Bellino Silvio, Paradiso Erika, Bogetto Filippo
Unit of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy.
J Clin Psychiatry. 2006 Jul;67(7):1042-6. doi: 10.4088/jcp.v67n0705.
Second-generation antipsychotics with a favorable tolerability profile have offered new treatment options for patients with borderline personality disorder. Sparse data are available on the use of quetia-pine in treating this disorder. The aim of the present study is to investigate efficacy and tolerability of quetia-pine in a group of patients with borderline personality disorder.
Fourteen consecutive outpatients with a DSM-IV diagnosis of borderline personality disorder were treated for 12 weeks with open-label quetiapine at the dose of 200-400 mg/day. Patients were assessed at baseline, week 4, and week 12 with the Clinical Global Impressions (CGI) severity item, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Social and Occupational Functioning Assessment Scale (SOFAS), the Borderline Personality Disorder Severity Index (BPDSI), and the Barratt Impulsiveness Scale-version 11 (BIS-11). Adverse effects were evaluated using the Dosage Record and Treatment Emergent Symptom Scale. Statistical analysis was performed with the ANOVA for repeated measures. Significant p values were < or = .05.
Eleven patients completed the study. Three patients (21.4%) dropped out due to excessive somnolence or noncompliance. The mean +/- SD dose of quetia-pine was 309.09 +/- 83.12 mg/day. A significant change was found for the scores of the following scales: CGI severity item, BPRS, HAM-A, SOFAS, BPDSI total score, BPDSI items "impulsivity" and "outbursts of anger," and BIS-11. Common adverse effects were mild-to-moderate somnolence, dry mouth, and dizziness.
Initial data suggest that quetiapine is efficacious and well tolerated in treating patients who have borderline personality disorder, particularly when impulsiveness/aggressiveness-related symptoms are prominent. At the moment, no reliable comparison is available in the literature. Double-blind controlled trials are needed to verify these findings.
具有良好耐受性的第二代抗精神病药物为边缘型人格障碍患者提供了新的治疗选择。关于喹硫平治疗该障碍的使用数据稀少。本研究的目的是调查喹硫平在一组边缘型人格障碍患者中的疗效和耐受性。
14名连续的门诊患者，根据《精神疾病诊断与统计手册》第四版（DSM-IV）诊断为边缘型人格障碍，接受为期12周的开放标签喹硫平治疗，剂量为200 - 400毫克/天。在基线、第4周和第12周时，使用临床总体印象量表（CGI）严重程度项目、简明精神病评定量表（BPRS）、汉密尔顿抑郁评定量表（HAM-D）、汉密尔顿焦虑评定量表（HAM-A）、社会和职业功能评定量表（SOFAS）、边缘型人格障碍严重程度指数（BPDSI）以及巴拉特冲动性量表第11版（BIS-11）对患者进行评估。使用剂量记录和治疗中出现的症状量表评估不良反应。采用重复测量方差分析进行统计分析。显著p值≤0.05。
11名患者完成了研究。3名患者（21.4%）因过度嗜睡或不依从退出。喹硫平的平均剂量±标准差为309.09±83.12毫克/天。在以下量表的得分上发现了显著变化：CGI严重程度项目、BPRS、HAM-A、SOFAS、BPDSI总分、BPDSI项目“冲动性”和“愤怒爆发”以及BIS-11。常见的不良反应为轻至中度嗜睡、口干和头晕。
初步数据表明，喹硫平在治疗边缘型人格障碍患者时有效且耐受性良好，特别是当与冲动性/攻击性相关的症状突出时。目前，文献中尚无可靠的比较。需要进行双盲对照试验来验证这些发现。
