Identity disturbance and interpersonal affective symptoms are less apt to improve with medication alone. Most available medications target impulsivity and aggression, symptoms that are most likely to resolve. Experimental use of glutamatergic medications or alteration of endocannabinoid signaling may enhance affective habituation during processing of interpersonal stressors in psychotherapy. Neuropeptide research may inform understanding of interpersonal dysfunction and identity disturbance characteristic of BPD. There exists potentially great variability in Inhibitors,research,lifescience,medical oxytocin and opioid signaling across individuals with BPD, or within a single patient over

time. Opioid partial agonists or kappa antagonists may be an efficacious psychopharmacological intervention in BPD, but no direct evidence exists for such a practice clinically. At best, these psychopharmacological strategies remain theoretical and require Inhibitors,research,lifescience,medical further research on safety and efficacy prior to drawing any conclusions. Although antidepressants have shown limited efficacy in treating BPD, Inhibitors,research,lifescience,medical they are well-tolerated and greater receptor specificity may be needed for effective serotonergic treatment of impulsive aggression. Atypical antipsychotics and anticonvulsants

provide broader and more prominent benefit on some BPD symptoms, but are also associated with potential risks. Thus far, basic research has been difficult to translate into novel psychopharmacologic treatments for BPD. Further research on the functional neurobiology of BPD may improve understanding of chronic, refractory symptoms and assist in predicting treatment response. By relying on the best available evidence, clinicians can assist BPD patients in alleviating debilitating symptoms.
Narcissistic personality disorder Inhibitors,research,lifescience,medical (NPD) has its roots in nearly a century of psychoanalytic studies. Kernberg’s1,2 and Kohut’s3,4 groundbreaking efforts to organize Inhibitors,research,lifescience,medical psychoanalytic Tyrphostin B42 clinical trial theory and clinical studies into comprehensive descriptions and treatment strategies moved

NPD towards recognition as a separate personality disorder. In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV,5,6 NPD has been characterized as a pervasive enough pattern of grandiosity, need for admiration, and lack of empathy, with interpersonal entitlement, exploitativeness, arrogance, and envy. Other notable phenotypic characteristics include interpersonal distancing and avoidance, insecurity and vulnerability, hypersensitivity, aggressivity, and proneness to shame.7-9 The transformation of NPD into a DSM diagnostic category in 198010 required significant adjustments and narrowing of extensive clinical observations. Several components and characteristics of narcissistic personalitypathology that were central in the psychoanalytic conceptualization of narcissism and NPD were left aside in the final choice and formulation of the diagnostic trait criteria.