Borderline Personality Disorder (BPD) is one of the most prevalent psychiatric disorders with
high morbidity and mortality. It affects the lives of millions worldwide and is often highly
incapacitating, leading to significant psychosocial dysfunction. Moreover, nearly all
patients have experienced suicidal ideation and about 10% actually commit suicide, a rate
almost 50 times higher than in the general population. Mostly young women are at greater risk
for the disorder and are three times more likely to be diagnosed with BPD than men.
BPD aetiology is complex and could be explained by both biological and environmental factors.
Among the environmental factors, sexual or physical abuse, parental divorce, loss or
illnesses are identified as the most common ones. These factors can induce dysfunctional
behaviours, which might cause emotional dysregulation, high impulsivity and frequent self-
injurious behaviour.
However, there are no pharmacologic interventions that are known to be specifically effective
to treat BPD. Therapeutic options for this devastating disorder is still far from adequate
for treating acute illness episodes, relapses, and recurrences and in restoring premorbid
functioning. In addition, some patients are unable to tolerate existing therapies for BPD,
which leads to either frequent changes in medications or to non-adherence. Therefore there is
an urgent need for the development of more rapidly effective treatments for BPD.
A growing body of evidence suggests that glutamatergic neurotransmission, in particular
N-methyl-D-aspartate (NMDA) subtype may play a role in the pathophysiology of multiple
psychiatric disorders. This has led to various clinical trials with glutamate modulating
drugs. The trial drug is an uncompetitive NMDA receptor antagonist approved for Alzheimer's
disease is increasingly being studied in a variety of non-dementia psychiatric disorders.
Results from these studies have proved that the trial drug was safe and well tolerated and
has the potential for use in the treatment of psychiatric disorders.
To date, there are no published data on the use of trial drug in the treatment for BPD.
Therefore, the investigators intend to study the efficacy of this novel drug as an addition
to ongoing therapy with atypical antipsychotics in patients with Borderline Personality
Disorder. This study will recruit 30 BPD patients. The patients will be randomly allocated to
receive either the study medication (20mg/ day) or placebo via oral administration for eight
weeks. To observe the efficacy of the trial treatment, all participants will be assessed at
various time intervals for different borderline and cognitive symptoms.