This application will prepare the candidate to pursue a systematic program of research in the pharmacologic characterization and treatment of the borderline disorder. There is no """"""""treatment of choice"""""""" for borderline disorder, a highly prevalent syndrome characterized by affective, schizotypal and impulsive-destructive symptoms with a social and vocational outcome akin to schizophrenia. Building upon previous research using descriptive, family, neuroendocrine and sleep studies to discriminate borderline from affective and schizophrenia-spectrum disorders, we are currently conducting the first NIMH funded study of Pharmacotherapy of Borderline Disorders. This double-blind, placebo-controlled trial of neuroleptic (haloperidol) and antidepressant (amitriptyline) medication simultaneously addresses the clinical need for empirically defined guidelines to treatment and the scientific need to resolve the heterogeneity of the borderline into meaningful subtypes through pharmacologic behavioral dissection. The preliminary results of this first pharmacotherapy study direct the content of our proposed Research Plan and clearly define the need for the candidate to pursue advanced psychopharmacology and biostatistics training to accomplish his long-term goal of synthesizing biological and pharmacologic perspectives on the borderline disorders. The advanced training and expert consultation detailed in this application are fully integrated with a Research Plan which expands the perspective of our work to include the role of atypical depression and MAOI antidepressants in borderline disorder and extends our time frame to longer term treatment effects and prophyllaxis against recurrence. We propose an acute treatment protocol comparing phenelzine to haloperidol in a double-blind placebo-controlled design followed by an outpatient continuation study of treatment responders. The results of this study, taken together with our Pharmacotherapy I protocol, will provide the first empirically based guidelines for medication in borderline patients. More importantly, these studies provide the framework for pursuing new directions in borderline disorders research, including the long awaited bridging of the gap between biologic, pharmacologic and physiosocial perspectives of the borderline patient through comparative studies of pharmacotherapy with newly developed operationalized forms of psychotherapy.
| Soloff, P H; Lis, J A; Kelly, T et al. (1994) Risk factors for suicidal behavior in borderline personality disorder. Am J Psychiatry 151:1316-23 |
| Soloff, P H; Cornelius, J; George, A et al. (1993) Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch Gen Psychiatry 50:377-85 |
| Cornelius, J R; Soloff, P H; George, A et al. (1993) Haloperidol vs. phenelzine in continuation therapy of borderline disorder. Psychopharmacol Bull 29:333-7 |
| Cornelius, J R; Soloff, P H; Perel, J M et al. (1993) Continuation pharmacotherapy of borderline personality disorder with haloperidol and phenelzine. Am J Psychiatry 150:1843-8 |
| Soloff, P H; Cornelius, J; George, A (1991) The depressed borderline: one disorder or two? Psychopharmacol Bull 27:23-30 |
| Soloff, P H; Cornelius, J; Foglia, J et al. (1991) Platelet MAO in borderline personality disorder. Biol Psychiatry 29:499-502 |
| Soloff, P H; George, A; Nathan, S et al. (1989) Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response. J Clin Psychopharmacol 9:238-46 |
| Cornelius, J R; Schulz, S C; Brenner, R P et al. (1988) Changes in EEG mean frequency associated with anxiety and with amphetamine challenge in BPD. Biol Psychiatry 24:587-94 |
| Soloff, P H; George, A; Nathan, R S et al. (1988) Patterns of response to amitriptyline and haloperidol among borderline patients. Psychopharmacol Bull 24:264-8 |
| Soloff, P H (1987) Neuroleptic treatment in the borderline patient: advantages and techniques. J Clin Psychiatry 48 Suppl:26-31 |
