Silvio Bellino
University of Turin, Italy

Abstract:

Objective: Treatment guidelines for BPD recommend antidepressants, mood stabilizers and antipsychotics for core dimensions of affective instability, impulsive behavioral dyscontrol and cognitive-perceptual abnormalities.

Combination of drugs and psychotherapy is considered the first-choice therapy. We tested new medications in order to assess their efficacy in BPD patients. We also compared combined therapy with antidepressant + interpersonal therapy (IPT) versus single pharmacotherapy.

Methods: Outpatients attending the Center for Personality Disorders, Unit of Psychiatry 1, University of Turin were selected for 12 weeks trials with one new therapeutic agent: the antidepressant duloxetine, the mood stabilizer oxcarbazepine and the antipsychotics aripiprazole, quetiapine, and paliperidone.

Randomized controlled studies were performed to compare a 24 weeks combined therapy with fluoxetine + IPT versus fluoxetine alone in patients with major depression and concomitant BPD and in BPD patients without comorbidity.

Results: New agents tested in our trials were found efficacious on impulsivity and anger. Duloxetine, oxcarbazepine, and quetiapine also reduced mood instability. Aripiprazole and paliperidone treated with good results paranoid ideation and dissociative symptoms.

Combined therapy was superior to single pharmacotherapy on ratings of interpersonal functioning and quality of life.

Conclusions: Data will be reported in detail and discussed in comparison with other clinical studies.