Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study

Biol Psychiatry. 2005 Mar 1;57(5):495-9. doi: 10.1016/j.biopsych.2004.11.044.


Background: Borderline personality disorder (BPD) is a complex mental disease associated with severe serious functional impairment, affective instability, and impulsive aggression. The aim of this study was to compare the efficacy of topiramate versus placebo in the treatment of aggression in men with borderline personality disorder.

Methods: We conducted an 8-week, double-blind, placebo-controlled study of topiramate in 42 male subjects (42 of 44) meeting DSM-IV criteria for BPD. The Structured Clinical Interview (SCID I and II) was carried out. The subjects were randomly assigned to topiramate (n = 22) or placebo (n = 20).

Results: Significant changes on four STAXI scales (State Anger, p < .01; Trait Anger, p < .05; Anger Out, p < .01; Anger Control, p < .01) were observed in the subjects treated with topiramate. A nonsignificant difference was found on the Anger In scale (p = .86). Additional significant weight loss was observed (difference in weight loss between the both groups was 5.0 kg, p < .01, 95% confidence interval = [-6.5 to 3.4]). All subjects tolerated topiramate relatively well.

Conclusions: Topiramate appears to be an effective agent in the treatment of anger in men with BPD. Mild weight loss can be expected.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aggression / drug effects*
  • Body Weight / drug effects
  • Borderline Personality Disorder / complications
  • Borderline Personality Disorder / drug therapy*
  • Double-Blind Method
  • Follow-Up Studies
  • Fructose / analogs & derivatives*
  • Fructose / therapeutic use*
  • Humans
  • Male
  • Mood Disorders / drug therapy*
  • Mood Disorders / etiology
  • Neuroprotective Agents / therapeutic use*
  • Personality Inventory / statistics & numerical data
  • Placebos
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Statistics, Nonparametric
  • Topiramate


  • Neuroprotective Agents
  • Placebos
  • Topiramate
  • Fructose