Abstract
BACKGROUND: Patients with borderline personality disorders are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. Prescribing practices in these populations are often based on anecdotal evidence rather than rigorous data. Although psychotherapy remains an integral part of treatment, psychopathology is increasingly conceptualized according to neurobiological substrates that correspond to specific psychopharmacological strategies. AIMS & OBJECTIVES: The aim of this presentation is to discuss rational polypharmacy and the management of specific symptoms in patients with borderline personality disorder. METHOD: The paper dissects various symptoms of borderline personality disorder and looks at the medications that would work best in these symptoms. Symptoms like aggression and mood issues as well as suicidality and non suicidal self injury are focused on. RESULTS: The paper reviews various molecules like antipsychotics both typical and atypical as well as SSRIs and other antidepressants along with benzodiazepines and their potential role in the management of specific symptoms in borderline personality disorder. There is a need for rational polypharmacy combination for the optimum management of these patients. Various potential combinations and how they work in synergy. DISCUSSION & CONCLUSIONS: The development of future rational pharmacotherapy will require increased understanding of the neurobiological underpinnings of borderline personality disorder and their component dimensions along with rational drug combinations that complement each other in the management of this condition.