Clozapine treatment of adolescent refractory emergent emotionally unstable personality disorder: Challenges in diagnostics and therapeutics

Abstract

Despite recent advances precision diagnostic criteria on how best to diagnose and treat EUPD remains debated. Therapeutic indication and appropriate use of anti-psychotics including clozapine in this patient group remains unclear. It is debated about personality disorder being diagnosed in children and adolescents, overall it is much more acceptable for adolescents to be given a diagnosis of ‘emerging’ personality disorder if they exhibit clinical features of such. Clozapine has been used (as an off-license treatment) in adults diagnosed with personality disorder improving psychopathology and quality of life. These patients have been tried on numerous other treatments. In a secure unit for adolescent girls who meet the criteria for a diagnosis of emergent personality disorder who posed serious risks to themselves and others three were given a trial of clozapine The off license use of clozapine was tried in all three patients showed a reduction in incidents, reduced need for polypharmacy and improvement in their qualities of life. One cannot account for these changes being the result of clozapine alone; however, these cases add to the growing body of evidence of the benefits of clozapine in patients with emergent personality disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.