Emerging evidence for the use of atypical antipsychotics in borderline personality disorder

The availability of new atypical antipsychotics provides new opportunities for the treatment of borderline personality disorder (BPD).

Original papers on this topic were sought. Our study reviewed and discussed 14 papers.

2 RCTs, 4 non-controlled open-label studies and 8 case reports. The patient populations studied were highly diverse and the dropout rate after a long follow-up period was high. All of the articles reported positive effects of olanzapine, clozapine, quetiapine and risperidone.

BPD patients with psychotic-like, impulsive or suicidal symptoms might benefit from atypical antipsychotics. Since the methodological quality of the reviewed articles is poor, further randomised placebo-controlled studies with longer follow-ups are needed before any firm conclusions can be drawn.