BPD is sometimes treated with medications for anxiety or depression, for instance, which may reduce some symptoms. Medications may also be used to treat psychological conditions that frequently co-occur with this condition, such as major depressive disorder. Medications are often used in conjunction with psychotherapy and other treatments rather than being a stand-alone option. Learning more about different borderline personality disorder medications can help you find the right one for you.
Why Use BPD Medication?
There are a number of reasons why people may want to try medications for borderline personality disorder. The important thing is to always work with your doctor to determine which medication options might be right for you based on your symptoms and needs. BPD medication may help:
Reduce symptom severity: Medications may help people better manage some of the symptoms of BPD, such as mood swings, irritability, depression, anxiety, and stress-related paranoia. Improve functioning: Because medications may make some symptoms less severe, they might also help improve functioning in areas including relationships and daily living. Prevent worsening of symptoms: Some symptoms of BPD may grow worse if left untreated, so taking medication to improve those symptoms may be helpful. Research has found that BPD symptoms do tend to decline in frequency and severity as people age. Treat co-occurring conditions: Borderline personality disorder often co-occurs with other conditions that can interact, overlap, and make it more difficult to accurately diagnose BPD. Conditions that commonly co-exist with BPD include depression, anxiety disorders, eating disorders, substance use disorders, and bipolar disorder. Decrease risk of suicide: BPD is associated with an increased risk of self-harm and suicide. Because medications may help reduce symptom frequency and severity, they may also lessen this risk. Improve treatment adherence: Not only do some medications ease BPD symptoms, but they can also make it easier to engage in other forms of treatment for BPD, such as psychotherapy.
Types of BPD Medication
There is no medication that specifically treats BPD. However, there are several types of medications that may be useful for treating BPD symptoms. The type of medication that your doctor prescribes will depend on your specific symptoms and needs. For more mental health resources, see our National Helpline Database. There are many types of antidepressants that have been studied for use with BPD. These include tetracyclic and tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs). Common antidepressants include:
Effexor (venlafaxine) Nardil (phenelzine) Prozac (fluoxetine) Wellbutrin (bupropion) Zoloft (sertraline)
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. Antipsychotic drugs can have a positive effect on a variety of non-psychotic disorders, including BPD. They have been shown to reduce anxiety, paranoid thinking, anger or hostility, and impulsivity in patients with BPD. Common antipsychotics include:
Abilify (aripiprazole) Geodon (ziprasidone) Risperdal (risperidone) Seroquel (quetiapine) Zyprexa (olanzapine)
Mood Stabilizers/Anticonvulsants
Medications with mood-stabilizing properties and some anticonvulsant or anti-seizure medications have been used to treat the impulsive behavior and rapid emotional changes associated with BPD. And research suggests that these classes of drugs seem to be commonly used in people with BPD. Common anticonvulsants and mood stabilizers for BPD include:
Depakote (valproate) Lamictal (lamotrigine) Lithobid (lithium) Tegretol or Carbatrol (carbamazepine)
Anxiolytics (Anti-Anxiety Drugs)
Because individuals with BPD also often experience intense anxiety, medications to reduce anxiety are sometimes prescribed. Common anxiolytics include:
Ativan (lorazepam) Buspar (buspirone) Klonopin (clonazepam) Valium (diazepam) Xanax (alprazolam)
Unfortunately, there is very little research to support the use of anti-anxiety medication to treat BPD. There is some evidence, however, that use of benzodiazepines (e.g., Ativan, Klonopin)—a particular class of anxiolytics—may actually cause a worsening of symptoms for some individuals with BPD. Benzodiazepines are particularly dangerous in people 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.
Other Borderline Personality Disorder Medications
As we learn more about BPD, new medications are being developed and tested for the disorder. Researchers are exploring anti-dementia drugs, anesthetics, and facial paralysis drugs to learn more about their effects on BPD. Findings from one study suggest that an omega-3-fatty acid supplement can lead to decreased aggression and feelings of hostility in people with BPD.
Side Effects
As with other medicines, people may experience side effects while taking BPD medications. It is important to remember that each medication has its own set of adverse effects. Some of the more common side effects include: There was an error. Please try again.
ConstipationDry mouthDizzinessSedationWeight gain
Always talk to your healthcare provider about both the common and rare side effects that are associated with a specific medication so that you know what to expect. It is also important to tell them about any other medications, substances, or supplements you are taking to avoid potentially serious drug interactions.
Challenges When Taking BPD Medications
There are a number of challenges that can affect the use of medications to treat BPD. These include:
People have differing needs: There tends to be a high degree of diversity in the symptoms that each person with BPD experiences. Co-occurring conditions are common: Having another condition can complicate medication choice. For example, antidepressants should not be used in cases where someone also has bipolar disorder, because these substances can trigger manic episodes. Multiple approaches may be necessary: Medications may not be able to manage all BPD symptoms, which is why things like psychotherapy and self-care are also important. Plus, it’s not uncommon for someone with a borderline personality disorder to be prescribed numerous medications.
Precautions
There are certain precautions to take before trying a medication to treat BPD. Some concerns to think about include:
Benzodiazepines may worsen symptoms for some individuals. Research suggests that benzodiazepines may worsen the symptoms of impulsivity and suicidality in people with BPD, so their use is discouraged. Some medications, such as benzodiazepines, may be habit-forming. Research also suggests that people with BPD may be at a higher risk of benzodiazepine dependence due to efforts to self-medicate. Antidepressants carry a black-box warning. This warning notes that antidepressants are associated with an increased risk for suicidal thinking in young people.
Coping With BPD
While psychotherapy is the standard treatment approach for BPD, medications may be useful for relieving and managing some symptoms. There are also steps that people with BPD can take to improve their ability to cope. These include:
Treating co-occurring conditions: Other mental health conditions such as substance use, anxiety disorders, depression, bipolar disorder, and post-traumatic stress disorder (PTSD) can make managing your BPD more difficult. Treating those co-occurring illnesses can help you feel better. Finding ways to manage stress: Stress can play a major role in exacerbating the symptoms of BPD, so finding ways to reduce or manage stress can be helpful. These might include deep breathing, exercise, visualization, and progressive muscle relaxation. Developing coping skills: Finding effective ways to deal with emotional distress and to control impulsive behaviors can also help you function better in daily life. Mindfulness, social support, and dialectical behavior therapy can help improve coping skills.
A Word From Verywell
While medications for BPD can be a useful part of your overall treatment plan, it is important to work with your doctor to determine the best approach for your needs. There is no single treatment that is appropriate for every person with BPD. The right approach for you will depend on your symptoms, medical history, and response to treatments. It is also important to be aware that medications are most effective when combined with other options such as psychotherapy. Talk to your doctor about what might be right for you. There was an error. Please try again.
