Hraniční porucha osobnosti

Rozdíly v mentální bolesti a znacích deprese mezi depresí pacientů s BPD a DD/MDD Silk, 2010; Fertuck, 2016
Mělo by být zohledněno při stanovení diagnózy bipolární porucha vs BPD.

Abilify (aripiprazole) Nickel, 2006 jako alternativa nebo doplněk ke quetiapinu

Stabilizátor nálad topiramate úbytek váhy (jako kompenzace ke quetiapinu; další viz Ripoll, 2013) Loew, 2006; Lieb, 2009; Joubert, 2008; case report Bruno, 2009 aripiprazole + tipiramate; Crawford, 2014 diskutuje užití nebo neužití u BPD

Topiramate Target dose 200-250 mg/d Improvements in anger, anxiety, interpersonal dysfunction, self-reported quality of life. Associated with weight loss.

Shrnutí možností a úspěšnosti medikace BPD Ripoll, 2013


Není u BPD rizikový alprazolam? Zvláště u pacientek s historií sebepoškozování/sebevražedných myšlenek? Gardner, 1985; Cowdry, 1988

“Alprazolam and other benzodiazepines are strongly discouraged in treating BPD, due to risks of worsening impulsivity and suicidality.78 BPD patients may be at increased risk for benzodiazepine dependence, in an effort to self-medicate chronic, refractory affective symptoms by fostering dissociative symptomatology.” (Ripoll, 2013)


Další možnosti:

Elektrokonvulzivní terapie u BSD Baniasad, 2016 (vliv na mood symptoms: sadness, anxiety and restlessness and feeling of absurdity)

Naltrexon opiat receptor antagonist Schmahl, 2012, Meiser, 2015  “Acute oral administration of naltrexone–an opioid antagonist–has been shown to curb self injury. Self injury in people, especially females, with borderline personality disorder is common. In most people, self injury, such as cutting the body, elicits pain. In people with borderline personality disorder, however, this self injury can be addictive and evokes euphoria, presumably because of an escalation in beta endorphins, perhaps reflecting dysfunction in the opioid system. The naltrexone might preclude this escalation in beta endorphins and has been shown to curb self injury at least in the context of other disorders such as mental retardation (e.g., Symons, Thompson, & Rodriguez, 2004).

Similarly, as Bandelow, Schmahl, Falkai, and Wedekind (2010) maintain, eating disorders, reported in over 50% of patients with borderline personality disorder (Zanarini, Reichman, Frankenburg, Reich, & Fitzmaurice, 2009), can also be ascribed to dysfunction of the opioid system. Binge eating could represent an attempt to stimulate the reward or endogenous opioid system. Anorexia nervosa and food restriction, paradoxically, might represent a form of deprivation or pain that also stimulates the endogenous opioid system. Consistent with this premise, fasting in humans has been shown to increase beta endorphins (Komaki, Tamai, Sumioki, Mori, Kobayashi, Mori, Mori, & Nakagawa, 1990). In addition, many studies indicate that dysfunction in the endogenous opioid system coincides with eating disorders (for a review, see Bandelow, Schmahl, Falkai, & Wedekind, 2010).”