Imperial College London

Emeritus ProfessorPeterTyrer

Faculty of MedicineDepartment of Brain Sciences

Emeritus Professor in Community Psychiatry - Clinical



+44 (0)20 3313 4161p.tyrer




13.09Claybrook CentreCharing Cross Campus






BibTex format

author = {Crawford, MJ and Sanatinia, R and Barrett, B and Cunningham, G and Dale, O and Gunguli, P and Lawrence-Smith, G and Leeson, V and Lmeonsky, F and Lykomitrou, G and Montgomery, A and Morriss, R and Munjiza, J and Paton, C and Skorodzien, I and Singh, V and Tan, W and Tyrer, P and Reilly, JG and LABILE, study team},
doi = {10.1176/appi.ajp.2018.17091006},
journal = {American Journal of Psychiatry},
pages = {756--764},
title = {The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial},
url = {},
volume = {175},
year = {2018}

RIS format (EndNote, RefMan)

AB - Objectives:To examine whether lamotrigine is a clinically effective and cost-effective treatment for people with borderline personality disorder. Method:Multicentre, double-blind, placebo-controlled randomized trial. Between July 2013 to November 2016, we recruited 276 people aged 18 or over, who met diagnostic criteria for borderline personality disorder. We excluded those with co-existing bipolar affective disorder or psychosis, those already taking a mood stabiliser, and women at risk of pregnancy. We randomly allocated participants on a 1:1 ratio to up to 400mg of lamotrigine per day or an inert placebo using a remote web-based randomization service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. Secondary outcomes included depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment and adverse events. Results:195 (70.6%) participants were followed up at 52 weeks, at which point 49 (36%) of those prescribed lamotrigine and 58 (42%) of those prescribed placebo were taking it. Mean total ZAN-BPD score was 11.3 (SD = 6.6) among those randomized to lamotrigine and 11.5 (SD = 7.7) among those randomized to placebo (adjusted difference in means = 0.1, 95% C.I = -1.8 to 2.0, p=0.91). There was no evidence of any differences in secondary outcomes. Costs of direct care for those prescribed lamotrigine were similar to those prescribed placebo. Conclusions:Treating people with borderline personality disorder with lamotrigine is not a clinically effective or cost-effective use of resources.
AU - Crawford,MJ
AU - Sanatinia,R
AU - Barrett,B
AU - Cunningham,G
AU - Dale,O
AU - Gunguli,P
AU - Lawrence-Smith,G
AU - Leeson,V
AU - Lmeonsky,F
AU - Lykomitrou,G
AU - Montgomery,A
AU - Morriss,R
AU - Munjiza,J
AU - Paton,C
AU - Skorodzien,I
AU - Singh,V
AU - Tan,W
AU - Tyrer,P
AU - Reilly,JG
AU - LABILE,study team
DO - 10.1176/appi.ajp.2018.17091006
EP - 764
PY - 2018///
SN - 0002-953X
SP - 756
TI - The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial
T2 - American Journal of Psychiatry
UR -
UR -
VL - 175
ER -