What Medication Is Usually Prescribed For Borderline Personality Disorder

How To Get Bpd Medication

Understanding medication and personality disorders

BPD medication must be prescribed by a psychiatrist. Therapists and psychologists wont be able to write you a prescription. They can, however, refer you to a clinician wholl be able to get you the medication for borderline personality disorder you need to best manage your symptoms.

Medications to treat BPD symptoms can be prescribed by a psychiatrist. If someone is already in therapy, their therapist can help make a referral so the patient is connected to a prescribing doctor who can do an assessment of them and provide medication options.

Criteria For Inclusion/exclusion Of Studies In The Review

Our population of interest were patients 13 years or older from a country with a very high human development index, with a diagnosis of BPD based on the DSM, versions IV or V , or the ICD-10 . As interventions, we included commonly used drug classes for the treatment of BPD, such as anticonvulsive medications, antidepressants, antipsychotic medications, benzodiazepines, melatonin, opioid agonists or antagonists, and sedative or hypnotic medications with a treatment duration of at least 8 weeks. Overall, these drug classes included 87 different pharmacotherapies. Outcomes of interest included severity of BPD, improvement of symptoms associated with BPD , general psychiatric symptoms, functioning, and adverse events. Supplementary Table 2 provides a detailed presentation of inclusion and exclusion criteria .

What Are The Best Treatments And Therapies For Borderline Personality Disorder

Certain drugs can help treat symptoms of BPD, but your best bet for finding relief is to explore psychotherapy options and practice self-care.

Ivan Ozerov/Stocksy

People with BPD may not adhere to treatment for various reasons. One potential issue: One symptom of BPD is difficulty maintaining relationships, and that can include the relationship between a patient and their therapist, says Elizabeth S. Ochoa, PhD, the chief psychologist at Mount Sinai Beth Israel in New York City.

Since a key component of therapeutic action is forming a solid, trusting working relationship with the therapist, individuals with BPD may not feel safe exposing their fears and feelings to their therapist, and can be emotionally very reactive to slights, perceived or real, Dr. Ochoa says.

Sometimes individuals with BPD are also reluctant to share traumatic experiences or talk about painful histories, Ochoa says. Finally, some people may feel depressed and hopeless, and quit therapy because they believe nothing can help their situation, she explains.

But therapy does provide concrete benefits to patients with BPD: It can help them cope with emotional pain and emotional swings, Ochoa says.

Therapy is the treatment of choice for individuals with BPD, Lazarus says. Therapy can help people learn new skills to manage their emotions and behavior more effectively.

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Bpd Can Be Treated With Medication

Unfortunately, there is no permanent cure to borderline personality disorder. It is a mental health condition that will plague the patient for their entire lives. However, there are a lot of ways that patients can take an edge off the symptoms. Many forms of medication have been proven to be effective and psychiatrists prescribe them regularly.

How Can I Help Someone With Borderline Personality Disorder

What Are The Medications For Borderline Personality Disorder?

If you know someone who lives with borderline personality disorder, here are some ways you can help them:

  • Take time to learn about the BPD to understand what your loved one is experiencing.
  • Encourage your loved one to seek treatment for BPD and ask about family therapy if theyre a relative of yours.
  • Offer emotional support, understanding and patience. Change can be difficult and frightening to people with BPD, but their symptoms can improve over time with treatment.
  • Seek therapy for yourself if youre experiencing significant stress or symptoms of mental health conditions, such as anxiety or depression. Choose a different therapist from the person your loved one is seeing.

People with BPD have a significantly higher rate of self-harming and suicidal behavior than the general population.

People with BPD who are thinking of harming themselves or attempting suicide need help right away.

If you or someone you know is in immediate distress or thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1.800.273.TALK .

A note from Cleveland Clinic

Its important to remember that borderline personality disorder is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help people with BPD manage their thoughts and behaviors.

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Questions To Ask Your Doctor

When you meet with your doctor or therapist about possibly treating your BPD with medication, its important to have your questions ready. Youll want to ask things like:

1. What can I expect with this medication?

2. What are the potential side effects of the medication?

3. When and how should I take this medication?

4. Is this medication habit-forming for some people?

5. If this medication doesnt work, what are my other options?

6. How much does this medication costand do you have any co-pay cards or manufacturers discount codes?

7. How long will I have to take this medication?

The good news is you dont have to deal with the symptoms of BPD without help. Psychotherapy particularly a specialized type known as dialectical behavioral therapy , which was developed specifically to treat BPD is the first line of psychological treatment, but you can always discuss whether or not medication is something you should try.

For many people, BPD medication makes a huge difference in their quality of life. It can allow them to minimize, if not completely eliminate, the anxiety, depression, thoughts of self-harm, and mood swings that often accompany BPD. Its also worth repeating that BPD medication generally works best when used in conjunction with other forms of BPD treatment.

What Are The Signs And Symptoms Of Borderline Personality Disorder

Signs and symptoms of borderline personality disorder usually appear in your late teenage years or early adulthood. A troubling event or stressful experience can trigger symptoms or make them worse.

Over time, symptoms usually decrease and may go away completely.

Symptoms can range from manageable to very severe and can include any combination of the following:

Not everyone with borderline personality disorder experiences all of these symptoms. The severity, frequency and duration of symptoms are unique to each person.

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How Effective Are Bpd Medications

No one medication has proved to work all of the time on every case of BPD. In fact, RC Psych College publishes that 75 percent of those diagnosed with BPD also received poly-pharmacy or the use of multiple medications. Antipsychotic medications seem to be the ones used most commonly to treat symptoms of BPD, and they seem to be most effective in higher doses.

Each case of borderline personality disorder is unique, however, and while the use of medication can be an effective intervention or treatment tool, it isnt a cure. Studies that have been performed on the efficiency of medication on BPD are inconclusive and highly variable.

Medication can be a useful tool for stabilizing mood, preventing suicidal behavior, dampening impulsivity and anxiety, treating depression, and managing many other symptoms of borderline personality disorder. Some cases of BPD are more likely to benefit from different forms of treatment.

For Information And Support

When is Medication Right for Personality Disorders?

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Drug Treatment For Borderline Personality Disorder

Many people with borderline personality disorder receive medical treatment. However, there are no drugs available for BPD treatment specifically. A certain drug is most often chosen because of its known properties in the treatment of associated disorders, or BPD symptoms that are also known to be present in other conditions, such as depressive, psychotic, or anxious disorders. BPD itself is characterised by a pervasive pattern of instability in affect regulation , impulse control , interpersonal problems , and cognitive-perceptual problems . This review aimed to summarise the current evidence of drug treatment effects in BPD from high-quality randomised trials.

Available studies tested the effects of antipsychotic, antidepressant and mood stabiliser treatment in BPD. In addition, the dietary supplement omega-3 fatty acid which is supposed to have mood stabilising effects was tested. Twenty-eight studies covering 1742 study participants were included.

The findings tended to suggest a benefit from using second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but most effect estimates were based on single study effects so repeat studies would be useful. Moreover, the long-term use of these drugs has not been assessed. The small amount of available information for individual comparisons indicated marginal effects for first-generation antipsychotics and antidepressants.

How Is Borderline Personality Disorder Treated

BPD historically has been challenging to treat. But with newer, evidence-based treatment, many people with borderline personality disorder experience fewer and less severe symptoms, improved functioning and better quality of life.

But effective treatment takes time, patience and commitment. Treatment may include psychotherapy , medications or both.

Your healthcare provider may recommend a short-term hospital stay if youre very distressed or at risk of harming yourself or others. During your stay, your healthcare provider will work with you to develop a treatment plan.

People with borderline personality disorder often have other mental health conditions, including:

If they have a co-existing condition, theyll also need treatment for it.

Psychotherapy treatment for BPD

Psychotherapy is the treatment of choice for borderline personality disorder. The goal of treatment is to help you uncover the motivations and fears associated with your thoughts and behavior and to help you learn to relate to others more positively.

Types of therapy that can help treat BPD include:

Medications for BPD

Because the benefits of prescription medication for borderline personality disorder are unclear, healthcare providers typically dont prescribe medications as the main treatment for BPD.

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Who Does Borderline Personality Disorder Affect

Most personality disorders begin in the teen years when your personality further develops and matures. As a result, almost all people diagnosed with borderline personality disorder are above the age of 18.

Although anyone can develop BPD, its more common if you have a family history of BPD. People with other mental health conditions, such as anxiety, depression or eating disorders, are also at higher risk.

Nearly 75% of people diagnosed with BPD are people assigned female at birth . Research suggests that people assigned male at birth may be equally affected by BPD, but they may be misdiagnosed with post-traumatic stress disorder or depression.

What Medication Is Usually Prescribed For Borderline Personality Disorder

Treatment for BPD

Borderline personality disorder is often treated with anticonvulsants, antidepressants, or antipsychotics. There is no medication that is best for treating BPD. The type and amount of medication prescribed will depend on the individuals symptoms The following medications are commonly used to treat distressing symptoms of BPD:

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Fear Of Being Alone Or Abandoned

This is one of the most prominent signs since it can cause a full spectrum of emotions.

They are basically terrified of being left alone or abandoned even in most trivial scenarios.

This can trigger feelings of betrayal, for example, if your partner goes to the store and is taking more time than usual, this will immediately cause an intense panic attack.

This could make the person with BPD adopt certain behaviors like extreme jealousy, being controlling and manipulative, followed by a constant clinginess and conflict, just to keep the other person with them.

Vasopressin Activity In Bpd

Vasopressin is also implicated in social behaviour and aggression as demonstrated by animal studies using vasopressin antagonists and receptor knockouts . In human studies, its has been observed that vasopressin concentration in the cerebrospinal fluid is positively correlated with disinhibited aggression, including patients with BPD , and that administration of intranasal vasopressin increases the perception to threat in response to neutral stimuli , which is consistent with the tendency of patients with BPD to interpret neutral faces as potentially threatening .

It has been suggested that, in the context of close interpersonal relationships, the predisposition towards enhanced irritability and aggression in BPD patients is partially explained by increased vasopressin concentrations . As such, vasopressin antagonists may be helpful in the management of BPD, as has been proposed previously for major depressive disorder .

Anxiety Medications For Borderline Personality Disorder

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To date, there are no medications approved by the Food & Drug Administration to treat borderline personality disorder . However, some individuals with BPD are prescribed anti-anxiety medications, also known as anxiolytics,” to treat the intense anxiety and agitation associated with BPD. This is completely up to your individual doctor and your unique situation.

Like any medication, however, there are both advantages and drawbacks to treatment with anti-anxiety medications. Here are some things to keep in mind and to ask your doctor if your psychiatrist is considering prescribing anti-anxiety medications for your BPD symptoms.

Evidence For Drug Therapy

9 Things About Borderline Personality Disorder You Need to Know

Pharmacotherapy has been investigated as a stand-alone or adjunctive treatment option for borderline personality disorder. There are many high-quality reviews16,27,28 including a Cochrane review.27,29 The Cochrane group found 33 randomised controlled trials in adults with borderline personality disorder,27,29 but commented that the overall evidence base for prescribing is unsatisfactory. The literature is hampered by small trials of numerous drugs, short treatment periods , diverse outcome measures, infrequent replication of findings, and lack of independence from the pharmaceutical industry.30,31 In addition, controversy has surrounded the methods of one research group and the integrity of the findings.29

The available evidence16,2729 does not support a prominent role for selective serotonin reuptake inhibitors in the treatment of borderline personality disorder, despite their widespread use. Other drugs require further investigation. Mood stabilisers have shown some effect in reducing affective dysregulation and impulsive aggression. Antipsychotics such as aripiprazole, olanzapine and quetiapine have shown some effect in reducing cognitiveperceptual symptoms and affective dysregulation. Omega-3 polyunsaturated fatty acids might reduce the overall severity of borderline personality disorder.27

Can Bpd Be Cured

Borderline personality disorder is a complex disorder to live with and treat. It is among the most treatable personality disorders, and symptoms can be greatly reduced with consistent therapy. It cant be cured entirely, but can be well managed and treated. According to the National Alliance on Mental Illness, most people respond well to comprehensive treatment that includes medication and psychotherapy. Natural and home remedies are also used in conjunction with more traditional treatment options to help manage symptoms.

A Novel Drug For Borderline Personality Disorder

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Verified January 2020 by Jayashri Kulkarni, Professor, The Alfred. Recruitment status was: RecruitingFirst Posted : March 27, 2014Last Update Posted : January 9, 2020
  • Study Details

Borderline Personality Disorder is one of the most prevalent psychiatric disorders with high morbidity and mortality. It affects the lives of millions worldwide and is often highly incapacitating, leading to significant psychosocial dysfunction. Moreover, nearly all patients have experienced suicidal ideation and about 10% actually commit suicide, a rate almost 50 times higher than in the general population. Mostly young women are at greater risk for the disorder and are three times more likely to be diagnosed with BPD than men.

BPD aetiology is complex and could be explained by both biological and environmental factors. Among the environmental factors, sexual or physical abuse, parental divorce, loss or illnesses are identified as the most common ones. These factors can induce dysfunctional behaviours, which might cause emotional dysregulation, high impulsivity and frequent self- injurious behaviour.

Condition or disease

How Is Borderline Personality Disorder Diagnosed

Personality continues to evolve throughout child and adolescent development. Because of this, healthcare providers dont typically diagnose someone with borderline personality disorder until after the age of 18. Occasionally, a person younger than 18 may be diagnosed with BPD if symptoms are significant and last at least a year.

Personality disorders, including borderline personality disorder, can be difficult to diagnose, as most people with a personality disorder lack insight into their disruptive behavior and thought patterns.

When they do seek help, its often due to conditions such as anxiety or depression as a result of the problems created by their personality disorder, such as divorce or lost relationships, not the disorder itself.

A licensed mental health professional such as a psychiatrist, psychologist or clinical social worker can diagnose borderline personality disorder based on the diagnostic criteria for BPD in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders.

They do so by performing a thorough interview and having conversations about symptoms. They ask questions thatll shed light on:

  • Personal medical history and family medical history, especially histories of mental health conditions.
  • Previous work history.
  • Impulse control.

Mental health professionals often work with the persons family and friends to collect more insight into their behaviors and history.

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