Related Experiment Video
Updated: Nov 19, 2025

Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
Published on: March 8, 2018
Selective Serotonin Reuptake-Inhibitors for Symptom-Based Treatment of Borderline Personality Disorders in Older
Julie Schulkens1,2, Nina Bergs3, Theo Ingenhoven4
1Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Hospital, Heerlen, The Netherlands.
Objective:
International guidelines on symptom-based treatment of borderline personality disorders (BPD) in older adults are lacking. The number of older adults (≥ 65 years) with borderline personality disorder is rising. Effectiveness of Selective Serotonin Reuptake Inhibitors (SSRIs) on symptoms of BPD has only been investigated in younger adults and results are ambiguous. During life, serotonergic function changes, which can influence the indication and effectiveness of SSRIs in older adults with BPD. Aim of this study is to reach consensus on the suitability of SSRIs for the treatment of older adults with BPD.
Methods:
A Delphi study was conducted among eighteen international experts. In three successive rounds, a total of 16 statements addressing the treatment with SSRI's in older adults with BPD were assessed. Consensus on specific statements was reached if at least two-third of these experts agreed.
Results:
Consensus was reached on 11 statements related to the indication and effectiveness of SSRIs in the treatment of older adults with BPD.
Conclusion:
The results of this study suggest a valuable role for SSRIs in the treatment of affective instability, and to a lesser extent impulsive behavior, in older adults with BPD. Sertraline or citalopram are suggested to be the first-choice medication but should be prescribed with some caution. Treatment recommendations have been suggested (presented in a flowchart), but still have to be investigated in clinical practice.
Related Concept Videos
Borderline Personality Disorder
Genetic and Environmental Contributions
Borderline Personality...
Antidepressant Drugs: MAOIs and Other Agents
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
Psychosis: Goals of Pharmacotherapy
Personality Disorders: Paranoid and Schizoid
Paranoid Personality Disorder
Paranoid personality disorder is...
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...

