E-EPA Helpful in Borderline Personality Disorder

Laurie Barclay, MD

January 16, 2003

Jan. 16, 2003 — Although borderline personality disorder is poorly treated with existing pharmacotherapy, results of a double-blind, placebo-controlled pilot study reported in the January issue of the American Journal of Psychiatry suggest that women with this condition may be partially reponsive to ethyl-eicosapentaenoic acid (E-EPA).

"Because response to antidepressants and mood stabilizers has typically been clinically modest in [borderline personality disorder] the identification of novel treatments is needed," write Mary C. Zanarini, EdD, and Frances R. Frankenburg, MD, from McLean Hospital in Belmont, Massachusetts. "Candidates include omega-3 fatty acids, such as E-EPA and docosahexaenoic acid, which are commonly found in seafood and have beneficial effects and none of the adverse side effects commonly associated with pharmacotherapy."

Of 30 women meeting Revised Diagnostic Interview for Borderlines and DSM-IV criteria for borderline personality disorder who were enrolled in this randomized study, 18 (90%) of 20 women given 1 g daily of E-EPA and nine (90%) of 10 women given placebo completed all eight weeks of the trial.

After controlling for baseline severity, E-EPA was superior to placebo in decreasing both aggression and the severity of depressive symptoms. Because the study enrolled only women with moderately severe disease, the authors warn against generalizing the results to men or to subjects with more severe disease.

"The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder," they write. "Studies assessing different doses of E-EPA for longer periods of time in larger samples are needed."

Am J Psychiatry. 2003;160(1):167-169

Reviewed by Gary D. Vogin, MD

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