Open-Label Study of Atypical Neuroleptic Quetiapine for Treatment of Borderline Personality Disorder: Impulsivity as Main Target
J Clin Psychiatry 2005;66(10):1298-1303
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: Recent studies indicate that
atypical neuroleptics may be safe and useful in treating
many symptoms of borderline personality disorder
(BPD), including impulsivity, which can constitute the
core dimension of this pathology. This study aimed
to evaluate the efficacy and safety of quetiapine in
patients with well-defined BPD. It was
hypothesized that quetiapine would reduce impulsivity
(primary hypothesis) and also affective and
micropsychotic symptoms, resulting in improved social and
global functioning (secondary hypothesis).
Method: Twenty-three outpatients with BPD
according to DSM-IV criteria and the revised
Diagnostic Interview for Borderlines completed a
12-week open-label study with quetiapine. The study was
conducted from May 2001 to May 2003. The clinical efficacy was assessed using the following:
Hamilton Rating Scales for Depression and Anxiety,
Hopelessness Scale, Brief Psychiatric Rating Scale,
Barratt Impulsivity Scale, Buss-Durkee Hostility
Inventory, Temperament and Character Inventory, Social
Adjustment Scale, and Global Assessment of
Results: The mean daily dose of
quetiapine (251 ± 50 mg; range, 175 - 400 mg) was well
tolerated. Impulsivity was significantly improved by quetiapine (p = .0015), as were most of our outcome measures: hostility, depression, anxiety,
character dimensions, and social and global
functioning (p < .05). In the small subgroup of patients with
psychotic symptoms at baseline, there was a
significant reduction in these symptoms (N = 8, p = .018).
Conclusion: In a sample of patients with
severe BPD without or with only few psychotic
symptoms, a low dose of quetiapine was associated with
a strong positive clinical impact, including
improvement of impulsivity.