The prescription of psychotropic drugs in adolescence is a medical act leading to reflection about what it means for both the adolescent and the prescribing physician. A new generation of psychotropes has upset the habits of prescribing physicians. Nosographic clinical practice must combine with psychopathological clinical practice, so that medication becomes a “tool of liberty” permitting the subject to grasp the “psychotropic” capacity of the medication, thanks to the “magic of words”.
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.
Revue semestrielle de psychanalyse, psychopathologie et sciences humaines, indexée AERES au listing PsycINFO publiée avec le concours du Centre National du Livre et de l’Université de Paris Diderot Paris 7