Starting on page 209 of The Angry Heart I talk about medications that can help with BPD symptoms. Understand that no medications that have been specifically approved to treat BPD. A variety of medications are used to treat symptoms associated with BPD. These include anti-depressants, mood stabilizers, anti-psychotic medications, and anti-anxiety medications.

In general, it is best to try one medication at a time to determine whether it is helping you to feel better without creating unacceptable levels of side effects. People with BPD should avoid taking addictive medications such as ativan, valium, klonapin and xanax as you may become dependent on them and require ever higher doses. If debilitating anxiety is a problem for you and it leads to poorly thought out decisions then a low dose of risperdal, zyprexa or seroquel is a better choice because they are effective and non-addictive. Another option, and one I would suggest as a starting point is a combination of Zoloft and buspar both non-addictive. The combination (you need to take both at the same time) will help to manage anxiety and depressive symptoms. The side effects are generally mild and they are not addictive. Finally, a natural remedy called SAMe, available at health and food stores, is very effective for managing depression and anxiety. It is non-addictive and is virtually side effect free. I recommend trying it at a dose of 300 to 600 mg for one week to see if it helps you. Do not take it with any other anti-depressant medications.

Avoid starting two or more medications (unless it is the Zoloft/Buspar combination) at the same time. You will not know which is effective and may end up taking more medication then you really need. Remember, no medication will "cure" BPD. The goal of medication is to help reduce symptoms that are interfering with your progress in therapy. As you make progress you should need less medication.

In our residential program we have admitted people with BPD who were on up to seven psychotropic medications. Despite these medications they were still very troubled. The medications were not helpful but they were still told to take them. Worse still some were on high dosages of potentially addictive medications (e.g., xanax, klonapin) which they had become dependent upon. This created another problem for them. Yes these medications made them feel better initially but after months on them they needed more medication and got less benefit. Our treatment team's first goal was to get them off these and other medications to find out what they really needed. So do yourself a favor, avoid addictive anti-anxiety medications.

I suggest you read the medication section of The Angry Heart for a more extensive discuss (pages 209 to 213). You can get more medication information from the psychopharmacology section of our Pocket Guide to Behavioral Health Treatment. Of course, the final choice of what medications to try is a decision that only you and your doctor should make.