Why Use Borderline Personality Disorder Medication?
Although no drugs have been approved by the Food and Drug Administration specifically for treating borderline personality disorder, certain medications may help with symptoms or co-occurring problems such as depression, impulsiveness, aggression, or anxiety. Medications may include antidepressants, antipsychotics, or mood-stabilizing drugs. Talk to your doctor or a mental health professional about medications’ benefits and side effects.
Borderline personality disorder (BDP) is mainly treated using psychotherapy, but medication may be added. Your doctor also may recommend hospitalization if your safety is at risk. Mental health treatment can help you learn skills to manage and cope with your condition. It’s also necessary to get treated for other mental health disorders that often occur along with borderline personality disorder, such as depression or substance misuse. You can feel better about yourself and live a more stable, rewarding life with treatment.
FDA Approved Medications for Borderline Personality Disorder
As mentioned above, no medications are approved by the US Food and Drug Administration (FDA) for treating BPD. Very limited data exist for any single medication improving overall BPD severity. Coordination between psychopharmacologists, psychotherapists, and others involved in patients’ treatment is often necessary for targeted, timely intervention and ongoing re-evaluation of attendant risks versus benefits of treatment.
Alprazolam (Xanax – used to treat anxiety and panic disorders) and other benzodiazepines are strongly discouraged in treating BPD due to the risks of worsening impulsivity and suicidality. BPD patients may be at increased risk for benzodiazepine dependence to self-medicate chronic, refractory affective symptoms by fostering dissociative symptomatology. Targeting noradrenergic signaling has been less frequently studied in the psychopharmacological treatment of BPD. The “ocadrenergic agonist clonidine” proved effective in treating comorbid post-traumatic stress disorder (PTSD) and BPD, but this effect seemed specific to PTSD symptoms.
Consistent with increasing recognition of omega-3 fatty acids in mood stabilization, one trial demonstrated tolerability and efficacy of omega-three ethyl-eicosapentaenoic acid (EPA) supplementation, decreasing aggression and affective symptoms in patients with moderate to severe BPD.
Symptoms of BPD include:
- Affective instability
- Transient psychotic symptoms
- Interpersonal dysfunction
All these symptoms occur as manifestations of core disturbances in representations of self and other. This core is associated with complex interactions between genetic risk factors and developmental attachment stressors. Specific neurobiological effects of these risk factors in BPD remain ill-defined. Most up-to-date evidence suggests that anticonvulsant agents, such as topiramate, valproate, or lamotrigine, and atypical antipsychotics, such as aripiprazole and olanzapine, are most effective in treating BPD.
- Why Use Borderline Personality Disorder Medication?
- FDA Approved Medications for Borderline Personality Disorder
- Borderline Personality Disorder Statistics
- Borderline Personality Disorder Treatment Medication
- Therapies and Medications for Borderline Personality Disorder
- Borderline Personality Disorder Medications & Side Effects
- Challenges When Taking BPD Medications & Safety Precautions
- Borderline Personality Disorder Treatment
Consistent with their benefits on impulsivity, a recent review recommended anticonvulsants and atypical antipsychotics for decreasing alcohol craving and consumption in BPD patients with comorbid alcoholism. Of the antidepressants, MAOIs and fluvoxamine may offer more significant therapeutic benefits, but the effects of antidepressants on BPD symptoms are more modest.
Nonetheless, antidepressant medications may help treat comorbid mood and anxiety disorders, and they may be more efficacious in treating male BPD patients with prominent impulsive aggression. No medications are approved for treating BPD, and targeted, transient medication use for specific symptom domains is advised. Identity disturbance and interpersonal affective symptoms are less apt to improve with medication alone. Most available medications target impulsivity and aggression, symptoms that are most likely to resolve. 
People with BPD are more at risk for suicide than the general population. If a person talks about ending their life or makes suicidal gestures, it is essential to ask if they are serious about killing themselves. Let the person know that if you are concerned for their safety, you will act because you care. If in doubt, seek help through a crisis phone line or mental health services available in your local area.
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Borderline Personality Disorder Statistics
In the United States, recent research has shown that 1.6% of the population has BPD. That number may seem small, but when you consider just how large the United States is, you may realize that 1.6% represents quite a large number of people. Borderline personality disorder is one of the most challenging mental health disorders to manage. It is best managed with an interprofessional team, including psychiatrists, psychologists, pharmacists, mental health nurses, and social workers. 
It’s estimated that 1.4% of the adult U.S. population experiences BPD.
Nearly 75% of people diagnosed with BPD are women.
Surveys have estimated the prevalence of borderline personality disorder to be 20% in the inpatient psychiatric population.
Borderline Personality Disorder
Medication Facts Sheet
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 borderline personality disorder medication that your doctor prescribes will depend on your specific symptoms and needs.
Borderline Personality Disorder Medication
Exams and Tests
BPD is diagnosed based on a psychological evaluation. The healthcare provider will consider how long and severe the person’s symptoms are.
The treatment outlook depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person often gradually improves.
Individual talk therapy may successfully treat BPD. Group therapy can sometimes be helpful.
Medicines have less of a role in treating BPD than other mental disorders. In some cases, they can improve mood swings and treat depression or other disorders that may occur with this disorder.
When to Contact a Medical Professional
See your provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help immediately if you or someone you know is having thoughts of suicide.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number immediately. DO NOT leave the person alone, even after you have called for help.
 Source: Borderline personality disorder – U.S. Department of Health and Human Services National Institutes of Health
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Top 4 Types of Borderline Personality Disorder Treatment Medication
Several studies have been conducted to assess the efficacy of various medications in managing patients with BPD. Here, we present a summary of randomized clinical trials (RCTs) of antidepressants, antipsychotics, and mood stabilizers for borderline personality disorder treatment medication.
Antidepressants were developed for people with major depressive disorder and other disorders characterized by low mood. But many people with BPD are treated with these medications as well. 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)
These medications may help with sadness, low mood, anxiety, and emotional reactivity but do not seem to substantially affect other BPD symptoms (e.g., anger, impulsivity).
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 positively affect 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)
3. Mood Stabilizers/Anticonvulsants
Medications with mood-stabilizing properties and some anticonvulsant or anti-seizure medications have been used to treat 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)
4. 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, very little research supports the use of anti-anxiety medication to treat BPD. There is some evidence. However, the 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. 
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Therapies and Medications for Borderline Personality Disorder
Psychotherapy, also called talk therapy, is a fundamental treatment approach for borderline personality disorder. Your therapist may adapt the type of therapy to meet your needs best. Suppose you’re unsure where to get help. In that case, a healthcare provider can refer you to a licensed mental health professional, such as a psychiatrist or psychologist with experience treating borderline personality disorder. If you need help starting the conversation, contact We Level Up FL for a confidential call.
Contact a mental health professional if you are having symptoms of BPD. People with BPD experience wide mood swings and can feel extreme instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:
- Frantic efforts to avoid real or imagined abandonment by friends and family.
- Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as “splitting.”
- Distorted and unstable self-image affects moods, values, opinions, goals, and relationships.
- Impulsive behaviors have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances.
- Self-harming behavior, including suicidal threats or attempts.
- Periods of intense depressed mood, irritability, or anxiety lasting a few hours to a few days.
- Chronic feelings of boredom or emptiness.
- Inappropriate, intense, or uncontrollable anger—often followed by shame and guilt.
- Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
The Goals of Psychotherapy
- Focus on your current ability to function
- Learn to manage emotions that feel uncomfortable
- Reduce your impulsiveness by helping you observe feelings rather than acting on them
- Work on improving relationships by being aware of your feelings and those of others
- Learn about borderline personality disorder
Types of Psychotherapy
- Dialectical behavior therapy (DBT). DBT includes group and individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to manage your emotions, tolerate distress, and improve relationships.
- Schema-focused therapy. Schema-focused therapy can be done individually or in a group. It can help you identify unmet needs that have led to negative life patterns, which at some time may have been helpful for survival, but, as an adult, are hurtful in many areas of your life.
- Mentalization-based therapy (MBT). MBT is a type of talk therapy that helps you identify your thoughts and feelings at any given moment and create an alternate perspective on the situation. MBT emphasizes thinking before reacting.
- Systems training for emotional predictability and problem-solving (STEPPS). STEPPS is a 20-week treatment that involves working in groups that incorporate your family members, caregivers, friends, or significant others into treatment. STEPPS is used in addition to other types of psychotherapy.
- Transference-focused psychotherapy (TFP). Also called psychodynamic psychotherapy, TFP aims to help you understand your emotions and interpersonal difficulties through the developing relationship between you and your therapist. You then apply these insights to ongoing situations.
- Good psychiatric management. This treatment approach relies on case management, anchoring treatment in an expectation of work or school participation. It focuses on making sense of emotionally tricky moments by considering the interpersonal context for feelings. It may integrate medications, groups, family education, and individual therapy.
Therapy for Caregivers and Family Members
Having a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved one’s symptoms. Although more research is needed to determine how well family therapy helps with borderline personality disorder, studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy.
Family therapy helps by:
- Allowing the relative or loved one to develop skills to understand and support a person with a borderline personality disorder
- Focusing on the needs of family members helps them understand the obstacles and strategies for caring for someone with the disorder
Borderline Personality Disorder Medications & Side Effects
People may experience side effects while taking borderline personality disorder medications as with other medicines. It is important to remember that each medication has its own set of adverse effects. Some of the more common side effects include:
- Dry mouth
- Weight gain
Always talk to your healthcare provider about the typical and rare side effects 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.
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Challenges When Taking BPD Medications & Safety Precautions
Learning to manage your emotions, thoughts and behaviors takes time. Most people improve considerably, but you may always struggle with some symptoms of borderline personality disorder. You may experience times when your symptoms are better or worse. But borderline personality medications and therapies can improve your ability to function and help you feel better about yourself.
A diagnosis of borderline personality disorder is usually made in adults, not children or teenagers. That’s because what appear to be signs and symptoms of borderline personality disorder may go away as children get older and become more mature.
You have the best chance of success when you consult a mental health provider with experience treating borderline personality disorder. However, no single treatment is appropriate for every person with BPD. The right approach depends on your symptoms, medical history, and treatment response.
Several challenges can affect using borderline personality disorder medications in treatment. 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 expected: Having another condition can complicate medication choice. For example, antidepressants should not be used in cases where someone also has a 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.
There are certain precautions to take before trying a borderline personality disorder medication. Some concerns to think about include the following:
- 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.
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Borderline Personality Disorder Treatment
Individuals with borderline personality disorder (BPD) suffer from marked affective disturbance, an unstable sense of self, difficulty in interpersonal relationships, and heightened impulsivity, leading to high rates of self-harm and suicide. Patients are often stubborn to treatment and are at high risk for acute or dangerous presentations, with a severe impact on mental health services.
There has been much debate on the effectiveness of medications in treating different facets of the psychopathology of BPD. Several guidelines recommend using antidepressant agents, mood stabilizers for affective dysregulation and impulsive-behavioral dyscontrol, and antipsychotics for cognitive-perceptual symptoms.
There is evidence that long-term psychotherapy is a helpful treatment for those with BPD. It is often chosen for pharmacological treatment due to reports of the limited efficacy of drug therapy. Despite this, borderline personality disorder medication has been recommended as an adjunctive, symptom-targeted component of treatment. While borderline personality medication can be a valuable part of your overall treatment plan, it is crucial to work with mental health professionals to determine the best approach for your needs.
Call us now for a free mental health assessment! In addition, for the substance abuse or dual diagnosis approach, We Level Up FL inpatient treatment, inpatient medical detox, and residential primary addiction treatment may be available at our affiliated facility. For more BPD treatment resources, call us about your loved one’s symptoms, and we can help you determine the cause and develop a treatment plan.
Dealing with someone with borderline personality disorder can sometimes be distressing and difficult. It can seem like nothing is changing. If you are the family, friend, or carer of someone with BPD, there are some things you can do to help.
Is it an emergency?
Get help immediately if the person:
- Has deliberately injured themselves
- Is acting out in a highly aggressive or abusive manner
- Is expressing thoughts of suicide or of killing someone else
- Is disorientated (does not know who they are, where there are, or what time of day it is)
- Has delusions (strange beliefs) or hallucinations (hearing or seeing things that are not real)
- Is confused or not making sense
- Is badly affected by drugs and or alcohol and acting abnormally
Sometimes a person with BPD doesn’t want to attend their appointment with their psychiatrist or another therapist, even though they have previously committed to their treatment. If this happens:
- Ask them what is worrying them and let them talk about it
- Keep giving them emotional support and encouragement
- Talk about what kind of practical help they need to keep going with their treatment
- Contact the healthcare team for advice on how to motivate someone with borderline personality disorder
BPD is a mental illness that severely impacts a person’s ability to regulate their emotions. This loss of emotional control can increase impulsivity, affect how a person feels about themselves, and negatively impact their relationships with others. Effective borderline personality disorder medication and therapies are available to manage the symptoms of BPD. Contact We Level Up FL today for personalized treatment options for you. Your call is private and confidential.
Popular Borderline Personality Disorder Medication Frequently Asked Questions
What is the best medication for borderline personality disorder?
To date, there are no best 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.
What medication is usually prescribed for borderline personality disorder?
Antipsychotics are widely used in BPD, as they are believed to improve impulsivity, aggression, anxiety, and psychotic symptoms.
Is there an over the counter medication for borderline personality disorder?
There is currently no OTC borderline personality disorder medication specifically approved by the Food and Drug Administration (FDA). Psychotherapy, also called talk therapy, is the primary treatment approach for borderline personality disorder. Your therapist may acclimate the type of therapy to meet your necessities best.
How can I treat my BPD at home?
Be careful with alcohol or drug use. Try to improve your sleep. Sleep can help give you the energy to cope with complicated feelings and experiences. Eat a healthy diet. It can be hard to reach out when you’re not feeling well, but it might help to share complex thoughts. If you don’t feel you can talk to the people around you, you could try contacting a helpline.
What vitamins help with BPD?
Vitamin C supplements might benefit people with BPD symptoms, including anxiety and nervous tension.
How do you treat BPD without borderline personality disorder medication?
People with BPD can benefit by being physically active, practicing self-care, keeping busy, and taking breaks. Dialectical behavioral therapy and group/individual therapy can help someone deal with BPD. Grounding exercises and having an emergency safety plan are recommendations to overcome BPD.
Can you control BPD on your own?
BPD can cause significant disruption in your life, and the symptoms can feel debilitating. However, it’s crucial to recognize that it is possible to learn how to manage your condition, and with time, you can master the coping skills needed to do so.
Why do people develop BPD?
Being a victim of emotional, physical, or sexual abuse. being exposed to long-term fear or distress as a child. being neglected by 1 or both parents. growing up with another family member who had a severe mental health condition, such as bipolar disorder or a drink or drug misuse problem.
Who is most likely to develop borderline personality disorder?
Women are far more likely to be diagnosed with BPD than men. About 75% of people diagnosed with BPD are women; that’s a ratio of 3 women to 1 man diagnosed with BPD.
What is BPD life expectancy?
If left untreated, people with borderline personality disorder have a reduced life expectancy of some 20 years. Primarily attributable to physical health disorders, notably cardiovascular. Risk factors include obesity, a sedentary lifestyle, poor diet, and smoking.
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 Borderline Personality Disorder – MentalHealth.gov U.S. Department of Health & Human Services