Pharmacologic interventions that address the balance of 5HT and DA may serve a distress tolerance function. For example, SSRIs have been recommended as a first-line treatment for both the affective dysregulation and behavioral dyscontrol symptoms of BPD (Grossman, 2002; Soloff, 2000). Because 5HT and DA interact, it is likely that SSRIs are effective at treating emotion-based risky behavior because as the levels of 5HT in the brain are regulated, the DA levels are also stabilized. Perhaps, by increasing 5HT, and thus reducing DA levels, these drugs tend to reduce the propensity for rash action in patients. If so, they may actually facilitate the learning of adaptive emotion regulation and coping skills in the long run.
