The psychopharmacology of borderline personality disorders

DSM-III borderline personality disorder defines a group of patients who are characterised by impulsivity and unpredictable behaviour, inappropriate aggression, intense and unstable relationships and are often associated with repeated suicidal behaviour. A substantial body of research has established an association between disturbance of serotonin and also dopamine and suicidal behaviour in depression. A similar relationship is also seen in studies of personality disorders which suggests the association is not specific to depression. A placebo controlled study of low dose flupenthixol has been shown to significantly reduce subsequent suicidal behaviour in patients with personality disorders without depression or schizophrenia. Evidence points to a biological basis for suicidal behaviour and borderline personality disorder and possibly of pharmacotherapy.