An open trial of valproate in borderline personality disorder

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dc.contributor.authorStein D.J.
dc.contributor.authorSimeon D.
dc.contributor.authorFrenkel M.
dc.contributor.authorIslam M.N.
dc.contributor.authorHollander E.
dc.date.accessioned2011-05-15T16:01:58Z
dc.date.available2011-05-15T16:01:58Z
dc.date.issued1995
dc.description.abstractBackground: Target symptoms in pharmacotherapy of borderline personality disorder include mood instability, anxiety, and impulsivity. Valproate appears useful for the treatment of these target symptoms in several disorders, and carbamazepine has been found effective for such symptoms in borderline personality disorder. We therefore conducted a preliminary open- label trial of valproate in borderline personality disorder. Method: Eleven patients who met DSM-III-R criteria for borderline personality disorder were entered into an 8-week study of valproate. Exclusion criteria included current major depression or major medical disorder. All patients were in psychotherapy at least once a week for a minimum of 8 weeks prior to starting medication. Valproate was increased as tolerated to reach blood levels of 50 to 100 μg/mL. Clinician- and self-rated scales were completed each week. Results: Three patients did not complete the study. Of completers, 4 of 8 patients were responders ('much less' or 'less') on clinician-rated change scores for overall pathology and for mood. Three of 8 patients were responders on change scores for anxiety, anger, impulsivity, and rejection sensitivity. There was a significant (p = .03) decrease in total Symptom Checklist-90 scores between the start and end of the trial. On the Overt Aggression Scale (Modified), total other-directed assault did not significantly decrease, but there was a significant (p = .02) decrease in global subjective irritability. Conclusion: Valproate led to overall improvement in 50% of a small sample of borderline personality disorder patients who completed an 8-week open trial. The medication was modestly helpful for mood and irritability as well as for anxiety, anger, rejection sensitivity, and impulsivity, but specific therapeutic effects varied from patient to patient. More extensive controlled trials of anticonvulsants for impulsive personality disorders are warranted.
dc.description.versionArticle
dc.identifier.citationJournal of Clinical Psychiatry
dc.identifier.citation56
dc.identifier.citation11
dc.identifier.issn1606689
dc.identifier.urihttp://hdl.handle.net/10019.1/12241
dc.subjectcarbamazepine
dc.subjectphenytoin
dc.subjectvalproate semisodium
dc.subjectadult
dc.subjectanger
dc.subjectanxiety
dc.subjectarticle
dc.subjectborderline state
dc.subjectclinical article
dc.subjectclinical trial
dc.subjectdiarrhea
dc.subjectdyspepsia
dc.subjectfemale
dc.subjecthair loss
dc.subjecthamilton scale
dc.subjectheadache
dc.subjecthuman
dc.subjectimpulsiveness
dc.subjectirritability
dc.subjectmale
dc.subjectmood
dc.subjectnausea
dc.subjectoral drug administration
dc.subjectpriority journal
dc.subjectself concept
dc.subjectskin tingling
dc.subjecttremor
dc.subjectvertigo
dc.subjectAdult
dc.subjectAmbulatory Care
dc.subjectBorderline Personality Disorder
dc.subjectDrug Administration Schedule
dc.subjectFemale
dc.subjectHuman
dc.subjectMale
dc.subjectPersonality Inventory
dc.subjectPsychiatric Status Rating Scales
dc.subjectSupport, Non-U.S. Gov't
dc.subjectTreatment Outcome
dc.subjectValproic Acid
dc.titleAn open trial of valproate in borderline personality disorder
dc.typeArticle
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