Welcome to my little BPD knowledge corner!

Here's a list of papers for using buprenorphine to treat borderline personality disorder (or treatment resistant depression).


Another paper I believe that's worth reading theorizes that BPD symptoms can be explained by a dysregulated endogenous opioid system. It described many behaviors that I've seen in myself and others with BPD. This was the first paper I read that gave me hope. Finally there was a reasonable explanation for why I behaved the way I did!
**Borderline Personality Disorder: A Dysregulation of the Endogenous Opioid System? (2010) DOI**

After reading many research papers on this topic, I determined that I thought the most effective medicine would be something that is an agonist for the mu-opioid receptor and an antagonist at the kappa-opioid receptor. There's only 1 prescription medication that fits that description, buprenorphine. However, this medication is primarily used for opioid use disorder (and sometimes chronic pain) so it can be difficult to get.

Low-dose naltrexone has some of the same effects. At low doses (between 0.5mg - 4.5mg) it has agonistic effects at the mu-opioid receptor, but no antagonistic action on any of the opioid receptors. Naltrexone at typical doses (50mg) is antagonistic for all opioid receptors, so it could potentially be helpful, but long-term use of blocking opioid receptors has health risks, like increased risk of cancer.

Another option that is both a mu-opioid agonist and a kappa-opioid antagonist is kratom. Kratom is not something I've personally looked into and I don't believe there's any research to support this. Looking online, I've seen some folks with BPD have had good effect using kratom.

Please do your own research, talk with a medical professional, and determine what the best medical treatment for your BPD is for you! Medicine is highly individualized. What has worked for someone else may not necessarily work for you. I'm wishing you the best and please don't give up on treatment for BPD. Getting better is possible!

My own personal experience with buprenorphine is that it has been life-changing. I've taken this medicine just over a year now and the effects have remained positively consistent over time at the dose that I found effective for me, 0.32mg taken sublingually daily. I no longer feel disabled by my BPD and I'm able to live my life the way I want. My relationships with others feel stable. I no longer have feelings of emptiness and my emotions feel much more stable. I am free from suicidal ideation and self-harming behaviors. I haven't noticed any side effects from taking this medicine with my current dose. However, I did experience side effects while I was finding the right dose for me. My doctor started me at 0.5mg and this resulted in nausea, vomiting, and confusion, but those were resolved by reducing my dose. I achieve a lower dose of buprenorphine by titrating a 2mg pill with 2mL of water so that I am able to take the lowest effective dose possible. I've tried several other antidepressants, mood stabilizers, and anti-anxiety medications that didn't resolve or meaningfully improve these symptoms. I've been in therapy for almost a decade and DBT has helped, but it only helped me live with these symptoms. Buprenorphine has enabled me to feel "normal," how I imagine people without BPD might feel.

**Please note that not everyone believes in freely sharing our collective scientific knowledge and the full text of these papers is not available at all links.** (hopefully only the starred ones)
I suggest using sci-hub (or a trusted mirror of sci-hub) to access these papers by either copying the DOI of the paper or the title.
Access to free and unrestricted scientific research is a human right. sci-hub has been a vital resource for finding effective medical treatments for many illnesses.