Divalproex Sodium Treatment of Women With Borderline Personality Disorder and Bipolar II Disorder: A Double-Blind Placebo-Controlled Pilot Study
Frances R. Frankenburg and Mary C. Zanarini
J Clin Psychiatry 2002;63(5):442-446
© Copyright 2019 Physicians Postgraduate Press, Inc.
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Background: The intent of this study was
to compare the efficacy and safety of divalproex sodium and placebo in the treatment of
women with borderline personality disorder and
comorbid bipolar II disorder.
Method: We conducted a
placebo-controlled double-blind study of divalproex sodium in
30 female subjects aged 18 to 40 years who met Revised Diagnostic Interview for Borderlines
and DSM-IV criteria for borderline personality
disorder and DSM-IV criteria for bipolar II
disorder. Subjects were randomly assigned to
divalproex sodium or placebo in a 2:1 manner.
Treatment duration was 6 months. Primary outcome
measures were changes on the interpersonal
sensitivity, anger/hostility, and depression scales of
the Symptom Checklist 90 (SCL-90) as well as the total score of the modified Overt
Aggression Scale (MOAS).
Results: Twenty subjects were randomly
assigned to divalproex sodium; 10 subjects to placebo. Using a
last-observation-carried-forward paradigm and controlling for baseline
severity, divalproex sodium proved to be superior to
placebo in diminishing interpersonal sensitivity
and anger/hostility as measured by the SCL-90 as well as overall aggression as measured by
the MOAS. Adverse effects were infrequent.
Conclusion: The results of this study
suggest that divalproex sodium may be a safe and
effective agent in the treatment of women with criteria-defined borderline personality disorder
and comorbid bipolar II disorder, significantly decreasing their irritability and anger, the
tempestuousness of their relationships, and their
impulsive aggressiveness.