Bridler René, Häberle Anne, Müller Sabrina T, Cattapan Katja, Grohmann Renate, Toto Sermin, Kasper Siegfried, Greil Waldemar
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.
Eur Neuropsychopharmacol. 2015 Jun;25(6):763-72. doi: 10.1016/j.euroneuro.2015.03.017. Epub 2015 Apr 11.
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.
边缘型人格障碍（BPD）患者通常会被开具各种精神药物；然而，指南中并未推荐任何一种药物，也没有任何药物被批准用于这一适应症。由于关于BPD药物处方的数据稀少，因此使用了欧洲药物安全项目AMSP的横断面数据来分析2001年至2011年间2195例BPD住院患者的药物处方，并计算了平均值、置信区间和回归分析。所有BPD患者中有70%使用了抗精神病药物和/或抗抑郁药物，33%使用了抗惊厥药物，30%使用了苯二氮䓬类药物，4%使用了锂盐；90%的患者至少服用了一种精神药物，80%的患者服用了≥2种，54%的患者服用了≥3种精神药物（平均：2.8种）。喹硫平是BPD中最常用的单一药物（22%），其处方率随时间显著增加。鉴于BPD年轻女性比例较高，将18至40岁的BPD女性患者与同年龄但患有抑郁症（单相和双相）及精神分裂症的患者进行了比较。除双相抑郁症外，典型的镇静性抗精神病药物和抗惊厥药物在BPD中的处方率高于其他诊断组；喹硫平、左美丙嗪、氯普噻吨、卡马西平和丙戊酸盐等单一药物均是如此。该研究的一个局限性是使用了临床数据，而未通过结构化访谈来核实诊断。与指南相反，约90%的BPD住院患者接受了精神药物治疗。联合用药很常见，具有镇静作用的抗精神病药物如喹硫平和具有心境稳定作用的抗惊厥药物如丙戊酸盐似乎更受青睐。
