Medications for Borderline Personality Disorder

There are several medications being used to treat patients with Borderline Personality Disorder:

The Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants came into use with the availability of Prozac in the mid-80’s. These medications, which now include Prozac, Zoloft, Paxil, Luvox, and Celexa, have become powerful tools in the treatment of depression and various forms of anxiety. They have been helpful in limiting the degree of depression that many people who have Borderline Personality Disorder experience, as well as controlling anxiety and panic attacks, and to control other overwhelming feelings that often lead to the patient’s self-destructive behaviors.

For some people with Borderline Personality Disorder, SSRIs significantly reduce the urge to self-mutilate or to engage in other self-destructive behaviors such as binge eating and purging. The new generation of Antidepressants also includes Serzone, Effexor, Wellbutrin, and Remeron. While the mechanisms of action of each of these medications may vary, each medication has had a role in the treatment of some patients with Borderline Personality Disorder.

Mood-stabilizing drugs have also recently had a more prominent role in treating patients with Borderline Personality Disorder. Lithium used to be the only drug commonly used to treat mood swings; however, a number of agents originally developed to treat seizures have been found to have powerful mood-stabilizing effects. Depakote was the next anti-seizure medication most commonly used by psychiatrists to control mood swings.

Other mood-stabilizing medications include: Tegretol, Neurontin, Lamictal, and Topamax, among others. These have been studied primarily in the treatment of patients with Bipolar Disorder (manic-depressive illness), but are also being used by some clinicians to treat the drastic mood changes that occur in Borderline Personality Disorder as well. These drugs may also enhance the effects of Antidepressants when the response to treatment has been incomplete.

The major tranquilizers, or antipsychotic drugs, have long been used to treat some of the symptoms of Borderline Personality Disorder. They can be most helpful in treating dissociative symptoms and in the control of self-destructive impulses. The older drugs, such as Haldol, Navane, Stelazine, and Thorazine have, unfortunately, had severe and sometimes lasting side effects, including muscle spasms and involuntary movements. A new generation of Antipsychotics, including Risperdal, Zyprexa, and Seroquel, has drastically reduced the likelihood of these side effects, however; since they can be used safely and comfortably, psychiatrists have been more willing to prescribe them for patients with Borderline Personality Disorder.

The minor tranquilizers, or Benzodiazepines, have a very limited role in the treatment of Borderline Personality Disorder, mostly because of their potential for addiction. In some people, their dissociative symptoms may increase under the influence of Benzodiazepines. For these people, when Benzodiazepines are prescribed, they should be closely monitored. An exception would be BuSpar, a unique, non-benzodiazepine anti-anxiety agent that is non-addicting and, for the most part, non-sedating. BuSpar is often used in combination with an SSRI. When so combined, BuSpar may enhance the antidepressant and anti-anxiety effects of the SSRIs.

One other drug that merits mention is ReVia (Naltrexone). This drug, which blocks the effects of narcotics on the nervous system, was originally studied as a treatment for narcotics addiction, and has been found also to limit the craving for alcohol in some alcoholics. A less studied effect of ReVia is the reduction of self-mutilation in patients with a variety of diagnoses. While it is not clear how helpful this drug will turn out to be in preventing the self-mutilation that often accompanies Borderline Personality Disorder, is worth watching. It may even be worth trying for some people who struggle both with chemical addictions and compulsive self-injury.

This information is for informational purposes only, all medications should be prescribed by a qualified healthcare provider.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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