Drug Used To Treat Schizophrenia and Bipolar Disorder Shows Promise In Borderline Personality Disorder Treatment

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Researchers have identified numerous medications that could potentially help treat borderline personality disorder (BPD), but so far none have been formally approved. Now, a study in AJP in Advance shows that quetiapine, an antipsychotic intended for treatment of bipolar disorder and schizophrenia, may potentially work as therapy for BPD.

The team of researchers led by Donald Black, M.D., video chair of education and professor of psychiatry at the University of Iowa Carver College of Medicine, compared the efficacy and tolerability of low to moderate dosages of extended-release quetiapine in adults diagnosed with BPD.

“A variety of psychotherapies has been developed [to treat BPD], and while research on the use of medication is ongoing, no drug has been approved in the United States or elsewhere for its treatment,” the researchers pointed out. “This study was designed to provide a rigorous test of extended-release (ER) quetiapine in the treatment of borderline personality disorder.”

The researchers say second-generation antipsychotics such as quetiapine have been the category of medications most thoroughly studied for the treatment of borderline personality disorder, but randomized, controlled, trials of aripiprazole, olanzapine, and ziprasidone have produced mixed results.

Compared to these drugs, quetiapine has gone relatively unresearched. Only five studies have investigated the medication, all with positive effects. However, the reearchers did note that these studies used small sample sizes and focused on specific symptoms of BPD, rather than the general symptomatology of the illness.

In an effort to build on this previous research, Black and colleagues randomly assigned 95 participants between the ages of 18 and 45 to receive low (150 mg/day) or moderate (300 mg/day) dosages of queritapine-ER or placebos for eight weeks.

The researchers then evaluated changes in BPD symptoms using the Zanarini Rating Scale for Borderline Personality Disorder and the Modified Overt Aggression Scale.

Of the participants who completed the study, 82 percent of those receiving low-dosage qutiapine-ER showed signficiant improvements in numerous BPD symptoms including cognitive disturbance, disturbed relationships, and aggression, compared to 48 percent in the placebo group. Moderate dosages also showed slight increases in effectiveness compared to placebos, but the difference was not statistically significant.

Those taking the higher dosage were also more likely to experience negative side-effects and discontinue the study compared to those administered low dosages.

“This study joins a growing body of evidence showing that a relatively brief course of quetiapine can provide clinically meaningful benefit to borderline patients,” the researchers said.

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