The Health Benefits And Risks Of Using Mood Stabilizers For Treating BPD

Borderline Personality Disorder (BPD) affects a little more than 1% of people in the United States, with women accounting for about three-quarters of the diagnoses (per National Alliance on Mental Illness). Those who have BPD experience unstable emotions, impulsive behaviors, and fear of abandonment.

Therapy is an effective treatment for BPD. However, this treatment is often challenging because many people drop out of therapy, according to a 2016 study in Borderline Personality Disorder and Emotion Dysregulation.

Because the mood shifts associated with BPD can be similar to those with bipolar disorder, mood stabilizers may be prescribed to help treat this aspect of BPD, according to Psychiatric Times. According to Verywell Mind, mood stabilizers fall into three main types. The first is the mineral lithium, which stabilizes the neurotransmitters in the brain. Anticonvulsants such as lamotrigine are in the second category of mood stabilizers. Originally prescribed for seizures, anticonvulsants settle excess activity in the brain and can ease depression from bipolar disorder. Antipsychotics such as Seroquel can stabilize the mania associated with bipolar disorder.

Although there is no FDA-approved treatment for BPD, research has looked into the effectiveness of mood stabilizers in reducing the severity of BPD symptoms. 

The effectiveness of mood stabilizers for BPD

A study in 2019 in BMC Psychiatry looked at a two-decade trend of prescribing medication for BPD. Because people with BPD suffer from multiple symptoms, they are often prescribed more than one medication. The study showed a decline in prescriptions for mood stabilizers, which the authors attribute to a lack of consistency in effectiveness.

However, mood stabilizers can be effective for treating impulsive behavior related to BPD. According to a 2020 review in Psychiatric Quarterly, mood stabilizers were found to be more effective than antidepressants for impulsivity. A 2009 study in Journal of Personality Disorders found that mood stabilizers can also be effective for moderating anger.

Some experts recommend against mood stabilizers for long-term care because of the risk of side effects (per BMJ). The Psychopharmacology Institute advises caution when prescribing mood stabilizers for patients with BPD, but suggested lamotrigine can help with mood instability.

The side effects of mood stabilizers vary according to medication. According to the National Institute of Mental Health, some side effects include slurred speech, excessive thirst, tremors of the hands, and swelling of the limbs or face. Lithium, for example, can tax the kidneys if you're dehydrated or too much of the mineral is in your system.

Individual medications have specific side effects, so be sure to read the literature from your pharmacist. You should also take the medication as instructed since doing otherwise might increase the risk of side effects.