BPD Treatment: Antidepressants

No single medication can effectively treat Borderline Personality Disorder (BPD), but some can help ease the common BPD symptoms and make daily life more tolerable.

Antidepressants are one medicaton often prescribed to people with Borderline Personality Disorder to help reduce anger, depression, impulsivity, irritability, and self-harm.

SSRI Antidepressants for BPD

Selective serotonin reuptake inhibitors (SSRIs) and medications in a similar drug class are the most commonly prescribed medicines for BPD symptoms. These drugs include the following:

• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Sertraline (Zoloft)
• Venlafaxine (Effexor)

Pros and Cons of SSRI Antidepressants to Treat BPD

Placebo-controlled research trials using SSRIs indicate they have moderate effectiveness in addressing only anger and anxiety. In the trials, they had little impact on depression, rapid mood changes, impulse control, and aggression.

The limited effectiveness of antidepressants compared to the other two types of medication typically used to treat Borderline Personality Disorder – mood stabilizers and antipsychotics – make them the last drug of choice for some clinicians providing Borderline Personality Disorder treatment.

However, SSRIs may be helpful for the treatment of patients who don’t respond well to antipsychotics and mood stabilizers. The best use of antidepressants with BPD patients seems to be when the Borderline Persoanlity Disorder co-occurrs with major depression.

Some researchers advocate using SSRIs after numerous studies revealed genetic abnormalities related to serotonin function in the brains of patients with Borderline Personality Disorder. This research provides scientific justification for treating BPD with SSRIs, since these drugs increase serotonin activity. Researchers aren’t sure why SSRIs don’t seem as effective in Borderline Personality Disorder treatment as the other two classes of drugs. 

Side Effects of SSRI Antidepressants 

If you do take SSRIs to treat your Borderline Personality Disorder, you might experience some common side effects. These can include reduced interest in sex, lack of motivation, emotional “flatness,” and weight gain. Not everyone will experience these side effects, however, and some people feel that the benefit of the medication outweighs the unpleasant side effects. 

You should also know that there is a potential increase in suicide among depressed people taking SSRIs, especially in teenagers. 

MAOI Antidepressants for BPD  

Monoamine oxidase inhibitors (MAOIs), such as Nardil, are another class of antidepressants that may be more effective in Borderline Personality Disorder treatment than SSRIs. However, improper use of these medications can result in serious side effects, so most doctors will only prescribe an MAOI if other drugs haven’t worked and the doctor is confident that the patient will use it correctly. 

Tricyclic Antidepressants for BPD 

Lastly, there are tricyclic antidepressants, which haven’t shown to be effective in Borderline Personality Disorder treatment. This category of antidepressants includes amitriptyline (including Amitril, Elavil, and Endep) and nortriptyline (Aventyl and Pamelor). These drugs may worsen Borderline Personality Disorder symptoms in some patients.

Though antidepressants are one form of medication used to treat BPD, recent research reveals they may only be effective for people in specific circumstances. Your doctor will be able to determine whether SSRIs are a good choice for you.