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Borderline Personality Disorder Medications

Learn More About Borderline Personality Disorder Medications

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Updated April 29, 2011

Borderline personality disorder medications have been shown to reduce some of the symptoms of borderline personality disorder (BPD). While there are currently no medications approved by the FDA to treat BPD, research has shown that some medications do reduce certain symptoms. Also, medications may be used to treat psychological conditions that frequently co-occur with BPD (e.g., major depressive disorder). Medications may be particularly effective for BPD when they are used in conjunction with psychotherapy and other treatments.

Antidepressants

While antidepressants were specifically developed for individuals with major depressive disorder and other disorders characterized by low mood, many individuals with BPD are treated with these medications.

There are several types of antidepressants that have been studied for use with BPD, including tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs). Research has shown that these medications may help with the sadness, low mood, anxiety, and emotional reactivity often experienced by people with BPD, but they do not seem to have a strong effect on other symptoms of the disorder (e.g., anger, impulsivity).

Common antidepressants include:

  • Nardil (phenelzine)
  • Prozac (fluoxetine)
  • Zoloft (sertraline)
  • Effexor (venlafaxine)
  • Wellbutrin (bupropion)

Antipsychotics

The term "borderline" was coined because early psychiatrists believed that the symptoms of BPD were "on the border" between neurosis and psychosis. For this reason, some of the first medications tested for BPD were antipsychotics. Since this time, it has been found that antipsychotics can have a positive effect on a variety of non-psychotic disorders, including BPD. Antipsychotics have been shown to reduce anxiety, paranoid thinking, anger/hostility, and impulsivity in patients with BPD.

Common antipsychotics include:

  • Haldol (haloperidol)
  • Zyprexa (olanzapine)
  • Clozaril (clozapine)
  • Seroquel (quetiapine)
  • Risperdal (risperidone) (Risperdal)

Mood Stabilizers/Anticonvulsants

Medications with mood stabilizing properties, such as lithium, and some anticonvulsant (anti-seizure) medications, have been used to treat the impulsive behavior and rapid changes in emotion that are associated with BPD. There is research to suggest that these classes of drugs may be useful in BPD.

Common mood stabilizers/anticonvulsants include:

  • Lithobid (lithium carbonate)
  • Depakote (valproate)
  • Lamictal (lamogtrigine)
  • Tegretol or Carbatrol (carbamazepine)

Anxiolytics (Anti-Anxiety)

Because individuals with BPD also often experience intense anxiety, medications to reduce anxiety are sometimes prescribed. Unfortunately, there is very little research to support the use of anti-anxiety medication to treat BPD. Also, there is some evidence that use of a particular class of anxiolytics, benzodiazepines (e.g., Ativan, Klonopin), may actually cause a worsening of symptoms for some individuals with BPD, and should be prescribed with caution. Benzodiazepines are particularly dangerous for use by individuals with co-occurring substance use disorders because they can be habit forming. Buspar, an anxiolytic that is not habit-forming, is an alternative to medications from the benzodiazepine family.

Common anxiolytics include:

  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Xanax (alpazolam)
  • Valium (diazepam)
  • Buspar (buspirone)

Other Borderline Personality Disorder Medications

As we learn more about the biological causes of BPD, new medications are being developed and tested for the disorder. For example, findings from a recent study suggest that an omega-3-fatty acid supplement can lead to decreased aggression and feelings of hostility in people with BPD.

Sources:

American Psychiatric Association. "Practice Guidelines for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158: 1-52, October 2001.

Triebwasser, J, and Siever, LJ. "Pharmacotherapy of Personality Disorders." Journal of Mental Health, 16: 5-50, February 2007.

Zanarini, MC, Frankenburg, FR. "Omega-3 fatty acid treatment of women with borderline personality disorder: A double-blind, placebo-controlled pilot study." American Journal of Psychiatry, 160: 167-169, 2003.

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