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The following is a summary of “Trends in pharmacological prescriptions and polypharmacy for personality disorders: a 10-year cross-sectional analysis of naturalistic data,” published in the April 2025 issue of BMC Psychiatry by Leone et al. 

Researchers conducted a prospective study to examine 10-year prescribing trends for individuals with personality disorders (PD) in a metropolitan area of Sweden. The study assessed the alignment of these patterns with national clinical guidelines. 

They analyzed 26,520 prescriptions from electronic health records (EHRs), between January 2011 and December 2020. Annual psychotropic prescription proportions and polypharmacy (≥3 psychiatric medications) were compared between individuals with PD alone and those with comorbidities. 

The results showed a significant increase in medication use among individuals with PD alone. Polypharmacy remained common in both groups without significant change. In the PD alone group, prescriptions for antidepressants, mood stabilizers, and benzodiazepines declined, while stimulant use rose. Antipsychotics and non-benzodiazepine sedatives increased in those with co-occurring conditions. 

Investigators found mixed adherence to Swedish national guidelines, marked by reduced benzodiazepine use but persistent issues with polypharmacy and prescribing without clear indications, especially in those without comorbidities. They highlighted the need for improved diagnostic accuracy, ongoing clinician education, and integration of prescribing, diagnostic, and treatment data to guide future clinical practice. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06716-4