Efficacy of pharmacotherapy against core traits of borderline personality disorder: meta-analysis of randomized controlled trials

Int Clin Psychopharmacol. 2006 Nov;21(6):345-53. doi: 10.1097/01.yic.0000224784.90911.66.

Abstract

We conducted a meta-analysis of published randomized, placebo-controlled clinical trials that evaluated the effect of pharmacotherapy in patients with borderline personality disorder. Comprehensive searches of the MEDLINE, EMBASE, PsychLIT and Cochrane Central Register of Controlled Trials databases were performed using web-based search engines. Twenty articles, reporting 22 placebo-controlled comparisons, were included in the meta-analysis: eight involved antipsychotics, seven antidepressants and seven mood stabilizers. Antidepressants (four studies, standardized mean difference -0.55, 95% confidence interval -0.92, -0.17) and mood stabilizers (six studies, standardized mean difference -1.74, 95% confidence interval -2.76, -0.73) were effective against affective instability and anger, but did not produce significant benefits against impulsivity and aggression, unstable relationships, suicidality and global functioning. Antipsychotics as a class had a positive effect in terms of impulsivity and aggression (three studies, standardized mean difference -0.31, 95% confidence interval -0.63, -0.003), interpersonal relationships (three studies, standardized mean difference -0.52, 95% confidence interval -0.87, -0.17) and global functioning (seven studies, standardized mean difference -0.56, 95% confidence interval -1.00, -0.11). No difference was observed between pharmacotherapy and placebo in terms of participants leaving the study early. Pharmacotherapy can exert a modest beneficial effect on some core traits of borderline personality disorder.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Affect / drug effects
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Antipsychotic Agents / therapeutic use*
  • Borderline Personality Disorder / drug therapy*
  • Borderline Personality Disorder / psychology*
  • Female
  • Humans
  • Impulsive Behavior / drug therapy
  • Impulsive Behavior / psychology
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antipsychotic Agents