Endoxifen Dosing for Personality Disorders
There is no established or recommended dose of endoxifen for treating personality disorders as this is not an FDA-approved indication for this medication.
Current Evidence on Endoxifen
- Endoxifen is primarily known as an active metabolite of tamoxifen, which is used in breast cancer treatment 1
- The only FDA-approved formulation of endoxifen indicates "3 sprays orally, once daily" for its approved indication, which is not related to personality disorders 2
- Recent research has investigated endoxifen as a protein kinase C inhibitor for treating bipolar disorder at doses of 4-8 mg/day, but not for personality disorders 3, 4
Treatment Approaches for Personality Disorders
- Psychological or psychosocial interventions are recommended as the primary treatment for personality disorders, particularly borderline personality disorder, with pharmacotherapy considered only as adjunctive treatment 5
- The evidence base for effective pharmacological treatment of personality disorders is insufficient, with most existing research focused on borderline personality disorder 5
- Current pharmacological approaches to personality disorders typically target specific symptom clusters rather than the disorder itself 6
Common Medications Used for Symptom Management in Personality Disorders
- Antipsychotics (particularly those with sedative profiles like quetiapine) and mood-stabilizing anticonvulsants (such as valproate) are commonly prescribed for borderline personality disorder despite limited guideline support 7
- Approximately 90% of inpatients with borderline personality disorder receive psychotropic medications, with polypharmacy being common (average of 2.8 medications per patient) 7
- Antipsychotics and antidepressants are prescribed to approximately 70% of patients with borderline personality disorder, anticonvulsants to 33%, and benzodiazepines to 30% 7
Bipolar Disorder Research on Endoxifen (Not Personality Disorders)
- In bipolar disorder research, endoxifen has been studied at doses of 8 mg/day compared to 1000 mg/day of divalproex for acute manic episodes 3
- Another study examined endoxifen at 4 mg/day and 8 mg/day for bipolar I disorder with manic or mixed episodes, with the 8 mg/day dose showing a 64.29% response rate 4
Conclusion
- There is no established dosing regimen for endoxifen in the treatment of personality disorders as this is not an FDA-approved or evidence-based application of the medication 5, 6
- Clinicians should be aware that pharmacotherapy for personality disorders generally targets specific symptoms rather than the disorder itself, and psychological interventions remain the first-line treatment 5, 6