Changes over the last 15 years in the psychopharmacological management of persons with borderline personality disorder

• Published in: Acta psychiatrica Scandinavica 2017-09, Vol.136 (3), p.323-331
• Main Authors: Martín‐Blanco, A., Ancochea, A., Soler, J., Elices, M., Carmona, C., Pascual, J. C.
• Format: Article
• Language: English
• Subjects: Adult; Antidepressants; Antidepressive Agents, Tricyclic - therapeutic use; Antipsychotic Agents - therapeutic use; Antipsychotics; Benzodiazepines - therapeutic use; Borderline personality disorder; Borderline Personality Disorder - drug therapy; Borderline Personality Disorder - epidemiology; Comorbidity; Cross-Sectional Studies; Drug Prescriptions - statistics & numerical data; Drug therapy; Female; Humans; Male; Personality; personality disorder; Personality disorders; Psychopharmacology; Retrospective Studies; Spain - epidemiology; treatment; Tricyclic antidepressants; Young Adult
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12767

Objective To describe the pharmacological management of borderline personality disorder (BPD) in Spain from 2001 through 2016, the factors associated with prescriptions, and changes in pharmacotherapy over this time period. Methods Retrospective, cross‐sectional, observational study conducted in a sample of 457 patients with BPD consecutively admitted to a specialist BPD Program between January 2001 and November 2016. Data on sociodemographic and clinical variables, as well as pharmacological treatment upon the admission to the programme, were used to describe pharmacological prescriptions, the factors associated with these medications, and changes in prescription over the last 15 years. Results Most (88.4%) patients were on pharmacological treatment, with 53.8% of persons taking ≥3 medications. No significant changes in these percentages were observed over the study period. The use of tricyclic antidepressants and benzodiazepines decreased, while the use of atypical antipsychotics increased. Axis I comorbidity was the main factor associated with pharmacological treatment and polypharmacy. Conclusions This study provides further evidence confirming the worldwide overuse of prescription medications for BPD and shows that there has been a shift in the prescription pattern in the last 15 years. These results suggest that real clinical practice only partially adheres to clinical treatment guidelines.