Question: How do SSRIs work in the Treatment of Borderline Personality Disorder?
SSRIs, Selective Serotonin Reuptake Inhibitors appear to work by decreasing the uptake of Serotonin, allowing more of the neurotransmitter to be available to the receptors. This process occurs between the nerve cells (neurons) in the brain. Serotonin has been found to be significant in the regulation of mood and emotion.
Although the are no specific drugs approved by the FDA in the treatment of BPD, there are numerous drugs approved to treat the symptoms evident in those with BPD. SSRIs are considered to be the appropriate initial psychotropic medication prescribed to a person with BPD. Research, including controlled studies, has found SSRIs to be effective in treating the difficulties those with BPD have in the regulation of their mood, impulse control, and cognitive/perceptual issues. In addition, the SSRIs are considered to be relatively low-risk in the event of overdose and have minimal side effects.
Specifically, in those with BPD, SSRIs have been found to alleviate such symptoms as depression, anxiety, mood swings, anger, impulsive aggression, self-injurious behavior, sensitivity to rejection, and generally poor functioning.
There can be occasions where an initial SSRI does not yield the optimal reduction in symptoms or additional symptoms may be present. In this event, physicians may switch to another SSRI or add an additional type of medication such as an anti-anxiety medication, an atypical or typical anti-psychotic (neuroleptic) medication, or a different class of antidepressant.
Often, for an individual with BPD, an SSRI can provide a high level of symptom relief in combination with psychotherapy.