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Medications for Borderline Personality Disorder

The following treatment guidelines are meant as a reference tool only, and are not intended as treatment advice or to replace the clinical decision-making process of psychiatrists or other health professionals who administer these treatments. In clinical practice there are often good reasons why treatment approaches differ from what is described here.


Based on the sparse amount of studies that have examined the role of medications for treating Borderline Personality Disorder, Atypical Antipsychotics and Anticonvulsants seem to show the most promise as treatments for this condition.

Among the Atypical Antipsychotics, Olanzapine and Aripiprazole have the most evidence for improving many of the symptoms of the condition, including the emotional instability, impulsivity, paranoid thoughts, and interpersonal sensitivities [ref, ref, ref]. Either of these medications would thus be considered a good first choice as a medication to add to psychotherapy. It remains unclear whether other Atypical Antipsychotics have similar effects.

In terms of Anticonvulsants, Topiramate, Lamotrigine and Valproic Acid may be effective in reducing impulsivity and aggression in Borderline Personality Disorder [ref, ref, ref].

There is some evidence that Omega-3 Fatty Acids can help treat some of the aggressivity and emotional instability of this disorder [ref]. Because this natural supplement is very safe for use, and known to offer other important health benefits, it can be recommended to all individuals who suffer from Borderline Personality Disorder.

The SSRI antidepressants by and large do not seem to be an effective class of medications for treating this disorder [ref], though Fluoxetine, which has been the most studied of the SSRIs in this respect, has been shown to have some moderate effects in alleviating impulsive aggression and hostility in individuals with Borderline Personality Disorder [ref, ref].

Individuals with Borderline Personality Disorder will often require medications for treating their other concurrent mental health conditions.