Question:
I am 23, a single mom, my son is three. I live
with my mom. I need help. I was hospitalized
sept 04 and Dx with Borderline Personality
Disorder. They put me on some meds and I was
doing pretty well for a few months but now I
think my meds need changed. I am getting messed
up again. I can't think. I get moody and angry.
I hurt myself. I am in paramedic school and I
don't want this to ruin my life like it almost
did last year. I got fired and wrecked my car
and, hurt myself. right now I'm not that bad but
I don't want to get worse I want to get better
for myself and my son. I'm not sure of all the
meds they put me on in the hospital but I'm
currently on Seroquel 25mg, Lexapro 20mg,
Klonopin 1mg all at bedtime. I also have Ambien
10mg but I don't take them every night. I feel
like I'm headed downhill fast and I don't want
that. What med combinations are good for me?
I know that's hard b\c you don't know me. I
wouldn't consider myself severe, but I don't
think my meds are working anymore. I don't want
to hurt myself anymore. My Dr. is a PA and
doesn't know much about this sort of thing. I
live in a small town and don't think there is
anyone around that can help me.
Please, Please, Please Reply.
Dr. Heller's Answer:
Seroquel is great for sleep, although you're on
a minimal dose. It rarely has any positive
effect on the BPD.
Klonopin (clonazepam) can help with restless
legs syndrome and is reasonably safe at night,
but can cause a worsening of losing control of
one's behavior.
Lexapro (escitalopram) has been disappointing
for BPD treatment. It helps some people, but
is not as effective as Prozac (fluoxetine).
Ambien (zolpidem) helps many individuals with
sleep but doesn't have much effect on the BPD,
although the BPD gets worse with sleep
deprivation.
The Prozac (fluoxetine) / Tegretol
(carbamazepine) combination is unsurpassed in
terms of effectiveness and lack of side
effects. Prozac (fluoxetine) with Zyprexa
(olanzapine) is very expensive and causes
significant weight gain.
http://www.BiologicalUnhappiness.com/bpd.htm
explains how I treat the BPD and why,
particularly the as needed medications for
dysphoria (anxiety, rage, depression and
despair):
http://www.BiologicalUnhappiness.com/dysphori.htm
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