BPD

Clinical Update

How to Use Lamotrigine

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Borderline Personality Disorder | BPD | Hypomania | Lamictal | Lamotrigine | Medication | Mood Stabilizers | OCD | Pharmacology | Psychopharmacology

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

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Clinical Update

Take a Breather: A Mindful Tactic for Borderline Dysphoria

Topics: Agitation | Behavior therapy | Borderline Personality Disorder | BPD | Crisis intervention | Mindfulness | Psychotherapy | Self-injury | Therapy during medication appointment | Therapy with Med Management

Managing the intense, explosive dysphoria experienced by patients with borderline personality disorder (BPD) is one of the tougher challenges we face. These complex states, with elements of anxiety, rage, depression, and shame, are hard for patients to tolerate, let alone examine. Worse, they can generate dangerous solutions: suicide, self-harm, and o

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Expert Q&A

A Pragmatic Approach to Borderline Personality Disorder

Topics: Borderline Personality Disorder | BPD | Brief psychotherapy | Psychotherapy | Therapy during medication appointment | Therapy with Med Management

TCPR: Tell us about this new approach to borderline personality disorder (BPD): good psychiatric management. Dr. Choi-Kain: We have many effective therapies for BPD. There’s dialectical behavior therapy (DBT), transference-focused therapy, and mentalization-based therapy. Good psychiatric management borrows from the other approaches, but differs in t

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Clinical Update

The Modafinils in Bipolar Depression

Topics: ArModafinil | Bipolar Disorder | Borderline Personality Disorder | BPD | Modafinil | Novel Medications | Nuvigil | Personality Disorders | Provigil | Psychopharmacology

Your patient has recovered enough from bipolar depression to leave the hospital, but not enough to return to work. He is inactive, he can’t concentrate, and it takes him 4 hours to wake up in the morning. What can you add to his regimen of lithium, lamotrigine, and lurasidone? Modafinil (Provigil) and armodafinil (Nuvigil) are wakefulness-promoting

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