Real-World Effectiveness of Clozapine for Borderline Personality Disorder: Results From a 2-Year Mirror-Image Study.

  title={Real-World Effectiveness of Clozapine for Borderline Personality Disorder: Results From a 2-Year Mirror-Image Study.},
  author={Christopher Rohde and Christoffer Polcwiartek and Christoph U. Correll and Jimmi Nielsen},
  journal={Journal of personality disorders},
  volume={32 6},
While some second-generation antipsychotics have shown efficacy on patients with borderline personality disorder (BPD), limited data exist regarding the effect of clozapine. Thus, we aimed to investigate the effects of clozapine on naturalistic outcomes in BPD patients with a 2-year mirror-image model. Among 25,916 patients with BPD, 1,107 redeemed ≥ 1 clozapine prescription. Of these, 18,188 were "specific" BPD patients, and 102 redeemed ≥ 1 clozapine prescription. During a mean observation… 

Real-world effectiveness of clozapine for intellectual disability: Results from a mirror-image and a reverse-mirror-image study

This nationwide study, which is the largest to date, suggests that treatment with clozapine is associated with a reduction in psychiatric admissions and inpatient days in patients with intellectual disability.

The clinical effectiveness and cost effectiveness of clozapine for inpatients with severe borderline personality disorder (CALMED study): a randomised placebo-controlled trial

The study findings highlight problems in conducting placebo-controlled trials of clozapine and in using clozAPine for people with BPD, outside specialist inpatient mental health units.

Off-label use of second-generation antipsychotics in borderline personality disorder: a comparative real-world study among oral and long-acting injectables in Spain

The use of LAIs may play a role in the management of BPD, and patients treated with LAIs showed a decreased ratio of visits to emergency compared with the oral treatment group, and between LAIs, PP3M vs. aripiprazole-1-month group.

Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough?

An individualized, tailored pharmacotherapy for BPD that targets the prominent symptom clusters can improve relevant aspects of the clinical picture, but no medication is indicated to treat the global psychopathology of BPD.

The use of stimulants in depression: Results from a self-controlled register study

Methylphenidate was associated with a 54% reduction in incidents of self-harm or suicide attempts, indicating that methylphenidate may potentially be useful in patients with depression with suicidal- or self-harming behaviour.

Recovery in borderline personality disorder: time for optimism and focussed treatment strategies.

BPD diagnosis does not need to overwhelm clinicians, nor does it require therapeutic pessimism, and targeted interventions, including meaningful psychoeducation, are helpful in promoting optimism and enhancing recovery-oriented treatments.

A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology

Rational use requires modification of the clozapine package insert worldwide to include lower doses for Asians and to avoid the lethality associated with pneumonia, the use of clozAPine levels for personalizing dosing, and theUse of slow and personalized titration to make clozabine as safe as possible and contribute to increased life expectancy and well-being.

Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough? Highlights

  • Psychology
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Use of Clozapine for Borderline Personality Disorder: A Case Report

  • Badii AmamouW. Salah L. Gaha
  • Psychology
    Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology
  • 2016
After treatment failure with other psychotropic medications, clozapine medication was initiated; not only did suicidal ideation cease, but social and professional functioning also greatly improved to the point of no longer requiring intensive levels of observation or restrictive procedures.

The novel use of clozapine in an adolescent with borderline personality disorder

  • S. ArgentS. Hill
  • Psychology, Medicine
    Therapeutic advances in psychopharmacology
  • 2014
This very preliminary data does nonetheless suggest that clozapine may have a role in treating adolescents with emerging borderline personality disorder when other treatment options have been exhausted.

Olanzapine for the treatment of borderline personality disorder: variable dose 12-week randomised double-blind placebo-controlled study

Individuals treated with olanzapine and placebo showed significant but not statistically different improvements on overall symptoms of borderline personality disorder.

Borderline personality disorder and comorbid addiction: epidemiology and treatment.

There is no evidence for any restriction on drug therapy to prevent recurrent addiction in patients with borderline personality disorder and comorbid addiction and the psychotherapeutic techniques that can be used include DBT-SUD, DFST, and DDP.

Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study.

Aripiprazole appears to be a safe and effective agent in the treatment of patients with borderline personality disorder.

A dose comparison of olanzapine for the treatment of borderline personality disorder: a 12-week randomized, double-blind, placebo-controlled study.

Olanzapine 5-10 mg/d showed a clinically modest advantage over placebo in the treatment of overall borderline psychopathology and should be weighed against the risk of adverse events (particularly weight gain), which were consistent with the known safety profile of olanzapine.

Ziprasidone in the treatment of borderline personality disorder: a double-blind, placebo-controlled, randomized study.

This trial failed to show a significant effect of ziprasidone in patients with borderline personality disorder, and the drug was seen to be safe, and no serious adverse effects were observed.

Predictors of Clozapine Response in Patients With Treatment-Refractory Schizophrenia: Results From a Danish Register Study

Although the study design does not allow any causal inferences, all 3 models suggested a lower number of psychiatric hospitalizations and antipsychotic trials before clozAPine initiation to be associated with greater clozapine response.

Experiences of women in secure care who have been prescribed clozapine for borderline personality disorder

When psychological interventions are, at least initially, ineffective then clozapine treatment is likely to be evaluated positively by a group of women with borderline personality disorder in secure care despite the potential disadvantages.

Borderline and schizotypal personality disorders treated with low-dose thiothixene vs placebo.

Thiothixene seems to have more than an antipsychotic effect, and a subdiagnosis defined by those symptoms that are drug-responsive, some of which are not included in current diagnostic criteria is suggested.