Borderline personality disorder (BPD) is a mental health condition that makes it difficult to regulate emotions, maintain stable relationships, and cope with intense feelings of abandonment or anger. Mood swings can be dramatic, and impulsive behaviors may create challenges in day-to-day life.
While there is no cure for this condition, BPD medication can help individuals manage their symptoms so they can lead more fulfilling and stable lives. For many, medication can even address co-occurring conditions that are frequently seen in those with BPD.
Keep reading to learn about the types of medications used for BPD, potential risks and side effects, and how they can fit into a comprehensive treatment plan.
Living with borderline personality disorder can feel like an emotional roller coaster. Intense mood swings, impulsive behaviors, and difficulties in relationships can make everyday life exhausting. Fortunately, medication can help make symptoms more manageable and give people the stability they need.
BPD also rarely exists on its own. Many people with BPD struggle with other mental health conditions that can make symptoms even harder to manage. Research shows that:
When these conditions go untreated, they can make BPD symptoms worse. Another reason medication is used in BPD treatment is its potential to reduce the risk of suicide. Studies have found that:
With the right medication, people with BPD may experience fewer impulsive urges and less emotional distress.
There are currently no FDA-approved medications specifically for BPD, but providers will often prescribe certain off-label medications to help manage symptoms. These medications fall into four categories: antidepressants, antipsychotics, mood stabilizers, and anxiolytics (anti-anxiety medications).
Antidepressants are commonly prescribed to help manage depressive symptoms, anxiety, and low mood in those with borderline personality disorder. However, they are not effective in treating anger or impulsive behavior, which are the core symptoms of BPD.
There are different types of antidepressants, but selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed for this condition. These include:
Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), like Nardil (phenelzine), are generally avoided due to their higher risk of overdose, side effects, and poor tolerability.
Over 90% of patients are prescribed medications to treat their BPD, and up to 60% are prescribed antipsychotics. Atypical antipsychotics are used to help regulate mood, reduce impulsivity, and improve social and occupational functioning. These medications are also prescribed for other conditions like bipolar disorder and schizophrenia, but research suggests they may be beneficial for BPD as well.
Commonly prescribed antipsychotics for BPD include:
BPD is characterized by intense emotional instability and impulsivity, which is why mood stabilizers are sometimes used to help regulate mood swings and reduce aggressive behavior.
Research has found that topiramate and lamotrigine may be effective in reducing aggression in BPD patients, though more studies are needed to confirm their long-term benefits.
Common mood stabilizers prescribed for BPD include:
Since anxiety disorders affect a large number of individuals with BPD, anti-anxiety medications, or anxiolytics, are sometimes prescribed to help manage anxiety and panic symptoms.
Common anxiolytics for BPD include:
However, benzodiazepines (e.g., Xanax, Klonopin, and Valium) should be used with caution in BPD patients. Research suggests that these medications can be habit-forming and may increase the risk of suicidal behaviors. Buspar is sometimes considered a safer alternative for managing anxiety without the same risks of dependence.
Like any medication, those prescribed for BPD can come with side effects. Not everyone experiences them, and some may only have mild symptoms that fade over time. However, it’s important to be aware of potential reactions, especially since different types of BPD medications each have their own set of possible side effects.
Some of the most common side effects include:
Since BPD medications affect brain chemistry and neurotransmitters, some people may need time to adjust to new prescriptions. Side effects can vary based on dosage, individual body chemistry, and medication combinations, so it’s important to communicate any concerns with your doctor.
Before starting any medication, it’s imperative that you discuss potential risks with a healthcare provider. Some medications come with specific warnings, including:
Always keep track of how you respond to your prescribed medications. Regular check-ins with your doctor can help you make sure that the medication is working and that any side effects are addressed and properly managed.
Medication can help manage some of the symptoms of borderline personality disorder, but it’s not a standalone treatment. Because BPD is a complex disorder that affects emotions, behavior, and relationships, psychotherapy is recommended as a first-line treatment.
Research has shown that therapy is highly effective in treating BPD. Studies suggest that psychotherapy can reduce the severity of symptoms, lower the risk of suicide, decrease self-harm, and improve overall mental health compared to standard treatment.
Two of the most used therapies for BPD are dialectical behavior therapy (DBT) and mentalization-based treatment (MBT). DBT is a type of therapy that teaches skills in emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness to help individuals gain control over intense emotions and impulsive behaviors. Conversely, MBT helps people with BPD better understand their own emotions and the emotions of others, which improves self-awareness and relationships.
BPD medication can be beneficial in treating the accompanying symptoms of the disorder; however, it works best when paired with other treatments like psychotherapy. At Cura Behavioral Health, our team offers personalized medication management and therapy to help you find what works best for you. From helping you manage your symptoms to helping you build long-term coping skills, we’re here to support you every step of the way. If you’re looking for expert BPD treatment that will help you get the relief you deserve, reach out to our office today.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
