Long-acting injectable risperidone in treatment resistant borderline personality disorder. A small series report

Abstract

Introduction. Borderline personality disorder (BDP) is usually treated with a combination of antipsychotic and anticonvulsant drugs although only limited efficacy is obtained in many patients. A major problem in the treatment of BPD is the lack of compliance derived form the pathological impulsivity of BPD patients.

Methods. Twelve severe BPD patients refractory to previous treatment with drug combinations for three months were treated with intramuscular long-acting risperidone for a six-month period. Clinical changes were rated with the Clinical Global Impression (CGI), the Brief Psychiatric Rating Scale, anxiety and aggression scales. Functional improvement was evaluated with the Global Assessment of Functionng (GAF).

Results. Six-month treatment with IM risperidone was associated with significant improvement of CGI (t: 5.7; gl: 10; p < 0.01) and of GAF (t: –4.5; gl: 10; p < 0.01). Clinical improvement was robust after the first month of treatment. No relevant extrapiramidal side effects were reported with the exception of mild psychomotor slowing which requires dose adjustments in four patients.

Conclusions. Treatment with i.m. long acting risperidone during six months was associated with significant clinical and functional improvement and excellent tolerability in a group of BPD patients refractory to previous treatment. The results indicate that the effect of IM risperidone in BPD should be further investigated in large placebo-controlled trials.