Does Fluoxetine Help You With BPD? (3 Benefits)

In this article, we will answer the question, “Does fluoxetine help you with BPD?” and its benefits. In addition, we will discuss the studies and reports supporting the efficacy of fluoxetine (Prozac).

Does fluoxetine help you with BPD?

Fluoxetine can help you with Borderline Personality Disorder (BPD). It is a selective serotonin reuptake inhibitor that can increase the serotonin levels in your brain. This action will help you deal with symptoms of anxiety, depression, and self-harm, which often coexist with BPD. A high dosage of fluoxetine is usually prescribed for BPD.

This condition does not have a drug approved by the Food and Drug Administration (FDA). Most treatments depend on the doctor’s evaluation of a patient. Nevertheless, selective serotonin reuptake inhibitors (SSRIs) like fluoxetine are one of the medications you can add to a patient’s treatment plan.

Fluoxetine may not be a primary treatment for BPD, but it has shown benefits proven by studies and reports from patients.

How does fluoxetine help you with BPD?

The effects of fluoxetine, which helps with BPD, are attributed to its ability to increase serotonin levels in the brain. SSRIs like fluoxetine regulate your mood using this method. The neurotransmitter serotonin affects mood stability, impulsive behaviors, and depressive symptoms in BPD.

When serotonin is taken back to your presynaptic neuron, this process is called reuptake. Fluoxetine works by inhibiting or blocking the reuptake process, which regulates the serotonin on the part of your brain responsible for mood regulation.

What are the benefits of taking fluoxetine for borderline personality disorder?

A treatment plan for BPD often involves a combination of medication and psychotherapy. Depending on the evaluation of your doctor, they will prescribe you fluoxetine to manage BPD. The following are the potential benefits of fluoxetine as an off-label treatment for BPD:

Reduce anxiety and depression

Fluoxetine, as an antidepressant, will help with symptoms of anxiety, depression, and self-harm. These symptoms often accompany BPD. Therefore, it can help improve your overall mood and well-being.

Reduce impulsivity and mood swings

Fluoxetine can tackle these common symptoms of BPD. It can stabilize mood swings and reduce impulsive behaviors.

Have lesser side effects and drug interactions

Most side effects caused by SSRIs like fluoxetine are temporary and mild. If you take this medication as prescribed to you by your doctor at the recommended therapeutic dose, you will rarely experience complications. However, it is still essential to ensure that the benefits of fluoxetine outweigh any risks.

Nevertheless, drug interactions for SSRIs are less compared to other medications suggested for BPD (1).

What evidence supports fluoxetine treatment for borderline personality disorder?

Research suggests that fluoxetine can help with aggression, impulsivity, affect lability, and self-harm in BPD. However, fluoxetine cannot solely manage your BPD. It doesn’t address all the symptoms of BPD, such as emotional dysregulation, identity disturbance, or interpersonal relationships. Several studies have shown positive findings on SSRIs for patients with BPD.

Since fluoxetine can influence your serotonin levels, it is found helpful for impulsive, aggressive, and suicidal patients. A placebo-controlled trial was conducted on 38 patients with BPD for several weeks. Twenty of the patients were receiving SSRI treatment for mood swings, impulsive behavior, and aggression.

It showed that SSRIs could significantly improve rapid mood shifts in women. There was only a 5% dropout rate for the experimental group because of adverse events (2). Different medications can tackle varying core symptoms.

Antidepressants can be effective for some symptoms of BPD. A 12-week trial on fluoxetine was conducted on 27 patients with BPD. The study found that fluoxetine is helpful for aggression at 20% or less. In another study on 17 patients, 9 took fluoxetine, and eight were given the placebo.

Patients taking fluoxetine showed significant improvement, while the placebo group showed none (3). The practice guideline for the treatment of BPD by the American Psychiatric Association reviewed various therapies. SSRI antidepressants were one of the drug classes used to treat BPD symptoms of affective dysregulation, impulsive-behavioral dyscontrol, and cognitive-perceptual difficulties.

Fluoxetine was able to create significant efficacy on:

• Depressed mood
• Anxiety
• Anger
• Impulsive aggression
• Self-mutilation (1)

Patients with BPD will usually try different medications or therapies. Your doctor will develop a treatment plan that may include fluoxetine if it suits your needs. With regular check-ups and monitoring, they will evaluate whether fluoxetine is an effective treatment for you.

Reports on fluoxetine will vary per individual depending on how they react to it. Nevertheless, fluoxetine has a good success rate. Some patients whose symptoms are targeted by fluoxetine will experience better results than others. A few people might also be uncomfortable or sensitive to the side effects of fluoxetine.

So, despite evidence of the efficacy of fluoxetine, it is crucial to discuss with your doctor whether it is appropriate for your condition throughout therapy.

Can fluoxetine be used for long-term treatment of borderline personality disorder?

Although SSRIs are more favorable in terms of side effects and overdose risk than other antidepressants, high doses and long-term use of fluoxetine may pose some issues. There is a lack of evidence on the safety and efficacy of fluoxetine as a maintenance or continuous treatment for BPD. Anecdotal reports stated improvement in impulsive aggression and self-harm for several years.

However, there are risks involved, with rapid return of BPD symptoms when fluoxetine is discontinued. Efficacy and tolerance to fluoxetine are less desirable after a while, with patients having to take higher dosages. Therefore, doctors will only make a clinical judgement on long-term treatment, depending on your clinical status and tolerance to fluoxetine (3).

Conclusion

Fluoxetine is not a first-line or agency-approved treatment for BPD. It doesn’t target the core symptoms of BPD. Nevertheless, antidepressants are one of the pharmacotherapies recommended for alleviating specific symptoms of BPD. In my experience as a pharmacist, patients with BPD will have differing symptoms and severity.

Some may find fluoxetine helpful if they have trouble dealing with anxiety, depression, and impulsivity. However, these results come from case to case. Fluoxetine is still an off-label treatment and will be helpful if recommended by your doctor.

References