Quetiapine in patients with borderline personality disorder and psychosis: a case series

Objective

Atypical antipsychotics appear to be effective and well tolerated in the treatment of borderline personality disorder. One such agent, quetiapine (“Seroquel”), has a favourable side-effect profile and may be of value in acute and chronic treatment of this disorder.

Methods

In this case series, 12 outpatients with psychotic disorders meeting ICD-10, DSM-IV and DIB-R criteria for borderline personality disorder were treated with quetiapine monotherapy 300–750 mg/day. The CGI-S and the GAS assessed changes in symptom severity and global functioning, whereas the BIS, the HAM-D and the SCL-90-IX scales assessed change of psychotic symptoms and/or borderline personality disorder core symptomatology over time. Patients were evaluated at baseline and at 4 and 12 weeks after treatment. Statistical analyses included Page's trend test and Wilcoxon tests.

Results

All patients completed the 12-week study. The mean quetiapine dose was 537.5±18.9 mg/day. For all efficacy measures (with the exception of HAM-D), significant improvements were observed as early as Week 4 (P<0.01) and at endpoint (P<0.05).

Conclusion

Quetiapine relieved symptoms of psychosis, reduced impulsivity or depressed mood and improved global functioning in patients with borderline personality disorder and psychosis. Quetiapine was well tolerated.

• Borderline personality disorder
• atypical antipsychotics
• quetiapine
• psychotic symptoms
• efficacy

We would like to thank Dr H Neus and Dr J Kanz from Alexiuskrankenhaus in Neuss for their support and referral of patients. We also thank Professor M Schmidt-Degenhard, from the Florence Nightingale-Hospital in Düsseldorf and Dr H Köhler from AstraZeneca Germany for their valued advice and encouragement during the study.