Start slow, simple to avoid polypharmacy among patients with borderline personality disorder

SAN DIEGO — In a presentation at U.S. Psychiatric and Mental Health Congress, Victor Hong, MD, and Kenneth Silk, MD, of the University of Michigan, discussed how psychiatrists could potentially avoid polypharmacy when treating patients with borderline personality disorder. Polypharmacy, or the use of two or more medications for the same disorder, is common among patients with borderline personality disorder, according to Hong.

Results from the McLean Study of Adult Development, conducted by Zanarini and colleagues, show that at 16 years of follow-up, 36% of patients with borderline personality disorder take three or more medications, 19% take four or more medications and 7% take five or more medications, Hong said.

“So do [these medications] work? The most we can say is that their efficacy is non-specific. Most clinical trials demonstrate a high placebo success rate and a high dropout rate. The trials are typically short and there are no continuation studies, which limits our ability to interpret much from the results,” Hong told Healio.com/Psychiatry. “Borderline personality disorder is a disorder that has chronic, long-standing symptoms, so trials with shorter time frames can’t tell us much about longer-term results. Furthermore, patients with borderline personality disorder tend to be quite sensitive to side effects.” While there are no FDA-approved medications for personality disorder… –U.S. Psychiatric and Mental Health Congress,Psychiatric Annals, September 15, 2015