QUESTION:
Dear Dr. Heller,
I've been trying to find out any information about the long term use of Tegretol. I have been taking this medication for almost ten years for BPD. My mood swings were well controlled until a couple of years ago. Since then they have been getting only worse and worse.
Do the effects of the drug decrease after being on it for such a long time? My doctor does not want to take me off of it and try something new, but I think that maybe it just isn't working for me anymore. Any thoughts about this subject would be a great help.
Thank you!
ANSWER:
1) So far there are no long term risks of taking Tegretol except for
rare liver and bone marrow problems that need to be monitored regularly.
2) I don't believe Tegretol on it's own is that successful for
the BPD. The combination with Prozac is crucial. I also believe in "as needed"
medications for dysphoria (anxiety, rage, depression and despair).
http://www.BiologicalUnhappiness.com/20a.htm
and
http://www.BiologicalUnhappiness.com/dysphori.htm
explain my medical approach.
3) I haven't found that the effects decrease over time; however a
significant minority of patients develop hypothyroidism (low thyroid) from Tegretol - and
this is easily treated with
thyroid replacement.
4) I agree completely with your physician - Tegretol shouldn't be
stopped at this time!
