Medication for BPD?

[Depression = 72% of members]

I'm pretty new to all of this and am still working to sort it all out. I posted the other day that my wife is starting to come around to the idea that she may have BPD, it will probably take a confirmed diagnosis from a psychiatrist (which is fine and actually I agree)... . But I'm working on what comes after that.

She is very much against "medication". She's had some bad experiences with it, and has read several articles online which suggest that long term medication for depression can actually make things worse, especially SSRI's which she was on for some time. At the moment she's not taking anything, beyond OTC allergy medication. Is she better or worse at the moment? I'm not sure... . It's hard to say. The reading I've done suggests that treating depression with medication in patients that have BPD without treating the BPD isn't that effective and personal experience suggests that's true... . She was just more "numb" on medication. She still was "tired", she still had rapid mood swings, and all the "normal" symptoms of BPD.

So, my question is, is medication usually prescribed in BPD cases? I'm hopeful about trying to find someone who can do DBT with her, assuming she gets an official diagnosis, but I'm worried that she'll resist medication based on her past experience. Is DBT or another "talk therapy" enough? I realize that each case is different, so what works for one, may not work for another, I'm just trying to get a general feel here... .

[lostandunsure]

I'm pretty new to all of this and am still working to sort it all out. I posted the other day that my wife is starting to come around to the idea that she may have BPD, it will probably take a confirmed diagnosis from a psychiatrist (which is fine and actually I agree)... . But I'm working on what comes after that.

She is very much against "medication". She's had some bad experiences with it, and has read several articles online which suggest that long term medication for depression can actually make things worse, especially SSRI's which she was on for some time. At the moment she's not taking anything, beyond OTC allergy medication. Is she better or worse at the moment? I'm not sure... . It's hard to say. The reading I've done suggests that treating depression with medication in patients that have BPD without treating the BPD isn't that effective and personal experience suggests that's true... . She was just more "numb" on medication. She still was "tired", she still had rapid mood swings, and all the "normal" symptoms of BPD.

So, my question is, is medication usually prescribed in BPD cases? I'm hopeful about trying to find someone who can do DBT with her, assuming she gets an official diagnosis, but I'm worried that she'll resist medication based on her past experience. Is DBT or another "talk therapy" enough? I realize that each case is different, so what works for one, may not work for another, I'm just trying to get a general feel here... .

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[Surnia]

Lostandunsure

as far as I know, there is no medical cure for BPD.

Some members has some good experience with medication against anxiety/depression of her SO, some not, its very individual.

Here is a article which could be interesting for you:

Treatment of Borderline Personality Disorder [New].

[maryy16]

My H has been on Prosac and Buspar for years.  No therapy... . he refuses that. While the severity of his episodes are pretty much the same, the frequency is greatly reduced.  So in that respect, for him, medication works well.

He tried going off the medication for a few months last year to see if he could handle it on his own and it was a disaster! BPD came back with a vengeance and made up for lost time!   So, in our experience, the medication absolutely has an positive impact.

[mcc503764]

Lostandunsure

as far as I know, there is no medical cure for BPD.

Some members has some good experience with medication against anxiety/depression of her SO, some not, its very individual.

Here is a article which could be interesting for you:

Treatment of Borderline Personality Disorder [New].

There is no "cure," as they can only treat the symptoms... . (anxiety, depression, mood stabilizers, etc... . ) A combination of meds with a commitment to therapy I hear is the most effective treatment... .

BUT... .

My question for the board on this one... . these meds have some pretty nasty side effects, mostly weight gain, sexual dysfunction, etc... . Now, for a disorder that highly revolves around a negative self-image, what incentive would the BPD have to consider meds for treatment?

MCC

[Cloudy Days]

Every therapist my husband has gone to has tried to get him to take medication. He has turned Manic on antidepressants too so it has always been a struggle to find one that didn't cause terrible side effects and actually did some good. He has been on almost everything and has gotten to the point where he refuses to take the medication. Honestly I have no problem with it, he was never any different on medication, except for the added side effects including 6 months of no sex! The way I see it is that they can't really take medication for the rest of their life can they? So why not learn how to deal with their issues without a pill. Going off of them can cause a heck of a lot of stress too, it's just seems unneeded since it doesn't do much but numb things. My husband is doing DBT therapy and yes therapy alone will do a lot of good it just has to be the right kind of therapy. Talk therapy doesn't do a bit of good, it has to be either Schema therapy or DBT therapy. My husband is also doing EMDR for some of his trauma. He's been going for a year without medication and I've seen a lot of improvement. Mainly in the intensity, length and frequency of his rages.

[mcc503764]

That sounds like it's working.  BIG kudos to you for having the patience and the love to support this!  That speaks volumes of you and you should definitely be commended for it!   

Unfortunately, in todays society, the drug manufacturers want to find a pill that will cure everything!  They push these pills on the doctors and schmooze them and their staff into pushing these meds on people with free lunches provided by the drug reps to the staff, and give financial kickbacks to the doctors for prescribing them... .

At the end of the day, it's all about the $$$$$

MCC

[Cloudy Days]

At the end of the day, it's all about the $$$$$

Absolutely, We have figured that out. It's sickening the amount of pills he would actually be taking if he took what they wanted him too, we wouldn't even be able to afford them. One of the side effects of the last pill was a life threatening rash and sudden death. How is that helpful to anyone?

It's been a long hard road but I am still here. It may just be that I am hard headed but I still love him so that has to mean something. He is trying and that's all I really have asked for, it did take him hitting rock bottom and the chance that he could loose me to get him to do it but he's doing it so I guess it was worth it.

[Want2know]

So that this does not become a debate about the ethics of pharmaceutical companies, let's stick to the question that has been asked regarding medication and BPD.

Here is some information that I pulled from the NIH website, just to give a general idea of how medication is used regarding treatment:

"No medications have been approved by the U.S. Food and Drug Administration to treat BPD. Only a few studies show that medications are necessary or effective for people with this illness. However, many people with BPD are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression. Often, people are treated with several medications at the same time, but there is little evidence that this practice is necessary or effective.

Medications can cause different side effects in different people. People who have BPD should talk with their prescribing doctor about what to expect from a particular medication."

Reference: www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

[sunshine40]

MY uBPDh has been on an SSRI for a few months now. It seems to help him feel better over all... . BUT when he started another downward spiral with several deregulation episodes, I talked to another friend on the same medication who gave me some great advice.

He said that the medication does not solve people's issues, but will create a new baseline to work from. They still have to work out their own other issues.

In our case medication has definitely helped. The only side effects he has had have been beneficial.

His bulimia is under control, and his libido at first was higher and has lessened back to what it was before, which is not low... . but his ideas of initiating intimacy are no longer "yell at your wife until she gives in"... . that probably had more to do with working out an issue of his, and me setting boundaries than medication... but I DO notice a new higher baseline.

Medication works differently for different people. It may help some and completely backfire for others. The question is it worth it to you to give it a try.

[waverider]

Medications can stabilize some of the extreme side issues in order that therapy can be more effective. If a patient is suffering extreme depression or anxiety then it it is hard to even attempt effective therapy.

Different meds have different success rates with different people. They do come with side effects. The big danger is that people with BPD often have greater issues with addictions and so can become addicted to these meds eg xanax and valium. This can open a new can of worms. So close supervision and monitoring is required.

[Cloudy Days]

We were told by my husbands current doctor that she doesn't prescribe benzo's to people with BPD. I'm sure there are other doctors that do though. She said that benzo's cause people with impulse control disorders to be less inhibited. My husbands first doctor gave him Xanax for two years and honestly, he did seem to have more anger problems when taking them. They would basically just make him sleep it off and if he did have a blow up on them, he remembered even less than he usually did.

[mcc503764]

We were told by my husbands current doctor that she doesn't prescribe benzo's to people with BPD. I'm sure there are other doctors that do though. She said that benzo's cause people with impulse control disorders to be less inhibited. My husbands first doctor gave him Xanax for two years and honestly, he did seem to have more anger problems when taking them. They would basically just make him sleep it off and if he did have a blow up on them, he remembered even less than he usually did.

I was told by a doctor that the problem with benzo's is that they are not only highly addictive, but that they target the same nerve center in the brain that alcohol does... .

Which makes sense if one is to instantly stop taking them, just like with drinking, they run the risk of seizures as a result from the withdrawal... .

MCC

[Cloudy Days]

That's interesting, He did have terrible withdrawals when he went off of them. They actually matched alcohol withdrawals now that I think about it.

[waverider]

Xanax has a short half life, they wear off quick and so withdrawal sets in quick, which creates the "need" quickly>>highly addictive. Valium is used to withdraw off this as it is with acohol as it is slower acting has a longer half life so the extreme kick of the high and onset of withdrawal is slower... it is easier to taper off valium than xanax.

Xanax I think is mainly for Panic disorder where quicker acting is required than simple anxiety disorder. Too much xanax will have the impression as being very drunk, and it can happen extremely quickly. Fast withdrawal will lead to seizures and is very dangerous.

pwBPD are not the most reliable patients at taking their meds strictly as per script, so close monitoring is essential. Dependency can be both physical and psychological

My partner is going through chemo due to breast cancer and the medication addiction side of it (oxycodeine/xanax in particular) are causing more issues than the physical illness itself