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THE PSYCHOLOGY OF PERSONALITY DISORDERS
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Author Topic: What Medications are used for BPD and what their side effects?  (Read 94275 times)
dmiller


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« Reply #180 on: March 08, 2013, 07:52:59 AM »

My BPDh is taking mood stabilizer but not anti depressents.
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Mischeevious


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« Reply #181 on: March 08, 2013, 08:23:47 AM »

Mine has been on anti-depressants for years, I certainly notice the difference if he decides to stop for a few days ( in the narcissistic phase when he thinks there's nothing wrong with him) I wouldn't say they've improve the BPD they just stop him from being quite as volatile.
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Daveh


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« Reply #182 on: March 08, 2013, 01:05:11 PM »

My SO was on a maintenance dose of Prozac the she told me it had been prescribed for depression.

I discovered some months ago that she had chosen to come off it herself. Strangely enough I had noticed an increase in her irritability and anger about a year ago and I am guessing that was about time she stopped taking it.

I have only recently learned that she most likely surfers from BPD. She is seeing a T but wont speak to me since she started going 5 weeks ago, never mind tell me the diagnosis!

Although knowing what I do now I can still see signs of BPD in her over a year ago I do think that the Prozac probably helped balance her mood swings somewhat.
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« Reply #183 on: May 09, 2013, 01:24:40 PM »

From the Clinical Practice Guidelines for the Management of Borderline Personality Disorder, Australian Government National Health and Medical Research Council., 2013

www.nhmrc.gov.au/_files_nhmrc/publications/attachments/mh25_borderline_personality_guideline.pdf

Effects of pharmacotherapy on specific outcomes

Placebo-controlled clinical trials of the following medicines were available for meta-analysis

(Table 5.3 and Section 5.2):

• antidepressant agents including fluvoxaminen (a selective serotonin reuptake inhibitor) and phenelzine (a monoamine oxidase inhibitor)

• anticonvulsant agentso including carbamazepine, valproate,p lamotrigine and topiramate

• antipsychotic agentsq including haloperidol, a first-generation (‘conventional’ or ‘typical’) antipsychotic agent, and the second-generation (‘atypical’) antipsychotic agents aripiprazole, olanzapine and ziprasidone. No studies were identified that evaluated the use of quetiapine in people with BPD.

The findings of the meta-analyses should be interpreted with caution due to the small number of trials for most individual agents and pharmacological classes, and inconsistency between trials for some outcome measures (details in Appendix H). Wide confidence intervals for some studies suggest relatively high variance within those study samples. Included clinical trials do not capture long-term effects of treatment.

Individual agents showed mixed effects on various outcomes compared with placebo, but none showed a consistent, clinically significant benefit across most relevant target outcomes. Overall, aripiprazole achieved the most consistent benefits across several outcome measures, but other agents may be useful in the management of specific symptoms.

Findings of the meta-analyses for specific medicines included the following (versus placebo):

Among the antidepressant medicines:

–– fluvoxamine (one trial49) was associated with an improvement in BPD symptoms,

but not in anger

–– phenelzine was associated with an improvement in hostility (two trials53, 209), but not in BPD symptoms (two trials53, 209), general psychopathology (two trials53, 209), depression(two trials53, 209), anxiety (one trial53), or general functioning (two trials 53, 209).

Among the anticonvulsant medicines:

–– carbamazepine (one trial41) was not associated with significant improvements in any of the outcomes included (general psychopathology, hostility, anxiety, depression, general functioning, and interpersonal and social functioning)

–– valproater was associated with significant improvements in irritability (one trial43), depression (two trials42, 43) and in interpersonal and social functioning (one trial42), but not in anger (two trials42, 43), hostility (one trial42), or suicidality (one trial43)

–– lamotrigine was associated with a significant improvement in anger (one trial48) but not BPD symptoms (one trial207)

–– topiramate was associated with a significant improvement in general psychopathology (one trial45), hostility (one trial45), anxiety (one trial45) and in interpersonal and social functioning (one trial45), but not in anger (two trials46, 47) or depression (one trial45).

Among the antipsychotic medicines:

–– haloperidol was associated with a significant improvement in general functioning two trials53, 208), but a significant worsening of depression (two trials53, 208), and no change in BPD symptoms (two trials53, 208), general psychopathology (two trials53, 208), hostility (two trials53, 208) or anxiety (one trial53)

–– aripiprazole (one trial59) was associated with significant improvements in general psychopathology, anger, hostility, depression, anxiety, and in interpersonal and social functioning

–– olanzapine was associated with improvements in BPD symptoms (two trials55, 57), general psychopathology (two trials55, 57), hostility (one trial57) and irritability (one trial57), and general functioning (two trials55, 57), but not anger (three trials54, 55, 57), depression (one trial54), anxiety (one trial54), suicidality (two trials55, 57) or interpersonal and social functioning (two trials54, 55). Based on pooled data from four trials,54-57 olanzapine was not associated with significantly more weight gain than placebo.

–– ziprasidone (one trial60) was not associated with significant improvements in any  of the included outcomes (BPD symptoms, general psychopathology, anger, hostility, depression, anxiety, or suicidality).

The Committee determined that reliable evidence-based recommendations could not be made about the use of a particular agent to target specific outcomes where fewer than three randomized placebo-controlled clinical trials were available for meta-analysis.

General considerations for the use of pharmacotherapy in BPD

Any pharmacological treatment for a person with BPD should be part of a documented management plan and should be reviewed regularly for therapeutic and adverse effects. When selecting medicines, the prescriber and person with BPD should discuss and agree on specific goals of treatment. Before prescribing any medicine for a person with BPD, prescribers should carefully consider potential interactions with alcohol and other substances, potential drug-to-drug interactions with other prescription and non-prescription medicines, and potential adverse effects in

overdose. People with BPD are at elevated risk of attempted suicide using prescription

medicines210 (e.g. monoamine oxidase inhibitors, tricyclic antidepressant agents, lithium).

Use one medicine at a time and avoid polypharmacy. Review its efficacy and discontinue before trialling another medicine.

If medicines are prescribed to manage acute crisis, the management plan should specify dose and duration of treatment. The length of crises may vary.

Health professionals should explain to people with BPD that medicines only have a limited role in the management of BPD and may have unwanted effects.

BPD is not listed as an approved indication for any medicine licensed in Australia by the Therapeutic Goods Administration, nor is any medicine reimbursed by the Pharmaceutical Benefits Scheme specifically for the treatment of BPD.
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Undine


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« Reply #184 on: August 23, 2013, 04:02:09 PM »

I have a mother w/BPD who has sisters that display similar symptoms. They are all on Prozac and say that it has kept them from indulging in the rage episodes. They all seem much happier. They have never been in therapy and it seems to have worked wonders! Yet I have a friend w/BPD on Prozac and it has made absolutely no difference. It is such a frustrating disorder!
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Theo41
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« Reply #185 on: October 20, 2013, 08:10:07 PM »

Skip, My uBPDw has the classic behaviors as described in SWOE. At a point, about 15 years ago, she started taking Paxil. The effect was dramatic : my perception was that Paxil restored her to normal. She became the woman I married. Unfortunately, like so many others, she did not like some of the side effects especially weight gain , and ultimately discontinued use. Well, it was nice while it lasted.
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hergestridge
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« Reply #186 on: November 19, 2013, 10:05:41 AM »

Short question in addition to my (overlong) post above:

What effect will lithium have on a person that is not bipolar, but is in fact BPD?

My wife has clearly been mis-diagnosed because her doctor is not familiar with her situation. She's not even convinced herself that she is bipolar, she just talked her way to a situation where she could have "better medication", i e a bipolar diagnosis (this out of desperation apparently). Only afterwards does she realize that she may be medicating for something she does not have.
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Googie
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« Reply #187 on: January 05, 2014, 05:57:32 AM »

Has anyone had any experience with the new drug Lurasidone (Latuda)?

My daughter started taking it a little over two weeks ago and she just had her first meltdown in months which ended up with having to have her admitted on Wednesday.

I heard there were very few if any side effects so I just wanted to see what any of you might have to say.

Googie

Lurasidone (Latuda)

Prescription drug

Consult a doctor if you have a medical concern.

Treats schizophrenia and BiPolar disorder

Side effects - Warnings - How to use

National Library of Medicine

Brand name: Latuda

Pregnancy risk: Category B (No evidence of risk in humans)

Drug class: Atypical antipsychotic

Other drugs in same class: Aripiprazole, Asenapine, Quetiapine, More
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pessim-optimist
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« Reply #188 on: January 05, 2014, 06:49:11 PM »

It appears that is is not a brand new drug (we have a mention of it here from 2011):

https://bpdfamily.com/message_board/index.php?topic=145158.msg1415932#msg1415932

So hopefully some members may have some real-life reports about it...  

NAMI has a description of it from the College of Psychiatric and Neurologic Pharmacists from January 2013:

www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=51&ContentID=119465

Another site quotes that there is only minimal risk of weight-gain as a side-effect (that's a plus!)
« Last Edit: January 05, 2014, 09:49:45 PM by pessim-optimist, Reason: add info » Logged

uBPD step-daughter (adult, married w/3 kids), uBPDm, NPD-traits dad
ncmoms


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« Reply #189 on: January 12, 2014, 11:38:07 AM »

I know I'm posting in an old thread, but wanted to relay my experiences.

My DD has been on this medication roller coaster for about 2 years now, starting with Zoloft for depression, a number of anti-anxiety meds, Welbutrin, Abilify, Lexapro, lithium, and most recently Saphris.  Of all these, the Abilify was the first to show any sign of positive change in her, helping her to at least stabilize emotionally somewhat.  She still had depression, anxiety and  self harm tendencies but not as frantically.   After a suicide attempt a year ago, the hospital decided to take her off all the antidepressants and start lithium.  After about 3 weeks she was a completely different person with very few signs of the depression and anxiety.  The problem was the weight gain, and so the doctor switched her to Saphris.  Although she still exhibits all the classic signs of BPD, her suicidal ideation and self harm are almost completely gone. 
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