Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series

<i>Background</i>: Borderline personality disorder (BPD) is a heterogeneous and highly comorbid disorder. Suicidality, aggression and substance abuse are common presentations of BPD. Our case series is the first to highlight the role of brexpiprazole in improving these symptoms in patien...

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Main Authors: Benedict Francis, Vijay A/L Ganasan, Abdul Rasyid Bin Sulaiman
Format: Article
Language:English
Published: MDPI AG 2024-02-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/60/2/283
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author Benedict Francis
Vijay A/L Ganasan
Abdul Rasyid Bin Sulaiman
author_facet Benedict Francis
Vijay A/L Ganasan
Abdul Rasyid Bin Sulaiman
author_sort Benedict Francis
collection DOAJ
description <i>Background</i>: Borderline personality disorder (BPD) is a heterogeneous and highly comorbid disorder. Suicidality, aggression and substance abuse are common presentations of BPD. Our case series is the first to highlight the role of brexpiprazole in improving these symptoms in patients with BPD. <i>Case presentation</i>: We describe three cases demonstrating the role of brexpiprazole in improving BPD’s prominent features and comorbidities. All cases improved when brexpiprazole was added to their treatment regime. Case 1: A 26-year-old woman who was diagnosed with BPD and cyclothymia, presented to the psychiatric emergency unit with impulsive suicidal behaviour. Case 2: A 43-year-old woman suffering from BPD sought help due to her violent behaviour and emotional dysregulation. Case 3: A 22-year-old woman with underlying attention deficit and hyperactivity disorder, polysubstance use disorder and BPD presented with dysregulated emotions. <i>Conclusions</i>: Our case series provides anecdotal evidence of the potential role of brexpiprazole in attenuating suicidality, aggression and substance abuse in patients with BPD. We postulate that brexpiprazole’s high affinity for the 5HT1A/5HT2A receptors, coupled with its low intrinsic effect on the D2/D3 receptor system, is fundamental in its actions to stabilise the aberrant dopaminergic and serotonergic signalling in BPD. Future research should focus on well-designed clinical trials investigating the efficacy of brexpiprazole in patients with BPD.
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spelling doaj.art-459ce7044e1948939837b3007cf2224a2024-02-23T15:26:39ZengMDPI AGMedicina1010-660X1648-91442024-02-0160228310.3390/medicina60020283Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case SeriesBenedict Francis0Vijay A/L Ganasan1Abdul Rasyid Bin Sulaiman2Department of Psychiatry, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Psychiatry and Mental Health, Hospital Tuanku Ja’afar, Seremban 70300, MalaysiaDivision of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia<i>Background</i>: Borderline personality disorder (BPD) is a heterogeneous and highly comorbid disorder. Suicidality, aggression and substance abuse are common presentations of BPD. Our case series is the first to highlight the role of brexpiprazole in improving these symptoms in patients with BPD. <i>Case presentation</i>: We describe three cases demonstrating the role of brexpiprazole in improving BPD’s prominent features and comorbidities. All cases improved when brexpiprazole was added to their treatment regime. Case 1: A 26-year-old woman who was diagnosed with BPD and cyclothymia, presented to the psychiatric emergency unit with impulsive suicidal behaviour. Case 2: A 43-year-old woman suffering from BPD sought help due to her violent behaviour and emotional dysregulation. Case 3: A 22-year-old woman with underlying attention deficit and hyperactivity disorder, polysubstance use disorder and BPD presented with dysregulated emotions. <i>Conclusions</i>: Our case series provides anecdotal evidence of the potential role of brexpiprazole in attenuating suicidality, aggression and substance abuse in patients with BPD. We postulate that brexpiprazole’s high affinity for the 5HT1A/5HT2A receptors, coupled with its low intrinsic effect on the D2/D3 receptor system, is fundamental in its actions to stabilise the aberrant dopaminergic and serotonergic signalling in BPD. Future research should focus on well-designed clinical trials investigating the efficacy of brexpiprazole in patients with BPD.https://www.mdpi.com/1648-9144/60/2/283brexpiprazoleborderline personality disordersuicideaggressionsubstance-related disorders
spellingShingle Benedict Francis
Vijay A/L Ganasan
Abdul Rasyid Bin Sulaiman
Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
Medicina
brexpiprazole
borderline personality disorder
suicide
aggression
substance-related disorders
title Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
title_full Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
title_fullStr Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
title_full_unstemmed Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
title_short Brexpiprazole Attenuates Aggression, Suicidality and Substance Use in Borderline Personality Disorder: A Case Series
title_sort brexpiprazole attenuates aggression suicidality and substance use in borderline personality disorder a case series
topic brexpiprazole
borderline personality disorder
suicide
aggression
substance-related disorders
url https://www.mdpi.com/1648-9144/60/2/283
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