Question:
I am bipolar and have BPD. I get severe dysphoric episodes,
usually in the evening. I am a self injurer and the
dysphoria usually drives me to cut, often very badly. I was
put on Ativan for panic attacks and to control the
dysphoria. It worked well, but I began abusing it. Now
they
won't prescribe me any benzo (I don't blame them). I need a
drug that acts very quickly and slows me down but doesn't
put me to sleep. I've been on Risperdal for the cutting,
(it
made me cut even more so they took me off it after 6 weeks)
Seroquel for sleep (it made me feel drugged and horrible,
even at a very low dose) Fluanxol for depersonalization (it
worked but the injections hurt) Zyprexa (didn't work and I
gained lots of weight) Nozinan for sleep (it doesn't work
very well and an increase in dose makes me feel drugged and
have a stuffy nose) and Loxapine (makes me feel angry and
agitated). I have also been on Celexa (drove me into a
manic
state) Effexor (did nothing till I tried to get off of it
and made then I got sick) and Lamictal (at a high dose made
me agitated)I have difficulty swallowing pills, so whatever
drug I have to take needs to be a small shape or liquid
form. I am very anti drug, and at this time do not want to
be
on a medication daily, I'd like something I can take
PRN. Would Haldol be the answer? Would it be difficult to
convince my psychiatrist to let me try it? I've heard it's
a very strong drug.
Dr. Heller's Answer:
Haldol isn’t any stronger than Risperdal, Seroquel or
Zyprexa. When a BPD patient is successfully treated
chronically with Prozac (and commonly Tegretol) Haldol
usually works within 10 minutes with no side effects for the
vast majority. I only prescribe it for prn (as needed) use.
There were studies in the 1980's that showed its
effectiveness
(http://www.BiologicalUnhappiness.com/studies.htm
), although
it hasn’t been studied for as needed use.
It’s a terrific medication for the uses you described in
your question.
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