Anxiety Medications for Borderline Personality Disorder

Man taking an Ativan

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To date, there are no medications approved by the Food & Drug Administration (FDA) to treat borderline personality disorder (BPD). However, some individuals with BPD are prescribed anti-anxiety medications, also known as “anxiolytics," to treat the intense anxiety and agitation associated with BPD. This is completely up to your individual doctor and your unique situation.

Like any medication, however, there are both advantages and drawbacks to treatment with anti-anxiety medications. Here are some things to keep in mind and to ask your doctor if your psychiatrist is considering prescribing anti-anxiety medications for your BPD symptoms.

Are Anti-Anxiety Medications for BPD 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.

Research has been mixed on these medications' overall effects.

On an individual basis, some have reported significant improvement in their BPD symptoms. Others reported worsened symptoms when taking certain drugs like Xanax because it heightened their urges for impulsive behaviors.

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. These tend to be more frequently recommended, as they can help you transition as you make progress in your therapy and recovery.

Risks and Side Effects of Anti-Anxiety Medications

It's important to know that these drugs can have significant side effects, particularly in people with BPD since they have not been thoroughly tested in that population.

The most common side effect of anti-anxiety medication is feeling sleepy, fatigued or groggy. Other side effects include impaired coordination and memory problems.

You should not take anti-anxiety medication if you drink, as it can worsen the foggy effect. Many anti-anxiety medications should not be taken by pregnant women or women trying to become pregnant.

Medications from the benzodiazepine family should not be mixed with other sedating medications or 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, let them 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.

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • 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.
  • Mayo Clinic. "Borderline Personality Disorder", 2015.

By Kristalyn Salters-Pedneault, PhD
 Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University.