The British Journal of Psychiatry (2008) 193: 485-492. doi: 10.1192/bjp.bp.107.037903
© 2008 The Royal College of Psychiatrists
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Olanzapine for the treatment of borderline personality disorder: variable dose 12-week randomised double-blind placebo-controlled study

S. Charles Schulz, MD

Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

Mary C. Zanarini, EdD

McLean Hospital, Harvard Medical School, Boston, MA, USA

Anthony Bateman, MA, FRCPsych

Halliwick Unit, St Ann’s Hospital, Barnet, Enfield and Haringey Mental Health Trust, London, UK

Martin Bohus, MD

Department of Psychosomatic Medicine, Central Institute of Mental Health, University of Heidelberg, Germany

Holland C. Detke, PhD, Quynh Trzaskoma, MA, Yoko Tanaka, PhD and Daniel Lin, PhD

Lilly Research Laboratories, Indianapolis, IN, USA

Walter Deberdt, MD

Lilly Research Laboratories, Belgium

Sara Corya, MD

Lilly Research Laboratories, Indianapolis, IN, USA

Correspondence: Dr S. Charles Schulz, Department of Psychiatry, Medical School, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA. Email: scs{at}umn.edu

Declaration of interest

This study was sponsored by Eli Lilly. S.C.S. has received honorarium from Eli Lilly, AstraZeneca and Bristol-Meyers Squibb; grant fees from Eli Lilly, AstraZeneca, Abbott, MIND Institute and the NIMH; and consultation fees from Eli Lilly, AstraZeneca and Vanda. H.C.D., Q.T., Y.T., D.L. and S.C. are employed by Lilly Research Laboratories.

Background

Despite the prevalence and clinical significance of borderline personality disorder, its treatment remains understudied.

Aims

To evaluate treatment with variably dosed olanzapine in individuals with borderline personality disorder.

Method

In this 12-week randomised, double-blind trial, individuals received olanzapine (2.5–20 mg/day; n=155) or placebo (n=159) (trial registry: NCT00091650). The primary efficacy measure was baseline to end-point change on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN–BPD) using last-observation-carried-forward methodology.

Results

Both olanzapine and placebo groups showed significant improvements but did not differ in magnitude at end-point (–6.56 v. –6.25, P=0.661). Response rates (50% reduction in ZAN–BPD) were 64.7% with olanzapine and 53.5% with placebo (P=0.062); however, time to response was significantly shorter for olanzapine (P=0.022). Weight gain was significantly greater (2.86 v. –0.35 kg, P<0.001), with higher incidence of treatment-emergent abnormal high levels of prolactin for the olanzapine group.

Conclusions

Individuals treated with olanzapine and placebo showed significant but not statistically different improvements on overall symptoms of borderline personality disorder. The types of adverse events observed with olanzapine treatment appeared similar to those observed previously in adult populations.


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