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Tratamento farmacológico do transtorno de personalidade limítrofe: revis?o crítica da literatura e desenvolvimento de algoritmos

DOI: 10.1590/S0101-81082004000200007

Keywords: borderline personality disorder, clinical trials, review, psychopharmacology, algorithms, selective serotonin reuptake inhibitors, divalproex, antipsychotics.

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introduction: borderline personality disorder (bpd) is a psychiatric syndrome that causes significant morbidity and mortality to both inpatients and outpatients treated by mental health care providers. due to its relatively high prevalence in the psychiatric population, efforts are necessary to treat this problematic group of patients properly. objective: the aim of this paper is to review current evidence of the effectiveness of the various pharmacological approaches employed as part of the treatment plan designed for individuals coping with this illness. methods: for this purpose, the medline database was searched for clinical trials from 1986 to 2003. "borderline personality disorder" and "clinical trials" were used as descriptors. results: numerous works were retrieved, but very few controlled trials were available. noteworthy is the fact that virtually all classes of psychopharmacological agents were tested in this set of patients, often with modest and variable outcomes. due to methodological limitations observed in the vast majority of trials involving specific drugs in this group of patients, it was difficult to estimate the real benefit of the several agents tested. the most robust evidence exists for selective serotonin reuptake inhibitors, antipsychotics and divalproex. discussion: clearly, more well-designed clinical trials are needed, but the data reviewed suggest that drugs are effective in the treatment of target symptoms in these patients. psychotropics are useful when used in association with the psychotherapeutic approaches usually employed with borderline patients.


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