title: Psychopharmacological treatment of 2195 in-patients with borderline personality disorder: A comparison with other psychiatric disorders.
abstract: Patients with borderline personality disorder (BPD) are usually prescribed a variety of psychotropic drugs; however, none is recommended in the guidelines nor has any been approved for this indication. As data on drug prescriptions for BPD are sparse, cross-sectional data from the European Drug Safety Project AMSP were used to analyse drug prescriptions of 2195 in-patients with BPD between 2001 and 2011, and the mean values, confidence intervals and regression analyses were calculated. 70% of all BPD patients were medicated with antipsychotics and/or antidepressants, 33% with anticonvulsants, 30% with benzodiazepines, and 4% with lithium; 90% received at least one, 80%≥2, and 54%≥3 psychotropic drugs concomitantly (mean: 2.8). Prescription rates for quetiapine, the single drug most often used in BPD (22%), increased significantly over time. In view of the high percentage of young females with BPD, 18-40 year-old female patients with BPD were compared with patients of the same age but with depression (unipolar and bipolar) and schizophrenia. Typical sedative antipsychotics and anticonvulsants were prescribed more often in BPD than in the other diagnostic groups, with the exception of bipolar depression; this was true for the single substances quetiapine, levomepromazine, chlorprothixene, carbamazepine, and valproate. A limitation of the study was the use of clinical data without verifying the diagnoses by structured interviews. Contrary to the guidelines, about 90% of in-patients with BPD received psychotropic drugs. Polypharmacy was common, and antipsychotics with sedative profiles such as quetiapine and mood-stabilizing anticonvulsants such as valproate appear to be preferred.
authors.affiliation: Sanatorium Kilchberg/Zurich, Private Psychiatric Hospital, Alte Landstr. 70, CH-8802 Kilchberg ZH, Switzerland.
authors.forename: René
authors.initials: R
authors.lastname: Bridler
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Nussbaumstr. 7, D-80336 Munich, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Häberle
authors.affiliation: Sanatorium Kilchberg/Zurich, Private Psychiatric Hospital, Alte Landstr. 70, CH-8802 Kilchberg ZH, Switzerland.
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Müller
authors.affiliation: Sanatorium Kilchberg/Zurich, Private Psychiatric Hospital, Alte Landstr. 70, CH-8802 Kilchberg ZH, Switzerland; University Hospital of Psychiatry, Bolligenstr. 111, CH-3060 Bern, Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Cattapan
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Nussbaumstr. 7, D-80336 Munich, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Grohmann
authors.affiliation: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany.
authors.forename: Sermin
authors.initials: S
authors.lastname: Toto
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.affiliation: Sanatorium Kilchberg/Zurich, Private Psychiatric Hospital, Alte Landstr. 70, CH-8802 Kilchberg ZH, Switzerland; Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Nussbaumstr. 7, D-80336 Munich, Germany. Electronic address: waldemar.greil@med.uni-muenchen.de.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Greil
mesh_terms: D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000188:drug therapy*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D019338:Polypharmacy; D011600:Psychopharmacology / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012044:Regression Analysis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Antidepressants; Borderline personality disorder; Drug safety; Prescription drugs; Psychotropic drugs; Quetiapine