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Despite lacking good-quality evidence, clinicians are using lamotrigine, an antiepileptic with mood-stabilizing properties, to treat patients with borderline personality disorder (BPD) and emotional dysregulation. In a double-blind trial, investigators randomized 276 patients with BPD (mean age, 36; 75% women) to lamotrigine or placebo. Medication was titrated to 200 mg/day over 6 weeks or to 400 mg/day for women on combined oral contraceptives.
Patients continued to receive their usual care, including medications and psychotherapy, but no additional antiepileptics. Exclusions included people with bipolar I or II disorder, psychotic disorder, or mood stabilizers within 4 weeks and women who were pregnant, breast-feeding, or contemplating pre…