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A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder.
J Clin Psychiatry. 2004 Jul; 65(7):903-7.JC

Abstract

BACKGROUND

The intent of this study was to compare the efficacy and safety of fluoxetine, olanzapine, or the olanzapine-fluoxetine combination (OFC) in the treatment of women meeting criteria for borderline personality disorder (without concurrent major depressive disorder).

METHOD

We conducted a randomized double-blind study of these agents in female subjects meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-IV criteria for borderline personality disorder. Treatment duration was 8 weeks. Outcome measures were clinician-rated scales measuring depression (the Montgomery-Asberg Depression Rating Scale) and impulsive aggression (the Modified Overt Aggression Scale). Data were collected from August 2001 through March 2003.

RESULTS

Fourteen subjects were randomized to fluoxetine; 16, to olanzapine; and 15, to OFC. Forty-two of these subjects (93.3%) completed all 8 weeks of the trial. Using random-effects regression modeling of panel data of change-from-baseline scores and controlling for time, olanzapine monotherapy and OFC were associated with a significantly greater rate of improvement over time than fluoxetine on both outcome measures. However, it should be noted that fluoxetine treatment led to a substantial reduction in impulsive aggression and severity of depression. Weight gain was relatively modest in all 3 groups but significantly greater in the olanzapine-treated group than in the groups treated with fluoxetine alone or OFC.

CONCLUSION

All 3 compounds studied appear to be safe and effective agents in the treatment of women with borderline personality disorder, significantly ameliorating the chronic dysphoria and impulsive aggression common among borderline patients. However, olanzapine monotherapy and OFC seem to be superior to fluoxetine monotherapy in treating both of these dimensions of borderline psychopathology.

Authors+Show Affiliations

Laboratory for the Study of Adult Development, McLean Hospital, Belmont, MA 02478, USA. zanarini@mclean.harvard.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15291677

Citation

Zanarini, Mary C., et al. "A Preliminary, Randomized Trial of Fluoxetine, Olanzapine, and the Olanzapine-fluoxetine Combination in Women With Borderline Personality Disorder." The Journal of Clinical Psychiatry, vol. 65, no. 7, 2004, pp. 903-7.
Zanarini MC, Frankenburg FR, Parachini EA. A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. J Clin Psychiatry. 2004;65(7):903-7.
Zanarini, M. C., Frankenburg, F. R., & Parachini, E. A. (2004). A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. The Journal of Clinical Psychiatry, 65(7), 903-7.
Zanarini MC, Frankenburg FR, Parachini EA. A Preliminary, Randomized Trial of Fluoxetine, Olanzapine, and the Olanzapine-fluoxetine Combination in Women With Borderline Personality Disorder. J Clin Psychiatry. 2004;65(7):903-7. PubMed PMID: 15291677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A preliminary, randomized trial of fluoxetine, olanzapine, and the olanzapine-fluoxetine combination in women with borderline personality disorder. AU - Zanarini,Mary C, AU - Frankenburg,Frances R, AU - Parachini,Elizabeth A, PY - 2004/8/5/pubmed PY - 2004/9/14/medline PY - 2004/8/5/entrez SP - 903 EP - 7 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 65 IS - 7 N2 - BACKGROUND: The intent of this study was to compare the efficacy and safety of fluoxetine, olanzapine, or the olanzapine-fluoxetine combination (OFC) in the treatment of women meeting criteria for borderline personality disorder (without concurrent major depressive disorder). METHOD: We conducted a randomized double-blind study of these agents in female subjects meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-IV criteria for borderline personality disorder. Treatment duration was 8 weeks. Outcome measures were clinician-rated scales measuring depression (the Montgomery-Asberg Depression Rating Scale) and impulsive aggression (the Modified Overt Aggression Scale). Data were collected from August 2001 through March 2003. RESULTS: Fourteen subjects were randomized to fluoxetine; 16, to olanzapine; and 15, to OFC. Forty-two of these subjects (93.3%) completed all 8 weeks of the trial. Using random-effects regression modeling of panel data of change-from-baseline scores and controlling for time, olanzapine monotherapy and OFC were associated with a significantly greater rate of improvement over time than fluoxetine on both outcome measures. However, it should be noted that fluoxetine treatment led to a substantial reduction in impulsive aggression and severity of depression. Weight gain was relatively modest in all 3 groups but significantly greater in the olanzapine-treated group than in the groups treated with fluoxetine alone or OFC. CONCLUSION: All 3 compounds studied appear to be safe and effective agents in the treatment of women with borderline personality disorder, significantly ameliorating the chronic dysphoria and impulsive aggression common among borderline patients. However, olanzapine monotherapy and OFC seem to be superior to fluoxetine monotherapy in treating both of these dimensions of borderline psychopathology. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/15291677/A_preliminary_randomized_trial_of_fluoxetine_olanzapine_and_the_olanzapine_fluoxetine_combination_in_women_with_borderline_personality_disorder_ L2 - http://www.psychiatrist.com/jcp/article/pages/2004/v65n07/v65n0704.aspx DB - PRIME DP - Unbound Medicine ER -