Michan Colin
A six-month RCT was included in 38 patients who had been hospitalized for suicide. The results showed no significant differences in the outcome of the Mianxin group and the placebo group.
Antidepressants: Summary
There are few studies on the treatment of BPD with antidepressants. At present, TCAs can effectively improve the depressive symptoms of BPD patients, and SSRI, phenylhydrazine and rice Anguolin evidence is insufficient.
State of mind stabilizer
* Carbamazepine: In a RCT that was included in 20 BPD hospitalized patients, carbamazepine did not show a benefit compared to placebo.
* Dipro-valerate: A 10-week, double-blind, placebo-controlled study included 16 outpatients with BPDs aimed at comparing the efficacy of dipropentanate versus placebo in the treatment of BPD. Only six people completed the study, five of them achieved a response, defined as the end of the CGI-I score of 1 or 2 points.
In a double-blind, placebo-controlled study of 30 female patients over a six-month period, sodium valproate was superior to placebo in reducing interpersonal sensitivity (SMD, -1.046) and anger / hostility Aggressive also improved.
In the third study, 15 BPD patients first received a “compressed version” of DBT, after treatment SCL-90 score of more than 150 were randomly assigned to the placebo group or dipropionate sustained-release group. The results showed that there was no significant difference in the outcome of the two groups.
* Lamotrigine: A 12-week, double-blind placebo-controlled study of 28 patients compared to placebo, lamotrazine in patients with emotional instability and impulsive improvement was significantly improved. In another placebo-controlled study, after eight weeks of treatment, the analgesic symptoms (SMD, -1.696) of the lamotrazine group were significantly improved.
* Topiramate: Three RCTs explored the efficacy of topiramate against BPD, and these studies were performed by the same group of investigators. In the first study, the investigators explored the effects of topiramate on aggressive efficacy in 29 female BPD patients. After eight weeks of treatment, the improvement in the score of the STAXI four subscales (anger, anger, anger, and anger) score was significantly better than placebo in the topiramate group. The second study used a similar design, but the subjects were replaced by 42 BPD male patients, and eventually a similar result was obtained.
In the third study, the investigators sought to investigate whether topiramate can improve the psychopathological status of BPD, health-related quality of life and interpersonal problems. The results showed that topiramate was effective in reducing psychiatric symptoms (SMD, -1.196), anxiety (SMD, -1.406), anger (SMD, -3.006) and interpersonal difficulties at the 8th week and the 10th week (SMD, -0.916 ).
State of mind stabilizer: summary
The RCT treated by mood stabilizer was subject to lower statistical efficacy. Sodium dibprovalerate improves the anger and interpersonal sensitivity of BPD patients, and topiramate and lamotrigine have an improved effect on anger. Carbamazepine did not show a statistically significant effect.
Antipsychotics
Loxapine vs. chlorpromazine: A 6-week study of 80 outpatients with BPD compared the efficacy of loxapine (mean dose 14.5 mg) and chlorpromazine (mean dose 110 mg / d) The indicators included BPD severity, emotional instability, psychotic symptoms assessed by BPRS, and overall mental status of CGI assessment. Researchers reported that both groups were significantly improved compared to baseline, and that in patients with depression and anger / hostility, loxapine was significantly better than chlorpromazine.
* Fenfloxacine: Fipronol can significantly reduce the number of suicide attempts in patients with personality disorder after 4 months compared to placebo, and 30 in the study at 6 months The same is true for patients, 23 of whom are BPD patients.
* Sulfonamide thioxanthone: the drug is a sulfur anthracene antipsychotics, and phenothiazine pharmacological effects similar. A 50-week outpatient BPD and / or schizoid of personality disorder patients, a 12-week study of sulfoxide thiophene at a dose of 8.7 mg / d in the last week. In improving psychotic symptoms, Significantly superior to placebo, while depressive symptoms were not significantly different.
* Haloperidol: In the first 5-week, double-blind, randomized controlled study, the investigators compared the efficacy of haloperidol, amitriptyline and placebo in the treatment of 90 patients with BPD, The average dose of alcohol was 5 mg / d. The results showed that haloperidol was significantly superior to placebo in improving overall function, depression, hostility, splitting symptoms and impulsive behavior.
In the second study, the investigators compared the efficacy of haloperidol, perphenazine and placebo in the treatment of emotional, cognitive and impulsive symptoms in 108 BPD hospitalized patients. Compared with perphenazine, haloperidol showed a tendency to reduce the interpersonal problems of patients.
Aripiprazole: In only one RCT, 43 women and 9 male BPD patients received aripiprazole 15 mg / d for 8 weeks. The results showed that the effects of aripiprazole on depression (SMD, -1.256), interpersonal relationship (SMD, -0.77), impulsivity (SMD, -1.846), anger (SMD, 1.146) and paranoid thinking (SMD, -1.056) Have a significant effect, and anxiety with moderate efficacy (SMD, -0.736).
The average dose of ziprasidone was 84 mg / d in a single-center, double-blind, placebo-controlled study of 60 adult BPD patients, and the outcome included CGI scale scores And other self-assessment reports related to emotion, behavior, psychosis, etc. Researchers also explored clinical safety. There was no statistically significant difference between the ziprasidone group and the placebo group.
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