[Empirical evidence for the use of anticonvulsants in personality disorders].
OBJECTIVE
There is a common practice of polypharmacy and an increased use of mood stabilizers in personality disorders (PD). This paper reviews all randomized controlled trials (RCTs) of anticonvulsants to evaluate the evidence base supporting their use in treatment of PD.


METHODS
German and English language literature cited in Medline and published between 1970 and 2008 was searched using the following terms: Borderline/personality disorder, anticonvulsant, mood stabilizer, carbamazepine, felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenytoine, pregabalin, tiagabine, topiramate, and valproate.


RESULTS
Twelve RCTs were identified which included anticonvulsants in treatment of personality disorders. The anticonvulsants valproate and topiramate appeared to have the most empirical support for having a favorable effect on symptoms of borderline personality disorder. Evidence for the use of other anticonvulsants in patients with PD is sparse.


CONCLUSIONS
Valproate and topiramate, probably also lamotrigine, carbamazepine, and oxcarbazepine as well, were useful in treating symptoms of affective dysregulation and impulsive aggression in PD. However, further RCTs of anticonvulsants are greatly needed as clinical use of these agents has risen without sufficient evidence supporting their efficacy and safety in personality disorders.
Sieberer
M
M
Zentrum Psychologische Medizin, Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover. Sieberer.Marcel@mh-hannover.de
Emrich
H M
HM
D000588:Amines / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000188:drug therapy / Q000523:psychology; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D000078330:Oxcarbazepine; D010554:Personality Disorders / Q000188:drug therapy* / Q000523:psychology; D000069583:Pregabalin; D016032:Randomized Controlled Trials as Topic; D000077236:Topiramate; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D002220:Carbamazepine; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D000077206:Gabapentin; D000077213:Lamotrigine; D000078330:Oxcarbazepine