Olanzapine versus haloperidol in the management of borderline personality disorder: a randomized double-blind trial

Abstract

Introduction: The newer atypical antipsychotics seem to be as effective as previous antipsychotics for impulsivity and aggressiveness of patients with borderline personality disorder (BPD). Objective of this assessment was to compare the effectiveness of olanzapine versus haloperidol in BPD.

Method: Twenty-eight female inpatients, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for BPD, were randomly entered in one of the 2 matching contemporaneous groups for an 8-week parallel double-blind study. This included the random assignment to olanzapine or haloperidol in a 1:1 ratio. Primary outcome measurements were as follows: Brief Psychiatric Rating Scale, Clinical Global Impression-Severity Scale, Buss-Durkee Hostility Inventory. Baselines were created at the beginning of the trial through patient assessments and final assessments at the end of the experiment. Analysis of effect size, calculation of confidence intervals and power analysis were also prepared.

Results: All of the patients from within both groups completed the study. Intragroup analysis at the eighth week interval revealed significant positive response by both olanzapine and haloperidol in comparison with the baseline (P < 0.05); however, the between-group analysis showed no significant difference, among the patients, at the end of the experiment. The analysis of specific Brief Psychiatric Rating Scale subscales in both groups revealed considerable and comparable improvements in anxiety, tension, depressive mood, and hostility. The effect size analyzes illustrated remarkable improvements with both groups.

Conclusion: There seems to be no significant difference between olanzapine and haloperidol regarding the management of mental and behavioral symptoms of patients with BPD.