BACKGROUND: Borderline personality disorder (BPD) is prevalent among the general population (2%). Treatment of BPD is with the use of psychotherapy and pharmacotherapy. The use of psychotherapy for treatment of BPD has been well established, the effectiveness of pharmacotherapy remains less clear. OBJECTIVES: To evaluate the effectiveness of olanzapine and fluoxetine on outcomes (including depression, anxiety, anger/impulsivity/aggression and global assessment of functioning) of BPD patients. SEARCH STRATEGY: Searched PubMed for the terms fluoxetine and borderline personality disorder and olanzapine and borderline personality disorder. SELECTION CRITERIA: Only included randomized controlled trials in the English language that focused primarily on objective as stated above. MAIN RESULTS: Two fluoxetine studies included in this review, only one study showed significant improvement in depression and anger in BPD patients receiving fluoxetine but this was small (approximately 20% ). Both studies showed significant improvement in global assessment of functioning (GAF) in fluoxetine groups. Four olanzapine studies included in this review, 3 compared olanzapine to placebo and 1 compared olanzapine to a mixed olanzapine-fluoxetine combination (OFC) to fluoxetine. In 2 of the 3 olanzapine studies, there was significant improvement in depression, anxiety and GAF, improvements ranged from 21%-39% for depression and anxiety. All 3 olanzapine studies show improvement in anger/impulsivity/aggression (highest improvement was 49%). In the mixed study, OFC and olanzapine group showed significant improvement in depression and anger but this improvement was mild. Anxiety and GAF were not measured in the mixed study. CONCLUSIONS: Overall, fluoxetine leads to mild improvement in depression, anger and GAF. Olanzapine treatment of BPD patients leads to mild-moderate improvement in depression, anxiety, anger/impulsivity/aggression and GAF.Master of Public Healt
