Efficacy of omega-3 fatty acids in the treatment of borderline personality disorder: a study of the association with valproic acid

Omega-3 fatty acids have received increasing interest for their effects in stabilizing plasmatic membranes and regulating cell signalling. Authors have studied the efficacy of omega-3 fatty acids in psychiatric disorders, in particular mood disorders. Two trials on eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the treatment of borderline personality disorder (BPD) are available. The present 12-week controlled trial is aimed to assess the efficacy of the association of EPA and DHA with valproic acid, compared to single valproic acid in 43 BPD consecutive outpatients. Participants were evaluated at baseline and after 12 weeks with: CGI-S, HAM-D, HAM-A, SOFAS, BPDSI, BIS-11, MOAS, SHI, and DOTES. Nine subjects discontinued treatment: 2 for symptoms of dyspepsia, 7 for lack of compliance. Results indicated that monotherapy with valproate and combination of valproate and omega-3 fatty acids had a similar efficacy on global symptoms, symptoms related to BPD, anxiety and depressive symptoms, and social functioning. The association of DHA and EPA with valproate was significantly superior to single valproate in reducing severity of impulsive behavioural dyscontrol, outbursts of anger, and self-mutilating conducts. Mild to moderate adverse effects were registered: dyspepsia, nausea, and weight gain < 2 kg.