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. 2022 Nov 14;2022(11):CD012956. doi: 10.1002/14651858.CD012956.pub2

Comparison 15. Single medication compared with combination of medications.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
15.1 Primary: BPD symptom severity at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.1.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 8.48 [3.39, 13.57]
15.2 Primary: Self‐harm at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.2.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 2.55 [0.98, 4.12]
15.3 Primary: Suicide‐related outcomes at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.3.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.23 [‐0.74, 1.20]
15.4 Primary: Psychosocial functioning at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.4.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.88 [‐6.21, 7.97]
15.5 Secondary: Anger at end of treatment (continuous outcome, MDs) 2 89 Mean Difference (IV, Fixed, 95% CI) 0.64 [‐0.77, 2.04]
15.5.1 Olanzapine versus olanzapine plus fluoxetine 1 29 Mean Difference (IV, Fixed, 95% CI) 0.46 [‐12.93, 13.85]
15.5.2 Fluoxetine versus fluoxetine plus olanzapine 1 26 Mean Difference (IV, Fixed, 95% CI) 4.77 [‐9.67, 19.21]
15.5.3 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.60 [‐0.82, 2.02]
15.6 Secondary: Affective instability at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.6.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 1.72 [0.68, 2.76]
15.7 Secondary: Chronic feelings of emptiness at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.7.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.03 [‐0.97, 1.03]
15.8 Secondary: Impulsivity at end of treatment (continuous outcome, MDs) 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.8.1 Olanzapine versus olanzapine plus fluoxetine 1 29 Mean Difference (IV, Fixed, 95% CI) 0.46 [‐12.93, 13.85]
15.8.2 Fluoxetinge versus fluoxetine plus olanzapine 1 26 Mean Difference (IV, Fixed, 95% CI) 4.77 [‐9.67, 19.21]
15.8.3 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 12.59 [6.11, 19.07]
15.9 Secondary: Interpersonal problems at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.9.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.47 [‐0.41, 1.35]
15.10 Secondary: Abandonment at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.10.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.83, 0.85]
15.11 Secondary: Identity disturbance at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.11.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.70 [‐0.34, 1.74]
15.12 Secondary: Dissociation and psychotic‐like symptoms at end of treatment (continuous outcome, MDs) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.12.1 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 0.03 [‐1.09, 1.15]
15.13 Secondary: Depression at end of treatment (continuous outcome, MDs) 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
15.13.1 Olanzapine versus olanzapine plus fluoxetine 1 29 Mean Difference (IV, Fixed, 95% CI) ‐1.78 [‐6.48, 2.92]
15.13.2 Fluoxetine versus fluoxetine plus olanzapine 1 26 Mean Difference (IV, Fixed, 95% CI) 3.62 [‐1.36, 8.60]
15.13.3 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 34 Mean Difference (IV, Fixed, 95% CI) 1.30 [0.00, 2.60]
15.14 Secondary: Attrition at end of treatment (dichotomous outcomes, RRs) 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
15.14.1 Olanzapine versus olanzapine plus fluoxetine 1 31 Risk Ratio (M‐H, Fixed, 95% CI) 0.19 [0.01, 3.63]
15.14.2 Fluoxetine versus fluoxetine plus olanzapine 1 29 Risk Ratio (M‐H, Fixed, 95% CI) 0.54 [0.05, 5.28]
15.14.3 Valproic acid versus valproic acid plus eicosapentaenoic acid and docosahexaenoic acid 1 43 Risk Ratio (M‐H, Fixed, 95% CI) 0.92 [0.29, 2.97]