Efficacy of Quetiapine for Impulsivity and Affective Symptoms in Borderline Personality Disorder

Abstract

Data on the efficacy of quetiapine in borderline personality disorder (BPD) are still scarce. We aimed to investigate the efficacy of quetiapine for impulsivity and a broad range of affective symptoms in BPD. In this 12-week open-label study, we included individuals with BPD who presented to psychiatric in- and outpatient services. After a gradual titration of quetiapine, a flexible dose (range, 100-800 mg) was administered. The main outcome measures consisted of the scores on patient-rated questionnaires (Barratt Impulsiveness Scale, Buss-Durkee Hostility Inventory, Affective Lability Scale, Spielberger State and Trait Anxiety Inventory, Spielberger State and Trait Anger Inventory, and Beck Depression Inventory) and on neurocognitive tasks related to impulsivity (Stroop Color Word Task and IOWA Gambling Task). A mixed linear model, correcting for age, sex, antidepressant use, and weeks in psychotherapy, was applied. Forty-one patients (34 females and 7 males; mean [SD] age, 27.0 [9.0] years) were enrolled in the study, 32 of which completed the trial. Patients' scores decreased significantly (mean [SD] difference; P value) on the Barratt Impulsiveness Scale (19.7 [2.0]; P < 0.0001), Buss-Durkee Hostility Inventory (11.5 [1.4]; P < 0.0001), Affective Lability Scale (0.75 [0.08]; P < 0.0001), Beck Depression Inventory (25.0 [1.7]; P < 0.0001), Spielberger State and Trait Anxiety Inventory state (19.9 [1.9]; P < 0.0001) and trait (20.8 [1.7]; P < 0.0001) subscale, and Spielberger State and Trait Anger Inventory state (7.3 [1.1]; P < 0.0001) and trait (10.1 [1.0]; P < 0.0001) subscale. In addition, patients showed significantly less inference on the Stroop Color Word Task and had more 'good choices' on the IOWA Gambling Task. These results suggest that quetiapine may be efficacious in the treatment of impulsivity and affective symptoms in BPD.

Quetiapine treatment and improved cognitive functioning in borderline personality disorder

“…Binks et al, 2006;Herpertz et al, 2007). We have conducted a clinical trial with quetiapine in BPD in which we found this intervention to reduce affective symptoms and impulsivity (Van den Eynde et al, 2008). We report here on the findings on executive functioning as an additional assessment measure of efficacy in the same sample.…”

“…The study sample and data on the clinical outcomes impulsivity and affective symptoms have been described elsewhere (Van den Eynde et al, 2008). Fortyone (7 males and 34 females; mean age AE standard deviation: 27.0 AE 9.0 years) quetiapine-naïve treatment-seeking BPD patients (DSM-IV-TR diagnosis) completed a 12-week clinical trial with quetiapine.…”

Neurobiological bases for impulsive and compulsive behaviour: Implications for pharmacological and psychological interventions

“…Kvetiapin je efikasan u redukciji impulsivnog agresivnog ponašanja kod graničnog poremećaja ličnosti, poremećaja ponašanja kod dece, demencije i traumatskog oštećenja mozga. U otvorenoj studiji kod osoba sa graničnim poremećajem ličnosti, kvetiapin u dozama od 100-800mg/d je redukovao hostilnost, impulsivnost i bes [46]. Aripiprazol, parcijalni DA antagonist može pogoršati impulsivnost (npr.…”

Tratamento farmacológico da impulsividade e do comportamento agressivo

“…59 In an open-label trial with borderline personality disorder patients treated for 12 weeks, quetiapine (dose ranging from 100 to 800mg/day) was able to reduce impulsivity, hostility and anger, and also to improve performance in the Stroop Color Word Task and in the IOWA Gambling Test, data that support the anti-impulsive effect of the drug in these patients. 60 7. Methylphenidate It was mentioned above that serotonin is the central nervous system amine most studied in the context of impulsive and aggressive behavior, as demonstrated by several studies using different research paradigms in clinical and pre-clinical research.…”