Clonidine in Acute Aversive Inner Tension and Self-Injurious Behavior in Female Patients With Borderline Personality Disorder

Philipsen, Alexandra; Richter, Harald; Schmahl, Christian; Peters, Julia; Rüsch, Nicolas; Bohus, Martin; Lieb, Klaus

doi:10.4088/jcp.v65n1018

Cited by 80 publications

(39 citation statements)

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“…In BPD, self-destructing and self-injurious (e.g. cutting) behavior is a well-known clinical feature (Lieb et al 2004) which often co-occurs with aversive inner tension and dissociative symptoms (Philipsen et al 2004;Stiglmayr et al 2008). Interestingly, in adolescents with ADHD symptomatology (measured by the WURS), an enhanced risk was found for self-harm, particularly self-hitting (in females and males) and self-cutting (only in males) (Izutsu et al 2006).…”

Section: Self-destructionmentioning

confidence: 99%

Borderline typical symptoms in adult patients with attention deficit/hyperactivity disorder

Philipsen

Feige

Heßlinger

et al. 2009

ADHD Atten Def Hyp Disord

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Adult attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) share several clinical features, e.g. emotional lability and impulsivity. This study aimed to delineate differences and similarities between ADHD and BPD with respect to borderline typical symptomatology and gender specifics. Borderline symptomatology was assessed in 60 adult patients with ADHD with the borderline symptom list (BSL) and compared to both 60 gender- and age-matched BPD patients and control subjects. The BSL is a standardized instrument including 95 items on 7 subscales (self-perception, affect regulation, self-destruction, dysphoria, loneliness, intrusions and hostility). Adult ADHD patients showed significantly higher BSL total scores and all of the seven subscales compared to healthy controls (p < 0.001) but lower scores than BPD patients (p < 0.001). With respect to the seven subscales, the largest differences between ADHD and BPD patients were found with respect to self-destruction (d = 1.12) and affect dysregulation (d = 0.90), whereas the smallest difference was found with respect to loneliness (d = 0.36). In females, the BSL subscales "loneliness" and "hostility" did not differentiate between BPD and ADHD. Borderline typical symptoms are common in adult patients with ADHD but seem to be less pronounced than in patients with BPD. Females with ADHD and BPD share more clinical features than males. However, symptoms of self-destruction and affect dysregulation appear to be more severe in BPD patients.

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Section: Self-destructionmentioning

confidence: 99%

Borderline typical symptoms in adult patients with attention deficit/hyperactivity disorder

Philipsen

Feige

Heßlinger

et al. 2009

ADHD Atten Def Hyp Disord

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“…Also, a study of 14 female patients with BPD showed efficacy of clonidine in acute states of aversive inner tension, dissociative symptoms, and urge to commit self-injurious behaviours [25] .…”

Section: Clonidine In Ptsdmentioning

confidence: 99%

Clonidine Use in Psychiatry: Panacea or Panache?

Naguy¹

2016

Pharmacology

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Clonidine, an alpha agonist, formally prescribed in clinical medicine as antihypertensive medication, is currently being used more frequently to address a multitude of psychiatric entities. The long-acting formulation is approved by the Food and Drug Administration for use in treating the attention-deficit/hyperactivity disorder. In addition to this only legitimate indication, it has long been used successfully for opiate detoxification, post-traumatic stress disorder and de la Tourette syndrome. Moreover, clonidine helps in the treatment of neuroleptic-induced akathisia, stimulant-induced insomnia and clozapine-induced sialorrhea. It has been tried in treating menopausal syndrome and psychogenic polydipsia. Although the strength of evidence supporting the use of clonidine in such clinical scenarios is highly variable and oscillating, from strong to only flimsy, this overview is intended to shed some light on the clonidine portfolio as a potential and attractive addition to the psychopharmacologic armamentarium.

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“…Although tension, dissociative symptoms, self-injurious urges, and suicidal ideation decreased for both doses, there was no difference between the two doses (Philipsen et al 2004a). Ziegenhorn et al (2009) conducted an RCT of clonidine with BPD subjects with prominent symptoms of hyperarousal.…”

Section: Other Medicationsmentioning

confidence: 99%

Evidence-based pharmacotherapy for personality disorders

Ripoll

Triebwasser

Siever

2011

Int. J. Neuropsychopharm.

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Patients with personality disorders are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. Prescribing practices in these populations are often based on anecdotal evidence rather than rigorous data. Although evidence-based psychotherapy remains an integral part of treatment, Axis II psychopathology is increasingly conceptualized according to neurobiological substrates that correspond to specific psychopharmacological strategies. We summarize the best available evidence regarding medication treatment of personality disordered patients and provide optimal strategies for evidence-based practice. Most available evidence is concentrated around borderline and schizotypal personality disorders, with some additional evidence concerning the treatment of avoidant and antisocial personality disorders. Although maladaptive personality symptoms respond to antidepressants, antipsychotics, mood stabilizers, and other medications, evidence-based pharmacotherapy is most useful in treating circumscribed symptom domains and induces only partial improvement. Most available evidence supports use of medication in reducing impulsivity and aggression, characteristic of borderline and antisocial psychopathology. Efforts have also begun to reduce psychotic-like symptoms and improve cognitive deficits characteristic of schizotypy. Indirect evidence is also provided for psychopharmacological reduction of social anxiety central to avoidant personality disorder. Evidence-based practice requires attention to domains of expected clinical improvement associated with a medication, relative to the potential risks. The development of future rational pharmacotherapy will require increased understanding of the neurobiological underpinnings of personality disorders and their component dimensions. Increasing efforts to translate personality theory and social cognitive neuroscience into increasingly specific neurobiological substrates may provide more effective targets for pharmacotherapy.

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Clonidine in Acute Aversive Inner Tension and Self-Injurious Behavior in Female Patients With Borderline Personality Disorder

Cited by 80 publications

References 0 publications

Borderline typical symptoms in adult patients with attention deficit/hyperactivity disorder

Borderline typical symptoms in adult patients with attention deficit/hyperactivity disorder

Clonidine Use in Psychiatry: Panacea or Panache?

Evidence-based pharmacotherapy for personality disorders

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