A Preliminary Double-Blind, Placebo-Controlled Trial of Divalproex Sodium in Borderline Personality Disorder
J Clin Psychiatry 2001;62(3):199-203
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Background: Borderline personality disorder is
characterized by affective instability, impulsivity, and
aggression and is associated with considerable morbidity and
mortality. Since anticonvulsant agents may be helpful in such
symptomatology, we compared divalproex sodium with placebo in
patients with borderline personality disorder.
Method: A 10-week, parallel, double-blind
design was conducted. Sixteen outpatients meeting Structured
Clinical Interview for DSM-IV Axis II Personality Disorders
criteria for borderline personality disorder were randomly
assigned to receive placebo (N = 4) or divalproex sodium (N =
12). Change was assessed in global symptom severity (Clinical
Global Impressions-Improvement Scale [CGI-I]) and functioning
(Global Assessment Scale [GAS]) as well as in specific core
symptoms (depression, aggression, irritability, and suicidality).
Results: There was significant improvement from
baseline in both global measures (CGI-I and GAS) following
divalproex sodium treatment. A high dropout rate precluded
finding significant differences between the treatment groups in
the intent-to-treat analyses, although all results were in the
Conclusion: Treatment with divalproex
sodium may be more effective than placebo for global
symptomatology, level of functioning, aggression, and depression.
Controlled trials with larger sample sizes are warranted to
confirm these preliminary results.