Efficacy and Safety of Aripiprazole in Borderline Personality Disorder: A Systematic Review

Abstract

Introduction Aripiprazole is an atypical antipsychotic drug, and its use in the treatment of borderline personality disorder remains controversial. We aimed to determine the efficacy and safety of aripiprazole in patients diagnosed with borderline personality disorder. Methods The protocol was registered in PROSPERO (CRD42021256647) on July 2, 2021. PubMed, Scopus, Web of Science, Ovid-Medline, Embase, PsycINFO, and Cochrane (CENTRAL) were searched, without restriction by language or publication date. Furthermore, we searched ClinicalTrials.gov trial registries and the WHO International Clinical Trials Registry Platform. The inclusion criteria were randomized clinical trials including adult patients (> 18 years) diagnosed with borderline personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders criteria. The quality of the included studies was determined using the Cochrane risk-of-bias for randomized trials (RoB-2) tool. Results We included two randomized clinical trials published in three articles. Among these, 76 patients were diagnosed with borderline personality disorder, with 38, 12, and 26 assigned to the aripiprazole, olanzapine, and placebo groups, respectively. The majority of patients were women (88.16%), with an age range of 22.1–28.14 years. Aripiprazole was shown to reduce psychiatric symptoms (obsessive–compulsive behavior, insecurity, depression, anxiety, aggressiveness/hostility, phobic anxiety, paranoid thinking, psychoticism, and somatization), anxiety, depression, anger, hostility, and clinical severity. The adverse effects included headache, insomnia, restlessness, tremor, and akathisia. In both studies, the risk of bias was high, which is somewhat concerning. Conclusions Aripiprazole has shown promising results in the treatment of patients with borderline personality disorder. More randomized clinical trials are required.

Efficacy of Sertraline with Aripiprazole versus Paroxetine with Aripiprazole in Patient with Major Depressive Disorder

“…It has been found to have good short-and long-term tolerability, less extra pyramidal side effects and less likely to modify the metabolic profile. [12][13] Previous research using both open-label and placebocontrolled designs has shown that aripiprazole is an effective additional treatment for depressive disorder. However, it is unknown which SSRI is the better option to be combined with aripiprazole.…”