Taking antidepressants for borderline personality disorder

Although psychotherapy is considered a core aspect of the treatment of borderline personality disorder (BPD), many people are prescribed antidepressants for BPD. No drugs have been approved by the FDA for the treatment of BPD, but many drugs have been shown to be effective in reducing certain symptoms of BPD.

Antidepressants are one of the most commonly prescribed drugs for BPD. Although antidepressants alone will not fully recover from BPD, they can help you adequately control your symptoms, making psychotherapy more helpful.

If you suffer from depression, anxiety, or if your psychiatrist wants them to help you resolve symptoms related to BPD, BPD antidepressants may be recommended.

Types of antidepressants

There are many different types of antidepressants. The most commonly used antidepressants are called “selective serotonin reuptake inhibitors” or SSRIs.The effect of these drugs is to change the availability of the neurotransmitter serotonin in the brain. Some examples include:

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  • Celexa (Citalopram)
  • Lexapro (escitalopram)
  • Prozac (fluoxetine)
  • Zoloft (sertraline)
  • Paroxetine (Paroxetine)

Other types of antidepressants include serotonin-norepinephrine reuptake inhibitors (SNRI), “tricyclic drugs” and “monoamine oxidase inhibitors” or MAOIs. These drugs are older and have more severe side effects, so they are not commonly used.

Some three rings include:

  • Ilavir (amitriptyline)
  • Anafranil (clomipramine)
  • Tofranil (imipramine)

Some MAOIs include:

  • Nardil (phenelzine)
  • Parnate (Tranylcypromine)

Finally, there are other types of antidepressants that are commonly prescribed, including:

  • Wellbutrin (bupropion)
  • Remeron (mirtazapine)

Are antidepressants effective in treating BPD?

Many studies have shown that certain types of antidepressants are effective in treating specific symptoms of BPD. For example, SSRIs can reduce emotional instability, impulsivity, self-harm behavior, and anger. MAOI has also been shown to be effective in treating emotional instability.

Inconsistent evidence suggests that tricyclic antidepressants are helpful for patients with BPD. Although there is evidence that some people with BPD respond well to this type of antidepressant, there is a high risk of overdose.

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Risks and side effects of taking antidepressants

The risks and side effects of antidepressants may vary depending on the type of antidepressant you take. The side effects of SSRIs are often the least serious, but they can cause indigestion, headache, insomnia, sedation, and sexual dysfunction.

Tricyclic antidepressants can also cause dry mouth, blurred vision, weight gain, seizures, and heart problems. For people taking MAOI, certain foods rich in the amino acid tyramine (such as soy sauce, aged cheese) must be avoided because of the risk of severe hypertension. In addition, there are several types of drugs that can seriously interact with MAOI, so be sure to discuss your current medications with your doctor and pharmacist.

Questions for your psychiatrist

You should consult your psychiatrist before starting any type of BPD medicine. If you have any concerns (including some of the issues discussed above), please tell your doctor. Make sure you understand the risks and side effects, and make sure to discuss in depth the reason you are taking a certain medicine.

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Borderline Personality Disorder Discussion Guide

Get our printable guide to help you ask the right questions the next time you see a doctor.

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