Borderline Personality Disorder Treatment and Medication

Borderline personality disorder (BPD) is sometimes treated with anti-anxiety or antidepressant drugs, which may alleviate some of BPD symptoms. While there are currently no FDA-approved pharmaceuticals for BPD treatment, several substances have been proven to be beneficial in some cases. 1

They may also treat psychological illnesses such as major depressive disorder, which frequently co-occur with BPD.

Medications may be more beneficial for BPD when combined with psychotherapy and other treatments. Learning more about the many possibilities will assist you in selecting the best drug for you.

Types of BPD Medications

Although no medicine is specially designed to treat BPD, numerous types of pharmaceuticals may be effective for treating distinct symptoms of the condition. The sort of medication that your doctor recommends will be determined by the specific symptoms and needs that you present. 

Antidepressants

Antidepressants were specifically developed for individuals with major depressive disorder and other disorders characterized by low mood. But many people with BPD are treated with these medications.

Several types of antidepressants have been studied for use with BPD, including tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs). Antidepressants were designed primarily to treat people suffering from major depressive disorder and other diseases characterized by depressed mood. However, these drugs are used to treat many persons with BPD.

It has been studied that many forms of antidepressants, such as tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOI), and selective serotonin reuptake inhibitors (SSRIs), can be used to treat bipolar disorder (SSRIs).

Common antidepressants include

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

These drugs may alleviate sorrow, low mood, anxiety, and emotional control. Still, they do not appear to significantly impact the bulk of other symptoms (e.g., anger, impulsivity).

Antipsychotics

Early psychiatrists believed that the symptoms of borderline personality disorder (BPD) were “on the border” between neurosis and psychosis, hence coining the term “borderline.” As a result, antipsychotics were among the first drugs studied for bipolar disorder.

These medications are effective in treating a range of non-psychotic diseases, including BPD. The use of antipsychotic medications has been demonstrated to improve symptoms of BPD such as anxiety, paranoid thinking, anger/hostility, and impulsivity. 1 Antipsychotics that are commonly used include:

• Abilify is a prescription medication (aripiprazole)

• Geodon (ziprasidone)

• Risperdal is a prescription medication (risperidone)

• Seroquel is a medication that is used to treat schizophrenia (quetiapine)

• Zyprexa is a prescription medication (olanzapine)

Mood Stabilizers/Anticonvulsants

Because individuals suffering from BPD are also prone to experiencing intense anxiety, medications to alleviate this condition are sometimes prescribed. Unfortunately, there is very little evidence to support the use of anti-anxiety medications to treat borderline personality disorder (BPD).

Anxiolytics that are commonly used include: • Ativan (lorazepam)

• Klonopin is a prescription medication (clonazepam)

• Xanax is an anti-anxiety medication (alprazolam)

• Valium is a prescription medication (diazepam)

• Buspar is a prescription medication (buspirone)

Some evidence suggests that using a particular class of anxiolytics, benzodiazepines (e.g., Ativan and Klonopin), may worsen symptoms in some people with bipolar disorder (BPD). They should only be prescribed under strict supervision. 1

Because they can become habit-forming, benzodiazepines are particularly dangerous when taken by people who have co-occurring substance use disorders. It is possible to use Buspar as an alternative to medications from the benzodiazepine family because it is non-addictive and does not cause dependence.

Medications for other forms of borderline personality disorder

New medications for borderline personality disorder (BPD) are being developed and tested as we learn more about the biological causes of the disorder. Researchers are investigating new medication options for treating bipolar disorder, including neuropeptide agents, cannabinoid medications, and medications that target serotonin receptors with greater specificity than previously available.

For example, data from one study suggest that taking an omega-3 fatty acid supplement can reduce aggression and feelings of anger in patients with borderline personality disorder.

Reasons for Taking Bipolar Disorder Medications

For various reasons, persons with a borderline personality disorder may wish to experiment with medication to treat their condition. An essential thing to remember is to always collaborate with your doctor to establish which drug options may be appropriate for you based on your symptoms and requirements. Some of the reasons why you might wish to try BPD drugs are as follows:

• Decrease the intensity of symptoms: Medications may be used to assist people in better controlling some of the symptoms of BPD, such as mood swings, irritability, depression, anxiety, and stress-related paranoia. • Increase the effectiveness of treatment:

As a result of the medication’s ability to alleviate some symptoms, it may also be possible to improve a person’s functioning in various areas, including relationships and daily activities.

• Prevent the worsening of symptoms: Because certain BPD symptoms may increase if left untreated, using medication to alleviate those symptoms may be beneficial. • Improve the quality of life: By research findings, the frequency and severity of BPD symptoms tend to decrease as people get older. 3

In addition, borderline personality disorder frequently co-occurs with other conditions that can interact, overlap, and make it more difficult to diagnose BPD accurately. 

• Treat co-occurring conditions: Borderline personality disorder frequently co-occurs with other conditions that can interact, overlap, and make it more difficult to diagnose BPD accurately. 

Depression, anxiety disorders, eating disorders, substance use disorders, and bipolar disorder are all diseases that frequently co-occur with a borderline personality disorder.

• Reduced risk of suicide: Bipolar disorder is related to an increased risk of self-harm and suicide, among other things.

4 Because drugs may lower the frequency and severity of symptoms, and they may also minimize the chance of committing suicide.

Suicidal thoughts? Call the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a professional counsellor at any time of day or night. If you or someone you care about is in urgent danger, dial 911.

More information on mental health options can be found on our National Helpline Database

Symptoms and Consequences

When taking drugs to treat BPD, people may have adverse effects similar to those seen when using other substances. It is crucial to note that each one has its own set of negative effects when taking medications. Following are some of the more typical side effects that you can encounter:

• Changes in one’s appetite

• Constipation

• Diarrhea

• Mouth feeling dry

• Fatigue

• Insomnia

• Nausea

Some patients may also develop allergic responses to the medications they are prescribed. If you begin to develop symptoms of an allergic response, you should seek medical assistance as soon as possible. Never hesitate to inform your doctor about any adverse effects, both common and uncommon, that you are experiencing while taking a particular drug.

To avoid potentially dangerous drug interactions, it is also critical to inform your doctor of any other medications, substances, or supplements that you are taking.

Challenges

There are a variety of difficulties that can arise when using drugs to treat borderline personality disorder (BPD). These are some examples:

There is a great degree of variability and variety in each experience’s symptoms. • People have different needs:

It is common for patients to have co-occurring conditions, making medication selection more difficult. Antidepressants, for example, should not be administered in the presence of bipolar disorder since these medications have the potential to provoke manic episodes.

Several techniques may be required: Medication may not control all of your symptoms, which is why different approaches such as psychotherapy and self-care are also needed.

Precautions

Some precautions should be followed before using a drug to treat bipolar disorder. Among the issues to consider are the following:

• Some people may experience worsening symptoms when using benzodiazepines. According to research, benzodiazepines may exacerbate the symptoms of impulsivity and suicide ideation in people with bipolar disorder, and their use is prohibited. 1

• Some drugs, such as benzodiazepines, have the potential to become addictive. In addition, research suggests that patients with BPD may be at a higher risk of developing benzodiazepine dependence due to their attempts to self-medicate. 1

• Antidepressants are labelled with a black-box warning on the package. This warning states that antidepressants are connected with an elevated risk of suicide ideation in adolescents and young adults.

Coping

While psychotherapy is the gold standard for treating borderline personality disorder, medicines can effectively alleviate and manage some symptoms. Individuals who suffer from BPD can take steps to improve their ability to manage their condition. These are some examples:

Other mental health diseases such as substance abuse, anxiety disorders, depression, bipolar disorder, and post-traumatic stress disorder (PTSD) might make managing your BPD challenging. • Identifying and treating co-occurring conditions Taking care of your co-occurring illnesses can make you feel a lot better.

Discovering effective stress management techniques

 Stress can play a significant role in increasing the symptoms of BPD, therefore identifying and implementing strategies to minimize or manage stress can be beneficial. Deep breathing, exercise, visualization, and gradual muscle relaxation are just a few of the strategies that you might wish to attempt to relax your muscles.

It is also possible to improve your everyday functioning by learning effective coping skills. For example, learning efficient strategies to deal with emotional distress and regulate impulsive actions can help you perform better in your daily life. A few tools that can assist you in developing and strengthening your coping abilities are mindfulness, social support, and dialectical behavioural therapy, among others.