What is the role of medications in the treatment of borderline personality disorder (BPD)?

Updated: Nov 05, 2018
  • Author: Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
  • Print

Pharmacologic treatment may be necessary for impulsivity, affective instability, and psychosis. Medications are at times useful. See the following:

  • Selective serotonin reuptake inhibitors (SSRIs) are greatly preferred to the other classes of antidepressants; they can reduce impulsivity and aggression; they are less dangerous in overdose than many other psychoactive drugs; care must be taken that they do not lead to suicidality, however

  • Low-dose neuroleptics (eg, risperidone) are effective in the short term for control of transient psychotic symptoms and can decrease general agitation

  • Treatment with the opiate receptor antagonist naltrexone may reduce the duration and intensity of dissociative symptoms in a small number of patients with BPD [8]

  • Patients with BPD tend to have strong placebo responses to medication; thus, impressive short-term improvement might occur and unexpectedly fade

  • Patients with BPD commonly take overdoses of their prescribed medication; thus, tricyclic antidepressants, lithium, and other mood stabilizers must be prescribed with great caution and as part of an ongoing therapeutic relationship

  • Benzodiazepines, although helpful with anxiety, create risks of increased impulsivity and dependency

See Treatment and Medication for more detail.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!