Quetiapine for the treatment of borderline personality disorder; an open-label study |
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Authors: | Perrella Carmine Carrus Dario Costa Emilia Schifano Fabrizio |
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Affiliation: | I Clinica Psichiatrica, Policlinico Umberto I, Università La Sapienza di Roma, Viale Dell'Università, 30 - 00185, Rome, Italy. |
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Abstract: | PURPOSE: Only a few studies have commented on the use of atypical antipsychotics for the treatment of Borderline Personality Disorder (BPD) features, including affective dysregulation and aggression. We aimed at evaluating both efficacy and safety of quetiapine in a sample of consecutive BPD patients. GENERAL METHODS: 29 BPD outpatients entered, and 23 completed, a 12 week, open-label, regime of quetiapine at an average daily dosage of 540 mg (range: 400-800 mg). Efficacy assessment psychometric instruments included: Hamilton Rating Scales for Depression (HAM-D); Brief Psychiatric Rating Scale (BPRS); Global Assessment of Functioning (GAF); Clinical Global Impression Scale (CGI); and Aggression Questionnaire (AQ). FINDINGS: Both completer and intent-to-treat analysis showed that most psychometric scales' scores exhibited a highly significant (HAM-D: p=.003; BPRS Hostility and Suspiciousness subscales; CGI; GAF; AQ: all at p=.000) improvement over time. Six patients dropped out early from treatment due to side effects; quetiapine was associated with two cases of transient thrombocytopenia. CONCLUSIONS: Present findings would suggest that quetiapine may be effective for the treatment of a number of BPD features, including low mood and aggression. However, monitoring blood counts in patients receiving quetiapine seems to be justified. |
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Keywords: | BPD, Borderline Personality Disorder HAM-D, Hamilton Rating Scales for Depression BPRS, Brief Psychiatric Rating Scale GAF, Global Assessment of Functioning CGI, Clinical Global Impression Scale AQ, Aggression Questionnaire SSRIs, selective serotonin reuptake inhibitors 5HT2A/D2, serotonin2A/dopamine2 receptors SCID, structured clinical interview for DSM-IV DSM-IV, Diagnostic and Statistical Manual of mental Disorders, 4th edition SPSS, Statistical Package for the Social Sciences EPS, extrapyramidal side effects DIB-R, Revised Diagnostic Interview for Borderlines SAS, Simpson–Angus Scale BMI, body mass index mg, milligrams L, Liter ml, milliliter ITT, intention-to-treat LOCF, last observation carried forward vs, versus. |
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