Abstract | INTRODUCTION:
Borderline personality disorder (BPD) is associated with several symptoms, including impulsivity, aggression, and intense unstable affect, which can be targeted with anticonvulsant agents. Divalproex extended-release (ER) is used widely in clinical practice, which leads to the question of its efficacy and tolerability in treating BPD. METHODS: This study assessed the efficacy and tolerability of divalproex ER in 20 adult outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BPD via a 12-week open-label trial. Primary outcome measures included the Clinical Global Impression-Improvement (CGI-I) scale and the Global Assessment Scale. Secondary outcome measures assessed aggression (Aggression Questionnaire, Overt Aggression Scale-Modified); affective disturbance (Affective Intensity Measure, Affective Lability Scale); dissociation (Dissociative Experiences Scale); and general psychopathology (Symptom-Checklist 90-Revised). RESULTS: Thirteen subjects were male and seven were female with a mean age of 37.0+/-11.3 years. Treatment was associated with statistically significant improvement on the CGI-I, the Global Assessment Scale, the Overt Aggression Scale-Modified irritability subscale, and the Aggression Questionnaire. A trend toward significant improvement was observed on the Affective Intensity Measure. Seven out of 10 completers (70%) were treatment responders, with an endpoint CGI-I of 2 (much improved) or 1 (very much improved). There was no significant decline in affective lability or in dissociation. One participant discontinued treatment due to adverse events. CONCLUSION: These findings support that divalproex ER is an efficacious and well-tolerated pharmacologic agent for BPD, with the additional advantage of single daily dosing at bedtime. Placebo-controlled trials are needed for replication.
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Authors | Daphne Simeon, Bryann Baker, William Chaplin, Ashley Braun, Eric Hollander |
Journal | CNS spectrums
(CNS Spectr)
Vol. 12
Issue 6
Pg. 439-43
(Jun 2007)
ISSN: 1092-8529 [Print] United States |
PMID | 17545954
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anticonvulsants
- Delayed-Action Preparations
- Valproic Acid
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Topics |
- Adult
- Aggression
(drug effects)
- Anticonvulsants
(administration & dosage, adverse effects, therapeutic use)
- Borderline Personality Disorder
(drug therapy, psychology)
- Delayed-Action Preparations
- Female
- Humans
- Impulsive Behavior
(drug therapy, psychology)
- Male
- Middle Aged
- Psychiatric Status Rating Scales
- Valproic Acid
(administration & dosage, adverse effects, therapeutic use)
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