Atypical antipsychotics and borderline personality disorder
Antipsychotic medicines that might be used to treat symptoms of borderline personality disorder include olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel).
These medicines help stabilize certain brain chemicals called neurotransmitters, which control emotions and behavior. Balancing these brain chemicals may reduce symptoms of borderline personality disorder.
Olanzapine
Olanzapine acts as a mood stabilizer and can help you avoid the reckless and impulsive behaviors associated with borderline personality disorder. Olanzapine may be used in combination with other medicines, such as mood stabilizers like lithium or valproate.
The most common side effects of olanzapine are dry mouth, constipation, weight gain, drowsiness, and shakiness. It can sometimes cause slurred speech or low blood pressure that makes you feel dizzy when you stand up. Less common side effects include headaches or a skin rash caused by an allergic reaction to the medicine.
Risperidone
Risperidone is often used in people who have not improved with other medicines. It has fewer side effects compared with other available drugs. It is often used successfully to treat symptoms of psychosis.
Risperidone may cause sleepiness, weight gain, and breast tenderness. Unusual side effects include an allergic reaction that causes a skin rash, headaches, constipation, decreased sexual desire and function, and an irregular heartbeat. Risperidone may also be linked to an increased risk of stroke in older adults.
Quetiapine
Quetiapine has been used to treat the loss of touch with reality (psychosis) and other problems associated with schizophrenia. Initial research shows that it may also be useful in treating impulsive behavior or other symptoms of borderline personality disorder.
Quetiapine can cause side effects such as tiredness, headaches, dizziness, rash, fever, weight gain, dry mouth, and other flu-like symptoms.
What to think about
Olanzapine, risperidone, and quetiapine may be associated with an increased risk of adult-onset diabetes and high cholesterol. Your doctor may watch your blood sugar and cholesterol levels if you are taking any of these medicines. All of these medicines carry a small risk of a movement disorder called tardive dyskinesia.
The makers of Risperdal (risperidone) have issued a warning stating that older adults who are taking this medicine may have an increased risk of stroke. Discuss this risk with your doctor before trying Risperdal.
Before taking olanzapine, risperidone or quetiapine, be sure to tell your doctor whether you have other medical problems, because this may not be the right type of medicine for you. These medicines generally are not recommended if you are pregnant or have had a condition called neuroleptic malignant syndrome.
Antipsychotics should be started at a low dosage. Talk with your doctor about any other medicines you are taking to make sure there are no negative drug interactions. While taking an antipsychotic medicine, your doctor may need to test your blood now and then to check how well your liver is working. Your blood pressure should also be checked.
Avoid herbal stimulants (such as ma huang, ginseng, or kola) while taking an antipsychotic medicine.
Talk to your doctor or pharmacist about drinking grapefruit juice while you are taking an antipsychotic medicine. Grapefruit juice can increase the level of these medicines in your blood. Having too much medicine in your blood increases your chances of having serious side effects.
| Author: | Jeannette Curtis | Last Updated: March 26, 2007 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry | |
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