Borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) share overlapping neurobiological mechanisms, particularly reward deficiency and stress-like anti-reward processes. The authors propose reclassifying BPD as a "traumatic personality stress disorder" (TPSD) to unify therapeutic strategies that may stabilize dopaminergic reward function, such as psychedelic-assisted therapy (PAT). They argue that PAT could treat trauma-induced personality disorders by addressing these shared mechanisms. Reframing BPD as TPSD may lead to more effective, personalized interventions, reduce stigma, and improve understanding of underlying mechanisms, benefiting conditions characterized by anhedonia, negative affect, hypervigilance, and dissociation.
Terrifying lucid dreams—where the dreamer is aware and may control the dream—can plague patients with Reward Deficiency Syndrome (RDS), including those with ADHD, Tourette's syndrome, and PTSD. In eight clinical cases with histories of substance abuse, childhood abuse, and PTSD, administration of the neuronutrient KB200Z eliminated unpleasant or terrifying lucid dreams in 87.5% of cases. Other published cases have since shown long-term elimination of terrifying dreams in PTSD and ADHD patients. The article proposes that inducing dopamine homeostasis through such neuronutrients may mitigate neurogenetic and epigenetic changes in neuroplasticity underlying these disorders, and that precision formulations guided by Genetic Addiction Risk Score (GARS) testing may repair inheritable brain reward circuitry deficiencies, improving cognitive recall and attenuating trauma's harmful epigenetic insults.
A 45-year-old woman with dextromethorphan use disorder experienced intense cravings that prevented abstinence. Treatment with topiramate, chosen because both drugs act on the NMDA system, eliminated her cravings completely. Genetic testing revealed she carried the GRIK1 rs2832407(C:C) allele, which is linked to increased risk of alcohol use disorder and positive response to topiramate in heavy drinkers. This case illustrates personalized medicine using genetic testing and suggests possible shared genetic susceptibility for dependence across different substances.