TMS and BPD – The Evidence

Borderline Personality Disorder, or BPD, can be difficult for psychiatrists to diagnose because the symptoms can be so varied. There are no drugs currently licensed by NICE (the National Institute of Health and Care Excellence in the UK) for the treatment of DPD. Research suggests that around 1.7% of the UK population are diagnosed with BPD – although this doesn’t sound like a high percentage, it equates to over 1 million people!

The NICE guidelines recommend two types of therapy for BPD:

  • Dialectical Behaviour Therapy (DBT), which works to identify negative thought patterns and introduce positive thoughts and behaviours
  • Cognitive Analytical Therapy (CAT), which looks into the experiences that could have caused you to think and feel the way you do

It’s recognised that the research evidence for treatment of borderline personality is weak and DBT tends to only be effective for symptoms of deliberate self-harm. BPD does tend to improve with age, but research also suggests that suicide rates are up to 50 times higher in BPD sufferers than in those without BPD. This highlights how vital effective treatment is while the disorder is at its worst.

What is the evidence for TMS treatment for borderline personality disorder?

When treating borderline personality disorder with transcranial magnetic stimulation, we target the prefrontal cortex.

Since 2014, there have been a number of studies into treating BPD with TMS. Reyes-Lopez treated a number of patients with an average reduction in the severity of BPD symptoms of 30%. The biggest improvement was in symptoms of anger, mood instability and impulsivity.

Calihol treated half of his group of patients with a placebo to allow him to compare the improvements in their symptoms with a  group of patients receiving TMS treatment. The group receiving the active TMS saw 40% more patients with a significant improvement in their symptoms than the placebo group.

Feffer chose to study patients living with both borderline personality disorder and depression simultaneously. All of his patients saw a significant improvement in their depression, making other symptoms of BPD easier to cope with.

At Smart TMS, we have treated a number of patients with borderline personality disorder and see around 75% see a significant improvement in their symptoms with 60% going into remission.


What’s the verdict? Does TMS treat BPD?

With all research into using TMS to treat BPD, there is evidence that suggests that the patient will show signs of responding to the treatment within the first 15 sessions if they are going to see any response at all.

If we see a small but clear improvement in your symptoms within the first 15 sessions, you will be prescribed up to 30 sessions to maximise the effect of treatment.

In some cases, we don’t see any improvements so the decision to try TMS to treat your borderline personality disorder is an individual one and it’s important that you’re informed by the evidence above.

Find out more

As you may have experienced with your regular GP or psychiatrist, BPD is very difficult to treat. Our friendly, knowledgeable team of patient advisors will talk you through TMS and the response/remission rates we have seen since offering treatment for borderline personality disorder to help you make the best decision for you.


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