Efficacy and Tolerability of Quetiapine in the Treatment of Borderline Personality Disorder

Bellino, Silvio; Paradiso, Erika; Bogetto, Filippo

doi:10.4088/jcp.v67n0705

Cited by 58 publications

(44 citation statements)

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“…Three small open uncontrolled studies suggested that quetiapine may be effective in the treatment of impulsive aggression in patients with BPD [32][33][34]. Open studies of clozapine [35] and risperidone [36] also yielded encouraging preliminary results in the treatment of aggression in BPD.…”

Section: Pharmacological Approachesmentioning

confidence: 93%

Aggression in Borderline Personality Disorder

Látalová

Praško

2010

Psychiatr Q

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This review examined aggressive behavior in Borderline Personality Disorder (BPD) and its management in adults. Aggression against self or against others is a core component of BPD. Impulsiveness is a clinical hallmark (as well as a DSM-IV-TR diagnostic criterion) of BPD, and aggressive acts by BPD patients are largely of the impulsive type. BPD has high comorbidity rates with substance use disorders, Bipolar Disorder, and Antisocial Personality Disorder; these conditions further elevate the risk for violence. Treatment of BDP includes psychodynamic, cognitive behavioral, schema therapy, dialectic behavioral, group and pharmacological interventions. Recent studies indicate that many medications, particularly atypical antipsychotics and anticonvulsants, may reduce impulsivity, affective lability as well as irritability and aggressive behavior. But there is still a lack of large, double blind, placebo controlled studies in this area.

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Section: Pharmacological Approachesmentioning

confidence: 93%

Aggression in Borderline Personality Disorder

Látalová

Praško

2010

Psychiatr Q

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“…Several reports have provided evidence that olanzapine, which has a high affinity for serotonin and dopamine receptors, can reduce aggression in female patients with borderline personality disorder [104] and in children with Tourette's syndrome [90]. Another study reported that application of the drug, quetiapine, which is believed to function as an antagonist at dopamine and 5-HT receptors, was also effective in reducing outbursts and impulsive aggressiveness in patients suffering from borderline personality disorder [1]. Again, it cannot be determined whether the suppressive effects upon aggression were the result of the drug's actions on dopamine or 5-HT receptors.…”

Section: Serotoninmentioning

confidence: 99%

The Neurobiological Bases for Development of Pharmacological Treatments of Aggressive Disorders

Siegel

Bhatt²,

Bhatt³

et al. 2007

125

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Violence and aggression are major causes of death and injury, thus constituting primary public health problems throughout much of the world costing billions of dollars to society. The present review relates our understanding of the neurobiology of aggression and rage to pharmacological treatment strategies that have been utilized and those which may be applied in the future. Knowledge of the neural mechanisms governing aggression and rage is derived from studies in cat and rodents. The primary brain structures involved in the expression of rage behavior include the hypothalamus and midbrain periaqueductal gray. Limbic structures, which include amygdala, hippocampal formation, septal area, prefrontal cortex and anterior cingulate gyrus serve important modulating functions. Excitatory neurotransmitters that potentiate rage behavior include excitatory amino acids, substance P, catecholamines, cholecystokinin, vasopressin, and serotonin that act through 5-HT2 receptors. Inhibitory neurotransmitters include GABA, enkephalins, and serotonin that act through 5-HT1 receptors. Recent studies have demonstrated that brain cytokines, including IL-1 and IL-2, powerfully modulate rage behavior. IL-1 exerts its actions by acting through 5-HT2 receptors, while IL-2 acts through GABAA or NK1 receptors. Pharmacological treatment strategies utilized for control of violent behavior have met with varying degrees of success. The most common approach has been to apply serotonergic compounds. Others included the application of antipsychotic, GABAergic (anti-epileptic) and dopaminergic drugs. Present and futures studies on the neurobiology of aggression may provide the basis for new and novel treatment strategies for the control of aggression and violence as well as the continuation of existing pharmacological approaches.

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“…Factorial and also repeated measures ANOVA have thus previously been used in comparing CGI ratings. 25,26 We also performed separate one-way ANOVAs with SOS-10 ratings at admission and discharge as the dependent variable and diagnostic category as grouping factors. For pairwise post hoc comparisons we used Tukey's HSD Test.…”

Section: Statistical Analysesmentioning

confidence: 99%

Subjective Quality of Life in Psychiatric Patients: Diagnosis and Illness-Specific Profiles

et al. 2008

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Objective:In accordance with the definition of health by the World Health Organization, outcome measures beyond mere syndromic recovery, such as quality of life ratings, would aid psychiatric practice and research. This is the first study of psychiatric diagnosis and illness stage specific profiles of subjective quality of life (SQOL) impairment.Method: Patients (n = 150) hospitalized at the Prague Psychiatric Center rated their SQOL using the Schwartz Outcome Scale at admission and discharge. Severity of illness and clinical improvement were measured by the Clinical Global Impression Scale. Results:The highest and lowest SQOL at admission were reported by patients with psychosis and mood disorders respectively (F = 7.3, df = 2,147, P < 0.001). SQOL improved significantly during hospitalization in all diagnostic categories (F = 90.0, df = 1,147, P < 0.001), with the smallest and largest improvement in patients with psychosis and mood disorders, respectively (F = 5.6, df = 2,147, P = 0.005). There was a trend for differences in ratings of clinical improvement by patients, compared with psychiatrists, across diagnostic categories (F = 2.9, df = 2,147, P = 0.06), with significant differences only in patients with anxiety disorders. These patients also reported the lowest SQOL at discharge (F = 3.0, df = 2,147, P = 0.05). Global improvement correlated with improvement in SQOL only in patients with mood disorders (r = -0.4, P = 0.005). Conclusions:Main psychiatric diagnostic categories differ in SQOL and in association between SQOL and treatment. These differences may reflect illness-specific mechanisms, such as depressive symptoms in mood disorders, low insight in psychotic patients, aggravation of anxiety before discharge in patients with anxiety disorders, and may aid in planning of specific treatment interventions.Can J Psychiatry 2008;53(9):587-593 Clinical Implications· SQOL is a means of studying the physical, emotional, mental, social, and behavioural well-being of a patient. · Assessing SQOL can help identify specific problems and needs, and may help in tailoring specific treatment interventions. · Assessing SQOL may improve communication and understanding between patients and medical staff. Limitations· Generalizability of findings from tertiary care centre to other settings may be limited. · We combined inpatients and patients attending day treatment program. · There were differences between groups in age and number of previous hospitalizations, which we controlled for using multiple regression.

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Efficacy and Tolerability of Quetiapine in the Treatment of Borderline Personality Disorder

Cited by 58 publications

References 0 publications

Aggression in Borderline Personality Disorder

Aggression in Borderline Personality Disorder

The Neurobiological Bases for Development of Pharmacological Treatments of Aggressive Disorders

Subjective Quality of Life in Psychiatric Patients: Diagnosis and Illness-Specific Profiles

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