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Brexpiprazole in Borderline Personality Disorder

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The University of Chicago

Status and phase

Completed
Phase 2

Conditions

Borderline Personality Disorder

Treatments

Drug: Placebo
Drug: Rexulti

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT03418675
17-1729

Details and patient eligibility

About

The primary objective of the proposed study is to evaluate the safety and efficacy of Brexpiprazole in adults with borderline personality disorder (BPD). The hypothesis to be tested is that brexpiprazole will be more effective and well tolerated in adults with BPD compared to placebo. The proposed study will provide needed data on the treatment of a disabling disorder.

Full description

Borderline personality disorder is characterized by mood instability, cognitive symptoms, impulsive behavior, and disturbed relationships (1-3). A variety of psychotherapies have been developed (4-6) and, while research on the use of medication is ongoing, no drug has been approved in the United States or elsewhere for its treatment (7). Second generation antipsychotics have been the most intensively studied (8-11). Current treatments for BPD are often inadequate. Dialectical behavioral therapy has been shown to reduce BPD but finding trained psychologists is difficult.

Dysfunctions in the serotoninergic and dopaminergic systems have been demonstrated in-and considered as possible causes for-symptoms associated with the disorder (25-28). Several studies on the use of traditional (29) and atypical antipsychotic agents in patients with borderline personality disorder (30-31) have shown a positive effect on individual symptoms (29, 32-36). However, we are not aware of any study evaluating Brexpiprazole in the treatment of patients with borderline personality disorder. In the proposed double-blind, placebo-controlled study, the influence of Brexpiprazole on the multifaceted psychopathological symptoms and aggression of patients with borderline personality disorder will be investigated.

Brexpiprazole therefore has distinctive properties that make it a promising option for patients with BPD. Brexpiprazole is a novel D2 partial agonist, has affinity for 5-HT1A, acts as an antagonist of the noradrenergic α1/2 receptor, partial agonist for D3, and antagonist for 5-HT2A (37-39). In addition, because of low rates of side effects, Brexpiprazole should be a well-tolerated and in fact desired medication approach to BPD.

Enrollment

80 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. Men and women age 18-65;
  2. Primary diagnosis of BPD
  3. Zanarini scale score of at least 9 at baseline
  4. Ability to understand and sign the consent form.

Exclusion criteria

  1. Unstable medical illness based on history or clinically significant abnormalities on baseline physical examination
  2. Subjects with schizophrenia or bipolar I disorder
  3. Subjects with an active substance use disorder
  4. Current pregnancy or lactation, or inadequate contraception in women of childbearing potential
  5. Subjects considered an immediate suicide risk based on the Columbia Suicide Severity rating Scale (C-SSRS) (www.cssrs.columbia.edu/docs)
  6. Illegal substance use based on urine toxicology screening
  7. Initiation of psychological interventions within 3 months of screening
  8. Use of any other psychotropic medication
  9. Previous treatment with Brexpiprazole
  10. Cognitive impairment that interferes with the capacity to understand and self-administer medication or provide written informed consent

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Quadruple Blind

80 participants in 2 patient groups, including a placebo group

Placebo
Placebo Comparator group
Description:
1 milligram per day for the first week and 1 milligram per day for the final taper week 2 milligrams per day for 10 weeks between taper periods.
Treatment:
Drug: Placebo
Rexulti
Experimental group
Description:
1 milligram per day day for the first week and 1 milligram per day for the final taper week 2 milligrams per day for 10 weeks between taper periods.
Treatment:
Drug: Rexulti

Trial documents
1

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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