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Copyright (c) 2021 Andrea Rangel
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Persistence of impulsivity in an adolescent with Borderline Personality Disorder
Corresponding Author(s) : Andrea Rangel
Ciencia e Innovación en Salud,
2021
Abstract
Adolescence is a period of transition and changes where borderline personality traits can influence the manifestations of a depressive illness. Adolescents may present dysphoric features and extreme sensitivity to rejection, which can sometimes culminate in self-harm. The thoughtless and explosive behaviors are a group of impulsive acts whose purpose is to choose immediate and short responses as well as to select the most likely options regardless they are less rewarding, which represents a high risk for suicide. The pathogenesis of Borderline Personality Disorder (BPD) involves interactions between genetic, biological and environmental factors, resulting in fluctuations in mood, impulsivity, and cognitive dysfunctions. This is the case of an adolescent with major depressive disorder and BPD after numerous unsuccessful therapeutic regimens, including Selective Serotonin Reuptake Inhibitors (SSRIs), antipsychotics, and mood stabilizers, achieves improvement after medication with amitriptyline, a tricyclic antidepressant. There is no specific drug for treatment. The multidimensional nature of the factors involved makes drug management complex. Psychotherapeutic treatment is essential to modulate some target symptoms.
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- Falcato MA, Muñoz NH, Urquiola YC. Depresión en la adolescencia: consideraciones
- necesarias para su diagnóstico y tratamiento. Rev Finlay. 20 de julio de 2017;7(3):152-4.
- http://www.revfinlay.sld.cu/index.php/finlay/article/view/541/1583
- Dalley JW, Robbins TW. Fractionating impulsivity: neuropsychiatric implications. Nat Rev
- Neurosci. marzo de 2017;18(3):158-71. DOI: 10.1038/nrn.2017.8
- Moghaddas A, Dianatkhah M, Ghaffari S, Ghaeli P. The Potential Role of Naltrexone in
- Borderline Personality Disorder. Iran J Psychiatry. 23 de abril de 2017;12(2):142-6.
- https://pubmed.ncbi.nlm.nih.gov/28659987/
- Jupp B, Caprioli D, Saigal N, Reverte I, Shrestha S, Cumming P, et al. Dopaminergic and
- GABA-ergic markers of impulsivity in rats: evidence for anatomical localisation in ventral
- striatum and prefrontal cortex. Eur J Neurosci. mayo de 2013;37(9):1519-28.
- DOI: 10.1111/ejn.12146
- Di Sebastiano AR, Fahim S, Dunn HA, Walther C, Ribeiro FM, Cregan SP, et al. Role of
- Spinophilin in Group I Metabotropic Glutamate Receptor Endocytosis, Signaling, and Synaptic
- Plasticity. J Biol Chem. 19 de agosto de 2016;291(34):17602-15.
- https://www.jbc.org/article/S0021-9258(20)33402-5/fulltext
- Brunton Laurence, Lazo John. Goodman & Gilman. Las bases farmacológicas de la
- terapéutica. 13.a ed. McGraw-Hill; 2019.
- Areal LB, Hamilton A, Martins-Silva C, Pires RGW, Ferguson SSG. Neuronal scaffolding
- protein spinophilin is integral for cocaine-induced behavioral sensitization and ERK1/2
- activation. Mol Brain. 25 de febrero de 2019;12(1):15. DOI: 10.1186/s13041-019-0434-7
- Kumaresan V, Yuan M, Yee J, Famous KR, Anderson SM, Schmidt HD, et al. Metabotropic
- glutamate receptor 5 (mGluR5) antagonists attenuate cocaine priming- and cue-induced
- reinstatement of cocaine seeking. Behav Brain Res. 14 de septiembre de 2009;202(2):238-44.
- DOI: 10.1016/j.bbr.2009.03.039
- Caprioli D, Sawiak SJ, Merlo E, Theobald DEH, Spoelder M, Jupp B, et al. Gamma
- Aminobutyric Acidergic and Neuronal Structural Markers in the Nucleus Accumbens Core
- Underlie Trait-like Impulsive Behavior. Biol Psychiatry. 15 de enero de 2014;75(2):115-23.
- DOI: 10.1016/j.biopsych.2013.07.013
- Aguirre LE, De Leon-Benedetti A. Perspectivas en el abordaje farmacológico de la Epilepsia:
- una revisión extensa de la farmacoterapia. Rev. Ecuat Neurol. diciembre de 2019;28(3):59-67. http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&pid=S2631-25812019000300059
- Ellenbroek BA, Ghiabi B. The other side of the histamine H3 receptor. Trends Neurosci. abril
- de 2014;37(4):191-9. DOI: 10.1016/j.tins.2014.02.007
- Romigi A, Vitrani G, Lo Giudice T, Centonze D, Franco V. Profile of pitolisant in the
- management of narcolepsy: design, development, and place in therapy. Drug Des Devel Ther.
- de agosto de 2018;12:2665-75. DOI: 10.2147/DDDT.S101145
- Mena-Avila E, Márquez-Gómez R, Aquino-Miranda G, Nieto-Alamilla G, Arias-Montaño J-A.
- Clobenpropit, a histamine H3 receptor antagonist/inverse agonist, inhibits [3H]-dopamine
- uptake by human neuroblastoma SH-SY5Y cells and rat brain synaptosomes. Pharmacol Rep.
- de febrero de 2018;70(1):146-55. DOI: 10.1016/j.pharep.2017.08.007
- De Deurwaerdère P, Ramos M, Bharatiya R, Puginier E, Chagraoui A, Manem J, et al.
- Lorcaserin bidirectionally regulates dopaminergic function site-dependently and disrupts
- dopamine brain area correlations in rats. Neuropharmacology. 1 de abril de 2020; 166:107915.
- DOI: 10.1016/j.neuropharm.2019.107915
- Timäus C, Meiser M, Bandelow B, Engel K, Paschke A, Wiltfang J, et al. Pharmacotherapy of
- borderline personality disorder: what has changed over two decades? A retrospective
- evaluation of clinical practice. BMC Psychiatry. 1 de diciembre de 2019;19:393.
- DOI: 10.1186/s12888-019-2377-z
- Tabares ASG, Núñez C, Osorio MPA, Aguirre AMG. Risk and Suicidal Ideation and its
- Relationship with Impulsivity and Depression in School Adolescent. Rev Iberoam Diagn
- EVALUACION-E AVALIACAO Psicol. 1 de enero de 2020;54(1):147-63.
- https://investigaciones-pure.udem.edu.co/es/publications/risk-and-suicidal-ideation-and-its-
- relationship-with-impulsivity-
References
Falcato MA, Muñoz NH, Urquiola YC. Depresión en la adolescencia: consideraciones
necesarias para su diagnóstico y tratamiento. Rev Finlay. 20 de julio de 2017;7(3):152-4.
http://www.revfinlay.sld.cu/index.php/finlay/article/view/541/1583
Dalley JW, Robbins TW. Fractionating impulsivity: neuropsychiatric implications. Nat Rev
Neurosci. marzo de 2017;18(3):158-71. DOI: 10.1038/nrn.2017.8
Moghaddas A, Dianatkhah M, Ghaffari S, Ghaeli P. The Potential Role of Naltrexone in
Borderline Personality Disorder. Iran J Psychiatry. 23 de abril de 2017;12(2):142-6.
https://pubmed.ncbi.nlm.nih.gov/28659987/
Jupp B, Caprioli D, Saigal N, Reverte I, Shrestha S, Cumming P, et al. Dopaminergic and
GABA-ergic markers of impulsivity in rats: evidence for anatomical localisation in ventral
striatum and prefrontal cortex. Eur J Neurosci. mayo de 2013;37(9):1519-28.
DOI: 10.1111/ejn.12146
Di Sebastiano AR, Fahim S, Dunn HA, Walther C, Ribeiro FM, Cregan SP, et al. Role of
Spinophilin in Group I Metabotropic Glutamate Receptor Endocytosis, Signaling, and Synaptic
Plasticity. J Biol Chem. 19 de agosto de 2016;291(34):17602-15.
https://www.jbc.org/article/S0021-9258(20)33402-5/fulltext
Brunton Laurence, Lazo John. Goodman & Gilman. Las bases farmacológicas de la
terapéutica. 13.a ed. McGraw-Hill; 2019.
Areal LB, Hamilton A, Martins-Silva C, Pires RGW, Ferguson SSG. Neuronal scaffolding
protein spinophilin is integral for cocaine-induced behavioral sensitization and ERK1/2
activation. Mol Brain. 25 de febrero de 2019;12(1):15. DOI: 10.1186/s13041-019-0434-7
Kumaresan V, Yuan M, Yee J, Famous KR, Anderson SM, Schmidt HD, et al. Metabotropic
glutamate receptor 5 (mGluR5) antagonists attenuate cocaine priming- and cue-induced
reinstatement of cocaine seeking. Behav Brain Res. 14 de septiembre de 2009;202(2):238-44.
DOI: 10.1016/j.bbr.2009.03.039
Caprioli D, Sawiak SJ, Merlo E, Theobald DEH, Spoelder M, Jupp B, et al. Gamma
Aminobutyric Acidergic and Neuronal Structural Markers in the Nucleus Accumbens Core
Underlie Trait-like Impulsive Behavior. Biol Psychiatry. 15 de enero de 2014;75(2):115-23.
DOI: 10.1016/j.biopsych.2013.07.013
Aguirre LE, De Leon-Benedetti A. Perspectivas en el abordaje farmacológico de la Epilepsia:
una revisión extensa de la farmacoterapia. Rev. Ecuat Neurol. diciembre de 2019;28(3):59-67. http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&pid=S2631-25812019000300059
Ellenbroek BA, Ghiabi B. The other side of the histamine H3 receptor. Trends Neurosci. abril
de 2014;37(4):191-9. DOI: 10.1016/j.tins.2014.02.007
Romigi A, Vitrani G, Lo Giudice T, Centonze D, Franco V. Profile of pitolisant in the
management of narcolepsy: design, development, and place in therapy. Drug Des Devel Ther.
de agosto de 2018;12:2665-75. DOI: 10.2147/DDDT.S101145
Mena-Avila E, Márquez-Gómez R, Aquino-Miranda G, Nieto-Alamilla G, Arias-Montaño J-A.
Clobenpropit, a histamine H3 receptor antagonist/inverse agonist, inhibits [3H]-dopamine
uptake by human neuroblastoma SH-SY5Y cells and rat brain synaptosomes. Pharmacol Rep.
de febrero de 2018;70(1):146-55. DOI: 10.1016/j.pharep.2017.08.007
De Deurwaerdère P, Ramos M, Bharatiya R, Puginier E, Chagraoui A, Manem J, et al.
Lorcaserin bidirectionally regulates dopaminergic function site-dependently and disrupts
dopamine brain area correlations in rats. Neuropharmacology. 1 de abril de 2020; 166:107915.
DOI: 10.1016/j.neuropharm.2019.107915
Timäus C, Meiser M, Bandelow B, Engel K, Paschke A, Wiltfang J, et al. Pharmacotherapy of
borderline personality disorder: what has changed over two decades? A retrospective
evaluation of clinical practice. BMC Psychiatry. 1 de diciembre de 2019;19:393.
DOI: 10.1186/s12888-019-2377-z
Tabares ASG, Núñez C, Osorio MPA, Aguirre AMG. Risk and Suicidal Ideation and its
Relationship with Impulsivity and Depression in School Adolescent. Rev Iberoam Diagn
EVALUACION-E AVALIACAO Psicol. 1 de enero de 2020;54(1):147-63.
https://investigaciones-pure.udem.edu.co/es/publications/risk-and-suicidal-ideation-and-its-
relationship-with-impulsivity-