Eficacia de fluoxetina en el tratamiento prolongado del trastorno límite de la personalidad

Abstract

Objectives: Treatment of borderline personality disorder (BPD) is characterized by high rates of non-compliance and discontinuation of treatment. While fluoxetine has proved efficacy in controlled trials in BPD, conclusions for efficacy in the continuation treatment cannot be made. Method: Twenty patients with a DSM-IV diagnosis of BPD received treatment with 40 mg/day of fluoxetine during 3 months. Consequently, they entered an open and prospective study of six-month of duration with consecutive assignment to one of two groups of treatment: one with 20 mg of fluoxetine and the other with 5 mg of diacepam. Efficacy was rated with the Hamilton Rating Scales for depression (HDRS) and anxiety (HARS), the Positive and Negative Syndrome Scales for schizophrenia (PANSS) and the Global Assessment of Functioning Scale (GAF). Results: 80% of patients who received fluoxetine continued treatment up to the end of the study, while only 40% of patients with diacepam did. Dropouts were not attributed to adverse events in any case. Significant differences were found between both groups for HDRS and HARS scores at the end of the study. Conclusions: Fluoxetine could contribute to treatment of BPD by improving adherence to psychotherapeutic programs in the long run.