Nickel Marius K, Nickel Cerstin, Kaplan Patrick, Lahmann Claas, Mühlbacher Moritz, Tritt Karin, Krawczyk Jakub, Leiberich Peter K, Rother Wolfhardt K, Loew Thomas H
Department of Psychosomatic Medicine, Inntalklinik, 84359 Simbach/Inn, Germany.
Biol Psychiatry. 2005 Mar 1;57(5):495-9. doi: 10.1016/j.biopsych.2004.11.044.
Borderline personality disorder (BPD) is a complex mental disease associated with severe serious functional impairment, affective instability, and impulsive aggression. The aim of this study was to compare the efficacy of topiramate versus placebo in the treatment of aggression in men with borderline personality disorder.
We conducted an 8-week, double-blind, placebo-controlled study of topiramate in 42 male subjects (42 of 44) meeting DSM-IV criteria for BPD. The Structured Clinical Interview (SCID I and II) was carried out. The subjects were randomly assigned to topiramate (n = 22) or placebo (n = 20).
Significant changes on four STAXI scales (State Anger, p < .01; Trait Anger, p < .05; Anger Out, p < .01; Anger Control, p < .01) were observed in the subjects treated with topiramate. A nonsignificant difference was found on the Anger In scale (p = .86). Additional significant weight loss was observed (difference in weight loss between the both groups was 5.0 kg, p < .01, 95% confidence interval = [-6.5 to 3.4]). All subjects tolerated topiramate relatively well.
Topiramate appears to be an effective agent in the treatment of anger in men with BPD. Mild weight loss can be expected.
边缘型人格障碍（BPD）是一种复杂的精神疾病，与严重的功能损害、情感不稳定和冲动攻击性有关。本研究的目的是比较托吡酯与安慰剂治疗边缘型人格障碍男性攻击行为的疗效。
我们对42名符合DSM-IV边缘型人格障碍标准的男性受试者（44名中的42名）进行了一项为期8周的托吡酯双盲安慰剂对照研究。进行了结构化临床访谈（SCID I和II）。受试者被随机分配到托吡酯组（n = 22）或安慰剂组（n = 20）。
在接受托吡酯治疗的受试者中，观察到STAXI四个量表有显著变化（状态愤怒，p <.01；特质愤怒，p <.05；愤怒爆发，p <.01；愤怒控制，p <.01）。在愤怒内化量表上发现无显著差异（p =.86）。观察到额外的显著体重减轻（两组间体重减轻差异为5.0 kg，p <.01，95%置信区间 = [-6.5至3.4]）。所有受试者对托吡酯耐受性相对良好。
托吡酯似乎是治疗边缘型人格障碍男性愤怒的有效药物。预计会有轻度体重减轻。
