Borderline personality disorder (BPD) is a mental health condition that affects a person’s ability to regulate their emotions. The treatment usually involves psychotherapy. However, a doctor may prescribe medications to help treat specific symptoms, such as depression.

BPD can cause extreme mood shifts, impulsivity, and low self-esteem. It affects a person’s ability to maintain healthy relationships with others.

Several treatment strategies, including psychotherapy and medications, may help a person with BPD.

This article reviews some of the medications that can help treat the symptoms associated with BPD.

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There is no approved drug to treat BPD in the United States or Europe, and according to a 2020 review, the current evidence does not support the use of medications to treat BPD.

Instead, the National Institute of Mental Health states that the first-line treatment for BPD is psychotherapy.

However, doctors may prescribe medications to treat the symptoms associated with the condition, such as mood shifts and depression.

A doctor may prescribe medications that fall under the following categories:

These medications can help treat:

  • anxiety
  • sleep disturbances
  • depression
  • psychotic symptoms

A study from 2016 notes that major depressive disorder and dysthymia are the conditions that most commonly occur alongside BPD. Dysthymia refers to mild, persistent depression.

The authors of a 2020 review state that antidepressants are the most commonly prescribed medications for BPD.

A doctor may prescribe:

  • selective serotonin reuptake inhibitors (SSRIs)
  • tricyclic antidepressants
  • tetracyclic antidepressants
  • monoamine oxidase inhibitors (MAOIs)

However, MAOIs are not well-tolerated and can cause adverse reactions.

According to an older article from 2013, SSRIs may effectively treat anxiety and depression, but they do not have an effect on impulsivity and aggression.

Antidepressants can take 4–8 weeks to start working, and the optimal dosage will vary depending on the person and their symptoms.

Antipsychotics are medications that doctors typically prescribe to people with psychosis but may sometimes prescribe to individuals with BPD.

Antipsychotics may help treat:

  • anxiety
  • impulsivity
  • paranoid thoughts
  • anger or hostility

Examples of antipsychotics include:

  • ziprasidone (Geodon)
  • aripiprazole (Abilify)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • olanzapine (Zyprexa)

It can take up to 6 weeks before a person notices the effects of antipsychotic medication.

Doctors often prescribe mood stabilizers to help people with BPD manage periods of mania. Some studies have shown the effectiveness of these drugs in helping the person regulate their emotions and impulse control.

Examples include:

  • lamotrigine
  • topiramate
  • sodium valproate

The person’s characteristics, overall health, and symptoms will determine the dosage.

Anxiety can be challenging to treat in those with BPD.

Anxiolytics are a type of medication that doctors use to treat anxiety and its symptoms.

A common type of anxiolytics is benzodiazepines. Some examples include:

Benzodiazepines work quickly and may relieve anxiety in the short term.

However, they carry a risk of dependency.

They can also cause the following side effects:

Another common form of anxiolytic that works slightly differently is buspirone (formerly available as Buspar). Buspirone may take 3–4 weeks to start working effectively. People generally use it to treat long-term anxiety.


Although SSRIs are a type of antidepressant, a doctor may prescribe them to help treat anxiety in those with BPD.

The Food and Drug Administration (FDA) has approved the use of SSRIs to treat anxiety disorders, such as generalized anxiety disorder and social anxiety disorder.

According to a 2021 meta-analysis in The Journal of Clinical Psychiatry, taking marine omega-3 fatty acids may help reduce the severity of BPD symptoms, such as impulsivity and the inability to regulate emotions.

A person can find marine omega-3 fatty acids in fish, such as:

  • salmon
  • mackerel
  • tuna
  • sardines
  • herring

Another option is to take marine omega-3 dietary supplements, which include:

  • fish oil
  • krill oil
  • cod liver oil

The researchers state that omega-3 fatty acids may be beneficial as an add-on therapy. However, these fats cannot replace psychotherapy or other medications that a doctor may prescribe.

A person should speak with a doctor if they would like to take omega-3 fatty acids for BPD.

Medications are not the first-line treatment for BPD. There is limited evidence to support the use of medications to treat BPD, and they can result in adverse side effects.

Therapy is the primary treatment for BPD, and a person should schedule regular sessions with the therapist.

If a doctor has prescribed medications for BPD, a person should let the doctor know if they experience any side effects.

It is also important to remember that it can take several weeks for medications to take effect.

Medications will not cure BPD, and a person will need ongoing care.

Paying for medication can be expensive.

If a person does not have health insurance, they may find it helpful to speak with a doctor or pharmacist. These professionals may be able to provide a generic substitute or recommend different medications.

Some clinics may offer reduced cost or free medications.

Individuals looking for more assistance can try to contact one of the following organizations for help:

BPD is a severe mental health condition that results in the inability to regulate emotions.

Currently, the FDA has not approved any medications to treat BPD, for which the primary treatment is psychotherapy. However, a doctor may prescribe the following medications to help treat specific symptoms of BPD:

  • antidepressants
  • antipsychotics
  • mood stabilizers

A person may also find that taking marine omega-3 fatty acids can help reduce the severity of their symptoms.