Psychopharmacological treatment in borderline personality disorder: A pilot observational study in a real-world setting

Psychopharmacological treatment in borderline personality disorder: A
pilot observational study in a real-world setting

Psychotherapy is the cornerstone of treatment for borderline personality disorder (BPD) while pharmacotherapy
should be considered only as an adjunctive intervention. In clinical practice, however, most of BPD patients only
receive medication. The aim of the study is to first describe pharmacological treatment in BPD patients in Italy
and secondly to evaluate if comorbidity or illness severity are associated with the prescription of different class
compounds.
Data on pharmacological treatment and clinical evaluation of 75 BPD patients were collected in 5 clinical
settings. The association between comorbidity and medication was assessed. Moreover, we evaluated the association
between pharmacotherapy and severity, defined by a cluster analysis aimed at detecting different groups
of patients.
Most of the participants (82.7%) were characterized by polypharmacy, with a mean of 2.4 medications per
person. Interestingly, the prescription didn’t seem to depend on/be based on the severity of the disorder and was
only partially determined by the presence of comorbidity.
In conclusion, our findings are similar to what described in other clinical studies, supporting the idea that
medication management for BPD is only partially coherent with international guidelines. This pilot study confirms
the need for more rigorous studies to gain greater understanding of this topic and diminish the gap between
guidelines and the real clinical world.