Borderline personality disorder (BPD) sometimes uses medication to treat anxiety or depression, which may reduce some of the symptoms of BPD. Although the FDA has not approved drugs specifically for the treatment of BPD, some drugs have been found to be effective in certain situations.of
They can also be used to treat mental illnesses that often co-occur with BPD, such as major depression.
When drugs are used in combination with psychotherapy and other treatments, they may be particularly effective for BPD. Knowing more about the different options will help you find the right medicine for you.
Types of BPD drugs
There are no drugs specifically designed to treat BPD, but there are several types of drugs that can be used to treat different symptoms. The type of medicine your doctor prescribes will depend on your specific symptoms and needs.
Antidepressants are specifically developed for individuals suffering from major depression and other illnesses characterized by low mood. But many people with BPD are treated with these drugs.
Several types of antidepressants have been studied for BPD, including tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs).
Common antidepressants include:
- Nardil (phenelzine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
- Effexor (Venlafaxine)
- Wellbutrin (bupropion)
These drugs may help relieve sadness, depression, anxiety, and emotional reactions, but they do not seem to have a strong effect on other symptoms (such as anger, impulsivity).
The term “marginal” was coined because early psychiatrists believed that the symptoms of BPD were on the “marginal” between neurosis and psychosis. For this reason, some of the first drugs tested for BPD were antipsychotics.
These drugs can have a positive effect on various 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:
- Abilify (aripiprazole)
- Geodon (ziprasidone)
- Risperidone (risperidone)
- Seroquel (quetiapine)
- Zaipule (olanzapine)
Mood-stable drugs such as lithium and some anticonvulsant (anti-epileptic) drugs have been used to treat the rapid changes in impulsive behavior and mood associated with BPD. Studies have shown that these types of drugs may be useful for BPD.
Common mood stabilizers/anticonvulsants include:
- Lithobid (lithium carbonate)
- Depakote (Valproate)
- Lamictal (Lamotrigine)
- Tegretol or Carbatrol (Carbamazepine)
Anti-anxiety drugs (anti-anxiety drugs)
Because people with BPD also often experience intense anxiety, medications to reduce anxiety are sometimes prescribed. Unfortunately, few studies support the use of anti-anxiety drugs for the treatment of BPD.
Common anti-anxiety drugs include:
- Ativan (Lorazepam)
- Clonazepam (clonazepam)
- Xanax (Alprazolam)
- Valium (Diazepam)
- Buspar (Buspirone)
There is also some evidence that the use of specific classes of anti-anxiety drugs, benzodiazepines (such as Ativan, Klonopin) may actually worsen the symptoms of some BPD patients. They should prescribe with caution.
Benzodiazepines are especially dangerous for people who also suffer from substance use disorders because they may form a habit. Buspar is an anti-anxiety drug that does not form a habit. It is an alternative to benzodiazepines.
Other borderline personality disorder drugs
As we learn more about the biological causes of BPD, new drugs for this disease are being developed and tested. Researchers are exploring new drug options for the treatment of BPD, including neuropeptide drugs, cannabinoid drugs, and drugs that target serotonin receptors with higher specificity.
For example, the results of a study show that supplementing with omega-3-fatty acids can reduce aggression and hostility in patients with BPD.
Borderline Personality Disorder Discussion Guide
Get our printable guide to help you ask the right questions the next time you see a doctor.
Reasons for using BPD drugs
People may want to try drugs for borderline personality disorder for many different reasons. It is important to always make sure to work with your doctor to determine which medication options may be right for you based on your symptoms and needs. Some reasons you may want to try BPD medications include:
- Reduce the severity of symptoms: Medications can help people better control some of the symptoms of BPD, such as mood swings, irritability, depression, anxiety, and stress-related paranoia.
- Improve function: Because drugs can reduce the severity of certain symptoms, they may also help improve a person’s functions in many areas, including interpersonal relationships and daily life.
- Prevent symptoms from worsening: If left untreated, some symptoms of BPD may get worse, so taking medication to improve these symptoms may be helpful. Studies have found that with age, the frequency and severity of BPD symptoms does decrease.
- Treatment of concurrent diseases: Borderline personality disorder usually occurs at the same time as other diseases that can interact and overlap, and make accurate diagnosis of BPD more difficult. Mental illnesses that usually co-occur with BPD include depression, anxiety, eating disorders, substance use disorders, and bipolar disorder.
- Reduce suicide risk: BPD is associated with increased risk of self-harm and suicide.Because medication may help reduce the frequency and severity of symptoms, it may also reduce the risk of suicide.
As with other substances, people may experience side effects when taking drugs to treat BPD. It is important to remember that each drug has its own set of side effects. Some of the more common side effects you may experience include:
- Appetite changes
- Dry mouth
Some people may also have an allergic reaction to drugs. If you start to experience symptoms of an allergic reaction, you should seek medical attention immediately. You should always discuss with your doctor the common and rare side effects associated with specific drugs.
It is also important to tell your doctor about any other drugs, substances or supplements you are taking to avoid potentially serious drug interactions.
There are many challenges that affect the use of drugs to treat BPD. These include:
- People have different needs: the symptoms experienced by each person often have a high degree of difference and heterogeneity.
- Co-occurring situations are very common: this can complicate drug selection. For example, antidepressants should not be used for people with bipolar disorder, because these substances can trigger manic episodes.
- Multiple methods may be required: medications may not control all your symptoms, which is why methods such as psychotherapy and self-care are also important.
You should also take certain precautions before you try to treat BPD with drugs. Some issues to consider include:
- Benzodiazepines may make some people’s symptoms worse. Studies have shown that benzodiazepines may aggravate the impulsive and suicidal symptoms of BPD patients, so their use is discouraged.
- Some drugs, such as benzodiazepines, may form a habit. Research has also shown that BPD patients may face a higher risk of benzodiazepine dependence due to efforts to self-treat.
- Antidepressants have a black box warning. The warning states that antidepressants increase the risk of suicidal thoughts in young people.
Although psychotherapy is the standard treatment for BPD, medications can be used to relieve and control certain symptoms. There are also measures that BPD patients can take to improve their ability to cope.These include
- Treating comorbidities: Other mental health conditions such as substance abuse, anxiety, depression, bipolar disorder, and post-traumatic stress disorder (PTSD) can make your BPD more difficult to manage. Treating these concurrent illnesses can help you feel better.
- Find ways to manage stress: Stress can play an important role in exacerbating BPD symptoms, so finding ways to reduce or manage stress may be helpful. Strategies such as deep breathing, exercise, visualization, and progressive muscle relaxation are just some of the strategies you might want to try.
- Develop coping skills: Finding effective ways to deal with emotional distress and control impulsive behavior can also help you play a better role in daily life. Some things that can help you learn and strengthen coping skills include mindfulness, social support, and dialectical behavior therapy.
Very good sentence
Although BPD medications may be a useful part of your overall treatment plan, it is also important to work with your doctor to determine the best way to meet your needs.
There is no single treatment for every BPD patient. The method that is right for you depends on your symptoms, medical history, and response to treatment.
It is also important to note that medication is most effective when combined with other options such as psychotherapy. Discuss with your doctor what might be right for you.