Fortschr Neurol Psychiatr 2013; 81(8): 437-443
DOI: 10.1055/s-0033-1335385
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Pharmakotherapie der Borderline-Störung: Praxis und Studienlage

Pharmacological Treatment for Patients with Borderline Personality Disorder: Practice and Study Results
D. Schwerthöffer
,
J. Bäuml
,
M. Rentrop
Further Information

Publication History

Publication Date:
12 August 2013 (online)

Zusammenfassung

Viele Patienten mit einer Borderline-Störung (BPS) werden unter anderem pharmakologisch behandelt. Da es hierzu nur wenige – teilweise widersprüchliche – Behandlungsleitlinien gibt und bei der BPS oft wechselnde Symptome im Vordergrund stehen, kommt es dabei zum Einsatz verschiedener Substanzen. Die Übersichtsarbeit fasst Behandlungspraxis und Studienergebnisse zum Einsatz von Psychopharmaka bei BPS zusammen.

Abstracts

Many patients with borderline personality disorder (BPD) receive pharmacological treatment. On account of the few treatment guidelines and the often changing symptoms, different substances are used. The present article summarises treatment-practice and study results concerning the pharmacological treatment of BPD.

 
  • Literatur

  • 1 Mercer D, Douglass AB, Links PS. Meta-Analyses of Mood-Stabilizers, Antidepressants and Antipsychotics in the treatment of Borderline Personality Disorder: Effectiveness for Depression and Anger symptoms. J Personality Disord 2009; 23: 156-174
  • 2 Lieb K, Völlm B, Rücker G et al. Pharmacotherapy for Borderline Personality Disorder: Cochrane systematic review of randomised trials. Brit J Psych 2010; 196: 4-12
  • 3 Lieb K, Zanarini MC, Schmahl C et al. Borderline Personality Disorder. Lancet 2004; 364: 453-461
  • 4 Normann C, van Calcer D, Voderholzer U et al. Off-label-Indikationen in der Psychopharmakotherapie. Nervenarzt 2003; 74: 815-823
  • 5 Rentrop M, Reicherzer M, Bäuml J. Psychoedukation Borderline Störung. 1. Aufl. München: Elsevier Urban&Fischer; 2006
  • 6 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. 5. Aufl. Springer Verlag: Heidelberg; 2005
  • 7 Rentrop M, Martius P, Bäuml J et al. Patients with borderline personality disorder not participating in an RCT: are they different?. Psychopathology 2010; 43: 369-372
  • 8 Montgomery D, Roy D, Montgomery S et al. Mianserin in the prophylaxis of suicidal behaviour: a double-blind placebo controlled trial. In Proceedings of the 10th International Congress of Suicide Prevention and Crisis Interv. Pergamon; 1981: 786-790
  • 9 Soloff PH, George A, Nathan S et al. Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. J Clin Psychopharmacol 1989; 9: 238-246
  • 10 Soloff PH, Cornelius J, George A et al. Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch Gen Psychiatry 1993; 50: 377-385
  • 11 Salzmann C, Wolfson AN, Schatzberger A et al. Effect of Fluoxetin on anger in symptomatic volunteers with borderline personality disorder. J Clin Psychopharmacol 1995; 15: 23-29
  • 12 Rinne T, van der Brink W, Wouter L et al. SSRI treatment of borderline personality disorder: a randomised, placebo-controlled clinical trial for female patients with borderline personality disorder. Am J Psychiatry 2002; 159: 2048-2054
  • 13 Simson SimpsonEB, Yen S, Costello E et al. Combined dialectical behavior therapy and fluoxetin in a treatment of borderline personality disorder. J Clin Psychiatry 2004; 65: 379-385
  • 14 Zanarini MC, Frankenburg FR, Parachini EA. A preliminary, randomized trial of fluoxetin, olanazapin, and the olanzapine-fluoxetine combination in women with borderline personality disorder. J Clin Psychiatry 2004; 65: 903-907
  • 15 Herpertz SC, Zanarini M, Schulz CS et al. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment for Personality Disorders. World J Bio Psychiatry 2007; 8 (04) 212-244
  • 16 Knappich M, Rentrop M. Pharmacotherapy in the treatment of Patients with Borderline Personality Disorder. Results of a survey among psychiatrists in private practices. European Psych [under reviewing]
  • 17 Aigner M, Treasure J, Kaye W et al. WFSBP Task Force On Eating Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of eating disorders. World J Biol Psychiatry 2011; 12: 400-443
  • 18 Abraham PF, Calabrese JR. Evidenced-based pharmacologic treatment of borderline personality disorder: a shift from SSRIs to anticonvulsants and atypical antipsychotics?. J Affect Disord 2008; 111: 21-30
  • 19 Montgomery SA, Montgomery DB, Janianthi RS et al. Maintenance therapy in repeat suicidal behaviour: a placebo controlled trial. In Procedings of the 10th International Congress of Suicide Prevention and Crisis Intervention. International Association for Suicide Prevention; 1979: 227-229
  • 20 Goldberg SC, Schulz SC, Schulz PM et al. Borderline and schizotypal personality disorders treated with low-dose thiothixene vs. placebo. Arch Gen Psychiatry 1986; 43: 680-686
  • 21 Soloff PH, George A, Nathan S et al. Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. J Clin Psychopharmacol 1989; 9: 238-246
  • 22 Soloff PH, Cornelius J, George A et al. Efficacy of phenezine and haloperidol in borderline personality disorder. Arch Gen Psychiatry 1993; 50: 377-385
  • 23 Zanarini MC, Frankenburg FR. Olanzapine treatment of female borderline personality disorder patients: a double-blind, placebo-controlled pilot study. J Clin Psychiatry 2001; 62: 849-854
  • 24 Bogenschutz MP, Nurnberg HG. Olanzapine versus placebo in the treatment of borderline personality disorder. J Clin Psychiatry 2004; 65: 104-109
  • 25 Zanarini MC, Frankenburg FR, Parachini EA. A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. J Clin Psychiatry 2004; 65: 903-907
  • 26 Soler J, Pascual JC, Campins J et al. Double-blind, placebo-controlled study of dialectical behaviour therapy plus olanzapine for borderline personality disorder. Am J Psychiatry 2005; 162: 1221-1224
  • 27 Nickel MK, Muehlbacher M, Nickel C et al. Aripiprazol in the treatment of patients with borderline personality disorder: a double blind, placebo controlled study. J Clin Psychiatry 2006; 1663: 833-838
  • 28 Schulz SC, Zanarini MC, Bateman A et al. Olanzapine for the treatment of borderline personality disorder: variable dose 12week randomised double-blind placebo-controlled study. Br J Psychiatry 2008; 193: 485-492
  • 29 Linehan MM, McDavid JD, Brown MZ et al. Olanzapine plus dialectical behavior therapy for women with high irritability who meet criteria for borderline personality disorder: a double-blind, placebo-controlled pilot study. J Clin Psychiatry 2008; 69: 999-1005
  • 30 Pascual JC, Soler J, Puigdemont D et al. Ziprasidone in the treatment of borderline personality disorder: a double-blind, placebo-controlled, randomized study. J Clin Psychiatry 2008; 69: 603-608
  • 31 Feurino L, Kenneth SilkKR. State of the Art in the Pharmacologic Treatment of Borderline Personality Disorder. Curr Psychiatry Rep 2011; 13: 69-75
  • 32 De la Fuente JM, Lotstra F. A trial of carbamazepine in borderline personality disorder. Eur Neuropsychopharmacol 1994; 4: 479-486
  • 33 Hollaender E, Allen A, Lopez RP et al. A preliminary double-blind, placebo-controlled trial of divalproex sodium in borderline personality disorder. J Clin Psychiatry 2001; 62: 199-203
  • 34 Frankenburg FR, Zanarini MC. Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder: a double blind placebo-controlled pilot study. J Clin Psychiatry 2002; 63: 442-446
  • 35 Nickel MK, Nickel C, Mitterlehner FO et al. Topiramate treatment of aggression in female borderline personality disorder patients: a double-blind, placebo-controlled study. J Clin Psychiatry 2004; 65: 1515-1519
  • 36 Nickel MK, Nickel C, Kaplan P et al. Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study. Biol Psychiatry 2005; 57: 495-499
  • 37 Tritt K, Nickel C, Lahmann C et al. Lamotrigine treatment of aggression in female borderline-patients: a randomized, double-blind, placebo-controlled study. J Psychopharmacol 2005; 19: 287-291
  • 38 Loew TH, Nickel MK, Muehlbacher M et al. Topiramate treatment for women with borderline personality disorder: a double-blind, placebo-controlled study. J Clin Psychopharm 2006; 26: 61-66
  • 39 McGlashan TH, Grilo CM, Skodol AE et al. The collaborative longitudinal personality disorders study: baseline Axis I/II ans II/II diagnostic co-occurrence. Acta Psychiatr Scand 2000; 102: 256-264
  • 40 National Collaborating Centre for Mental Health. Borderline Personality Disorder: The NICE GUIDELINE on Treatment and Management. National Clinical Practice Guideline No. 78. British Psychological Society & Royal College of Psychiatrists: 2009
  • 41 Hallahan B, Hibbeln JR, Davis JM et al. Omega-3 fatty acid supplementation in patients with recurrent self-harm: single-centre double-blind randomised controlled trial. Br J Psychiatry 2007; 190: 118-122
  • 42 Zanarini MC, Frankenburg FR. Omega-3 fatty acid treatment of women with borderline personality disorder: a double blind, placebo-controlled pilot study. Am J Psychiatry 2003; 160: 167-169
  • 43 Ziegenhorn AA, Roepke S, Schommer NC et al. Clonidine improves hyperarousal in borderline personality disorder with or without comorbid posttraumatic stress disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychopharma 2009; 29: 170-173
  • 44 Schmahl C, Kleindienst N, Limberger M et al. Evaluation of naltrexone in dissociative symptoms in borderline personality disorder. Int Clin Psychopharmacol 2012; 27: 61-68
  • 45 Speranza M, Revah-Levy A, Cortese S et al. ADHD in adolescents with borderline personality disorder. BMC Psychiatry 2011; 24: 158-161
  • 46 Philipsen A, Limberger MF, Lieb K et al. Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder. Br J Psychiatry 2008; 192: 118-123
  • 47 Golubchik P, Sever J, Zalsman G et al. Methylphenidate in the treatment of female adolescents with cooccurence of attention-deficithyperactivity disorder and borderline personality disorder: a preliminary open label trial. Int Clin Psychopharmacol 2008; 23: 228-231
  • 48 American Psychiatric Association . Practice guideline for the treatment of patients with borderline personality disorder. Am J Psychiatry 2001; 158 (Suppl. 10) 1-52
  • 49 Tyrer P, Silk KR. A comparison of UK and US guidelines for drug treatment in borderline personality disorder. Int Rev Psychiatry 2011; 23: 388-394