Combination of Omega-3 Fatty Acids and Valproic Acid in Treatment of Borderline Personality Disorder: A Follow-Up Study

Background and Objectives Some evidence of efficacy has been found for omega-3 fatty acids in patients with borderline personality disorder (BPD). In a previous 12-week randomized trial we assessed the efficacy of the combination of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with valproic acid, in comparison with valproic acid monotherapy, in 43 BPD outpatients. Combined therapy was superior to valproic acid monotherapy (the control group) in the treatment of some BPD symptoms: impulsive-behavioral dyscontrol, outbursts of anger, and self-harm. The present study is a 24-week follow-up aimed at evaluating whether the differences in efficacy between the two subgroups were maintained after discontinuation of omega-3 fatty acids. Methods Thirty-four patients who completed the 12-week trial entered the follow-up study. Participants were evaluated at the beginning and at the end of the follow-up period using the rating scales that showed a significant difference between the groups after the 12-week trial with fatty acids supplementation: the Borderline Personality Disorder Severity Index (BPDSI) (items 'impulsivity' and 'outbursts of anger'), Barratt Impulsiveness Scale-Version 11 (BIS-11), and Self Harm Inventory (SHI). Statistical analysis was performed with analysis of variance (ANOVA) for repeated measures. Results At the end of the follow-up a significant difference within groups was maintained for all four variables examined, while a significant difference between groups was maintained for outbursts of anger. Concerning tolerability, no clinically significant adverse effects were registered during the follow-up period. Conclusions Combined therapy with omega-3 fatty acids showed long-lasting effects after discontinuation in terms of anger control.