Selective serotonin reuptake inhibitors (SSRIs) and borderline personality disorder

Selective serotonin reuptake inhibitors (SSRIs) balance brain chemicals called neurotransmitters. Balancing these brain chemicals can relieve symptoms of borderline personality disorder such as irritability, anger, impulsive behavior, and depression.

Some examples of SSRIs that may be used to treat borderline personality disorder are:

• Sertraline (Zoloft).
• Fluoxetine (such as Prozac).
• Paroxetine (Paxil).
• Fluvoxamine (such as Luvox).
• Citalopram (such as Celexa).
• Escitalopram (Lexapro).

SSRIs are often the first medicine used to treat borderline personality disorder because they often are effective and have few side effects.¹

Side effects of selective serotonin reuptake inhibitors include:

• Nausea, loss of appetite, diarrhea, or weight gain.
• Anxiety or irritability.
• Problems sleeping or drowsiness.
• Loss of sexual desire or ability.
• Headaches or dizziness.

SSRIs can take several weeks to start working, although they may be effective sooner.

Never suddenly stop taking antidepressants. Many antidepressants should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping antidepressant medicines can cause negative side effects or a return of symptoms of borderline personality disorder.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
• A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

Citations

1. American Psychiatric Association (2001). Practice guidelines for the treatment of patients with borderline personality disorder. American Journal of Psychiatry, 158(10): 1–52.