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Efficacy of extended-release divalproex combined with “condensed” dialectical behavior therapy for individuals with borderline personality disorder

Richelle Moen, PhD

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

Mary Freitag, PsyD

Integrative Psychological Services, St. Paul, MN, USA

Michael Miller, PsyD

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

Susanne Lee, PhD

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

Ann Romine, BA, RN

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

Sue Song, MA

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

Adit Adityanjee, MD

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

S. Charles Schulz, MD

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

BACKGROUND: Borderline personality disorder (BPD) is a significant psychiatric illness for which medication treatments are still being explored. The goal of this study was to assess divalproex extended release (ER) vs placebo for patients receiving dialectal behavior therapy (DBT).

METHODS: Patients with BPD received 4 weeks of “condensed DBT.” Those with Symptom Checklist-90 (SCL-90) scores >150 after this treatment were then randomly and blindly assigned to placebo or divalproex ER for 12 weeks. Repeated measures analysis of variance utilizing last observation carried forward was used to assess the results.

RESULTS: Seventeen participants completed the full assessment. Two patients had a significant decrease in SCL-90 in the first 4 weeks, leaving 15 patients for the medication phase of the trial. There were no significant differences between the participants assigned to divalproex ER compared with placebo. However, there was a significant improvement in both groups from baseline to endpoint (P = .001).

CONCLUSIONS: The response of 2 of 17 participants in the first 4 weeks prior to medication may point to a practice strategy in approaching outpatients with BPD. Although the patients had a decrease in symptoms during the study, there was no advantage observed for divalproex ER and DBT over placebo and DBT.

KEYWORDS: borderline personality disorder, divalproex ER, dialectical behavior therapy

ANNALS OF CLINICAL PSYCHIATRY 2012;24(4):255-260

CORRESPONDENCE: S. Charles Schulz, MD Department of Psychiatry, University of Minnesota Medical School F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454 USA E-MAIL: scs@umn.edu
Annals of Clinical Psychiatry ©2012 Frontline Medical Communications.

 
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