New studies on Topiramate - go to this link
Excerpts By Gregory Pacana 7-24-12
There are three classes of medications that are effective in treating patients with borderline personality disorder. They are atypical antipsychotics, mood stabilizers, and certain types of antidepressants.
class of medications that should generally be avoided when treating
patients with borderline disorder are benzodiazepines. These meds
are often prescribed to treat the anxiety which affects 9 out of 10
patient with bpd. However, since this class of medication, which
includes the drugs xanax and valium, has a high potential for abuse
and addiction and should generally be avoided in the case of
patients with bpd.
SSRIs are some of the most commonly prescribed medications in the United States. Medications in this class include drugs like Prozac, Celeza, and Zoloft. There are considered very safe and are effective in reducing both the anxious and depressive symptoms that often accompany borderline personality disorder. These meds have also been shown to be effective in calming borderline anger or rage.
Medications in this class include divalproex (Depakote), lamotrigine
Borderline personality disorder is a serious complex psychiatric condition with no known cure. However, with time and long-term talk therapy patients can make significant improvements. In addition medication is now showing greater promise in treating this often devastating disorder.
This discussion is written from a layperson's point of view and
non-technical jargon. A person with Borderline has deficits or
difficulties with varying degrees of the following dimensions.
These dimensions are:
Mood Stabilizers / Mood Stability
Antipsychotics / Impulsivity and Aggression
Antidepressants / Thinking
MORE COMPLETE LIST OF MEDICATIONS USED
( 8-9-09 )
excerpt by Dr. Pierre M Joubert
Relatively small and brief randomised, placebo-controlled studies indicate that Topiramate may be useful for treating borderline personality disorder (BPD) at dosages of 200 mg per day (that were titrated upwards from 25 mg per day). Loew et al.25 studied 56 patients over a 10-week period with promising results. Nickel et al.26 studied 29 women with BPD and found significant reductions in anger measurements. Nickel et al.27 repeated the study with 42 male subjects suffering from BPD, with similar results. In both the Nickel et al. studies, the dosages were 250 mg per day after titration upwards from 50 mg per day.
Do Prado-Lima et al.28 reported a case study of a woman with BPD who responded to Topiramate. Cassano et al.29 described a 24-year-old woman with bipolar II disorder and BPD who was treated with Topiramate in the course of trying to find a drug that controlled her depression; self-mutilation ceased after 2 weeks on 200 mg per day, despite no improvement of her depression. After Topiramate had been discontinued, self-mutilation recurred, but ceased again after re-introducing the Topiramate.
Anger, Aggression and Self-injury
Gobbi et al. 30 reported on a retrospective, case-controlled, mirrorimage study involving 45 inpatients with marked aggression and agitation who were managed in a maximum-security Canadian psychiatric hospital. The patients were suffering from schizophrenia, schizo-affective disorder and bipolar disorder. The authors compared sodium valproate, Topiramate and a combination thereof. Both valproate and Topiramate reduced aggression, but only valproate reduced agitation. They suggested that Topiramate might be useful in the treatment of aggression in psychosis, calling for double-blind randomised, placebo-controlled studies.
Nickelet al.31 studied the effects of Topiramate on symptoms of anger in women with recurrent major depressive disorder of a mild to moderate degree of severity. They used a randomised, double-blind, placebo-controlled design involving 64 subjects over a 10-week period. They concluded that Topiramate appeared to reduce depressive symptoms and anger. The reduction in anger symptoms was strongly correlated with a reduction in Hamilton Depression Rating Scale scores. The study reported a significant improvement in both depressive symptoms and anger, as well as a correlation between the two. It is however not clear whether the anger improved owing to a selective effect of Topiramate on anger or owing to the improvement in the depressive disorder.