Reuptake in Medications Used to Treat BPD Depression

synapse with neurotransmitters
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Reuptake is an important brain process to understand if you have borderline personality disorder (BPD) or any other mental health problem. Why? Because many medications used to treat mental health disorders work by altering a number of particular neurotransmitters in the brain. Reuptake is a key part of this process.

Neurotransmitters are chemical messengers that provide a pathway for transmitting signals released by nerve cells (neurons) across synapses (the spaces between cells) from one nerve cell to another.

Reuptake is what happens after a signal is transmitted: The neurotransmitter, its "work" completed, is reabsorbed back into the cell that previously released it. 

Why Is Reuptake Important in Treatment for BPD Depression?

Depression in BPD and other mental health disorders are associated with low levels of certain brain chemicals, including serotonin, dopamine, and norepinephrine.

If you have BPD and are taking medication to treat depression (in other words, an antidepressant), you may be taking a selective serotonin reuptake inhibitor or SSRI. The most commonly prescribed antidepressants, SSRIs are often used to treat people with BPD by reducing the symptoms of moderate to severe depression.

SSRIs increase the amount of the neurotransmitter serotonin in the brain by, as you're now aware, slowing its reuptake into the cells that transmitted it. As a result, higher-than-normal levels of serotonin are left to circulate in the brain.

Increasing the amount of serotonin in the brain appears to help brain cells communicate, which in turn helps lift depression and improve mood. Serotonin has been called the body's natural "feel-good" chemical because it produces a sense of well-being.

As you can see, SSRIs don't help the body to produce more serotonin. Instead, they help the body circulate more of the serotonin it has.

Examples of SSRIs

Here are the names of the SSRIs available for your doctor to prescribe:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac, Sarafem)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil, Paxil XR, Pexeva)
  • Sertraline (Zoloft)

A Word of Warning of Serotonin Syndrome

The process of reuptake also plays a role in this rare but dangerous condition, which generally occurs when a person takes more than one medication that increases the level of serotonin in the body. This can result in dangerously high serotonin levels in the brain.

Medications that should be taken with caution if at all with SSRIs include:

  • Certain pain or headache medications
  • The herbal supplement St. John's Wort
  • Certain OTC cold and flu medications

Signs and symptoms of serotonin syndrome include:

  • Rapid heart rate
  • Agitation
  • Lack of coordination
  • Confusion
  • Sweating
  • Tremors
  • Restlessness
  • High fever

If you have any of these signs or symptoms, get medical help immediately.

Serotonin syndrome is more likely to occur when you first start taking a serotonin-boosting medication or when you increase the dose.

Serotonin syndrome is rare, largely because doctors are very careful about prescribing medications that could cause it. Nevertheless, because this syndrome is so dangerous, the FDA has asked the makers of these types of medications to put warning labels on them that can alert you to this risk.

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