Preliminary Trial of the Effect of Glucocorticoid Receptor Antagonist on Borderline Personality Disorder (BPD)
Condition: Borderline Personality Disorder
MeSH terms: Personality Disorders; Borderline Personality Disorder
Intervention: mifepristone; Placebo
Intervention description: Mifepristone 600mg (3x200mg tablets) once daily for seven days; 3 tablets once daily for seven days
Intervention MeSH terms: Mifepristone
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Enrollment: 22.0
Sex: All
Minimum age: 18 Years
Maximum age: 64 Years
Healthy volunteers: No
Keywords: BPD; Borderline; personality disorder; mifepristone

Summary:

      Participants will be randomized to either Mifepristone 600mg once daily for seven days or
      Placebo tablet once daily for seven days. Rating scales, vital signs, cortisol levels will be
      collected for evaluation.
    

Eligibility criteria:

        Inclusion Criteria:

          -  18-64 years of age at study entry

          -  Female or Male

          -  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision
             (DSM-IV-TR) diagnosis of borderline personality disorder (confirmed by SCID II) with
             history of abuse prior to the age of 18.

          -  Able to provide informed consent

          -  Inpatient or outpatient

          -  Clinical stability as defined by:

               -  Subjects must not have experienced an exacerbation of their illness within 4
                  weeks prior to randomization, leading to an intensification of psychiatric care
                  in the opinion of the principal investigator. Examples of intensification of care
                  include, but are not limited to: inpatient hospitalization, day/partial
                  hospitalization, outpatient crisis management, or psychiatric treatment in an
                  emergency room AND

               -  Psychotropic treatment stability for at least 2 weeks prior to randomization (no
                  change in dosing or addition of any new psychotropic medication)

          -  Female subjects of childbearing potential must test negative for pregnancy at
             screening visit and agree to use the double-barrier method, as defined by 2 physical
             barriers such as a condom, diaphragm, or cervical occlusive cap, coupled with an
             additional barrier such as spermicidal foam, gel, film, cream or suppository for the
             duration of the study. Subjects having undergone a hysterectomy or bilateral
             oophorectomy or other form of female sterilization or patients having been medically
             confirmed to be post-menopausal, would not require any other method of contraception.

          -  Minimum severity of a total score > 3 on the The Clinical Global Impression severity
             (CGI-S)

          -  Must agree not to consume tonic water and grapefruit or grapefruit product for 3 days
             prior to beginning medication and until the final study visit

        Exclusion Criteria:

          -  DSM-IV TR diagnosis of (confirmed by SCID) schizophrenia or a related psychotic
             disorder, bipolar I disorder, or dementia

          -  Subjects who are considered prisoners per the Indiana University Standard Operating
             Procedures for Research Involving Human Subjects.

          -  Subjects with current acute, serious, or unstable medical conditions, including, but
             not limited to: inadequately controlled diabetes, asthma, Chronic obstructive
             pulmonary disease (COPD), severe hypertriglyceridemia, recent cerebrovascular
             accidents, acute systemic infection or immunologic disease, unstable cardiovascular
             disorders, malnutrition, renal gastroenterologic, respiratory, endocrinologic
             (particularly illnesses related to the HPA-axis, e.g., Cushing's Syndrome),
             neurologic, hematologic, or infectious diseases

          -  Clinically significant electrocardiogram (ECG) abnormality prior to randomization
             including: subjects with a corrected QT interval (Bazett's; QTcB) >470 msec prior to
             randomization (based on the cardiologist overread). Repeat ECGs will be conducted at
             the discretion of the principal investigator or medical designee

          -  Use of any exclusionary medications listed in the protocol Attachment 2: Concomitant
             Medications

          -  Pregnant or lactating women or women who plan to become pregnant or will be lactating
             within one month after cessation of study medication

          -  Known Intelligence quotient (IQ) <70 based on medical history

          -  Currently using an intrauterine device (IUD) (females only)

          -  History of treatment with mifepristone or any mifepristone-containing medication at
             any time

          -  Known history of (1) Hepatitis C virus antibody, (2) Hepatitis B surface antigen
             (HBsAg) with or without positive Hepatitis B core total antibody, or (3) HIV 1 or 2
             antibodies

          -  Subjects with moderate to severe renal impairment as defined by creatinine clearance
             (CrCl) < 60 ml/min (measured by the Cockcroft-Gault equation) at screening

          -  Subjects with hepatic impairment as defined by liver transaminases or total bilirubin
             > 3 × upper limit of normal (ULN)

          -  Subjects considered a high risk for suicidal acts, as determined by the principal
             investigator.

          -  Subjects who have participated in a clinical trial with any pharmacological treatment
             intervention for which they received study-related medication in the 4 weeks prior to
             screening OR Subjects currently receiving treatment (within 1 dosing interval plus 4
             weeks) with an investigational depot formulation of an antipsychotic medication

          -  Subjects who demonstrate overtly aggressive behavior or who are deemed to pose a
             homicidal risk in the principal investigator's opinion

          -  Psychosocial treatment changes 14 days prior to randomization

          -  History of unexplained vaginal bleeding, endometrial hyperplasia with atypia, or
             endometrial carcinoma