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Dodgy Prescriptions: Borderline Personality Disorder and Medication

The best medicine doesn’t come on a prescription sheet. However, there are drugs that help treat specific symptoms.

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Lamotrigine: Lamotrigine has shown evidence of decreasing impulsivity in Borderline Personality Disorder. Well tolerated but unfortunately this medicine contains a ‘black box’ warning, due to its potential life threatening skin reaction

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Valproate: There is some evidence Valproate works in reducing aggression, and can also lift mood, but the data available is inconsistent. An old-fashioned drug with limited usage for BPD.

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Carbamazepine: It is commonly believed that carbamazepine has specific anti-aggressive properties. However, there is no clear evidence that it works with BPD, and its interactions with other drugs means its best avoided.

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Topiramate: There is evidence that Topiramate helps with anger, anxiety, & depression. However, it has a long list of side effects; the most problematic being excessive sleepiness and poor concentration.

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Haloperidol: A heavy duty old fashioned drug, which reduces anger, hostility, and impulsivity. Unfortunately major side effects include massive weight gain and sleepiness

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Olanzapine: A 2nd generation antipsychotic, Olanzapine It may help with dissociation or paranoia in BPD but evidence is limited. The main drawback is weight gain.

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Aripiprazole: Another 2nd generation antipsychotic used to treat Schizophrenia there is some evidence that it can also lift mood and ease depression, but evidence is again limited.

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fluoxetine: Everyone’s on prozac these days, but its proliferation is not necessarily good. Prozac can ease depression & anxiety in BPD, but improvements are modest to say the least.

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Fluvoxamine: Used primarily in the treatment of MDD, OCD PTSD & anxiety, Fluvoxamine is a very potent SSRI. It has some evidence that it diminishes anxiety in individuals with BPD.

Thats the way it should be: After all the personality is as rich and complex thing. That we could be reduced to chemical reactions is rather disappointing. Recovery is a long road out of hell, and we have to be willing to take the journey if we have a chance of getting better. When it comes to medication, be your own advocate, don’t let yourself be harassed into taking drugs which you don’t think will work; meanwhile don’t let yourself misled by those who are resolutely anti-medication full stop. Arm yourself with knowledge, self-respect, and self-reliance, and in time you’ll recognise you yourself can be your own doctor and have the best prognosis possible.

Written by

Freelance journalist writing on mental health and disability. Words have the power to shine a light on realities otherwise missed.

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