What Medications Are Successful at Treating the BPD and What Are the Side Effects?

Written by Dr. Leland Heller

QUESTION:

Borderline Personality Disorder: What medications are successful in treating this and what about side effects?

DR. HELLER'S ANSWER:

There are extensive discussions on the subject on this Website. The instruction sheet I use for my patients is available here.

The dysphoria instruction sheet I use for my patients is available here.

Medication induced sexual dysfunction is discussed at length in my new book "Biological Unhappiness." It can usually be safely treated with the herb ginkgo.

If Prozac or other SSRI's cause hyperness or other side effects, the generalized anxiety disorder is usually to blame. It's discussed at length in "Biological Unhappiness" as well. There seems to be an imbalance of serotonins - some too high and some too low. SSRI's raise all of them, causing an increase in the high ones as well which worsens anxiety symptoms. BuSpar is the key medication here.

There seems to be a subset of the BPD with chronic or frequent dysphoria (anxiety, rage, depression and despair), panic, GAD, and carbohydrate cravings. They are very difficult patients to treat. I've had some success recently by initially starting Effexor, followed a few weeks later by Remeron, followed then by the usual treatments I recommend.

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