title: Medication for borderline personality disorder: a survey at a secure hospital.
abstract: OBJECTIVE
  To study the use of medication in the treatment of inpatients with borderline personality disorder (BPD). To survey clinicians' views on the UK National Institute for Health and Clinical Excellence (NICE) Guideline on BPD.
  
  
  METHODS
  Cross-sectional survey of the use of psychotropics purely for BPD at a large secure UK psychiatric hospital, together with interviews with the treating psychiatrists.
  
  
  RESULTS
  A total of 79 patients had a DSM diagnosis of BPD, of whom 80% were receiving one or more psychotropics and 48% were receiving two or more. Most prescriptions were off-label. Antipsychotics followed by antidepressants were the most frequent class of drug prescribed for BPD. Clozapine was the most commonly prescribed drug and according to the treating psychiatrists the one most likely to lead to a major improvement in target symptoms. Other psychotropics were generally rated as resulting in minor improvement or no change. Clinicians were aware they were prescribing contrary to NICE but justified this on the basis of having to treat severe and complex cases.
  
  
  CONCLUSIONS
  Use of psychotropics (especially clozapine), off-label prescribing and polypharmacy were very common in these inpatients with BPD. Randomised controlled trials of the use of clozapine in severe BPD are needed.
authors: St Andrew's Healthcare, Northampton, UK. chaw@standrew.co.uk
authors: Camilla
authors: C
authors: Haw
authors: Jean
authors: J
authors: Stubbs
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001883:Borderline Personality Disorder / Q000188:drug therapy*; D015283:Citalopram / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use; D003625:Data Collection; D005260:Female; D017408:Guidelines as Topic; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D006113:United Kingdom
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D015283:Citalopram; D003024:Clozapine