Medication Treatment for BPD

June 27, 2014

Due to the range of symptoms for borderline personality disorder, there is no magic pill that helps treat all who suffer from the disorder. There are, however, different types of medications that have been effective for some. Those suffering primarily from issues with perception and thought can benefit from an antipsychotic medication that helps deter feelings of paranoia and hallucinations. Mood stabilizers are likely to work best for the symptoms of unstable moods and mood swings.

How Medication Works to Treat BPD

While the FDA has not approved any specific medication to treat BPD as a whole, some medications can be helpful in managing specific symptoms. According to Psych Central, serotonin reuptake inhibitors, or SSRIs, are typically the go-to for treating borderline personality disorder. SSRIs work to alleviate symptoms of anxiety, depression, suicidal behavior, anger and impulsivity. One of the most common SSRIs is Prozac which is an antidepressant.

The Mayo Clinic explains that SSRIs work to prevent the reuptake or reabsorption of serotonin in the brain. By changing the balance of the neurotransmitter serotonin in the brain, mood is boosted.

NAMI suggests that medications like valproate may help to control impulsive actions, naltrexone is likely to deter self-injurious behavior, while omega-3 fatty acids can work to stabilize moods. Olanzapine, which is not a typical antipsychotic, has also worked in some cases to minimize symptoms of borderline personality disorder.

Many who suffer from BPD are also diagnosed with an additional mental health disorder, making treatment that much more delicate. What works for one disorder may be counterproductive in another. Here are some of the common disorders, and their percentage of frequency, that are comorbid with borderline personality disorder in their lifetime, as reported by the Psychiatric Times:

  • Mood disorders: 96 percent
  • Anxiety disorder: 88 percent
  • Depression: 71 – 83 percent
  • Alcohol and substance abuse: 50 – 65 percent
  • PTSD: 47 – 56 percent
  • Panic disorder: 34 – 48 percent
  • Eating disorders: 7 – 26 percent

It is important to have the correct diagnosis so that treatment can be tailored to fit the specific needs of each individual.

Effectiveness of Medication on BPD

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 isn’t 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.

Alternatives to Medication

Dialectical behavior therapy, or DBT, is a form of therapy that seems to be very effective in treating BPD. It was developed by Marsha Linehan and is a hybrid of traditional cognitive behavioral therapy and skills-based training that works to teach validation and mindfulness.

DBT usually works as an outpatient treatment in which sufferers of BPD are taught life skills and how to cope with their raging emotions. Individual and group therapy play a role, and therapists are typically available by phone as needed. Families are encouraged to participate also since family support is vital to recovery. This form of treatment is not necessarily used instead of medication, however, but often used in addition to it.

Medication in Conjunction With Treatment

A combination of medication and proper treatment is likely the best option in most cases of borderline personality disorder. While medication can work to soothe the intense symptoms as they occur, they address symptoms on a short-term basis and are not intended for long-term use. Medications alone will not work to treat borderline personality disorder; instead, it must be coupled with treatment.

Treatments, programs and therapies that work to teach those who suffer from BPD how to manage their symptoms in a healthy way are essential. Some will benefit from inpatient care, while others will be better served on an outpatient basis. All who learn what their triggers are, or the events, memories or situations that lead to BPD episodes, will be more successful in managing their disorder. Treatment for borderline personality disorder is very individualized, and a mental health professional is best suited to decide on the right course of treatment for the individual.

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