The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial
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, w...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Psychiatric Publishing
2018
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| Online Access: | https://eprints.nottingham.ac.uk/48936/ |
| _version_ | 1848797883379220480 |
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| author | Crawford, Mike J. Sanatinia, Rahil Barrett, Barbara Cunningham, Gillian Dale, Oliver Ganguli, Poushali Lawrence-Smith, Geoff Leeson, Verity Lemonsky, Fenella Lykomitrou, Georgia Montgomery, Alan A. Morriss, Richard K. Munjiza, Jasna Paton, Carol Skorodzien, Iwona Singh, Vineet Tan, Wei Tyrer, Peter Reilly, Joseph G. |
| author_facet | Crawford, Mike J. Sanatinia, Rahil Barrett, Barbara Cunningham, Gillian Dale, Oliver Ganguli, Poushali Lawrence-Smith, Geoff Leeson, Verity Lemonsky, Fenella Lykomitrou, Georgia Montgomery, Alan A. Morriss, Richard K. Munjiza, Jasna Paton, Carol Skorodzien, Iwona Singh, Vineet Tan, Wei Tyrer, Peter Reilly, Joseph G. |
| author_sort | Crawford, Mike J. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T20:10:57Z |
| format | Article |
| id | nottingham-48936 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:10:57Z |
| publishDate | 2018 |
| publisher | American Psychiatric Publishing |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-489362019-04-06T04:30:12Z https://eprints.nottingham.ac.uk/48936/ The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial Crawford, Mike J. Sanatinia, Rahil Barrett, Barbara Cunningham, Gillian Dale, Oliver Ganguli, Poushali Lawrence-Smith, Geoff Leeson, Verity Lemonsky, Fenella Lykomitrou, Georgia Montgomery, Alan A. Morriss, Richard K. Munjiza, Jasna Paton, Carol Skorodzien, Iwona Singh, Vineet Tan, Wei Tyrer, Peter Reilly, Joseph G. 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. American Psychiatric Publishing 2018-04-06 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/48936/1/AmJPsych5.pdf Crawford, Mike J., Sanatinia, Rahil, Barrett, Barbara, Cunningham, Gillian, Dale, Oliver, Ganguli, Poushali, Lawrence-Smith, Geoff, Leeson, Verity, Lemonsky, Fenella, Lykomitrou, Georgia, Montgomery, Alan A., Morriss, Richard K., Munjiza, Jasna, Paton, Carol, Skorodzien, Iwona, Singh, Vineet, Tan, Wei, Tyrer, Peter and Reilly, Joseph G. (2018) 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 https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2018.17091006 doi:10.1176/appi.ajp.2018.17091006 doi:10.1176/appi.ajp.2018.17091006 |
| spellingShingle | Crawford, Mike J. Sanatinia, Rahil Barrett, Barbara Cunningham, Gillian Dale, Oliver Ganguli, Poushali Lawrence-Smith, Geoff Leeson, Verity Lemonsky, Fenella Lykomitrou, Georgia Montgomery, Alan A. Morriss, Richard K. Munjiza, Jasna Paton, Carol Skorodzien, Iwona Singh, Vineet Tan, Wei Tyrer, Peter Reilly, Joseph G. The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title | The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title_full | The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title_fullStr | The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title_full_unstemmed | The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title_short | The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| title_sort | clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial |
| url | https://eprints.nottingham.ac.uk/48936/ https://eprints.nottingham.ac.uk/48936/ https://eprints.nottingham.ac.uk/48936/ |