Translated from our German original by AI. The German text was researched, written, and edited by the Psychedelia Foundation team and remains the authoritative version.
People with borderline personality disorder (BPD) could in future benefit from psychedelic treatment approaches. That is the conclusion of the review Psychedelics as a potential treatment for borderline personality disorder: A narrative review, which summarizes the current state of research on ketamine, esketamine, and psilocybin in this group.
Borderline personality disorder is a serious mental illness with a high burden of disease and strong social stigma. At the same time, the available treatment options are limited, so that many patients do not achieve lasting improvement in their symptoms.
Although scientific interest in psychedelics as a new form of therapy in psychiatry has grown considerably in recent years, people with borderline personality disorder are often excluded from clinical trials. The reasons are safety concerns, in particular regarding suicidality and possible substance misuse.
For the review, the researchers evaluated publications from the Ovid MEDLINE, PsycInfo, and Embase databases. In total, 22 studies with a range of study designs were included in the analysis. The compounds examined were above all ketamine, esketamine, and psilocybin.
In the authors’ assessment, the results provide first indications that these substances could have a positive effect both on core symptoms of borderline personality disorder and on the anxiety and depressive disorders that often accompany it. There are also signs of improvements in social and occupational functioning.
At the same time, the review stresses that the evidence so far remains limited. The available studies are heterogeneous and often not designed around borderline-specific endpoints. A conclusive assessment of efficacy and safety is therefore not yet possible.
The researchers therefore call for further high-quality clinical trials that deliberately include people with borderline personality disorder. Only such studies could clarify what role psychedelic therapies might play in treating the disorder in future.
