The effects of combined omega-3 fatty acids and valproic acid supplementation on symptoms of borderline personality disorder: a pilot study

In recent years, omega-3 fatty acids have received increasing interest for their stabilizing effects on plasmatic membranes and cell signalling. Recent studies have considered the efficacy of these agents in treatment of several psychiatric disorders, in particular mood disorders. Two recent trials have tested the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in patients with borderline personality disorder (BPD). The present pilot study is testing safety of administering EPA and DHA in association with valproic acid and efficacy of EPA and DHA plus valproic acid in reducing symptoms of BPD. A group of 10 BPD patients treated for 12 weeks was evaluated at baseline and after 12 weeks with: CGI – Severity Item, HAM-D, HAM-A, SOFAS, BPDSI for BPD related symptoms, BIS-11 for impulsivity, MOAS for aggressiveness, SHI for self-injuries, and DOTES for adverse effects. The association had significant effects on the complex of BPD related symptoms (p=0.010), depression (p=0.028), affective instability (p=0.001), impulsive behaviours (p=0.001), and outbursts of anger (p=0.008). Adverse effects were mild to moderate dyspepsia, nausea, and weight gain. These initial data suggest that combined therapy with omega-3 fatty acids and valproate is an effective and well tolerated option in the treatment of BPD. Actual contribution of EPA and DHA to the overall effects of the association need to be assessed in a controlled study.