Antipsychotic Medications for Borderline Personality Disorder

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It is common for people who suffer from Borderline Personality Disorder (BPD) to experience brief periods of psychosis, especially when they are under extreme stress. Antipsychotic medications for Borderline Personality Disorder may be prescribed to help treat or lessen the intensity of these episodes. Used in conjunction with other treatments such as psychotherapy it has proven to be effective in treating BPD.

What are Antipsychotics?

These medications work in a variety of ways; predominantly they affect neurotransmitters that allow communication between nerve cells. They bind to and block dopamine and serotonin receptors in the brain. In doing so they help patients with psychosis lead a more normal life by alleviating symptoms such as hallucinations and paranoid thoughts.

Common antipsychotic medications for borderline personality disorder include:

  1. Haldol (haloperidol)

This medication treats symptoms of dysphoria such as anxiety, rage, depression, and/or despair. It also helps in managing suicidal thoughts, self-destructive impulses and other stress symptoms, which are often present in BPD sufferers.

In terms of effectiveness, haloperidol is more effective in controlling “positive” psychotic symptoms such as delusions and hallucinations than against “negative” symptoms such as social withdrawal.

  1. Zyprexa (olanzapine)

It reduces symptoms of “psychoticism” such as depression, interpersonal sensitivity, and anger. It quite effective in decreasing moon swings, anxiety and self-injury in BPD patients. However it is known to cause massive weight gain and patients frequently complain that it causes emotional numbness and mental slowing.

  1. Clozaril (clozapine)

It is an atypical antipsychotic drug that has proved to be useful in managing both psychotic symptoms and mood disorders. Clozapine has been found to effectively reduce psychosis; self-injurious behavior (lowers risk of suicide, self-mutilation) decreases aggression and shortens the length of hospital stay for BPD patients.

  1. Seroquel (quetiapine)

Research shows this medication to be effective in treating impulsive behavior and other symptoms of borderline personality disorder such as suspiciousness, referential thinking, paranoid ideation, illusions, derealization, depersonalization, or hallucination-like symptoms. Further more it is very effective in the elderly with fewer side effects than Risperdal. Also less likely to cause weight gain.

  1. Risperdal (risperidone)

Symptoms of BPD are greatly reduced; some examples are a reduction in aggression, and decrease in depressive symptoms. This medication also effectively increases energy and global functioning in BPD patients.

Note: -

Although the above mentioned antipsychotic medications for borderline personality disorder have been shown to reduce anxiety, paranoid thinking, anger/hostility, and impulsivity in patients, it is still crucial for us to be fully informed by gathering information and educating ourselves on their possible harmful and adverse effects as well. Some antipsychotic medications for borderline personality disorder can cause massive weight gain, lower life expectancy, lower blood cell count, sexual dysfunction, an inability to sit still or remain motionless and there is also the long term risk of tardive dyskenisia.


  1. Haloperidol - What is Haloperidol?
  2. Clozapine reduces severe self-mutilation and aggression in psychotic patients with borderline personality disorder.
  3. Treatment of borderline personality disorder with risperidone _(The Journal of Clinical Psychiatry)
  4. Haldol: Medication for Borderline Personality Disorder
  5. How I Treat the Borderline Personality Disorder (BPD) and Why
  6. Borderline Personality Disorder Medications