From the Research
The most effective treatment for borderline personality disorder (BPD) is psychotherapy, particularly dialectical behavior therapy (DBT), and medication should only be used as an adjunct to treat comorbid disorders, with selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or sertraline being commonly prescribed for comorbid depression, anxiety, and emotional dysregulation 1.
Medication Options
- Antidepressants: SSRIs like fluoxetine (20-80mg daily) or sertraline (50-200mg daily) may help with comorbid depression, anxiety, and emotional dysregulation 1.
- Mood stabilizers: lamotrigine (typically 100-200mg daily) and topiramate (50-200mg daily) may help with mood swings and impulsivity, although evidence is limited 2.
- Antipsychotics: quetiapine (50-300mg daily) may be used for short-term treatment of acute crisis in BPD, consisting of suicidal behavior or ideation, extreme anxiety, psychotic episodes, or other extreme behavior likely to endanger a patient or others 1.
Important Considerations
- No single medication is FDA-approved specifically for BPD, and medication treatment should be individualized and monitored regularly for effectiveness and side effects 1, 3.
- Psychotherapy, particularly DBT, is the primary treatment for BPD, and medication should only be used as an adjunct to treat comorbid disorders 1, 3.
- Polypharmacy and the use of unsafe drugs should be avoided, and the prescription of medications should be considered only as an adjunct to BPD-specific psychotherapy 3.