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Asenapine in the treatment of borderline personality disorder: an atypical antipsychotic alternative

Martín-Blanco, Anaa,b,c,d; Patrizi, Barbarae; Villalta, Laiaa,b,d; Gasol, Xeroe; Soler, Joaquima,b,c,d; Gasol, Miquele; Pascual, Juan C.a,b,c,d

International Clinical Psychopharmacology: March 2014 - Volume 29 - Issue 2 - p 120–123
doi: 10.1097/YIC.0000000000000004
Short Communications

Many individuals with borderline personality disorder (BPD) receive medical treatment in clinical practice, although to date, there are no drugs specifically available for BPD. The recent Cochrane guideline suggests a benefit from using second-generation antipsychotics such as olanzapine or aripiprazole; nevertheless, side effects limit their use. Asenapine is a novel FDA-approved atypical antipsychotic for schizophrenia and bipolar disorder. However, it has not yet been tested for BPD. The goal of this observational open-label study was to assess the safety, tolerability and efficacy of asenapine in a series of cases of patients with BPD. Twelve individuals with BPD were recruited and treated with asenapine during an 8-week period. Eight individuals completed the study; a significant improvement was observed in the CGI-BPD (P<0.001) and BSL-23 (P<0.048) scales for BPD symptomatology. Besides, there was a significant improvement in the general psychopathology domains (BPRS, P<0.004), whereas no significant differences were observed in depressive symptoms. No serious adverse effects were reported and a significant weight reduction was observed (P=0.002). Asenapine appears to be a safe and effective agent in the treatment of patients with BPD, especially when other alternatives are not tolerated. These preliminary findings should be replicated in a controlled clinical trial.

aDepartment of Psychiatry, Santa Creu and Sant Pau Hospital

bUniversitat Autònoma de Barcelona (UAB)

cCentro de Investigación Biomédica en Red de Salud Mental, CIBERSAM

dInstitut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Barcelona

eBorderline Personality Disorder Unit, General de Catalunya Hospital, Sant Cugat, Spain

Correspondence to Juan C. Pascual, PhD, MD, Department of Psychiatry, Santa Creu and Sant Pau Hospital, Av. Sant Antoni Ma Claret 167, 08025 Barcelona, Spain Tel: +34 93 553 78 40; fax: +34 93 553 78 42; e-mail:

Received July 4, 2013

Accepted July 18, 2013

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