Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics Maternal and Child Health, University of Genoa, Psychiatry Unit, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
J Pers Disord. 2021 Jun;35(3):321-335. doi: 10.1521/pedi_2019_33_445. Epub 2019 Oct 14.
The guidelines for borderline personality disorder (BPD) treatment suggest non-pharmacological treatment as the first option, but second-generation antipsychotics (SGAs) are among the overprescribed medications. This study aimed to explore Italian psychiatrists' attitudes toward off-label use of SGAs in BPD. A randomly selected sample of Italian psychiatrists completed a questionnaire regarding off-label prescription of SGAs. Most respondents reported the off-label use of SGAs. Among the reasons supporting the prescription of SGAs, the presence of strong published data was the most determining factor (51.5%). The SGA olanzapine is considered the most appropriate, followed by quetiapine and aripiprazole. Although off-label prescription of SGAs represents a common clinical practice in accordance with a worldwide trend, the use of long-acting injection formulations was considered inappropriate by 69% of psychiatrists in our sample. Our results reiterate the discrepancy between everyday clinical practice and international recommendations, and show how relevant the literature is in off-label drug prescription.
边缘型人格障碍 (BPD) 治疗指南建议将非药物治疗作为首选，但第二代抗精神病药物 (SGAs) 是处方过多的药物之一。本研究旨在探讨意大利精神科医生对 BPD 中 SGA 药物超适应证使用的态度。随机抽取的意大利精神科医生完成了一份关于 SGA 药物超适应证处方的问卷。大多数受访者报告了 SGA 的超适应证使用。在支持 SGA 处方的原因中，有强有力的已发表数据是最具决定性的因素（51.5%）。奥氮平被认为是最合适的 SGA，其次是喹硫平和阿立哌唑。尽管 SGA 的超适应证处方是符合全球趋势的常见临床实践，但我们样本中的 69%的精神科医生认为使用长效注射制剂是不适当的。我们的结果重申了日常临床实践与国际建议之间的差异，并表明文献在药物超适应证处方中具有重要作用。
