Addressing Borderline Personality with Antidepressants

A study sponsored by the University of Chicago will test the effectiveness of Lexapro (escitalopram), a selective serotonin reuptake inhibitor (SSRI), in the treatment of borderline personality (BPD). As an SSRI, Lexapro belongs to the most commonly prescribed class of antidepressant medications. In recent years, the use of antidepressants has expanded to include chronic pain conditions, irritable bowel syndrome, and other mental health issues distinct from depression. In the current study, researchers intend to show that antidepressants can reduce thoughts of self-harm in individuals with BPD. The study is currently recruiting male and female subjects aged 18 to 40 years who have not taken an SSRI in the last two months.

As a mental health condition, BPD has not always been taken seriously. Many therapists simply viewed people with borderline personality issues as difficult cases, rather than examples of a specific but little-understood condition. People with borderline often respond poorly to traditional therapies, perhaps leading to the damaging stigmatization of BPD (Kernberg and Michels, 2009). Recently, however, BPD is among the most intensely studied personality issues.

While there are still more unknowns than knowns, the recognition of BPD as a legitimate condition with both a biological and psychiatric basis is firmly established. Approved treatments include customized cognitive behavioral therapy, anti-anxiety medications, and in some instances, low doses of antipsychotic medications. An ideal, one-size-fits-all approach has yet to be discovered. Because of the variable manifestations of the condition, such an approach may not even exist.

Self-loathing, self-harm, and thoughts of suicide are unfortunately quite common in people diagnosed with BPD. The University of Chicago study will include a placebo control group and an experimental group. Both groups will undergo eight weeks of treatment, with the experimental group receiving 10 to 20 milligrams of Lexapro.

The primary outcome measure for the study will be self-harm ideation; researchers expect the experimental group to report far fewer thoughts of self-harm. A second outcome measure will be symptoms of depression. The study’s recording methods will consist of electronic diaries for each participant and weekly therapeutic interviews.

Despite mountains of research and clinical investigations, there is still a long way to go in the treatment of BPD. Therapists are in search of methods that ensure long-term improvement in patients’ symptoms. Even today’s best interventions often only deliver short-term success. Because the risk of self-harm and suicide is so very real in this population, the University of Chicago Study will hopefully offer insight into reducing these outcomes.

References:

  1. Kernberg, O., & Michels, R. (2009). Borderline personality disorder. The American Journal of Psychiatry, 166(5), 505-508. Retrieved May 25, 2012, from the ProQuest database.
  2. Selective Serotonin Reuptake Inhibitors (SSRIs) in Borderline Personality Disorder – Full Text View – ClinicalTrials.gov. (n.d.). Home – ClinicalTrials.gov. Retrieved May 25, 2012, from http://clinicaltrials.gov/ct2/show/NCT01103180?cond=%22Personality+Disorders%22&rank=11

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