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Olanzapine safety and efficacy in patients with
borderline personality disorder and comorbid
dysthymia.
Schulz SC, Camlin KL, Berry SA,
Jesberger JA.
Department of Psychiatry, University of
Minnesota Medical School, Minneapolis 55454-1495,
USA.
BACKGROUND: Numerous medications have been tested in
patients with borderline personality disorder (BPD) and/or schizotypal
personality disorder (SPD). Although many of the medications tested have
been demonstrated to be useful, no clear main treatment for BPD has
emerged. Despite the efficacy of some of the medicines, acceptability
and side effects have proven to be barriers to the use of medication.
Therefore, an open-label olanzapine trial utilizing objective ratings
was performed. METHODS: Patients suffering from BPD and dysthymia were
included in an 8-week, open-label study of olanzapine monotherapy. The
first 4 weeks of the trial allowed for flexible dosing; during the last
4 weeks, olanzapine dose was held constant. Patients were rated on
Hopkins Symptoms Checklist 90 (SCL-90), Brief Psychiatric Rating Scale
(BPRS), Global Assessment of Function (GAF), Barratt Impulsivity Scale
(BIS 11), and Buss-Durkee Hostility Inventory (BDHI). RESULTS: Eleven
patients completed at least 2 weeks; nine of the patients finished the
entire trial. There was a robust and statistically significant reduction
in the five global ratings. Within the global ratings, symptoms of
psychoticism, depression, interpersonal sensitivity, and anger were
among the symptoms to be reduced. No movement disorder symptoms were
noted for any of the patients. CONCLUSIONS: In this open-label pilot
study, patients treated with olanzapine showed statistically significant
reduction in self-rated and clinician-rated scales. Symptoms associated
with BPD and dysthymia were among those to be substantially reduced.
Further studies to explore olanzapine's efficacy versus placebo, as well
as comparison to other potential treatments for BPD, are important next
steps.
Publication Types:
PMID: 10578457 [PubMed - indexed for
MEDLINE]
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