Some individuals with borderline personality disorder (BPD) are prescribed anti-anxiety medications (also called “anxiolytics”) to treat the intense anxiety and agitation that can come along with the disorder. Like any medication, however, there are both advantages and drawbacks to treatment with anti-anxiety medications. Here are some things to keep in mind if your psychiatrist is considering prescribing anti-anxiety medications for your BPD symptoms.
Anti-Anxiety Medications for BPD – Are They Effective?
Unfortunately, there is very little research to indicate whether anti-anxiety medications for BPD are actually effective. There are a few published papers that describe patients with BPD who have found relief from symptoms when taking these medications, but no controlled clinical trials have examined the usefulness of anti-anxiety medications for BPD.
The published reports have shown mixed results in how patients respond to these medications. Some have suggested that anti-anxiety medications can effectively reduce anxiety symptoms in BPD patients; however, at least one report has found that people with BPD may have a poor response to a certain kind of anti-anxiety medication (Xanax) because it can increase impulsivity.
Types of Anti-Anxiety Medications
The most commonly prescribed anti-anxiety medications are called benzodiazepines. Some examples include:
Unfortunately, these may not be the best choice for individuals with BPD who also have substance use problems, because benzodiazepines can be habit-forming. There are some non-benzodiazepine anti-anxiety medications that are not habit-forming, and these may be an alternative to medications from the benzodiazepine family.Risks and Side Effects of Anti-Anxiety Medications
The most common side effect of anti-anxiety medication is feeling sleepy, fatigued, or slowed. Other side effects include impaired coordination and memory problems.
Medications from the benzodiazepine family should not be mixed with other sedating medications or with alcohol.
Questions To Ask Your Psychiatrist
You should talk to your psychiatrist before you start taking anti-anxiety medications or any other type of medication for BPD. If you have any concerns (including some of those discussed above), let him or her know. Make sure you understand the risks and side effects, and be sure to have an in-depth discussion about the reasons you are being prescribed a certain medication. Here are some questions you might want to ask:
- Which symptoms do you expect this medication to address?
- Should I be concerned about developing tolerance to this medication?
- Should I be concerned about the potential for more impulsivity with this medication?
- How long do I need to take this medication before I start to notice effects?
- How long do you think I’ll need to be on this medication?
Sources:
American Psychiatric Association. "Practice Guidelines for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158: 1-52, October 2001.
Albers LJ, Hahn RK, & Reist C. Handbook of Psychiatric Drugs, Current Clinical Publishing Strategies, 2008.
