Mood Stabilizers for Borderline Personality Disorder (BPD)

The Benefits and Risks of Mood Stabilizers for BPD

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Mood stabilizers for borderline personality disorder (BPD) can be effective in reducing BPD symptoms, particularly emotion dysregulation and impulsivity symptoms. These psychiatric pharmaceutical medications are increasingly prescribed for people with BPD, although psychotherapy is still considered the most important form of treatment.

What Are Mood Stabilizers?

The term mood stabilizer is used to describe any medication that reduces the frequency of intense mood shifts, or lability.

Different types of medications are prescribed as mood stabilizers for BPD. Medications originally developed to treat seizures, called “anticonvulsants,” are commonly prescribed for their mood-stabilizing effects. Examples include:

  • Tegretol, Equetro (carbamazepine)
  • Lamictal (lamotrigine)
  • Trileptal (oxcarbazepine)
  • Topamax (topiramate)
  • Depakote (valproic acid, divalproex sodium)

Lithobid (lithium carbonate) is an anticonvulsant mood stabilizer that has been a mainstay of treatment for bipolar disorder for years. 

How Effective Are Mood Stabilizers for BPD?

Research is limited, but it does appear that mood stabilizers can treat some BPD symptoms effectively.

The most-studied medication is lithium. Most of those studies focused on treatment of impulsivity, but one study showed that lithium can be effective in treating BPD anger and irritation. Some studies hint that other anticonvulsant mood stabilizers may help treat mood and emotional symptoms in BPD, and a different type of medication, called atypical antipsychotics, offers an additional treatment option.

Risks and Side Effects of Mood Stabilizers for BPD

Risks and side effects of these medications can vary depending on the type of mood stabilizer you're taking. For example, each anticonvulsant mood stabilizer has its own unique side effect profile.

Lithium carbonate can cause gastrointestinal distress such as nausea and vomiting; weight gain; acne; tremors (shaking); and cognitive problems (for example, feeling that your thinking is slowed or fuzzy).

Lithium can also affect your kidneys and thyroid gland, so blood tests are required to monitor their function while you're taking this medication. Lithium can also be very toxic in high doses, so it is less likely to be prescribed for people with BPD who are at risk for suicide.

Other possible side effects with anticonvulsants include gastrointestinal complaints, weight gain, rashes, fatigue, and dizziness. In addition, some of these medications carry a risk of rare but serious side effects. For example:

  • People taking carbamazepine must be monitored for the possible development of agranulocytosis, a rare condition marked by a significant decrease in white blood cells.
  • Toxicity is also a concern with certain anticonvulsant mood stabilizers for BPD.

Questions to Ask Your Psychiatrist

Talk to your psychiatrist about any concerns you have before you start taking a mood stabilizer for BPD. Make sure you understand the risks and side effects as well as the reason(s) you are being prescribed a particular medication.

Here are some questions you might want to ask:

  • Which BPD symptoms do you expect this medication to affect?
  • Are there particular risks or side effects I should watch for?
  • How will this medication interact with other medications I'm taking?
  • How long will I need to take this medication before I start to notice its effects?
  • How long do you think I'll need to be on this medication?


American Psychiatric Association. "Practice Guidelines for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158: 1-52, October 2001.

Albers LJ, Hahn RK, & Reist C. Handbook of Psychiatric Drugs, Current Clinical Publishing Strategies, 2008.

Belli H, Ural C, Akbudak M. Borderline personality disorder: Bipolarity, mood stabilizers, and atypical antipsychotics in treatment. Journal of Clinical Medical Research: 4(5):301-308, 2012.

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