Borderline personality disorder (BPD) is a chronic mental health condition that’s marked by difficulty with emotions, unstable relationships, feelings of abandonment, dramatic mood swings, and often, anger. Though it’s not curable, BPD is very treatable. Through BPD therapy and some types of BPD medication, you can learn to manage your condition. 

Sometimes people with BPD experience suicidal ideation and thoughts of self-harm. Some forms of medication for BPD have been found effective in helping patients manage the more severe symptoms of this condition. 

It’s very important to note, though, that medication is generally most effective when used in conjunction with other forms of BPD treatment, such as one or more types of therapy such as dialectical behavior therapy or psychotherapy (talk therapy). Essentially, medication is most often used as an additional treatment, not a primary one. 

Explore the different types of borderline personality disorder medication options here. 

Types of Medications Used to Treat BPD

Many types of medications are used to successfully treat the symptoms of BPD. Even though there aren’t any FDA-approved medications to date that are specifically designated for use in treating BPD, a number of drugs have been approved for treating various symptoms of the condition. For example,  medication can successfully treat mood swings, depression, and anxiety.

Below you can review some of the more commonly used medications and learn how they work.

Antidepressants

Antidepressants are sometimes recommended to combat depressive symptoms like sadness, anxiety, and low mood in people with a BPD diagnosis. They’re generally not effective at treating anger and impulsiveness, though. Common antidepressant borderline personality disorder medications might include:

  • Nardil (phenelzine)
  • Prozac (fluoxetine)
  • Zoloft (sertraline)
  • Effexor (venlafaxine)
  • Wellbutrin (bupropion)

Antipsychotics

Antipsychotics might be suggested for people with BPD who have symptoms that include paranoia, anger, impulsiveness, and anxiety. It was the first type of medication that was tested and studied for treating BPD. Antipsychotics might be effective in reducing hostility, paranoid thought processes, impulsive behaviors, and anxiety. Commonly prescribed antipsychotics include:

  • Abilify (aripiprazole)
  • Geodon (ziprasidone)
  • Risperdal (risperidone)
  • Seroquel (quetiapine)
  • Zyprexa (olanzapine)

Mood stabilizers/anticonvulsants

Mood stabilizers, as the name implies, are prescribed to help people with BPD even out dramatic mood swings and impulsive behaviors. Commonly-prescribed mood stabilizers for those with BPD include:

  • Lithobid (lithium)
  • Depakote (valproate)
  • Lamictal (lamotrigine)
  • Tegretol or Carbatrol (carbamazepine)

Anti-anxiety drugs

Anti-anxiety BPD medication might be effective for some people who exhibit very high anxiety as part of their BPD symptoms. Some of the most commonly-prescribed anti-anxiety disorder medications used to treat symptoms of BPD include:

  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Xanax (alprazolam)
  • Valium (diazepam)
  • Buspar (buspirone)

Other BPD medications

A few other medications and holistic options have shown promise in treating borderline personality disorder as well. 

For example, vitamin C, omega-3 supplements, some dementia medications, and drugs designed to combat facial paralysis are all exciting possibilities. More research is still necessary to determine whether they’re truly viable BPD treatments.  

Possible side effects of BPD medication

As with virtually all drugs, many borderline personality disorder medications have potential side effects. Things to be aware of if you’re considering medication for BPD might include: 

  • Weight gain
  • Constipation
  • Dizziness 
  • Dry mouth
  • Substance abuse

Benzodiazepines — anti-anxiety drugs including Ativan and Klonopin — can make BPD symptoms worse in some people. Therefore, these drugs require close monitoring. In addition to being potentially habit-forming, this class of borderline personality disorder medication may increase impulsiveness and suicidal thinking.

It’s not unusual for someone with BPD to need to try several medications or combinations of medication and other mental health treatment options before they find an effective solution that works best for their unique needs.

How to Get BPD Medication

BPD medication must be prescribed by a psychiatrist. Therapists and (in most states) psychologists won’t be able to write you a prescription. They can, however, refer you to a clinician who’ll 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.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

Should You Treat BPD with Medication?

The decision whether or not to treat borderline personality disorder with medication should be made in consultation with your healthcare team. Many people have experienced substantial relief from the often-debilitating symptoms of BPD by using medication. 

For others, though, the side effects can be more troubling than the symptoms. Ultimately, medication can be a useful borderline personality disorder treatment option for some people, but it’s not the right choice for everyone.

“There are certain symptoms of BPD such as anxiety, depression, and suicidal thoughts that can be targeted through medication. Medications such as antidepressants and mood stabilizers can help decrease the intensity of these symptoms.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

Questions to ask your doctor

When you meet with your doctor or therapist about possibly treating your BPD with medication, it’s important to have your questions ready. You’ll 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 doesn’t work, what are my other options?

6. How much does this medication cost…and 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 don’t have to deal with the symptoms of BPD without help. Psychotherapy — particularly a specialized type known as dialectical behavioral therapy (DBT), 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. It’s also worth repeating that BPD medication generally works best when used in conjunction with other forms of BPD treatment.

If you don’t already have a therapist, ask your primary care physician to recommend someone with experience in treating BPD. Talkspace offers online therapy options that pair you with a qualified therapist that specializes in helping your specific condition.