Combination Treatments in Borderline Personality Disorder: Bridging the Gap Between Clinical Practice and Empirical Data

Purpose of Review This paper presents an empirical basis for combination treatments in borderline personality disorder (PD), including medication combinations, psychotherapy combinations, and psychotherapy with medication. The goals are to synthesize empirical data evaluating combination treatments and to demonstrate gaps between research and clinical practice. Recent Findings The limited research supporting combination treatments displayed mixed results. There is minimal support for the frequent clinical practice of polypharmacy, with some evidence for the use of atypical antipsychotics with antidepressants. The scant research in combination psychotherapies supported its use primarily in individuals with comorbid psychiatric disorders (e.g., borderline PD and PTSD). Similarly, medication combined with psychotherapy had the greatest utility in individuals with comorbid psychiatric diagnoses. Summary Further research is needed before firm conclusions can be drawn on the use of combination treatments in borderline PD. The few studies that exist had mixed results, were often based on small sample sizes, and had abbreviated treatment courses. Nonetheless, there does appear to be a potential utility in the use of combination treatments for this complex neuropsychiatric disorder with significant morbidity and mortality, a wide range of symptoms, and frequent comorbid diagnoses.