Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study.
BACKGROUND
Borderline personality disorder (BPD) is a complex mental disease associated with severe serious functional impairment, affective instability, and impulsive aggression. The aim of this study was to compare the efficacy of topiramate versus placebo in the treatment of aggression in men with borderline personality disorder.


METHODS
We conducted an 8-week, double-blind, placebo-controlled study of topiramate in 42 male subjects (42 of 44) meeting DSM-IV criteria for BPD. The Structured Clinical Interview (SCID I and II) was carried out. The subjects were randomly assigned to topiramate (n = 22) or placebo (n = 20).


RESULTS
Significant changes on four STAXI scales (State Anger, p < .01; Trait Anger, p < .05; Anger Out, p < .01; Anger Control, p < .01) were observed in the subjects treated with topiramate. A nonsignificant difference was found on the Anger In scale (p = .86). Additional significant weight loss was observed (difference in weight loss between the both groups was 5.0 kg, p < .01, 95% confidence interval = [-6.5 to 3.4]). All subjects tolerated topiramate relatively well.


CONCLUSIONS
Topiramate appears to be an effective agent in the treatment of anger in men with BPD. Mild weight loss can be expected.
Nickel
Marius K
MK
Department of Psychosomatic Medicine, Inntalklinik, 84359 Simbach/Inn, Germany. m.nickel@inntalklinik.de
Nickel
Cerstin
C
Kaplan
Patrick
P
Lahmann
Claas
C
Mühlbacher
Moritz
M
Tritt
Karin
K
Krawczyk
Jakub
J
Leiberich
Peter K
PK
Rother
Wolfhardt K
WK
Loew
Thomas H
TH
D000328:Adult; D000374:Aggression / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects; D001883:Borderline Personality Disorder / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy* / Q000209:etiology; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010555:Personality Inventory / Q000706:statistics & numerical data; D010919:Placebos; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D000077236:Topiramate
D018696:Neuroprotective Agents; D010919:Placebos; D000077236:Topiramate; D005632:Fructose