Treatment of aggression with topiramate in male borderline patients: A double-blind, placebo-controlled study

Background Borderline personality disorder (BPD) is a complex mental disease associated with severe serious functional impairment, affective instability, and impulsive aggression. The aim of this study was to compare the efficacy of topiramate versus placebo in the treatment of aggression in men with borderline personality disorder. Methods We conducted an 8-week, double-blind, placebo-controlled study of topiramate in 42 male subjects (42 of 44) meeting DSM-IV criteria for BPD. The Structured Clinical Interview (SCID I and II) was carried out. The subjects were randomly assigned to topiramate (n = 22) or placebo (n = 20). Results Significant changes on four STAXI scales (State Anger, p< .01; Trait Anger, p< .05; Anger Out, p< .01; Anger Control, p< .01) were observed in the subjects treated with topiramate. A nonsignificant difference was found on the Anger In scale (p = .86). Additional significant weight loss was observed (difference in weight loss between the both groups was 5.0 kg, p< .01, 95% confidence interval = [−6.5 to 3.4]). All subjects tolerated topiramate relatively well. Conclusions Topiramate appears to be an effective agent in the treatment of anger in men with BPD. Mild weight loss can be expected.