Pharmacotherapy

Although depressed patients with BPD usually have poorer responses to medications than those without BPD, randomized trials suggest that three classes of medications (classic and "atypical" antipsychotics, all types of anti-depressants, and mood stabilizers) may be helpful for at least some patients with BPD. It is not uncommon to encounter patients with BPD who are on four or five psychotropic medications, and to be unsure which, if any, medication is helping, and which may be leading to more symptoms or side effects. In an attempt to avoid such polypharmacy and base choice of medications on close observation of patient response, Soloff (2000) has published an algorithm for successive medication trials in the form of a Decision Tree based on symptoms and response. No single class of medications is superior to the others or is recommended as the standard of care or even drug of first choice. Rather, initial choice of medication is best determined by which particular symptoms are currently most prominent—antipsychotics for cognitive dysregulation or extreme anxiety, antidepressants or mood stabilizers for mood dysregulation, and mood stabilizers for anger problems or impulsive behaviors. Favorable results for benzodiazepines have been reported in only one, older trial, and these medications have the serious drawback of potentially leading to disinhibition of behavior, the last thing one would want in an impulsive patient.

Free Yourself from Panic Attacks

Free Yourself from Panic Attacks

With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.

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