The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial

Crawford, Mike J. and Sanatinia, Rahil and Barrett, Barbara and Cunningham, Gillian and Dale, Oliver and Ganguli, Poushali and Lawrence-Smith, Geoff and Leeson, Verity and Lemonsky, Fenella and Lykomitrou, Georgia and Montgomery, Alan A. and Morriss, Richard K. and Munjiza, Jasna and Paton, Carol and Skorodzien, Iwona and Singh, Vineet and Tan, Wei and Tyrer, Peter and Reilly, Joseph G. (2017) The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial. American Journal of Psychiatry . ISSN 1535-7228 (In Press)

[img] PDF - Repository staff only until 4 January 2019. - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (613kB)

Abstract

Objectives: To examine whether lamotrigine is a clinically effective and cost-effective treatment for people with borderline personality disorder.

Method: Multicentre, double-blind, placebo-controlled randomized trial. Between July 2013 to November 2016, we recruited 276 people aged 18 or over, who met diagnostic criteria for borderline personality disorder. We excluded those with co-existing bipolar affective disorder or psychosis, those already taking a mood stabiliser, and women at risk of pregnancy. We randomly allocated participants on a 1:1 ratio to up to 400mg of lamotrigine per day or an inert placebo using a remote web-based randomization service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. Secondary outcomes included depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment and adverse events.

Results: 195 (70.6%) participants were followed up at 52 weeks, at which point 49 (36%) of those prescribed lamotrigine and 58 (42%) of those prescribed placebo were taking it. Mean total ZAN-BPD score was 11.3 (SD = 6.6) among those randomized to lamotrigine and 11.5 (SD = 7.7) among those randomized to placebo (adjusted difference in means = 0.1, 95% C.I = -1.8 to 2.0, p=0.91). There was no evidence of any differences in secondary outcomes. Costs of direct care for those prescribed lamotrigine were similar to those prescribed placebo.

Conclusions: Treating people with borderline personality disorder with lamotrigine is not a clinically effective or cost-effective use of resources.

Item Type: Article
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Psychiatry and Applied Psychology
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Clinical Trials Unit
Depositing User: Eprints, Support
Date Deposited: 04 Jan 2018 11:35
Last Modified: 04 Jan 2018 13:07
URI: http://eprints.nottingham.ac.uk/id/eprint/48936

Actions (Archive Staff Only)

Edit View Edit View