St Andrew's Healthcare, Northampton, UK.
Int J Psychiatry Clin Pract. 2011 Nov;15(4):280-5. doi: 10.3109/13651501.2011.590211. Epub 2011 Jul 11.
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.
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.
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.
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.
研究精神科住院患者边缘型人格障碍（BPD）的药物治疗情况。调查临床医生对英国国家健康与临床优化研究所（NICE）BPD 指南的看法。
对英国一家大型精神科专科医院使用精神药物治疗 BPD 的情况进行横断面调查，并对治疗精神病医生进行访谈。
共有 79 名患者被诊断为 DSM 边缘型人格障碍，其中 80%的患者正在服用一种或多种精神药物，48%的患者正在服用两种或更多种。大多数处方均为超适应证用药。抗精神病药和抗抑郁药是最常用于治疗 BPD 的药物类别。氯氮平是最常开的药物，根据治疗精神病医生的说法，它最有可能导致目标症状的显著改善。其他精神药物通常被认为只会导致轻微改善或无变化。临床医生意识到他们的处方与 NICE 指南相悖，但基于治疗严重和复杂病例的需要，他们认为这是合理的。
这些 BPD 住院患者非常普遍地使用精神药物（尤其是氯氮平）、超适应证处方和联合用药。需要进行氯氮平治疗严重 BPD 的随机对照试验。
