Types of Borderline Personality Disorder Medications

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Borderline personality disorder (BPD) is sometimes treated with medications for anxiety or depression, which may reduce some symptoms of BPD. While there are currently no medications approved by the FDA to treat BPD specifically, some drugs have been found to be effective in some cases. Medications may be used to treat psychological conditions that frequently co-occur with BPD, such as major depressive disorder.

Medications may be particularly effective for BPD when they are used in conjunction with psychotherapy and other treatments. Learning more about the different options will help you find the right medication choice for you.

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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.

There are several types of antidepressants that have been studied for use with BPD, including tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs). These medications may help with sadness, low mood, anxiety, and emotional reactivity, but they do not seem to have a strong effect on other symptoms (e.g., anger, impulsivity).

Common antidepressants include:

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

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.

These drugs can have a positive effect on a variety of 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:

  • Haldol (haloperidol)
  • Zyprexa (olanzapine)
  • Clozaril (clozapine)
  • Seroquel (quetiapine)
  • Risperdal (risperidone) (Risperdal)

Mood Stabilizers/Anticonvulsants

Medications with mood stabilizing properties, such as lithium, and some anticonvulsant (anti-seizure) medications have been used to treat the impulsive behavior and rapid changes in emotion that are associated with BPD. There is research to suggest that these classes of drugs may be useful in BPD.

Common mood stabilizers/anticonvulsants include:

  • Lithobid (lithium carbonate)
  • Depakote (valproate)
  • Lamictal (lamotrigine)
  • Tegretol or Carbatrol (carbamazepine)

Anxiolytics (Anti-Anxiety Drugs)

Because individuals with BPD also often experience intense anxiety, medications to reduce anxiety are sometimes prescribed. Unfortunately, there is very little research to support the use of anti-anxiety medication to treat BPD.

There is also some evidence that uses of a particular class of anxiolytics, benzodiazepines (e.g., Ativan, Klonopin), may actually cause a worsening of symptoms for some individuals with BPD. They should be prescribed with caution.

Benzodiazepines are particularly dangerous for use by individuals 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.

Common anxiolytics include:

  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Xanax (alprazolam)
  • Valium (diazepam)
  • Buspar (buspirone)

Other Borderline Personality Disorder Medications

As we learn more about the biological causes of BPD, new medications are being developed and tested for the disorder. For example, 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.

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Article Sources
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  1. Ripoll LH. Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci. 2013;15(2):213-24.

  2. Zanarini MC, Frankenburg FR, Reich DB, Harned AL, Fitzmaurice GM. Rates of psychotropic medication use reported by borderline patients and axis II comparison subjects over 16 years of prospective follow-up. J Clin Psychopharmacol. 2015;35(1):63-7. doi:10.1097/JCP.0000000000000232

  3. Zanarini MC, Frankenburg FR. Omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Am J Psychiatry. 2003;160(1):167-9. doi:10.1176/appi.ajp.160.1.167

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