Development of melancholia during carbamazepine treatment in borderline personality disorder

Carbamazepine, an anticonvulsant, has shown efficacy in the treatment of a wide range of psychiatric disorders, including classical affective disorders. Because patients with borderline personality disorder show prominent affective symptomatology on the one hand and symptoms suggestive of an epileptoid disorder on the other, carbamazepine was included in a multidrug, placebo-controlled, double-blind study. During carbamazepine treatment, three of 17 (18%) patients developed melancholia, which remitted on discontinuation of carbamazepine. While carbamazepine may prove to be an effective medication for some patients with borderline personality disorder, careful attention to change in depressive symptoms is suggested.