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P0044 - Influence of topiramate in risk behaviors reduction with borderline personality disorder patients treated by DBT

Published online by Cambridge University Press:  16 April 2020

M. Ferrer ,
O. Andion ,
N. Saez ,
C. Barral ,
L. Alvarez-Cienfuegos ,
N. Calvo ,
A. Salmaso  and
M. Casas
M. Ferrer
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
O. Andion
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
N. Saez
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
C. Barral
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
L. Alvarez-Cienfuegos
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
N. Calvo
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
A. Salmaso
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain
M. Casas
Affiliation:
Psychiatry Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain

Abstract

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Background:

Psychotherapy is considered the primary treatment for Borderline Personality Disorder (BPD) and Dialectical Behavior Therapy (DBT) is one of the most effective, based on empirical data (Lieb et al.,2004). Pharmacotherapy strategies have been successful in decreasing some core symptoms like impulsivity (Oldham,2005). Topiramate has been effective against BPD anger, considered as an expression of affective instability and a proxy measure of impulsivity (Nickel et al.,2004;2005).

Aim:

To analyze the topiramate contribution in the aggressive impulsivity decrease with BPD patients treated by DBT.

Method:

23 BPD patients, treated with DBT, participated in the study. Patients were evaluated with SCID-I and SCID-II. Topiramate dosage was adapted to the frequency and severity of self-aggressive impulsive behaviors.

The influence of topiramate in behavior outcomes was analysed using step by step multivariated regression analysis.

Results:

Topiramate didn't decrease suicidal attempts number, but had strong influence in parasuicidal behaviors (Standarized Betha=0.57;t=3.16,p<0.05) and in the reduction of emergencies visits (Standarized Betha=0.22;t=2.151, p<0.05). The medium topiramate dosage was 200 mg UID (100-500mg).

Conclusions:

Topiramate can be helpful, as a symptom-targeted pharmacotherapy, for self-aggresive impulsive behavior with BPD patients treated by DBT.

Type
Poster Session I: Personality Disorders
Information
European Psychiatry , Volume 23 , Issue S2: 16th AEP Congress - Abstract book - 16th AEP Congress , April 2008 , pp. S93 - S94
Copyright
Copyright © European Psychiatric Association 2008

References

Lieb, K, Zanarini, MC, Schmahl, C, Linehan, MM, Bohus, M. Borderline personality disorder. Lancet (2004) 364:453–6110.1016/S0140-6736(04)16770-6CrossRefGoogle ScholarPubMed
Oldham, JM. Guideline watch: Practice guideline for the treatment of patients with borderline personality disorder. APA (2005)Google Scholar
Nickel, MK, Nickel, C, Kaplan, P, Lahmann, C, Mühlbacher, M, Tritt, K, Krawczyk, J, Leiberich, PK, Rother, WK, Loew, TH. Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study. Biological Psychiatry (2005) 57:495–49910.1016/j.biopsych.2004.11.044CrossRefGoogle ScholarPubMed
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