An open trial of valproate in borderline personality disorder

D. J. Stein, D. Simeon, M. Frenkel, M. N. Islam, Eric Hollander

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Background: Target symptoms in pharmacotherapy of borderline personality disorder include mood instability, anxiety, and impulsivity. Valproate appears useful for the treatment of these target symptoms in several disorders, and carbamazepine has been found effective for such symptoms in borderline personality disorder. We therefore conducted a preliminary open- label trial of valproate in borderline personality disorder. Method: Eleven patients who met DSM-III-R criteria for borderline personality disorder were entered into an 8-week study of valproate. Exclusion criteria included current major depression or major medical disorder. All patients were in psychotherapy at least once a week for a minimum of 8 weeks prior to starting medication. Valproate was increased as tolerated to reach blood levels of 50 to 100 μg/mL. Clinician- and self-rated scales were completed each week. Results: Three patients did not complete the study. Of completers, 4 of 8 patients were responders ('much less' or 'less') on clinician-rated change scores for overall pathology and for mood. Three of 8 patients were responders on change scores for anxiety, anger, impulsivity, and rejection sensitivity. There was a significant (p = .03) decrease in total Symptom Checklist-90 scores between the start and end of the trial. On the Overt Aggression Scale (Modified), total other-directed assault did not significantly decrease, but there was a significant (p = .02) decrease in global subjective irritability. Conclusion: Valproate led to overall improvement in 50% of a small sample of borderline personality disorder patients who completed an 8-week open trial. The medication was modestly helpful for mood and irritability as well as for anxiety, anger, rejection sensitivity, and impulsivity, but specific therapeutic effects varied from patient to patient. More extensive controlled trials of anticonvulsants for impulsive personality disorders are warranted.

Original languageEnglish (US)
Pages (from-to)506-510
Number of pages5
JournalJournal of Clinical Psychiatry
Volume56
Issue number11
StatePublished - 1995
Externally publishedYes

Fingerprint

Borderline Personality Disorder
Valproic Acid
Impulsive Behavior
Anxiety
Anger
Personality Disorders
Carbamazepine
Therapeutic Uses
Checklist
Aggression
Psychotherapy
Diagnostic and Statistical Manual of Mental Disorders
Anticonvulsants
Depression
Pathology
Drug Therapy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Stein, D. J., Simeon, D., Frenkel, M., Islam, M. N., & Hollander, E. (1995). An open trial of valproate in borderline personality disorder. Journal of Clinical Psychiatry, 56(11), 506-510.

An open trial of valproate in borderline personality disorder. / Stein, D. J.; Simeon, D.; Frenkel, M.; Islam, M. N.; Hollander, Eric.

In: Journal of Clinical Psychiatry, Vol. 56, No. 11, 1995, p. 506-510.

Research output: Contribution to journalArticle

Stein, DJ, Simeon, D, Frenkel, M, Islam, MN & Hollander, E 1995, 'An open trial of valproate in borderline personality disorder', Journal of Clinical Psychiatry, vol. 56, no. 11, pp. 506-510.
Stein, D. J. ; Simeon, D. ; Frenkel, M. ; Islam, M. N. ; Hollander, Eric. / An open trial of valproate in borderline personality disorder. In: Journal of Clinical Psychiatry. 1995 ; Vol. 56, No. 11. pp. 506-510.
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