Personality disorders: pharmacotherapy in borderline: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Personality disorders: pharmacotherapy in borderline

Sample item

A woman with borderline personality disorder is in crisis with impulsive overdoses. What is the best approach to medication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Use limited, targeted drugs for comorbidity or short crises and prescribe small quantities

Psychotherapy is the primary treatment. Drugs treat comorbid depression, or short-term symptoms, and should be limited with small supplies because of overdose risk. Tricyclics are dangerous in overdose and benzodiazepines can disinhibit and cause dependence.

Option by option

  • A. Withhold all psychological therapy

    Psychological therapy is the mainstay and should not be withheld.

  • B. Use limited, targeted drugs for comorbidity or short crises and prescribe small quantities (correct)

    Correct. Targeted and limited prescribing alongside therapy is advised.

  • C. Prescribe tricyclic antidepressants in bulk

    Bulk tricyclics are highly toxic in overdose.

  • D. Prescribe long-term benzodiazepines in large supplies

    Large benzodiazepine supplies risk disinhibition, dependence and overdose.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Use limited, targeted drugs for comorbidity or short crises and prescribe small quantities. Psychotherapy is the primary treatment.

Why is "Withhold all psychological therapy" not the answer?

Psychological therapy is the mainstay and should not be withheld.

Why is "Prescribe tricyclic antidepressants in bulk" not the answer?

Bulk tricyclics are highly toxic in overdose.

Why is "Prescribe long-term benzodiazepines in large supplies" not the answer?

Large benzodiazepine supplies risk disinhibition, dependence and overdose.

What concept does this question test?

It tests Personality disorders: pharmacotherapy in borderline in Psychiatry. Drugs treat comorbid depression, or short-term symptoms, and should be limited with small supplies because of overdose risk. Tricyclics are dangerous in overdose and benzodiazepines can disinhibit and cause dependence.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Personality disorders: pharmacotherapy in borderline?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.