QUESTION:

Dr. Heller:

Let me thank you for the feedback you gave me back in October 1999 (Borderline in LA). Since that time, I have found a psychiatrist to work with me regarding my BPD status. She seems to be updated on most of the BPD information and willing to listen to what I have to say regarding this disorder and my experience with it.

However, I only get maybe 5 minutes per month with her to check on med status. I am currently on Luvox (75)mg, and Risperdal (1 mg) as needed. The Risperdal works well, however, my blood pressure soars and I get pitted edema with it. The Luvox seems to work as an SSRI and I do not perceive any side effects with it.

Yet, since researching more of the information you provide, I have become more acutely aware of simple partial seizures and what they are. I have most, if not all the symptoms for this and have contacted my local epileptic foundation, receiving a referral to an epileptologist. I am unsure if I am reading TOO much into this influx of new information regarding my symptoms (psychosomatic) or if they are real.

IF they are real, then I sense there may be an increase in the type and form of seizures I may be suffering.

My question: Does Luvox INCREASE the risk of seizures? If it does, then this may explain the recent increase that I am sensing....if not, am I just now becoming aware of the symptoms or could I just be somatizing the illness? I've searched the web to see if Luvox does increase seizures but have found nothing. Thank you for your time in this matter....and mostly,

THANK YOU for the wonderful service you provide to those suffering from my illness. Blessings.

ANSWER:

First of all, thank you for your kind words and I’m thrilled you’re getting some good help.

While obviously I don’t know exactly what’s going on with you, in my experience it’s usually associated with chronic dysphoria (anxiety, rage, depression and despair). No SSRI, including Luvox, prevents this - although they will reduce the frequency. Often an epilepsy medication - also called a "mood stabilizer" is necessary. Risperdal can cause profound weight gain and fluid retention. That’s partly why I only use it on a crisis basis, and it’s usually necessary at higher doses. Tegretol is a far better choice.

The Dysphoria Instruction Sheet that I use for my patients may be useful to you. The How I treat the BPD and Why section may be of particular use to the physician.

Luvox, to the best of my knowledge, doesn’t cause seizures. However like Prozac if the generalized anxiety disorder is present, Luvox can also increase anxiety and trigger more dysphoria (anxiety, rage, depression and despair) and complex partial seizure symptoms.