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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EAlthough no drugs are currently approved for treatment of borderline personality disorder (BPD), studies have shown the benefit of antipsychotic agents for this indication, particularly when symptoms of mood instability, anger and irritability, and self-harm are prominent. Open-label studies have demonstrated that the atypical antipsychotic drug quetiapine is efficacious and well tolerated in treating these patients. This article presents results of a placebo-controlled trial demonstrating that low doses of long-acting quetiapine significantly improve symptoms in patients with BPD.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychopharmacology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPersonality Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychopharmacology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPersonality Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EDonald W. Black, MD, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA, presented results of a placebo-controlled trial demonstrating that low doses of long-acting quetiapine significantly improve symptoms in patients with borderline personality disorder (BPD).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAlthough no drugs are currently approved for treatment of BPD, studies have shown the benefit of antipsychotic agents for this indication, particularly when symptoms of mood instability, anger and irritability, and self-harm are prominent. Open-label studies have demonstrated that the atypical antipsychotic drug quetiapine is efficacious and well tolerated in treating these patients.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EDr. Black and colleagues conducted a randomized controlled trial (RCT) to investigate the efficacy and tolerability of extended-release quetiapine in the treatment of BPD [Black DW et al. \u003Cem\u003EAm J Psychiatry\u003C\/em\u003E 2014. In press; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00880919\u0026amp;atom=%2Fspmdc%2F14%2F8%2F18.atom\u0022\u003ENCT00880919\u003C\/a\u003E]. To be included in the study, patients were required to be from 18 to 45 years old, meet DSM-IV criteria for BPD, and show a score of \u22659 on the Zanarini Rating Scale for BPD (ZAN-BPD) at screening.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EExclusion criteria included patients with various psychiatric and nonpsychiatric conditions, such as comorbid current major depressive disorder or substance abuse, and pregnant women. Those with a history of nonresponse to an atypical antipsychotic agent were also excluded.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EA total of 95 patients were randomly assigned to groups receiving quetiapine 150 mg\/day (n=33), quetiapine 300 mg\/day (n=33), or placebo (n=29). All patients received a 50-mg starting dose on Day 1, which increased to 150 mg\/day after 1 week; patients in the 300-mg\/day arm were changed to that level after 4 weeks. The study comprised three treatment phases: screening (Visits 1 and 2), treatment (Visits 2 to 10), and discontinuation (Visits 10 and 11).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EPrimary outcome was ZAN-BPD total score. Secondary outcomes included the Borderline Evaluation of Severity over Time (BEST) index of BPD symptoms and ZAN-BPD subscales.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EPatients in all arms of the study experienced symptom improvement, as demonstrated by reduced ZAN-BPD total score (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). In both quetiapine arms, improvement was greatest from baseline (Visit 2) to Visit 6. The improvement was only significant (p=0.031) in the quetiapine 150-mg\/day arm compared with placebo, however.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/8\/18\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Changes in ZAN-BPD Total Score\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1618844489\u0022 data-figure-caption=\u0022Changes in ZAN-BPD Total Score\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/8\/18\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/8\/18\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/8\/18\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15844\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EChanges in ZAN-BPD Total Score\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EBPD=borderline personality disorder; ZAN-BPD=Zanarini Rating Scale for Borderline Personality Disorder.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from DW Black, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EAll secondary outcomes improved significantly in both quetiapine groups compared with the placebo group, except the improvement in the Young Mania Rating Scale score in the 300-mg\/day group, which missed significance (p=0.06).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EEighty-eight percent of patients reported at least one adverse event (AE), with a higher risk of occurrence in the quetiapine 300-mg\/day arm. The most common AEs in this group were sedation (HR, 2.16), appetite change (HR, 3.89), and dry mouth (HR, 16.8). The discontinuation rate in the study was high (33%). By 8 weeks, 42% of patients in the 300-mg\/day group had discontinued, compared with 33% of the 150-mg\/day group and with 20% of those receiving placebo. Sedation was a predictor of discontinuation (HR, 1.77).\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EDr. Black concluded that, despite the high discontinuation rate, which is not uncommon in trials in BPD, the results of this study demonstrate efficacy of low-dose quetiapine in treating the symptoms of BPD. He recommended that future RCTs involving larger patient numbers and active comparators will further understanding of the effectiveness and safety of atypical antipsychotic drugs in patients with BPD.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/8\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzp8e2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp8e2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}