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Aripiprazole in the Treatment of Patients With Borderline Personality Disorder: A Double-Blind, Placebo-Controlled Study

Marius K. Nickel, M.D., Moritz Muehlbacher, M.D., Cerstin Nickel, M.D., Christian Kettler, M.D., Francisco Pedrosa Gil, M.D., Egon Bachler, Ph.D., Wiebke Buschmann, M.D., Nadine Rother, Reinhold Fartacek, M.D., Christoph Egger, M.D., Javaid Anvar, M.D., Wolfhardt K. Rother, M.D., Thomas H. Loew, M.D. and Patrick Kaplan, M.D.

OBJECTIVE: Aripiprazole is a relatively new atypical antipsychotic agent that has been successfully employed in therapy for schizophrenia and schizoaffective disorders. A few neuroleptics have been used in therapy for patients with borderline personality disorder, which is associated with severe psychopathological symptoms. Aripiprazole, however, has not yet been tested for this disorder, and the goal of this study was to determine whether aripiprazole is effective in the treatment of several domains of symptoms of borderline personality disorder. METHOD: Subjects meeting criteria for the Structured Clinical Interview for DSM-III-R Personality Disorders for borderline personality disorder (43 women and 9 men) were randomly assigned in a 1:1 ratio to 15 mg/day of aripiprazole (N=26) or placebo (N=26) for 8 weeks. Primary outcome measures were changes in scores on the symptom checklist (SCL-90-R), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and the State-Trait Anger Expression Inventory and were assessed weekly. Side effects and self-injury were assessed with a nonvalidated questionnaire. RESULTS: According to the intent-to-treat principle, significant changes in scores on most scales of the SCL-90-R, the HAM-D, the HAM-A, and all scales of the State-Trait Anger Expression Inventory were observed in the subjects treated with aripiprazole after 8 weeks. Self-injury occurred in the groups. The reported side effects were headache, insomnia, nausea, numbness, constipation, and anxiety.
CONCLUSIONS: Aripiprazole appears to be a safe and effective agent in the treatment of patients with borderline personality disorder.

American Journal of Psychiatry 163:833-838, May 2006
doi: 10.1176/appi.ajp.163.5.833
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