Can Botulinum Toxin Help Patients With Borderline Personality Disorder?
Female patients ages 20–59 years with a diagnosis of borderline personality disorder received botulinum toxin treatment with 29 U of onabotulinumtoxinA at five injection sites in the glabellar region during inpatient treatment between December 2012 and July 2015 at the Hannover Medical School (N=5) and at the Asklepios Clinic North–Ochsenzoll (N=1). In all six patients, previous and current pharmacological (antidepressants, antipsychotics) and psychotherapeutic (including dialectic behavioral therapy) treatment attempts had been insufficient. Two to 6 weeks following the injection of botulinum toxin, the symptoms of borderline personality disorder as measured by the Zanarini borderline personality disorder rating scale and/or the Borderline Symptom List had improved by 49%−94% from baseline values (Wilcoxon signed ranks test, p≤0.05; Figure 1). Patients also showed a reduction in impulsivity, self-harming behavior, agitation, and concomitant depressive symptoms as well as an improvement in social functioning. Four patients sought repetition of the treatment months later in an outpatient setting, which led to a replication of the clinical improvement.
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