Treatment of aggression with topiramate in male borderline patients, part II: 18-month follow-up.
OBJECTIVE
We previously tested topiramate, an anticonvulsant, in the treatment of aggression in men with borderline personality disorder (BPD) (Nickel M, Nickel C, Kaplan P, Lahmann C, Mühlbacher M, Tritt K, et al. Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study. Biol Psychiatry 2005;57:495-9), and found significant changes on most scales of the state-trait anger expression inventory (STAXI) and significant weight loss eight weeks later. The aim of this trial was to assess topiramate's efficacy in the long-term therapy for aggression in men with BPD.


METHODS
This 18-month follow-up observation, in which the previous patients (topiramate group: n=22; former placebo group: n=22) were examined bianually, was carried out.


RESULTS
According to the intent-to-treat principle, significant changes on all scales of the STAXI were observed in the subjects treated with topiramate. Additional significant weight loss was observed. All subjects tolerated topiramate relatively well.


CONCLUSIONS
Topiramate appears to be an effective, relatively safe agent in the long-term treatment of patients with BPD. Mild, non-transient weight loss can be expected.
Nickel
Marius K
MK
Clinic for Psychosomatic Medicine and Psychotherapy, Sommersbergseestrasse 395, Medical University of Graz, 8990 Bad Aussee, Austria. m.nickel@klinik-badaussee.at
Loew
Thomas H
TH
D000328:Adult; D000374:Aggression / Q000187:drug effects*; D000786:Anger / Q000187:drug effects; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010555:Personality Inventory; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose