A comparative study on olanzapine and aripiprazole for symptom management in female patients with borderline personality disorder

Abstract

Objective: While Second Generation Antipsychotics (SGAs) have been shown, in some studies, to be helpfulfor amelioration of impulsiveness, aggressiveness and moodiness of patients with Borderline PersonalityDisorder (BPD), there are additional studies that believe that the evidence does not currently supporteffectiveness of SGAs for overall severity of borderline symptoms. In light of these conflicting reports,we conducted a trial to compare the efficacy and safety of olanzapine vs. aripiprazole with regard tomanagement of BPD.Method: Twenty-four female inpatients, meeting the diagnosis of BPD according to the DSM-IV-TRcriteria, were randomly entered into an 8-week parallel group, open-label study for random assignmentto olanzapine or aripiprazole (n=12 in each group). The patients were selected from outpatients amongclientele of two psychiatric clinics and also inpatients from female wards of Razi psychiatric hospital. Patientswere excluded from the trial if any prominent co-morbid mental disorder was present. The primary outcomemeasure included the Brief Psychiatric Rating Scale (BPRS) for estimation of baseline psychopathology,clinical outcome and treatment response. In addition, the Buss-Durkee Hostility Inventory (BDHI) for theassessment of anger and hostility, and the Clinical Global Impressions-Severity Scale (CGI-S) for assessmentof overall illness severity were used as secondary scales. Changes in mean total scores of the BPRS, CGI-S andBDHI were analyzed within each group by means of a paired t test and compared across the two groups byan unpaired t test. Statistical significance was defined as a 2-sided p value < or = to 0.05. In addition, analysisof effect size (ES) by calculation of Cohen s d was performed and recorded.Results: All of the patients remained in and completed the study. According to the findings olanzapineand aripiprazole reduced mean total score of the BPRS about 25.7% and 18.8% in their groups, and thus illustrated a significant improvement of primary outcome measure at the end of the trial, in comparisonwith baseline (p