Medications for Borderline Personality Disorder — what you need to know. I’m asked this question a lot. Current international guidelines are clear: medication is not a first-line treatment for borderline personality disorder. The most effective treatments are specialist psychological therapies, particularly: • Dialectical Behaviour Therapy (DBT) • Mentalization-Based Therapy (MBT) That said, in some cases, medications may be prescribed off-label to help manage specific symptoms such as emotional