Psychosomatisches Zentrum Waldviertel (PSZW), Kliniken Eggenburg und Gars, Universitätsklinik für Psychosomatische Medizin der Karl Landsteiner Privatuniversität , Eggenburg , Austria.
Int J Psychiatry Clin Pract. 2019 Sep;23(3):178-188. doi: 10.1080/13651501.2019.1576904. Epub 2019 May 29.
Borderline personality disorder (BPD) is a life-threatening mental disorder. Guideline recommendations for pharmacological treatment of patients with BPD vary widely. The objective of the present study was to investigate pharmacotherapy of BPD patients in a routine clinical care setting. Data on the pharmacological treatment of 110 patients (90% female) with BPD (F- 60.3), treated in an inpatient psychiatric-psychosomatic clinic in Austria were assessed. Results show that clinicians frequently prescribe psychotropic medications to patients with BPD, in many cases multiple medications. The most commonly prescribed substance groups were antipsychotics, mood stabilisers and antidepressants. The most commonly prescribed individual drugs were Quetiapine, Lamotrigine and Setraline. There was no significant difference in the different types or overall number of medications prescribed to BPD patients with vs. without comorbid diagnoses. Pharmacotherapy was not related to comorbidity. The present study shows that in routine clinical care settings psychotropic medications are frequently prescribed to patients with BPD, very often resulting in polypharmacy. A positive association between the number of medications and the effectiveness of the inpatient treatment program, as well as the absence of a relationship between number of medications and comorbidity contradicts the often suggested iatrogenic effect of polypharmacy. Key points Guidelines for pharmacotherapy of borderline personality disorders lack consensus Yet, clinicians frequently prescribe psychotropic medications to BPD patients Types/number of medications prescribed to patients with vs. without comorbidities are similar Larger treatment effects are observed for patients with greater numbers of medications Further knowledge is needed about how and why clinicians prescribe medications.
边缘型人格障碍（BPD）是一种危及生命的精神障碍。BPD 患者药物治疗的指南建议差异很大。本研究的目的是在常规临床护理环境中调查 BPD 患者的药物治疗情况。 评估了奥地利一家住院精神病-身心诊所治疗的 110 名 BPD 患者（90%为女性，F-60.3）的药物治疗数据。结果表明，临床医生经常为 BPD 患者开精神药物，在许多情况下是多种药物。最常开的药物类别是抗精神病药、心境稳定剂和抗抑郁药。最常开的药物分别是喹硫平、拉莫三嗪和舍曲林。有或没有合并症的 BPD 患者开的药物种类或总体数量没有显著差异。药物治疗与合并症无关。 本研究表明，在常规临床护理环境中，经常为 BPD 患者开精神药物，经常导致多种药物联合治疗。药物数量与住院治疗计划效果之间存在正相关，以及药物数量与合并症之间没有关系，这与经常提出的药物联合治疗的医源性效应相矛盾。 关键点 边缘型人格障碍药物治疗指南缺乏共识 然而，临床医生经常为 BPD 患者开精神药物 有或没有合并症的患者开的药物种类/数量相似 药物数量越多，患者的治疗效果越好 还需要进一步了解临床医生如何以及为什么开药物。
