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Repetitive Transcranial Magnetic Stimulation in the Treatment of a Difficult to Treat Condition, Borderline Personality Disorder


Journal of Psychiatric Practice®: January 2019 - Volume 25 - Issue 1 - p 14–21
doi: 10.1097/PRA.0000000000000350

Background: Borderline personality disorder (BPD) is a serious mental disorder characterized by a pervasive pattern of instability in affect regulation and interpersonal relationships, poor self-image and behavioral control, self-injurious behavior, suicidality, and other high-risk behaviors. It is also characterized by a high mortality rate by suicide.

Methods: The published literature on repetitive transcranial magnetic stimulation (TMS), theta-burst stimulation (TBS), and deep TMS in the treatment of BPD were reviewed.

Results: Four clinical studies (2 randomized trials and 2 case studies) with limited sample sizes found that TMS and TBS were safe and potentially effective in the reduction of symptoms of BPD.

Conclusions: Given the limited clinical evidence for efficacy on the basis of the results of these studies, future controlled studies involving larger samples and optimal stimulus parameters should be designed to confirm the short-term and long-term safety and efficacy of repetitive TMS and TBS in the treatment of BPD.

RACHID: Private practice, Geneva, Switzerland

The author declares no conflicts of interest.

Please send correspondence to: Fady Rachid, MD, 7, Place de la Fusterie, Geneva 1204, Switzerland (e-mail:

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