Evidence map›Paper›PMID 26187496›Full record

Trial reportTrials2015

Lamotrigine versus inert placebo in the treatment of borderline personality disorder: study protocol for a randomized controlled trial and economic evaluation.

Mike J Crawford, Rahil Sanatinia, Barbara Barrett, Sarah Byford, Gillian Cunningham, Kavi Gakhal, Geof Lawrence-Smith, Verity Leeson, Fenella Lemonsky, Georgia Lykomitrou and 6 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Lance Adams syndrome: two cases report and literature review.The Journal of international medical research · 2022
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 1 country.

Mike J CrawfordCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. m.crawford@imperial.ac.uk.
Rahil SanatiniaCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. r.sanatinia@imperial.ac.uk.
Barbara BarrettKing's Health Economics, King's College London, De Crespigny Park, London, SE5 8AF, UK. barbara.barrett@kcl.ac.uk.
Sarah ByfordKing's Health Economics, King's College London, De Crespigny Park, London, SE5 8AF, UK. s.byford@kcl.ac.uk.
Gillian CunninghamSchool of Medicine, Pharmacy and Health, Durham University, Stockton Road, Durham, DH1 3LE, UK. gillian.cunningham1@nhs.net.
Kavi GakhalCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. k.gakhal@imperial.ac.uk.
Geof Lawrence-SmithOxleas NHS Foundation Trust, Pinewood Place, Dartford, DA2 7WG, UK. geoff.lawrence-smith@oxleas.nhs.uk.
Verity LeesonCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. v.leeson@imperial.ac.uk.
Fenella LemonskyCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. flemonsky@sky.com.
Georgia LykomitrouFaculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. georgia.lykomitrou@nottshc.nhs.uk.
Alan MontgomeryFaculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. alan.montgomery@nottingham.ac.uk.
Richard MorrissFaculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. richard.morriss@nottingham.ac.uk.
Carol PatonOxleas NHS Foundation Trust, Pinewood Place, Dartford, DA2 7WG, UK. c.paton@imperial.ac.uk.
Wei TanFaculty of Medicine & Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. wei.tan@nottingham.ac.uk.
Peter TyrerCentre for Mental Health, Imperial College London, Du Cane Road, London, W12 ONN, UK. p.tyrer@imperial.ac.uk.
Joseph G ReillySchool of Medicine, Pharmacy and Health, Durham University, Stockton Road, Durham, DH1 3LE, UK. j.g.reilly@durham.ac.uk.
Centre for Mental Health · GBDurham University · GBKing's College London · GBOxleas NHS Foundation Trust · GB

Funding

Department of Health 10/103/01
6 · The paper itself

Abstract

backgroundPeople with borderline personality disorder (BPD) experience rapid and distressing changes in mood, poor social functioning and have high rates of suicidal behaviour. Several small scale studies suggest that mood stabilizers may produce short-term reductions in symptoms of BPD, but have not been large enough to fully examine clinical and cost-effectiveness. METHODS/

designA two parallel-arm, placebo controlled randomized trial of usual care plus either lamotrigine or an inert placebo for people aged over 18 who are using mental health services and meet diagnostic criteria for BPD. We will exclude people with comorbid bipolar affective disorder or psychosis, those already taking a mood stabilizer, those who speak insufficient English to complete the baseline assessment and women who are pregnant or contemplating becoming pregnant. Those meeting inclusion criteria and provide written informed consent will be randomized to up to 200mg of lamotrigine per day or an inert placebo (up to 400mg if taking combined oral contraceptives). Participants will be randomized via a remote web-based system using permuted stacked blocks stratified by study centre, severity of personality disorder, and level of bipolarity. Follow-up assessments will be conducted by masked researchers 12, 24 weeks, and 52 weeks after randomization. The primary outcome is the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). The secondary outcomes are depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment, adverse events and withdrawal of trial medication due to adverse effects. The main analyses will use intention to treat without imputation of missing data. The economic evaluation will take an NHS/Personal Social Services perspective. A cost-utility analysis will compare differences in total costs and differences in quality of life using QALYs derived from the EQ-5D. DISCUSSION: The evidence base for the use of pharmacological treatments for people with borderline personality disorder is poor. In this trial we will examine the clinical and cost-effectiveness of lamotrigine to assess what if any impact offering this has on peoples' mental health, social functioning, and use of other medication and other resources.

trial registrationCurrent Controlled Trials ISRCTN90916365 (registered 01/08/2012).

Indexed as

AffectAntipsychotic AgentsBorderline Personality DisorderClinical ProtocolsCost-Benefit AnalysisDrug CostsEnglandFemaleHumansLamotrigineMalePsychiatric Status Rating ScalesQuality-Adjusted Life YearsQuality of LifeResearch DesignTime FactorsAntipsychotic AgentsLamotrigineTriazines

Identifiers

PMID26187496
PMCPMC4506596
OpenAlexW1856612018

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.