Amitriptyline versus haloperidol in borderlines: final outcomes and predictors of response.
The authors report the final results of a 4-year study of amitriptyline and haloperidol in 90 symptomatic borderline inpatients. Medication trials were double-blind and placebo controlled and lasted 5 weeks. Haloperidol (4-16 mg/day) produced significant improvement over placebo in global functioning, depression, hostility, schizotypal symptoms, and impulsive behavior. Significant effects of amitriptyline (100-175 mg/day) were generally limited to measures of depression. Factor analysis identified three symptom change patterns: a global depression, hostile depression, and schizotypal symptom pattern. Medication effects favoring haloperidol were most prominent for hostile depression. Variables predicting favorable response to haloperidol included severity of schizotypal symptoms, hostility, and suspiciousness. Schizotypal symptoms and paranoia predicted poor outcome on both depression patterns with amitriptyline. Placebo effects were most prominent on acute state symptoms, with severe character traits predicting poor response.
Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, Pennsylvania.
P H
PH
Soloff
A
A
George
S
S
Nathan
P M
PM
Schulz
J R
JR
Cornelius
J
J
Herring
J M
JM
Perel
D000639:Amitriptyline / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D005500:Follow-Up Studies; D006220:Haloperidol / Q000627:therapeutic use*; D006791:Hostility / Q000187:drug effects; D006801:Humans; D010554:Personality Disorders / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D012569:Schizotypal Personality Disorder / Q000188:drug therapy / Q000523:psychology
D000639:Amitriptyline; D006220:Haloperidol