Clozapine treatment of borderline patients: A preliminary study

• Published in: Comprehensive psychiatry 1993-11, Vol.34 (6), p.402-405
• Main Authors: Frankenburg, Frances R., Zanarini, Mary C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Borderline Personality Disorder - diagnosis; Borderline Personality Disorder - drug therapy; Clozapine - administration & dosage; Clozapine - adverse effects; Clozapine - therapeutic use; Female; Humans; Male; Medical sciences; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Psychiatric Status Rating Scales; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Reproducibility of Results; Treatment Outcome
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/0010-440X(93)90065-C

Clinicians frequently encounter patients who present with borderline personality disorder (BPD) and prolonged and/or pronounced psychotic symptoms of an atypical nature. Fifteen such patients were treated with clozapine and rerated blind to baseline symptomatology and functional level from 2 to 9 months after beginning treatment (mean = 4.2 ± 2.1). The overall symptomatology of these patients as rated on the Brief Psychiatric Rating Scale (BPRS) decreased significantly from a mean of 57.0 ± 10.4 to a mean of 37.8 ± 7.7 ( t = 7.03, df = 14, P = .001). Their positive, negative, and general symptoms as rated by the BPRS also decreased significantly. Additionally, their Global Assessment Scale (GAS) score increased significantly from a mean of 30.8 ± 4.7 to a mean of 43.1 ± 8.6 ( t = 5.19, df = 14, P = .001). These results suggest that clozapine may be an effective antipsychotic agent for this subset of BPD patients. However, double-blind, placebo-controlled studies are necessary to confirm these preliminary results.