Pharmacotherapy of borderline outpatients

The charts of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder (BPD), 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder (APD), and 26 outpatients meeting DSM-III criteria for Dysthymic Disorder, as well as DSM-III criteria for some other type of Axis II disorder (dysthymic other personality disorder [OPD]) were reviewed blind to proband diagnosis to determine both the percentage of those in each group who had adequate medication trials and the efficacy of those trials. Borderlines were significantly more likely than antisocial controls to have received an adequate trial of some form of medication. They were also significantly more likely than antisocial controls to have received an adequate trial of anxiolytics and antidepressants. However, they were distinguished at the trend level or better from both antisocial and dysthymic OPD controls by their greater likelihood of having received an adequate trial of neuroleptics, lithium, and polypharmacy. The percentage of adequately treated borderlines who experienced some degree of symptom relief was not significantly different than that found in either control group. However, adequately treated borderlines were significantly less likely than adequately treated dysthymic OPD controls to have had a definite response to pharmacotherapy (i.e., shown marked improvement of target symptoms).