Hostname: page-component-cb9f654ff-d5ftd Total loading time: 0 Render date: 2025-09-08T11:28:00.132Z Has data issue: false hasContentIssue false
  • English
  • Français

Of polypharmacy and voids: pharmacotherapy in borderline personality disorder

Published online by Cambridge University Press:  13 May 2025

Sergio Armando Covarrubias-Castillo Open the ORCID record for Sergio Armando Covarrubias-Castillo [Opens in a new window]  and
Francisco José Barbosa-Camacho
Sergio Armando Covarrubias-Castillo*
Affiliation:
The Chief of the Department of Psychiatry at Hospital Civil de Guadalajara “Fray Antonio Alcalde”, at Guadalajara, Mexico. He is also the President of the Neurology & Psychiatry Academy within the University Center of Health Sciences at University of Guadalajara; his main areas of interest are general hospital psychiatry, psychiatric epidemiology, psychosis and caregivers’ mental health.
Francisco José Barbosa-Camacho
Affiliation:
A third year resident of psychiatry at Hospital Civil de Guadalajara ‘Fray Antonio Alcalde’, Guadalajara, Mexico. His main areas of interest are consultation-liaison psychiatry, psychiatric epidemiology, neuropsychiatry, psychosis and caregivers’ mental health.
*
Correspondence Sergio Armando Covarrubias-Castillo. Email: scovarrubias@hcg.gob.mx
Get access Rights & Permissions [Opens in a new window]

Summary

Despite being the most prevalent personality disorder, borderline personality disorder remains a diagnosis with many unanswered questions, particularly concerning pharmacological management. Although many clinical practice guidelines suggest not prescribing medication unless there are significant clinical comorbidities, it is one of the psychiatric diagnoses with the highest rates of polypharmacy. This commentary on a BJPsych Advances article aims to raise clinical questions regarding the voids of knowledge and the appropriateness of medicating and, perhaps, overmedicating in this particular group.

Keywords

Borderlinepersonality disorderspsychopharmacologypolypharmacycomplementary therapies

Information

Type
Commentary
Information
BJPsych Advances , Volume 31 , Issue 4 , July 2025 , pp. 223 - 225
Check for updates
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

†

Commentary on… Pharmacological management of personality disorders: from evidence to practice. See this issue.

References

American Psychiatric Association (2024) The American Psychiatric Association Practice Guideline for the Treatment of Patients with Borderline Personality Disorder (2nd edn). APA.Google Scholar
Bridler, R, Häberle A, Müller ST, et al (2015) Psychopharmacological treatment of 2195 in-patients with borderline personality disorder: a comparison with other psychiatric disorders. European Neuropsychopharmacology, 25: 763–72.CrossRefGoogle ScholarPubMed
National Collaborating Centre for Mental Health (2009) Borderline Personality Disorder: Treatment and Management (NICE Clinical Guidelines, No. 78). British Psychological Society and Royal College of Psychiatrists (https://pubmed.ncbi.nlm.nih.gov/21796831/). Accessed 4 Jan 2025.Google Scholar
Pascual, JC, Martín-Blanco A, Soler J, et al (2010) A naturalistic study of changes in pharmacological prescription for borderline personality disorder in clinical practice: from APA to NICE guidelines. International Clinical Psychopharmacology, 25: 349–55.CrossRefGoogle ScholarPubMed
Pascual, JC, Arias, L, Soler, J (2023) Pharmacological management of borderline personality disorder and common comorbidities. CNS Drugs, 37: 489–97.CrossRefGoogle ScholarPubMed
Riffer, F, Farkas M, Streibl L, et al (2019) Psychopharmacological treatment of patients with borderline personality disorder: comparing data from routine clinical care with recommended guidelines. International Journal of Psychiatry in Clinical Practice, 23: 178–88.CrossRefGoogle ScholarPubMed
Soler, J, Casellas-Pujol E, Fernández-Felipe I, et al (2022) ‘Skills for pills’: the dialectical-behavioural therapy skills training reduces polypharmacy in borderline personality disorder. Acta Psychiatrica Scandinavica, 145: 332–42.CrossRefGoogle ScholarPubMed
Stoffers-Winterling, JM, Storebø OJ, Pereira Ribeiro J, et al (2022) Pharmacological interventions for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 11: CD012956.Google ScholarPubMed
Tennant, M, Frampton C, Mulder R, et al (2023) Polypharmacy in the treatment of people diagnosed with borderline personality disorder: repeated cross-sectional study using New Zealand’s national databases. BJPsych Open, 9: e200.CrossRefGoogle ScholarPubMed
Völlm, B, Cerci D (2025) Pharmacological management of personality disorders: from evidence to practice. BJPsych Advances, this issue (Epub ahead of print: 1 Aug 2024). Available from: https://doi.org/10.1192/bja.2024.30.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.