olanzapine and Borderline-Personality-Disorder

Aripiprazole is an atypical antipsychotic medication, and its use in treating borderline personality disorder (BPD) is debatable because it is not FDA-approved for treating BPD. This study aimed to investigate the efficacy and safety of aripiprazole in patients with BPD. On July 2, 2021, the protocol (CRD42021256647) was registered in PROSPERO. PubMed, Scopus, Web of Science, Ovid-Medline, Embase, PsycINFO, and Cochrane (CENTRAL) were searched without regard for language or publication date. We also searched trial registries on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Randomized clinical trials with adult patients diagnosed with BPD met the inclusion criteria. The Cochrane risk of bias for randomized trials (RoB-2) method was used to assess the quality of the included studies. We included two previously published randomized clinical trials. There were 76 patients with BPD, with 38, 12, and 26 assigned to the aripiprazole, olanzapine, and placebo groups, respectively. Most patients (88.16%) were females, with ages ranging from 22.1 to 28.14 yr. Aripiprazole has been proven to reduce anxiety, depression, anger, hostility, clinical severity, and obsessive-compulsive behavior, insecurity, melancholy, anxiety, aggressiveness/hostility, phobic anxiety, paranoid thinking, psychoticism, and somatization. The adverse effects were headache, insomnia, restlessness, tremor, and akathisia. The risk of bias was considerable in both trials, which is somewhat problematic considering that prejudice can lead to incorrect outcomes and conclusions. Aripiprazole has demonstrated encouraging outcomes in the treatment of patients with BPD. More randomized controlled studies are needed.

Topics: Adult; Antipsychotic Agents; Anxiety Disorders; Aripiprazole; Borderline Personality Disorder; Female; Humans; Male; Olanzapine

The availability of new atypical antipsychotics provides new opportunities for the treatment of borderline personality disorder (BPD).. Original papers on this topic were sought. Our study reviewed and discussed 14 papers.. 2 RCTs, 4 non-controlled open-label studies and 8 case reports. The patient populations studied were highly diverse and the dropout rate after a long follow-up period was high. All of the articles reported positive effects of olanzapine, clozapine, quetiapine and risperidone.. BPD patients with psychotic-like, impulsive or suicidal symptoms might benefit from atypical antipsychotics. Since the methodological quality of the reviewed articles is poor, further randomised placebo-controlled studies with longer follow-ups are needed before any firm conclusions can be drawn.

Topics: Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Clinical Trials as Topic; Clozapine; Dibenzothiazepines; Humans; Olanzapine; Psychiatric Status Rating Scales; Quetiapine Fumarate; Randomized Controlled Trials as Topic; Research Design; Risperidone

Asenapine is a new second-generation antipsychotic that is understudied in borderline personality disorder (BPD). Only one study investigating the use of the drug in this indication (an open-label pilot study) has been conducted to date.. The present open-label, randomized, controlled trial aimed to evaluate the efficacy and tolerability of asenapine in comparison with olanzapine, the most broadly studied antipsychotic in BPD.. A total of 51 outpatients aged between 18 and 50 years with a diagnosis of BPD based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria were assigned for 12 weeks to asenapine (5-10 mg/day) or olanzapine (5-10 mg/day). Participants were assessed at baseline and after 12 weeks with the following instruments: the Clinical Global Impression Scale, Severity item (CGI-S), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Social Occupational Functioning Assessment Scale (SOFAS), Borderline Personality Disorder Severity Index (BPDSI), Barratt Impulsiveness Scale, version 11 (BIS-11), Modified Overt Aggression Scale (MOAS), Self-Harm Inventory (SHI), and Dosage Record and Treatment Emergent Symptom Scale (DOTES). Analysis of variance repeated measures was performed. Intention-to-treat analysis with last observation carried forward was conducted.. There were 11 drop-outs (21.57%): six patients taking asenapine and five patients receiving olanzapine. Two patients who received asenapine stopped the drug, one due to oral hypoesthesia and the other due to moderate anxiety. Two patients receiving olanzapine discontinued the treatment because of significant weight gain (≥3 kg). The remaining seven drop-outs resulted from the lack of compliance with the trial prescription. Forty out of the 51 patients (78%) completed the trial: 19 patients received asenapine, while 21 patients received olanzapine. We found a significant within-subject effect (trial duration) for all rating scales, except from the HAM-D, the MOAS, and two items of the BPDSI, namely, "identity disturbance" and "parasuicidal behaviors." A significant effect between subjects was found for the two items of the BPDSI "affective instability" and "dissociation/paranoid ideation." Asenapine was found superior to olanzapine in reducing the affective instability score (P = 0.001), whereas olanzapine was found superior to asenapine in reducing dissociation/paranoid ideation (P = 0.012). However, the study was found to be underpowered to detect a difference between the drugs on the dissociation/paranoid ideation item of the BPDSI. Two patients receiving asenapine experienced akathisia and another two restlessness/anxiety, while three patients receiving olanzapine reported somnolence and two fatigue.. Asenapine and olanzapine were demonstrated to have a similar efficacy. While asenapine was found to be more efficacious than olanzapine in treating affective instability, olanzapine was superior to asenapine in treating paranoid ideation and dissociation. However, the study was underpowered to detect a difference between groups on the dissociation/paranoid ideation item. Both medications were well tolerated, with asenapine being related to a higher frequency of oral hypoesthesia and akathisia, and olanzapine being prone to induce weight gain. The open-label study design, lack of a placebo group, and small sample size constitute major limitations of this trial. Our findings need to be replicated in further studies. Clinical Trials Registry code: ACTRN12614000551695.

Topics: Adolescent; Adult; Akathisia, Drug-Induced; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Dibenzocycloheptenes; Female; Heterocyclic Compounds, 4 or More Rings; Humans; Hypesthesia; Male; Middle Aged; Olanzapine; Psychiatric Status Rating Scales; Severity of Illness Index; Treatment Outcome; Weight Gain; Young Adult

This report presents efficacy and safety outcomes for patients with borderline personality disorder (BPD) treated with olanzapine for up to 24 weeks. In 2 concurrent studies, patients received open-label olanzapine for 12 weeks after 12 weeks of double-blind olanzapine or placebo. Open-label dosing started at 2.5 or 5 mg/d and could be increased up to 20 mg/d (study 1) or 15 mg/d (study 2). The primary efficacy measure was open-label baseline-to-endpoint change in Zanarini Rating Scale for BPD (ZAN-BPD) total score. Of 472 patients who completed the double-blind acute phase, 444 entered and 320 (72.1%) completed 12 weeks of open-label extension treatment. Mean ZAN-BPD total scores at the start of the acute phase were approximately 17, indicating moderate symptom severity. Mean ZAN-BPD total scores ranged from 7.8 to 10.5 at the start of the open-label treatment and decreased to 5.7 to 6.5, indicating mild symptom severity, by the end of the open-label treatment. Patients taking placebo during the acute phase showed increases in weight, prolactin level, and other laboratory values during open-label olanzapine treatment similar in magnitude to increases seen in olanzapine-treated patients during the acute phase. Patients proceeding from olanzapine during the acute phase to open-label olanzapine showed smaller changes in weight and laboratory values. In conclusion, these results suggest that continued therapy with olanzapine may sustain and build upon improvements seen with acute olanzapine treatment of patients with BPD. However, no medication is currently approved for treatment of BPD, and physicians should carefully weigh potential benefits and risks of antipsychotic treatment in this population.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Diagnostic and Statistical Manual of Mental Disorders; Drug Monitoring; Female; Humans; Male; Middle Aged; Olanzapine; Psychiatric Status Rating Scales; Time Factors; Young Adult

Pharmacogenomic analyses of weight gain during treatment with second-generation antipsychotics have resulted in a number of associations with variants in ankyrin repeat and kinase domain containing 1 (ANKK1)/dopamine D2 receptor (DRD2) and serotonin 2C receptor (HTR2C) genes. These studies primarily assessed subjects with schizophrenia who had prior antipsychotic exposure that may have influenced the amount of weight gained from subsequent therapies. We assessed the relationships between single-nucleotide polymorphisms (SNPs) in these genes with weight gain during treatment with olanzapine in a predominantly antipsychotic-naive population.. The association between 5 ANKK1, 54 DRD2, and 11 HTR2C SNPs and weight change during 8 weeks of olanzapine treatment was assessed in 4 pooled studies of 205 white patients with diagnoses other than schizophrenia who were generally likely to have had limited previous antipsychotic exposure.. The A allele of DRD2 rs2440390(A/G) was associated with greater weight gain in the entire study sample (P = .0473). Three HTR2C SNPs in strong linkage disequilibrium, rs6318, rs2497538, and rs1414334, were associated with greater weight gain in women but not in men (P = .0032, .0012, and .0031, respectively). A significant association with weight gain for 2 HTR2C SNPs previously reported associated with weight gain, -759C/T (rs3813929) and -697G/C (rs518147), was not found.. Associations between weight gain and HTR2C and DRD2 variants in whites newly exposed to olanzapine may present opportunities for the individualization of medication selection and development based on differences in adverse events observed across genotype groups.

Topics: Adult; Alleles; Antipsychotic Agents; Benzodiazepines; Bipolar Disorder; Borderline Personality Disorder; Depressive Disorder, Treatment-Resistant; Female; Genetic Association Studies; Humans; Linkage Disequilibrium; Male; Mental Disorders; Middle Aged; Olanzapine; Pharmacogenetics; Polymorphism, Single Nucleotide; Risperidone; Schizophrenia; Weight Gain

To examine the efficacy and safety of olanzapine at low and moderate doses for the treatment of borderline personality disorder.. In this 12-week randomized double-blind placebo-controlled trial, 451 outpatients aged 18-65 years with DSM-IV borderline personality disorder received olanzapine 2.5 mg/d (n = 150), olanzapine 5-10 mg/d (n = 148), or placebo (n = 153). The trial was conducted from February 2004 through January 2006 at 59 community-based and academic study centers in 9 countries (United States, Italy, Poland, Romania, Turkey, Chile, Peru, Argentina, and Venezuela). The primary efficacy measure was mean change from baseline to last-observation-carried-forward endpoint on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) total score. Secondary measures included the Montgomery-Asberg Depression Rating Scale, the Modified Overt Aggression Scale, the Global Assessment of Functioning, the Symptom Checklist-90-Revised, and the Sheehan Disability Scale.. An overall mean baseline ZAN-BPD total score of 17.2 (SD = 4.9) indicated moderate symptom severity. Only treatment with olanzapine 5-10 mg/d was associated with significantly greater mean change from baseline to endpoint in ZAN-BPD total score relative to placebo (-8.5 vs -6.8, respectively; P = .010; effect size = 0.29; 95% CI, 0.06-0.52). Response rates (response indicated by ≥ 50% decrease from baseline in ZAN-BPD total score) were significantly higher for olanzapine 5-10 mg/d (73.6%) versus olanzapine 2.5 mg/d (60.1%; P = .018) and versus placebo (57.8%; P = .006). Time to response was also significantly shorter for patients taking olanzapine 5-10 mg/d than for placebo-treated patients (P = .028). Treatment-emergent adverse events reported significantly more frequently among olanzapine-treated patients included somnolence, fatigue, increased appetite, and weight increase (all P values < .05). Mean weight change from baseline to endpoint was significantly greater for olanzapine-treated than for placebo-treated patients (olanzapine 2.5 mg/d: 2.09 kg; olanzapine 5-10 mg/d: 3.17 kg; placebo: 0.02 kg; P < .001). The overall completion rate for the 12-week double-blind treatment period was 65.2% (ie, 64.7% for olanzapine 2.5 mg/d, 69.6% for olanzapine 5-10 mg/d, and 61.4% for placebo).. Olanzapine 5-10 mg/d showed a clinically modest advantage over placebo in the treatment of overall borderline psychopathology. This advantage in effectiveness should be weighed against the risk of adverse events (particularly weight gain), which were consistent with the known safety profile of olanzapine.. clinicaltrials.gov Identifier: NCT00088036.

Topics: Adult; Benzodiazepines; Borderline Personality Disorder; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Interview, Psychological; Male; Olanzapine; Placebos; Psychiatric Status Rating Scales; Severity of Illness Index; Time Factors; Treatment Outcome

The newer atypical antipsychotics seem to be as effective as previous antipsychotics for impulsivity and aggressiveness of patients with borderline personality disorder (BPD). Objective of this assessment was to compare the effectiveness of olanzapine versus haloperidol in BPD.. Twenty-eight female inpatients, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for BPD, were randomly entered in one of the 2 matching contemporaneous groups for an 8-week parallel double-blind study. This included the random assignment to olanzapine or haloperidol in a 1:1 ratio. Primary outcome measurements were as follows: Brief Psychiatric Rating Scale, Clinical Global Impression-Severity Scale, Buss-Durkee Hostility Inventory. Baselines were created at the beginning of the trial through patient assessments and final assessments at the end of the experiment. Analysis of effect size, calculation of confidence intervals and power analysis were also prepared.. All of the patients from within both groups completed the study. Intragroup analysis at the eighth week interval revealed significant positive response by both olanzapine and haloperidol in comparison with the baseline (P < 0.05); however, the between-group analysis showed no significant difference, among the patients, at the end of the experiment. The analysis of specific Brief Psychiatric Rating Scale subscales in both groups revealed considerable and comparable improvements in anxiety, tension, depressive mood, and hostility. The effect size analyzes illustrated remarkable improvements with both groups.. There seems to be no significant difference between olanzapine and haloperidol regarding the management of mental and behavioral symptoms of patients with BPD.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Double-Blind Method; Female; Haloperidol; Humans; Inpatients; Olanzapine; Psychiatric Status Rating Scales; Treatment Outcome

Various drugs have been suggested for treatment of Borderline Personality Disorder (BPD)-a disabling disease affecting two percent of the general population. If a drug could alleviate a wide range of symptoms, it would be more suitable. In these disorders drug addiction is very common. This fact makes the symptoms complicated and the treatment more difficult.. This study is designed to evaluate the effect of Olanzapine and Sertraline in patients suffering from personality disorders who are on methadone maintenance therapy. This study is a clinical trial. 120 males and females were chosen for methadone maintenance therapy through interview by a psychiatrist based on DSM-IV-TR diagnostic criteria for BPD. Afterwards they were randomly divided into two groups. These groups separately received Olanzapine (5-10 mg daily) and Sertraline (50-100 mg daily) therapy. The SCL-90 questionnaire was filled by all participants before treatment and at the 4th, 8th and 12th weeks of treatment.. According to this clinical trial, Olanzapine and Sertraline are effective in ameliorating symptoms of depression, anxiety and aggression, reducing sensitivity in interpersonal relationships and alleviating obsessive symptoms, pessimistic behaviors and somatization disorders in patients with personality disorders on methadone maintenance therapy.. As result of this study it appears that Olanzapine and Sertraline are definitely effective in alleviating symptoms of patients with personality disorder, prescribing theses drugs are recommended for these patients.

Topics: Adult; Aggression; Analgesics, Opioid; Anxiety; Benzodiazepines; Borderline Personality Disorder; Depression; Diagnostic and Statistical Manual of Mental Disorders; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Interpersonal Relations; Male; Methadone; Obsessive Behavior; Olanzapine; Sampling Studies; Selective Serotonin Reuptake Inhibitors; Sertraline; Severity of Illness Index; Somatoform Disorders; Surveys and Questionnaires; Treatment Outcome

Despite the prevalence and clinical significance of borderline personality disorder, its treatment remains understudied.. To evaluate treatment with variably dosed olanzapine in individuals with borderline personality disorder.. In this 12-week randomised, double-blind trial, individuals received olanzapine (2.5-20 mg/day; n=155) or placebo (n=159) (trial registry: NCT00091650). The primary efficacy measure was baseline to end-point change on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) using last-observation-carried-forward methodology.. Both olanzapine and placebo groups showed significant improvements but did not differ in magnitude at end-point (-6.56 v. -6.25, P=0.661). Response rates (50% reduction in ZAN-BPD) were 64.7% with olanzapine and 53.5% with placebo (P=0.062); however, time to response was significantly shorter for olanzapine (P=0.022). Weight gain was significantly greater (2.86 v. -0.35 kg, P<0.001), with higher incidence of treatment-emergent abnormal high levels of prolactin for the olanzapine group.. Individuals treated with olanzapine and placebo showed significant but not statistically different improvements on overall symptoms of borderline personality disorder. The types of adverse events observed with olanzapine treatment appeared similar to those observed previously in adult populations.

Topics: Adolescent; Adult; Aged; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Double-Blind Method; Female; Humans; Male; Middle Aged; Olanzapine; Psychiatric Status Rating Scales; Treatment Outcome; Weight Gain; Young Adult

This double-blind study examined whether olanzapine augments the efficacy of dialectical behavior therapy (DBT) in reducing anger and hostility in borderline personality disorder patients.. Twenty-four women with borderline personality disorder (DSM-IV criteria) and high levels of irritability and anger received 6 months of DBT. Subjects were randomly assigned to receive either low-dose olanzapine or placebo and were assessed with standardized measures in a double-blind manner. The study was conducted from September 2000 to December 2002.. Intent-to-treat analyses indicated that both treatment conditions resulted in significant improvement in irritability, aggression, depression, and self-inflicted injury (p < .01 for each). Irritability and aggression scores tended (p < .10) to decrease more quickly for the olanzapine group than for the placebo group. Self-inflicted injury tended (p < .10) to decrease more for the placebo group than for the olanzapine group.. Olanzapine may promote more rapid reduction of irritability and aggression than placebo for highly irritable women with borderline personality disorder. Effect sizes were moderate to large, with the small sample size likely limiting the ability to detect significant results. Overall, there were large and consistent reductions in irritability, aggression, depression, and self-injury for both groups of subjects receiving DBT.

Topics: Adolescent; Adult; Aggression; Antipsychotic Agents; Behavior Therapy; Benzodiazepines; Borderline Personality Disorder; Depression; Diagnostic and Statistical Manual of Mental Disorders; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Humans; Irritable Mood; Middle Aged; Olanzapine; Pilot Projects; Prevalence; Self-Injurious Behavior; Severity of Illness Index

The aim of this study was to determine the efficacy and safety of dialectical behavior therapy plus olanzapine compared with dialectical behavior therapy plus placebo in patients with borderline personality disorder.. Sixty patients with borderline personality disorder were included in a 12-week, double-blind, placebo-controlled study. All patients received dialectical behavior therapy and were randomly assigned to receive either olanzapine or placebo following a 1-month baseline period.. Seventy percent of the patients completed the 4-month trial. Combined treatment showed an overall improvement in most symptoms studied in both groups. Olanzapine was associated with a statistically significant improvement over placebo in depression, anxiety, and impulsivity/aggressive behavior. The mean dose of olanzapine was 8.83 mg/day.. A combined psychotherapeutic plus pharmacological approach appears to lower dropout rates and constitutes an effective treatment for borderline personality disorder.

Topics: Adult; Antipsychotic Agents; Behavior Therapy; Benzodiazepines; Borderline Personality Disorder; Combined Modality Therapy; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Olanzapine; Placebos; Treatment Outcome

Atypical antipsychotics are increasingly used in clinical practice in the management of borderline personality disorder (BPD), and a small but growing body of literature supports their efficacy. Here, we report the results of a double-blind, placebo-controlled study of olanzapine as a treatment for BPD.. Forty BPD patients (25 female, 15 male) were randomly assigned in equal numbers to olanzapine and placebo. Diagnoses were made using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders and the Mini-International Neuropsychiatric Interview. Patients with schizophrenia, bipolar disorder, or current major depression were excluded. Olanzapine dosage was flexible, and the dose range was 2.5 to 20 mg/day, with most patients receiving 5 to 10 mg/day. No concomitant psychotropic medications were allowed. Patients were assessed at baseline and at 2, 4, 8, and 12 weeks. The primary outcome was change in the total score for the 9 BPD criteria on a 1-to-7 Likert scale, the Clinical Global Impressions scale modified for borderline personality disorder (CGI-BPD), using an analysis of covariance model including baseline score as covariate. Data were collected from July 2000 to April 2002.. Olanzapine was found to be significantly (p <.05) superior to placebo on the CGI-BPD at endpoint, with separation occurring as early as 4 weeks. Similar results were found for the single-item Clinical Global Impressions scale. Weight gain was significantly (p =.027) greater in the olanzapine group.. This study supports the efficacy of olanzapine for symptoms of BPD in a mixed sample of women and men. Further studies with olanzapine and other atypical antipsychotics are needed.

Topics: Adolescent; Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Double-Blind Method; Female; Humans; Male; Middle Aged; Olanzapine; Placebos; Treatment Outcome; Weight Gain

The intent of this study was to compare the efficacy and safety of fluoxetine, olanzapine, or the olanzapine-fluoxetine combination (OFC) in the treatment of women meeting criteria for borderline personality disorder (without concurrent major depressive disorder).. We conducted a randomized double-blind study of these agents in female subjects meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-IV criteria for borderline personality disorder. Treatment duration was 8 weeks. Outcome measures were clinician-rated scales measuring depression (the Montgomery-Asberg Depression Rating Scale) and impulsive aggression (the Modified Overt Aggression Scale). Data were collected from August 2001 through March 2003.. Fourteen subjects were randomized to fluoxetine; 16, to olanzapine; and 15, to OFC. Forty-two of these subjects (93.3%) completed all 8 weeks of the trial. Using random-effects regression modeling of panel data of change-from-baseline scores and controlling for time, olanzapine monotherapy and OFC were associated with a significantly greater rate of improvement over time than fluoxetine on both outcome measures. However, it should be noted that fluoxetine treatment led to a substantial reduction in impulsive aggression and severity of depression. Weight gain was relatively modest in all 3 groups but significantly greater in the olanzapine-treated group than in the groups treated with fluoxetine alone or OFC.. All 3 compounds studied appear to be safe and effective agents in the treatment of women with borderline personality disorder, significantly ameliorating the chronic dysphoria and impulsive aggression common among borderline patients. However, olanzapine monotherapy and OFC seem to be superior to fluoxetine monotherapy in treating both of these dimensions of borderline psychopathology.

Topics: Adolescent; Adult; Aggression; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Depressive Disorder; Drug Combinations; Drug Therapy, Combination; Female; Fluoxetine; Humans; Impulsive Behavior; Olanzapine; Psychiatric Status Rating Scales; Regression Analysis; Selective Serotonin Reuptake Inhibitors; Treatment Outcome

The intent of this study was to compare the efficacy and safety of olanzapine versus placebo in the treatment of women meeting criteria for borderline personality disorder (BPD).. We conducted a double-blind, placebo-controlled study of olanzapine in 28 female subjects meeting Revised Diagnostic Interview for Borderlines and DSM-IV criteria for BPD. The subjects were randomly assigned to olanzapine or placebo in a 2:1 manner. Treatment duration was 6 months. Primary outcome measures were self-reported changes on anxiety, depression, paranoia, anger/hostility, and interpersonal sensitivity scales of the Symptom Checklist-90.. Nineteen subjects were randomly assigned to olanzapine; 9. to placebo. When random effects regression modeling of panel data was used, controlling for baseline level of severity, olanzapine was associated with a significantly (p < .05) greater rate of improvement over time than placebo in all of the symptom areas studied except depression. Weight gain was modest in the olanzapine-treated group but was significantly higher than in those treated with placebo (p < .02). In addition, no serious movement disorders were noted.. Olanzapine appears to be a safe and effective agent in the treatment of women with criteria-defined BPD, significantly affecting all 4 core areas of borderline psychopathology (i.e., affect, cognition, impulsivity, and interpersonal relationships).

Topics: Adolescent; Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Double-Blind Method; Female; Follow-Up Studies; Humans; Interpersonal Relations; Olanzapine; Pilot Projects; Pirenzepine; Severity of Illness Index

Numerous medications have been tested in patients with borderline personality disorder (BPD) and/or schizotypal personality disorder (SPD). Although many of the medications tested have been demonstrated to be useful, no clear main treatment for BPD has emerged. Despite the efficacy of some of the medicines, acceptability and side effects have proven to be barriers to the use of medication. Therefore, an open-label olanzapine trial utilizing objective ratings was performed.. Patients suffering from BPD and dysthymia were included in an 8-week, open-label study of olanzapine monotherapy. The first 4 weeks of the trial allowed for flexible dosing; during the last 4 weeks, olanzapine dose was held constant. Patients were rated on Hopkins Symptoms Checklist 90 (SCL-90), Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF), Barratt Impulsivity Scale (BIS 11), and Buss-Durkee Hostility Inventory (BDHI).. Eleven patients completed at least 2 weeks; nine of the patients finished the entire trial. There was a robust and statistically significant reduction in the five global ratings. Within the global ratings, symptoms of psychoticism, depression, interpersonal sensitivity, and anger were among the symptoms to be reduced. No movement disorder symptoms were noted for any of the patients.. In this open-label pilot study, patients treated with olanzapine showed statistically significant reduction in self-rated and clinician-rated scales. Symptoms associated with BPD and dysthymia were among those to be substantially reduced. Further studies to explore olanzapine's efficacy versus placebo, as well as comparison to other potential treatments for BPD, are important next steps.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Brief Psychiatric Rating Scale; Consumer Product Safety; Dose-Response Relationship, Drug; Dysthymic Disorder; Female; Humans; Male; Middle Aged; Olanzapine; Pirenzepine; Severity of Illness Index

Topics: Benzodiazepines; Borderline Personality Disorder; Dose-Response Relationship, Drug; Humans; Olanzapine; Randomized Controlled Trials as Topic; Treatment Outcome

We report the case of two young subjects who developed an obsessive-compulsive disorder (OCD) during a heavy use of ecstasy. After several months of discontinuation of the drug, major depression with psychotic features developed in one subject and a psychotic disorder in the other individual. No mental disorder preceded the use of ecstasy in any subject.. A familial and personality vulnerability for mental disorder was revealed in one subject, but not in the other, and all physical, laboratory and cerebral NMR evaluations showed normal results in both patients. Remission of OCD and depressive episode or psychotic disorder was achieved after treatment with a serotoninergic medication associated with an antipsychotic.. The heavy long-term use of ecstasy may induce an alteration in the brain balance between serotonin and dopamine, which might constitute a pathophysiological mechanism underlying the onset of obsessive-compulsive, depressive and psychotic symptoms. The heavy use of ecstasy probably interacted with a vulnerability to psychiatric disorder in one subject, whereas we cannot exclude that an "ecstasy disorder" ex novo affected the other individual.

Topics: Adolescent; Amphetamine-Related Disorders; Antidepressive Agents, Tricyclic; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Brain; Clomipramine; Comorbidity; Depressive Disorder, Major; Dopamine; Female; Genetic Predisposition to Disease; Hallucinogens; Humans; Male; N-Methyl-3,4-methylenedioxyamphetamine; Obsessive-Compulsive Disorder; Olanzapine; Psychoses, Substance-Induced; Risk Factors; Risperidone; Serotonin; Substance Withdrawal Syndrome; Young Adult

We report the case of a 26-year-old woman suffering from borderline personality disorder (BPD), major depression and bulimia nervosa according to DSM-IV who showed unexplained impairment of the vitamin K-dependent coagulation pathway. Subsequently we discuss different manifestations of self damaging behaviour and comorbidities, as well as psychosocial issues potentially leading to coagulation abnormalities or complications in patients with BPD.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Blood Coagulation Disorders; Borderline Personality Disorder; Diagnosis, Differential; Female; Humans; Olanzapine; Treatment Outcome; Vitamin K

Agitation is relatively common among Borderline Personality Disorder (BPD) patients in Psychiatric Emergency Services (PES). New injectable atypical antipsychotics are indicated for treatment in agitated psychotic or maniac patients but not for agitated BDP patients. Twenty agitated BPD patients were treated with intramuscular atypical antipsychotics (olanzapine or ziprasidone). Results suggest intramuscular atypical antipsychotics may be effective, fast and safe for treating acute BPD patients.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Bipolar Disorder; Borderline Personality Disorder; Comorbidity; Emergency Services, Psychiatric; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Olanzapine; Piperazines; Psychiatric Status Rating Scales; Psychomotor Agitation; Psychotic Disorders; Schizophrenia; Thiazoles; Treatment Outcome

Borderline personality disorder is one of the most problematic psychiatric disorders with aggressiveness and impulsivity as its two main characteristics. Our objective was to determine the efficacy of olanzapine on 20 patients with borderline personality disorder. Results were found to be affirmative in this respect.

Topics: Adult; Antipsychotic Agents; Behavior; Benzodiazepines; Borderline Personality Disorder; Female; Humans; Olanzapine; Treatment Outcome

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Child; Child Abuse, Sexual; Female; Humans; Olanzapine

Topics: Adolescent; Benzodiazepines; Borderline Personality Disorder; Diabetes Insipidus; Dose-Response Relationship, Drug; Drug Overdose; Humans; Male; Olanzapine; Polyuria; Prazepam; Suicide, Attempted

This article is a report on a complicated case of delusional disorder in pregnancy and lactation, and effective multidisciplinary treatment. Few reports in the literature concern delusional disorder in pregnancy, or regard olanzapine's safety in pregnancy and lactation. A gravid woman in her third trimester merited twin diagnoses of delusional disorder and borderline personality disorder, and was successfully treated with olanzapine and psychotherapy during pregnancy and lactation. Her infant was large for gestational age (LGA) and had Erb's palsy, which resolved, and remained healthy at six months, with continued breastfeeding. Her delusional beliefs did not recur, nor did she have postpartum depression or psychosis.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Breast Feeding; Combined Modality Therapy; Comorbidity; Female; Humans; Infant; Infant, Newborn; Lactation; Male; Olanzapine; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Psychotherapy; Schizophrenia, Paranoid; Treatment Outcome

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Borderline Personality Disorder; Comorbidity; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Olanzapine; Pirenzepine; Self Mutilation; Treatment Outcome