Use of psychotropic medication among adolescents with borderline personality disorder: a 6-year descriptive follow-up study

INTRODUCTION: Psychotropic medications are widely used in the treatment of borderline personality disorder (BPD), despite limited supporting evidence. Characterizing the use of psychotropic medications in adolescents with BPD is a prerequisite for understanding the underlying factors that contribute to prescribing patterns, as well as for critically evaluating the clinical indications for such treatments. To the best of our knowledge, this study is the first to longitudinally assess psychotropic medication use in a sample of adolescents with BPD or BPD features over a six-year period. METHODS: Medication data were obtained from 110 adolescents with BPD or BPD features from medical records at baseline and at follow-ups after one, two, and six years. Descriptive analyses were conducted to characterize prescription patterns over time. RESULTS: Over the six-year follow-up period, the proportion of participants prescribed psychotropic medication remained high, increasing from 47% at baseline to 77% at the six-year follow-up, and polypharmacy was prevalent. Sertraline and quetiapine were most frequently prescribed, with quetiapine often used as pro re nata (PRN) medication. CONCLUSIONS: Our results indicate that treatment with psychotropic medication for BPD is initiated during adolescence and sustained over time, with high prescription rates and polypharmacy. High levels of psychiatric comorbidity and variable courses of BPD may, among other factors, influence the observed prescribing patterns. Considering the limited evidence supporting their effectiveness, and the potential adverse effects, our findings emphasize the need for research into the factors driving the excessive use of psychotropic medications in BPD.