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Re: Borderline Personality Disorder Meds tina

Posted by Elizabeth on October 13, 2001, at 17:45:37

In reply to Borderline Personality Disorder Meds, posted by tina on October 12, 2001, at 14:35:20

> What is usually given to someone who has this disorder?

Nikki is right, just about everything is effective for some people with BPD. Here are the main types of medications used for this disorder (this list is not all-encompassing):

Antidepressants: help with dysphoria, mood reactivity, impulsivity, irritability, aggression, pessimism. SSRIs, MAOIs, and Effexor are the most common ones used, and Wellbutrin and Remeron are used sometimes as well. Tricyclics are probably contraindicated since they tend not to work and may even worsen symptoms.

Mood stabilizers: help with moodiness, irritability, impulsivity. Depakote, Lamictal, and Tegretol are known to be effective, and Neurontin is used sometimes but I think it's not as popular as the other ones. Lithium sometimes works but I think not as often as the anticonvulsant mood stabilizers. MS should particularly be considered if there are features suggestive of dysphoric mania or hypomania; some researchers think that bipolar II disorder or cyclothymia in women are sometimes misdiagnosed as BPD.

Antipsychotics: the main ones used are the newer and safer "atypical" antipsychotics: Zyprexa, Risperdal, Seroquel, Geodon. They can relieve aggression and suicidal obsessions and prevent suicidal or parasuicidal acts.

Benzodiazepines: help with anxiety and agitation; may relieve dissociative symptoms but sometimes exacerbate then. The most commonly used one is probably Klonopin; Xanax should be avoided as it has triggered serious behavioral disinhibition in some people with BPD (I think Valium has too, not sure).

Stimulants (Ritalin, Dexedrine, Adderall): Sometimes ADHD (particularly in women) is misdiagnosed as BPD or occurs together with BPD. Stimulants can help with irritability, aggression, and impulsivity.

The opioid antagonist naltrexone (Trexan, ReVia) may help with self-injury. It also is used as a treatment for alcohol and opioid addictions, to relieve cravings. I don't think this drug is used all that much in BPD, but I wanted to mention it because I have encountered a couple people who used to self-injure and who felt they were really helped by naltrexone.

I hope this is helpful. Good luck to you -- it's a hard-to-treat disorder, but there are more and more treatments being recognized as effective.





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