QUESTION:
Dear Dr. Heller,
Thank you for your very helpful answer. According to the director of The Trauma Center, Complex PTSD is PTSD caused from chronic trauma during childhood (abuse, etc.) while PTSD is from a distinct episode. She also teaches that Complex PTSD is a little higher on the dissociation scale then PTSD.
The head of The Trauma Center is Bessel Van Der Kolk, M.D., who helped write the diagnostic criteria for PTSD in the DSM LV. (But maybe the director did not get this information from Dr. Van Der Kolk. I just assumed it. I didn't realize it wasn't common knowledge, nor that PTSD has to do with an elevated Serotonin #2 receptor - and BPD does not. Thank you for letting me know).
When I go on the Prozac and Tegretol should I get off of the Wellbutrin? I thought my doctor said the Wellbutrin will give the Prozac a boost? (I have BPD and PTSD with passing episodes of psychosis when under severe stress. I will see if I can get Haldol 2mg for this prescription as you suggested and maybe stay out of restraints). I also have Major Depression - recurrent. (Prozac never worked for me before but I will try it with the Tegretol and keep my fingers crossed). The Wellbutrin helps me focus and keeps my moods more stable, but I don't want to take unnecessary medicine if the Prozac with Tegretol will do this. (I have been worried about the Wellbutrin possibly causing seizures since my EEG was abnormal for the left temporal lobe, but Tegretol will help this).
Thank you for all the information - I think it will help me immensely.
ANSWER:
By raising serotonin levels, Prozac sometimes causes an imbalance requiring raising of
noradrenaline levels and perhaps dopamine levels. Wellbutrin can correct this problem, and
can resolve the problem of inability to achieve orgasm. I usually add it if needed.
Wellbutrin is highly unlikely to cause seizures. You may have ADHD, and the Wellbutrin may
be helping you here. Wellbutrin works for the hyperactive/impulsive type, not for the
inattention type. The criteria can be found at
http://www.BiologicalUnhappiness.com/AD-H-Dcr.htm.
Once again I reiterate that "complex PTSD" is not an official diagnosis, and
that many with the BPD did not have extensive or even mild abuse as a child. I've
observed that some specialists in one psychiatric field try to define virtually all mental
health problems as variations of their specialty. Examples would include creating multiple
"types" of ADHD, when in reality they are combining diagnoses. I suspect the
same thing is happening here with combining PTSD with the BPD.
