Question:
Dr. Heller,
I am diagnosed with BPD and bipolar II. At one point,
I was prescribed Tegretol, which made me have times
of distressing anger and pain in head that seemed to
come out of the blue. Seemed kind of like a seizure I
think. A different doctor took me off of it right
away and these strange occurrences stopped. I am
wondering if this means that I am allergic to
Tegretol or if, perhaps, it was caused by having the
wrong combo of meds initially. These were lithium,
Lexapro, Depakote (I believe) and probably a few
others that I cannot remember. I get intense
anger/fear dysphoria in response to triggers, but this
seemed different than the reactions on Tegretol.
Would you prefer to retry someone like me on Tegretol
and see if its effects would be more helpful this
time in combo with different meds?
Dr. Heller's Answer:
It's very unlikely that Tegretol was the
explanation.
A combination problem would be more likely as there
are considerable potential drug interactions with
that combination.
In my experience, Lexapro (while a good
antidepressant) is not as effective in the BPD as
Prozac (fluoxetine). The Prozac / Tegretol
combination has consistently been the best one.
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