We report the first double-blind, placebo-controlled continuation stud
y comparison of a neuroleptic (haloperidol less-than-or-equal-to 6 mg)
, monoamine oxidase inhibitor (MAOI) antidepressant (phenelzine less-t
han-or-equal-to 90 mg), and placebo in 54 patients with borderline per
sonality disorder. Continuation medication trials of 16 weeks followed
5 weeks of acute therapy. Haloperidol continued to be effective beyon
d the acute phase only for the treatment of irritability. Higher level
s of depression, hypersomnia, and leaden paralysis were noted in the h
aloperidol group than in the phenelzine and placebo groups. The dropou
t rate during the first half (8 weeks) of the continuation study was s
ignificantly higher for the haloperidol group (64%) than for the place
bo group (28%) (p < .05). Phenelzine demonstrated very modest efficacy
beyond that noted in the acute phase for the treatment of depression
and irritability. Phenelzine was shown to have an activating effect on
measures of excitement and reactivity.