The National Institute of Mental Health (NIH) defines borderline personality disorder as an “illness marked by an ongoing pattern of varying moods self-image, and behavior which often result in impulsive actions and problems in relationships.”
Currently, no specific medications are approved by the FDA for the treatment of borderline personality disorder. Overall, dialectical behavior therapy (DBT) is proven to be the most efficient treatment for BPD.
However, some medications may work for some of the symptoms and causes of BPD, like depression, anxiety, or mood swings.
Psychotherapists usually prescribe certain medications to treat severe BPD symptoms.
In addition, medicines help manage other psychological conditions that coexist with BPD.
In the mid-1980s, pharmacological treatments for borderline disorders gained momentum. By using the proper medication, psychotherapy treatments for BPD have become more effective than ever before.
First of all, the use of medication helps in rapidly stabilizing emotional disturbances and harmful aggression. Secondly, drugs work well for taming specific symptoms of borderline personality disorder.
Fortunately, effective medications are specially meant for several prominent symptoms of BPD, like depression, anxiety, volatile mood swings, and negative thoughts.
Nonetheless, some best-known psychotherapists and a few government medical advisory groups like NICE still do not approve of using medicines to treat BPD.
Unlike traditional beliefs, a combined approach of psychotherapy and pharmacology works best for managing borderline personality disorder. Moreover, don’t consider bipolar disorder treatment programs that rely solely on medications.
How do borderline personality disorder medications help?
Some psychiatrists and psychologists from the traditional school of mental health practice oppose using medications for BPD treatment. Also, some patients resist taking medication for people with BPD, regardless of the severity of their symptoms.
It should be noted that borderline disorder is primarily the result of inherent biological disturbances in specific chemical processes necessary for the proper functioning of the brain. Some symptoms of BPD happen because of certain improper chemical functions in the brain.
Specific medications can improve and balance the chemical processes in the brain. As a result, drugs reduce the symptoms of BPD and enhance the effects of psychotherapy.
Medicines improve the biological processes of the brain and relieve the symptoms of BPD. Once the patient returns to normal, discontinue the use of medications.
Recommended reading: Do I have BPD?
Despite using the medication, some patients may not show improvement. The patient may fail to respond to BPD treatment for reasons such as:
- Wrong or improper use of medicines
- Use of an ineffective psychotherapy approach
- Undiagnosed symptoms and their causes
- Unidentified co-occurring disorders such as substance abuse
Types of medications for borderline personality disorder
There are four types of medications helpful in treating borderline disorder:
- Antipsychotic agents
- Mood stabilizers
- Anti-anxiety agents
Your psychotherapist will choose the proper medication according to the severity of the symptoms and the condition of the disorder.
The efficacy of medication depends on various factors, such as the severity of symptoms, the biological makeup of the patient, and the type of medicine used. In other words, a medication that works well for one person may not necessarily work for another. For this reason, your psychiatrist will have to use a couple of trial-and-error methods to find the proper treatment for you.
Let us have a look at some of the common medicines useful for BPD:
Many symptoms of borderline personality disorder are common to both neurosis and psychosis. For this reason, certain medications used in neurosis conditions also work for BPD.
Common antipsychotic drugs are:
- Thiothixene (Navane)
- Haloperidol (Haldol)
- Trifluoperazine (Stelazine)
- Flupenthixol (Depixol)
Antipsychotic (FGA; neuroleptic) drugs may alleviate symptoms such as:
- Mood dysregulation
- Poor general functioning
- Assaultiveness, hostility, self-injury, suicide attempts,
- Paranoid thinking, suspiciousness, psychoticism, illusions
Most people with borderline personality disorder exhibit anxiety, agitation, and irritability symptoms. Your psychotherapist may give you anti-anxiety pills to calm the symptoms in such conditions.
Nevertheless, the continuous use of anxiety medications can make the user addicted. Such patients may exhibit more impulsive behavior than ever before.
Frequently used anti-anxiety medications include benzodiazepines and anxiolytics like:
- Diazepam (Valium)
- Alprazolam (Xanax)
- Temazepam (Restoril)
- Flurazepam (Dalmane)
- Triazolam (Halcion)
- Ativan (lorazepam)
- Klonopin (clonazepam)
Antidepressants are the commonly prescribed medications used to treat major depressive disorders.
Significant symptoms of depression are:
- Low mood
- Sad, empty, or anxious
- Helpless, worthless, or guilty
- Suicidal thoughts
Several types of antidepressants have been studied for BPD, including tricyclic and tetracyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs).
Many individuals with BPD occasionally fall into severe depression. For this reason, your psychiatrist may recommend the short-term use of antidepressants. Commonly used antidepressants include:
- Zoloft (sertraline)
- Effexor (venlafaxine)
- Nardil (phenelzine)
- Prozac (fluoxetine)
- Wellbutrin (bupropion)
Mood stabilizers or anticonvulsants
One of the chief traits of BPD patients is rapid and extreme mood swings. They face constant fluctuations in emotional states, alternating between happiness and depression.
Medications with mood-stabilizing properties, like lithium and anticonvulsants, may work for extreme mood swings. Mood stabilizer medications can help control symptoms such as:
- Unstable mood
- Irritability, anger
- Anxiety, depression,
- Interpersonal problems
Commonly used mood stabilizers and anticonvulsants are:
- Lamictal (lamotrigine)
- Tegretol or Carbatrol (carbamazepine)
- Lithobid (lithium carbonate)
- Depakote (valproate)
- Topiramate (Topamax)
Supplements are beneficial for BPD.
It is interesting to know that mental health experts are in continuous pursuit of developing medicines that help various mental disorders. Newer ways of treating borderline personality disorder have been discovered in multiple studies.
Omega-3 Fatty Acids
Recent research reports suggest that omega-3 fatty acids help manage mood disorders. Also, it helps to decrease depression and aggression, two common symptoms of borderline personality disorder.
The brain comprises at least 60 percent lipids so Omega-3 fatty acids can help the healthy functioning of the brain.
A magnesium supplement is a natural muscle relaxer. It can help relieve the nerves and reduce depression and anxiety.
A study conducted in 2015 noticed a correlation between deficient magnesium levels and the symptoms of BPD.
Another research report published in 2017 also recommended magnesium supplements for managing depression.
Supplements or foods high in vitamin C may help BPD patients with anxiety, restlessness, or nervousness. According to research, a significant reduction in anxiety levels was noticed when supplementation with 500 mg of Vitamin C was used regularly.