of a positive study by Marshall RD, Beebe KL, Oldham M, Zaninelli R., 2001
Spotlight on fluvoxamine (Luvox) in anxiety disorders in children and adolescents
Research by Cheer SM, Figgitt DP., 2002.
Investigates proper dosing for ages 12-17.
Fluoxetine (Prozac) Treatment for Obsessive-Compulsive Disorder in Children and Adolescents: A Placebo-Controlled Clinical Trial
by Daniel A. Geller, July, 2001
Controversial study links self-harm to SSRIs
A review in March, 2001, of a study that caused a stir. Contradictions to the results are discussed.
Atypical Antipsychotics
Examining the Effects of Atypical Antipsychotics on Cognitive Function
Promising results from a study conducted in 2000.
Treatment of Borderline Personality Disorder with Risperidone [Risperdal]
Detailed study by Paola Rocca, M.D., Livio Marchiaro, M.D., Elena Cocuzza, M.D. and Filippo Bogetto, M.D., 2002
Olanzapine safety and efficacy in patients with borderline personality disorder and comorbid dysthymia
Results of a 1999 study on Olanzapine (Zyprexa) showed that "[...] patients treated with olanzapine showed statistically significant reduction in self-rated and clinician-rated scales. Symptoms associated with BPD and dysthymia were among those to be substantially reduced."
Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study
Zanarini MC, Frankenburg FR., 2001
SSRIs, Neuroleptics May Help Personality Disorder
by Timothy F. Kirn, eClinical Psychiatry News, April 2001
You may have to register (it's free) to gain access to this article.
Clozapine reduces severe self-mutilation and aggression in psychotic patients with borderline personality disorder
Abstract of a 1999 study by KN Chengappa, et al.
Risperidone and Prolactin Response in BPD Patients
Review of studies by Frank J. Ayd Jr., M.D., 1999
Mood Stabilizers/Anticonvulsants (also function as
mood stabilizers)
Mood Stabilizers and Mood Swings: In Search of a Definition
by Simon Sobo, M.D., Psychiatric Times, October 1999
Borderline personality disorder in patients with bipolar disorder and response to lamotrigine
by Preston GA, Marchant BK, Reimherr FW, Strong RE, Hedges DW., April 2004
Lamotrigine as a promising approach to borderline personality
by O.C. Pinto and H.S. Akiskal
A preliminary double-blind, placebo-controlled trial of divalproex sodium [Depakote] in borderline personality disorder
by Hollander E, Allen A, Lopez RP, Bienstock CA, Grossman R, Siever LJ, Merkatz L, Stein DJ., 2001
An open trial of valproate [Depakene] in borderline personality disorder
by Stein DJ, Simeon D, Frenkel M, Islam MN, Hollander E, 1995
Valproate Therapy for Borderline Personality Disorder
1999
Valproate Therapy for Borderline Personality Disorder
1999
Paroxetine hcl and lithium in the treatment of ptsd with comorbid depressive disorder recurrent type
Andrei Novac, M.D.
Divalproex sodium for impulsive aggressive behavior in patients with personality disorder
by Kavoussi RJ, Coccaro EF, 1998
The pathophysiology and treatment of chronic fatigue syndrome and other neurosomatic disorders: cognitive therapy in a pill
Jay A. Goldstein, M.D., 2000
This report suggests the effectiveness of treating CFIDS and other neurosomatic conditions with Gabapentin (Neurontin). Its also got a great summary of proposed etiology of these disorders.
Opioid Antagonists (anti-addictive medications)
Naltrexone as a treatment
of self-injurious behavior - a case report2001: Positive report on treatment of self-injury using Naltrexone (Revia).
Naltrexone in the Treatment of Dissociative Disorders - Reflections with Regard to a Comprehensive Therapeutic Concept of Borderline Disorders
by Thomas Bolm, Theo Piegler, 2001
(Volltext auf Deutsch erhaeltlich)
Others: Newer and Experimental
Essential fatty acids and their role in the treatment of impulsivity disorders
by Brian Hallahan and Malcolm R. Garland, Oct 2004
"The psychiatric conditions of attention-deficit hyperactivity disorder and borderline personality disorder as well as the phenomena of deliberate self-harm and violence have been ameliorated by the supplementation of EFAs in a number of recent clinical trials. This paper summarises the burgeoning clinical and basic research indicating the existence of significant deficits of EFAs in impulsivity disorders and the supplementation studies of EFAs in these diverse conditions, all of which remain a major therapeutic challenge. "
Omega-3 Fatty Acid Treatment of Women With Borderline Personality Disorder: A Double-Blind, Placebo-Controlled Pilot Study
by Mary C. Zanarini, Ed.D., and Frances R. Frankenburg, M.D., 2003
"The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder."
Omega-3 Fatty Acids Evaluated for Bipolar Disorder
by by Arline Kaplan , Psychiatric Times, December, 1999
Recent studies on Omega-3 fatty acids suggest that this supplement has an effect on stabilizing mood in various psychiatric disorders.
Treatment of Depression With Antiglucocorticoid Drugs
Full-text study by Owen M. Wolkowitz, MD and Victor I. Reus, MD, 1999
This exciting new research demonstrates that antiglucocorticoid hormonal therapy (such as with the RU486 'abortion pill') may be extremely effective in reducing the psychotic and obsessive facets of depression in conjunction with a standard SSRI antidepressant.
"Across the 11 studies of antiglucocorticoid treatment of major depression, some degree of antidepressant response was noted in 67% to 77% of patients. Antidepressant or antiobsessional effects of antiglucocorticoid augmentation of other psychotropic medications have also been noted in small studies of patients with treatment-resistant depression, obsessive-compulsive disorder, and schizoaffective disorder or schizophrenia."
'Substance P' Antagonist Relieves Depression
by Kenneth J. Bender, Psychiatric Times, November, 1998
Open study of the catechol-O-methyltransferase inhibitor tolcapone in major depressive disorder
by Fava M, Rosenbaum JF, et al, 1998
Programs for those in need of financial assistance for
prescription medications
Free Meds and Solutions
A new site put together by consumers with many tips and links. They keep an updated list of patient assistance programs, should the links below not work.
Prescription Drug Reimbursement
Assistance Progams at Major Pharmaceutical
ManufacturersFree & Low-Cost MedsGreat consumer site with instructions & tons of contacts/links
Directory of Prescription Drug Patient Assistance Programs
The Medication Connection
The Medicine Program
This Page Last Updated: August 30, 2004
Helen's World of BPD Resources