Retos y adversidades en la terapia farmacológica del trastorno límite de la personalidad

Abstract

Introduction: Borderline Personality Disorder is a challenge for health professionals due to the symptomatic variability it presents, which leads to difficulties in its diagnosis and treatment. Little evidence is available on pharmacological treatment, and the guidelines' conclusions diverge. Polypharmacy is frequent and alarming because of high rates of indiscriminate use of benzodiazepines, antipsychotics, and antidepressants. Objective: To expose the challenges and adversities in pharmacological therapy for patients with Borderline Personality Disorder. Methodology: In this literature review, searches were performed in PubMed, UpToDate, Springer, ScienceDirect, Scopus, Dynamed Plus, and Web of Science databases. The following Spanish DeCS terms were used: treatment, borderline personality disorder, mood stabilizers, antipsychotics, benzodiazepines, antidepressants, omega-3, therapeutic criteria, efficacy, and adverse effects; these terms were combined using the Boolean operators "AND," "OR," and "NOT." It was considered to include meta-analyses, systematic reviews, articles with quantitative methodologies, randomized clinical trials, cohort studies, and randomized clinical studies in English and Spanish. Results: Scientific evidence on therapeutic alternatives and their efficacy was contrasted. Also, updated data on pharmacotherapy commonly used in Borderline Personality Disorder was collected.