Hélène Lida-Pulik, Nicole Vacher-Neill, Françoise Penin : psychotropic drugs and adolescence. issues of prescription in an institutional setting

If there one really complex subject in psychiatry, it is the prescription of medication and the analysis of its objective and subjective effects, particularly in the adolescent, for whom the use of psychotropic drugs is relatively recent, even though it has quickly expanded. The model of institutional treatment developed here rests on the theory proposed by experienced practicians: the institutional therapeutic setting is metaphorized as a transitional space. The medication is therefore conceived of as one of the concrete objects which will allow for mediation of the bond and the establishment of a common, malleable object within the transference relation with the young patient. We discuss the possible pitfalls of the prescription and try to highlight its subjective and intersubjective aspects. If the medication must allow for the containment of intra-psychical drive activity that is too overwhelming for the adolescent, it should nevertheless not be used as a tool to obtain mastery or control over him. A « well-tempered » use of psychotropic drugs would enable one to work usefully with the patient on his inner conflicts, within the institution.

Adolescence, 2009, T. 27, n°3, pp. 759-768.