Does sertraline treat borderline personality disorder (BPD)? 

In this article, we will discuss whether sertraline can help treat borderline personality disorder (BPD). We will also discuss some research studies and the potential benefits and risks of taking sertraline for BPD. We will also discuss how BPD is typically managed in clinical settings.

Does sertraline treat borderline personality disorder (BPD)? 

Sertraline can be used to manage borderline personality disorder (BPD), but may not be able to treat it. 

Sertraline is one of the most commonly prescribed selective serotonin reuptake inhibitors (SSRIs) approved by the Food and Drug Administration (FDA) for the treatment of depression, social anxiety, and several other mental health conditions (1,2). 

BPD is a personality disorder in which a person fails to manage their emotions. This can cause several disturbing symptoms and can affect the quality of your life. 

Sertraline is not approved by the FDA to manage and treat BPD, but it can manage some symptoms since depression and BPD might have overlapping symptoms. 

Furthermore, such patients are usually depressed and anxious, so taking sertraline, which is approved to manage these symptoms, can be beneficial for such individuals. It can also prevent worsening of BPD because of depression. 

However, sertraline is a prescription medication which should not be used without a proper prescription. If you’re concerned about your symptoms, please reach out to your provider.

What does research suggest?

Several research studies have indicated that SSRIs, including sertraline, can play a positive role in the management of BPD. 

One research study focused on the effects of SSRIs on older adults with BPD and showed that SSRIs can help manage impulsive behaviour, aggression, anger, mood swings, etc, in such individuals and are considered well-tolerated (3). The SSRIs chiefly studied were sertraline and citalopram. 

However, determining the appropriate dosage strength of these medications for BPD needs more research.

Another research study indicated that sertraline, in combination with olanzapine, an antipsychotic medication, can be effective in managing BPD in some cases (4). This suggests that sertraline can be used in combination with other suitable medications and psychotherapy for the management of BPD.

What are the benefits of taking sertraline for BPD?

The potential benefits of taking sertraline for BPD are:

Symptomatic management

Sertraline, as a selective serotonin reuptake inhibitor (SSRI), may assist in managing certain symptoms associated with BPD. This can include mood swings, impulsivity, and emotional instability, contributing to a more stabilised emotional state.

Management of BPD comorbid with Major Depressive Disorder (MDD)

Individuals with BPD often experience comorbid conditions, such as Major Depressive Disorder (MDD). Sertraline’s antidepressant properties can aid in managing depressive symptoms, which can make BPD worse.

Improving suicidal behaviour

Managing suicidal thoughts or behaviours is a critical aspect of BPD treatment. Sertraline is effective in reducing suicidal tendencies by stabilising mood and managing depressive symptoms, contributing to better prevention of suicidal thoughts in individuals with BPD. 

What are the risks of sertraline when used for BPD?

Sertraline is associated with some side effects that may affect you during the early course of treatment for BPD. these include: (5)

  • headache
  • dizziness
  • excessive tiredness
  • nervousness
  • Tremors 
  • dry mouth
  • heartburn
  • Insomnia 
  • constipation
  • diarrhoea
  • nausea
  • vomiting
  • loss of appetite
  • weight changes
  • Excessive sweating
  • Sexual side effects

Sertraline can also cause some serious side effects and might unmask psychosis in people with an underlying psychotic illness comorbid with BPD. This is why it’s important to keep an eye on your side effects and report anything unusual to your provider promptly. 

Is there any medication approved for BPD?

There is no medication specifically approved by the FDA for the management and treatment of BPD. The basic treatment approach to treat BPD in clinical settings is symptomatic management. As stated earlier, BPD and other mental health conditions can have overlapping symptoms. 

Some people may have other psychological comorbidities with BPD, which can worsen their conditions. These conditions, such as depression, anxiety, psychosis, etc., have medications to treat them. 

So, these medications can be prescribed to individuals with BPD to manage their symptoms or to prevent their condition from getting worse. The common medications that can be prescribed for BPD are: (6)

Medication ClassExamples Purpose/Effect
AntidepressantsSertraline, fluoxetine, escitalopram, citalopram, venlafaxine, etc.Address mood instability, impulsivity, and depression.
Mood StabilizersLamotrigine, lithium, etcHelp stabilise mood, and reduce impulsivity.
AnxiolyticsBenzodiazepines (diazepam, lorazepam, alprazolam, etc).Short-term relief from acute anxiety or agitation.
Buspirone Non-benzodiazepine option for anxiety.
AntipsychoticsOlanzapine, quetiapine, risperidone, etc.Address symptoms like paranoia, and hallucinations.

It is also important to note that psychotherapy is very important to manage BPD. Psychotherapy provides a supportive and structured environment to explore and understand emotions, develop coping strategies, and improve interpersonal relationships. 

The benefits of psychotherapy for individuals with BPD include: (7)

  • Improved emotional regulation.
  • Enhanced interpersonal skills.
  • Development of coping mechanisms.
  • Increased self-awareness and insight.
  • Better management of impulsive behaviours.

The management of BPD with sertraline

In my experience as a pharmacist, I have seen people with BPD get significantly better with medications and psychotherapy. However, in my healthcare experience, I have noticed that BPD can have triggers and lifestyle factors play a great role in such mental health conditions. 

If you’re leading a poor lifestyle, falling into addictions or substance abuse, maintaining a poor diet, or leading a sedentary lifestyle, your condition can worsen.

It’s quite common for people with BPD to develop symptoms of depression and anxiety, which can exacerbate suicidal ideation in such patients. Poor lifestyle factors can further increase this risk, significantly affecting the quality of your life. 

So, if you wish to get better, you have to decide to change all the things that can impact your mental health and commit to making positive changes. Medications, good lifestyle factors, and psychotherapy can help you manage BPD safely and effectively.


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  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from:
  1. Schulkens J, Bergs N, Ingenhoven T, Rosowsky E, Alphen SV, Sobczak S. Selective Serotonin Reuptake-Inhibitors for Symptom-Based Treatment of Borderline Personality Disorders in Older Adults: An International Delphi Study. Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):53-62. doi: 10.9758/cpn.2021.19.1.53. PMID: 33508788; PMCID: PMC7851470. 
  1. Jariani M, Saaki M, Nazari H, Birjandi M. The effect of Olanzapine and Sertraline on personality disorder in patients with methadone maintenance therapy. Psychiatr Danub. 2010 Dec;22(4):544-7. PMID: 21169896. 
  1. National Library of Medicine. Sertraline: MedlinePlus Drug Information [Internet]. Bethesda (MD): U.S. National Library of Medicine. Available from:
  1. Choi-Kain, L.W., Finch, E.F., Masland, S.R. et al. What Works in the Treatment of Borderline Personality Disorder. Curr Behav Neurosci Rep 4, 21–30 (2017). 
  1. Zanarini MC. Psychotherapy of borderline personality disorder. Acta Psychiatr Scand. 2009 Nov;120(5):373-7. doi: 10.1111/j.1600-0447.2009.01448.x. PMID: 19807718; PMCID: PMC3876885. 

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