Pregabalin augmentation in the treatment of borderline personality disorder with partial therapeutic response – case report

Abstract

Introduction

Emotional dysregulation is one of the core problems of borderline personality disorder (BPD). Forty-one year-old married female diagnosed with BPD at the age of 21, was admitted to the partial hospitalization unit due to a depressive symptoms and emotional dysregulation and poor overall functioning.

Objective

Patient was previously treated with numerous psychotropic agents: antipsychotics (AP) – fluphenazine, levomepromazine, risperidone, clozapine; antidepressants (AD) sertraline, mirtazapine, maprotiline, amitriptyline; psychostabilizers – carbamazepine/valproate) without achieving the full therapeutic response. After switching to combination of clomipramine and aripiprazole, we have reached partial clinical response.

Aim

The aim of this treatment was to improve clinical response and achieve emotional stability by augmentation with neuromodulator pregabalin.

Method

Augmentation strategy was realized by gradual titration and tapering of pregabalin (300 mg/d) over a two-week period. We started with pregabalin dose of 75 mg/d, followed by gradual increase to the dose of 300 mg/d. The Beck Depression Scale (BDS) and the Emotional Dysregulation Scale-short form (EDS) have been used for efficacy monitoring.

Results

Mental state before augmentation therapy: the BDS (score 30-moderate depression) and the EDS-short form (score 127). Parameter status after augmentation with pregabalin: BDS score 16-mild mood disturbance, EDS score 87.

Conclusions

Augmentation strategy with pregabalin have improved emotional control, maintained affective and behavioral stability, with significant reduction of feelings of emptiness, as well as the achievement and maintaining of emotional attachment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.