Weinstein Wendy, Jamison Katrina L
Buffalo Medical Group, Williamsville, NY, USA.
CNS Spectr. 2007 Mar;12(3):207-10. doi: 10.1017/s1092852900020927.
The diagnosis of borderline personality disorder is complex as is its pharmacologic treatment. Lamotrigine may offer promise in the treatment of this condition.
To assess the use of lamotrigine to treat symptoms of affective instability in patients with borderline personality disorder.
Charts of patients treated with lamotrigine in a private practice during the period of 2003-2004 were reviewed. Patients were included in the analysis if they had been given a clinical diagnosis of borderline personality disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, had continued to display affective instability while taking their previous medications before being treated with lamotrigine; had received a Clinical Global Impression-Severity score before and after lamotrigine therapy; had been treated with lamotrigine, as monotherapy or adjunctive therapy, at a dose ranging from 50-200 mg/day; and continued to take lamotrigine for at least 3 months.
The charts of 13 patients were reviewed and included in the analysis. All patients were female, 19-43 years of age, and had reported continuing symptoms of affective instability despite treatment with two to seven psychotropic drugs, including, but not limited to, fluoxetine, paroxetine, escitalopram, buproprion, and clonazepan. The duration of lamotrigine treatment, before the end of the period covered by the chart review was 3-15 months. The patients had initial Clinical Global Impression-Severity scores of 5 or 6 and a final scores of 1 or 2, except for one patient with an initial score of 3 and a final score of 1 and one patient with an initial score of 6 and a final score of 7.
Lamotrigine seems to be a safe and effective option for the treatment of patients with symptoms of affective instability associated with borderline personality disorder.
边缘型人格障碍的诊断及其药物治疗都很复杂。拉莫三嗪可能为治疗这种疾病带来希望。
评估拉莫三嗪治疗边缘型人格障碍患者情感不稳定症状的疗效。
回顾了2003年至2004年期间在一家私人诊所接受拉莫三嗪治疗的患者病历。如果患者符合以下条件，则纳入分析：根据《精神疾病诊断与统计手册》第四版修订版的定义，临床诊断为边缘型人格障碍；在接受拉莫三嗪治疗前，服用之前的药物时仍表现出情感不稳定；在拉莫三嗪治疗前后接受了临床总体印象严重程度评分；接受拉莫三嗪单一疗法或辅助疗法治疗，剂量范围为50-200毫克/天；持续服用拉莫三嗪至少3个月。
共回顾了13例患者的病历并纳入分析。所有患者均为女性，年龄在19至43岁之间，尽管使用了两到七种精神药物（包括但不限于氟西汀、帕罗西汀、艾司西酞普兰、安非他酮和氯硝西泮）治疗，但仍报告有情感不稳定的持续症状。在病历回顾期结束前，拉莫三嗪的治疗时间为3至15个月。除一名患者初始评分为3分，最终评分为1分，另一名患者初始评分为6分，最终评分为7分外；其余患者的初始临床总体印象严重程度评分为5或6分，最终评分为1或2分。
拉莫三嗪似乎是治疗与边缘型人格障碍相关的情感不稳定症状患者的一种安全有效的选择。
