What Medications are used for BPD and what their side effects?

[Skip]

Pennsyvania area study for anyone interested in this information.

Regional Expert:
Emil F. Coccaro, M.D.
 Dept. of Psychiatry
 Eastern Penn Psych. Institute
 Medical College of Pennsylvania
 3200 Henry Ave.
 Philadelphia, PA 19129
 215-842-4192

VOLUNTEERS NEEDED FOR A BORDERLINE PERSONALITY DISORDER STUDY:
 
Do you have symptoms of feeling abandoned, anxiety, anger, feeling bad about yourself and difficulty in relationships with others? Eli Lilly is conducting a research study assessing whether the antipsychotic drug Zyprexa (olanzapine) will be effective in controlling symptoms of borderline personality disorder (BPD). The study is looking for men or women 18 to 65 years of age, with this diagnosis. The study will last-up to 24 weeks. Subjects who qualify will be closely monitored by a faculty psychiatrist and receive study medication at no charge. They will be compensated up to $600 for participation in the study. For more information, or to see if you qualify, call Louise  at 1-888-602-9900.

[Abigail]

   Thanks for the info.   don't know anyone with BPD in the Philly area.
                                                                                                                                                                  Dr. Heller sometimes uses Zyprexa for periods of dysphoria, but I think they only take it for a week.  My daugher took it for a week, I believe, and so did one of my friends who has BPD and bipolar.  One of the biggest problems with it is that it causes weight gain.  But it does help for the dysphoria.

[another_guyD]

My ex was on this. She gained weight and tried to commit suicide.

~AguyD

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[A.J. Mahari]

A word of caution here. Zyprexa has been in the news as a drug (you can read about this on lots of web sites by the way) that not only causes incredible amounts of weight gain but that is seriously being looked at and there are law suits emerging and being pursued against the drug company because of a high incidence of diabetes that appears to be associated with the drug. It is also alleged that Eli Lilly sought to supress this information.

My bpd/npd ex was on this drug. Three things, she gained a lot of weight, she got diabetes, and it DID not help her paranoid issues. It seemed to slow down the shifts in moods ever-so-slightly but otherwise was ruining her health and not really helping her emotionally.

Just my two cents worth here but I would not want to have anyone I cared about enter such a study.

[Skip]

Interesting information AJ.

I did a quick Internet search - if I understand it correctly, these are known side effects that can occur with this entire class of drugs... so your caution is very valid.  I saw one estimate that said 7-10% of patients.

The FDA said that there are tests that can be done to identify which patients are at risk. “Physicians can use the genetic information from this test to prevent harmful drug interactions and to assure drugs are used optimally, which in some cases will enable patients to avoid less effective or potentially harmful treatment choices,” ~Lester M. Crawford, Acting FDA Commissioner (12/2004)

The first lawsuit (State of Alaska vs Lilly)  alleges that the manufacturer was too aggressive in its marketing and did not disclose the risk adequately - and as a result, people have been needlessly injured. As I understand it, the state is not asking that the drug be pulled from the market.  But, who knows what's next in these things.

So clearly, if anyone is considering this route, they should be proactive with their physician about learning about the risks, the screening tests, the monitoring tests, and the alternatives.

Thanks for bringing it up.

Skippy

PS: What I looked at:
Drugs.com
Zyprexa Lawsuit
Risperdal and Seroquel Lawsuit
Psych Drug Truth
Seroquel

Zyprexa (Lilly),  Seroquel (AstraZeneca), and Risperdal (Johnson & Johnson) are the top 3 atypical antipsychotics - medicines less likely to cause side effects, such as tremors, than haloperidol, an older psychiatric drug.  Studies linking these drugs to weight gain and diabetes prompted the FDA to require warnings to doctors in 2003 and 2004.

Alaska is suing to recover money it claims it had to pay for Medicaid patients who suffered serious health problems after taking Zyprexa. The claim is that Lilly did not adequately disclose that using the drug, could lead to severe obesity, elevated blood sugar and diabetes.

Lilly claims that it met Food and Drug Administration labeling requirements; that  Zyprexa has helped 23 million people; and despite filing the lawsuit two years ago, Alaska has not restricted the use of Zyprexa and at times has sought court orders to administer the drug to Alaskans with mental illness.

Alaska is one of nine states suing Lilly over Zyprexa and the first go to trial. The others are Utah, Pennsylvania, West Virginia, Montana, Louisiana, New Mexico, Mississippi and South Carolina.

[JCohen1015]

New to BPD, previously misdiagnosed as MDD and BP II, mid-50s, meds notwithstanding, does an individual with BPD need therapy for life - very expensive - interested in experiences of others

[Tania]

With my BPD my P-doc has prescribed to different types of anti-depressants and an anti- anxiety pill.  At times I feel overwhelmed as I have to take these meds at different times of the day.  I am not sure if it is the right meds.  They definitely helped bring me out of my depression and suicidal thoughts, but how will they help with the long term battle of my diagnosis?  I am also in therapy and understand that they help me with my communication of thoughts and feelings, but I don't feel like I am really getting to the root of the rest of my problems such as splitting and impulsive activities.

[Tania]

I was on Resperadol, but I started lactating milk and it really scared me.  My P-doc took me off of it right away.  I am currently on Clonazepam, Remeron, and Effexor.  Sometimes Zoplicon if I can't sleep.

[hardatwork]

I was on Resperadol, but I started lactating milk and it really scared me.  My P-doc took me off of it right away.  I am currently on Clonazepam, Remeron, and Effexor.  Sometimes Zoplicon if I can't sleep.

My BPD "friend" (quotes because it's not clear what that means right now) also takes a regimen of Resperadol, Clonazepam, Remeron, & Effexor.  For her, it's the best combination of meds she's tried (and there have been many attempts)--it really works well for her.

[Abigail]

Depends on the doctor and what other comorbidities are present.  Remeron is a sleeping aid, not necessarily just for BPD.  My husband who has BPD, takes Prozac and Tegretol on a daily basis and uses Haldol and Risperdal or Abilify on an as needed basis.  My daughter who also has BPD, but a different type than my husband, takes Prozac on a daily basis but does not need to take the Tegretol.  She also uses Haldol on an as needed basis.  She takes Remeron for sleep and Buspar for anxiety.  And they both take either Adderall or Vyvanse for their ADHD.
Prozac and Tegretol have been shown in research studies to help those with BPD.  The use of a low dose antipsychotic like Haldol has also been studied and found to be effective.
Our doctor explains that it is not just the medication, but the dosage, sequence and timing.  And all of the comorbidities need to be treated such as anxiety, PTSD, OCD, ADHD, etc, whichever are present.  His website at www.biologicalunhappiness.com explains more about BPD and how and why he treats it as he does.  He has had a lot of success with his treatment plan.

[Karma Police]

There have been so many moments of clarity over the last two years that I am beginning to get used to a permanent look of "WOW" on my face.     This is one of those moments.

I took my D6's father, whom I now heavily suspect is BPD (of the waif-ish variety), to the emergency room for a psych eval after he told me he wanted to kill himself after I ended the relationship.  That was one of the worst days of my life.  That's the beginning of this story and how it pertains to your question.

After he finally moved out, he told me that he had started seeing a therapist (something that he actively refused to do during the tenure of our relationship) AND a psychiatrist.     They put him on Prozac--perhaps Zoloft--and Seroquel.  Forgive me for being a little slow on the uptake here, but I just put two and two together.

I would describe what took place after he left our relationship as nothing less that him being euphoric.  I couldn't understand why he had such a HUGE change.  So huge that he actually quit counseling after four sessions (why in the hell is that the magic number?) and got married four months after he moved out to someone he knew at work.  He said to me "When you know it, you just know it."

How profound.   :

So, the question remains...how has it affected him?  Well, he certainly lost inhibitions, which is a good since he was completely agoraphobic, but very bad because less than a month after leaving our house this woman was sleeping in his bed with our child in the same room (he lived in a one-bedroom apartment).  Very confusing for our two-year-old girl.  He's still an asshat, still makes wacky accusations, and still tries to engage me in these constant pissing matches.  When I ignore him, it just gets worse.

So I guess my answer is this: medication+no therapy=bad.   

[Abigail]

Antipsychotics can work as part of the BPD treatment.  But success depends on more than just using antipsychotics.  Several medications are usually needed to effectively treat BPD, along with therapy that also includes some type of cognitive behavioral therapy. 
And you need to treat all of the comorbidities as well.
   Our doctor has found a successful treatment plan that has worked very well.  So well, in fact, that people have come from all over the world to see him for their BPD.  My husband is a totally different person because of the right treatment.  And I know several others who have had some dramatic changes as well. 
   When used correctly, with the right timing, the results can be rather amazing.  But again, it's a little more complicated than simply giving someone an antipsychotic. 

  Abigail

[peacebaby]

My dbpdso takes risperdal, gabapentin, and prozac every day--I think risperdal is the anti-psychotic, but it could be the gabapentin. Anyway, the doses she takes keep her non-zombi-fied, and she has less psychotic behavior than she used to, though it still does happen sometimes. I can't imagine what she'd be like if she weren't on these meds. And at the same time, she's preparing to re-evaluate them, because ya never know, she could potentially be less symptomatic if the doses were changed or she switched or added one...

Peacebaby

[KissMyBass]

I've noticed that the person's BPD got way worse once they stop smoking marijuna. Is there any research on
marijuana and BPD? Or any other natural treatments? It seemed to be a better mood stablizer than anti-depressant/anxiety pills, without turning someone into a zombie like the pills do. But once they stopped the marijuana, their behavior became much worse physically, mentally and verbally. This continues to go on a year after they had stopped marijauna, which rules out it got worse due to THC withdrawl.

[Skip]

There is an interesting article of the state of therapies and population studies on our new website that is still under construction.  BPD Resources on the Net

My limited understanding of the role of pharmaceuticals in BPD therapy is to stabalize the patient so that  talk therapy can be undertaken.  The real healing come out of explorations of the past as well as the use of behavioral modification methods such as CBT, DBT, Schema, Mentalization, etc.

The use of drugs alone, is not seen as very affective - it just takes the edge off.  Alcohol does the same for an alcoholic.  People affected with BPD are prone to drug abuse already.

Leland Heller has made numerous statements about using drugs to treat underlying conditions that could be exacerbating BPD - like thyroid defiencies, or clinical depression, etc.

Joel Paris.MD, made the comment below about the use of pharmaceuticals in the treatment of BPD per se' last January...

"The problem is that there is no science to support polypharmacy [use of single or multiple drugs], and it's probably bad for patients," he said at the meeting. "When you give patients with classical depression an antidepressant, they may be cured in a few weeks. But you never see that in patients with borderline personality. It might take the edge off, but patients never go into remission." Paris is a professor and chair of the Department of Psychiatry at McGill University in Montreal and editor in chief of the Canadian Journal of Psychiatry. He is also a past president of the Association for Research in Personality Disorders.

If the pharmaceuticals have not yet been studied - it's probably a fair guess that herbs and alternatives have not yet been studied either.

[geroldmodel]

Well in my experience my ex-BPD would not rage as often when she was stoned... 
I doubt it would help on a long-term basis to get the "edge" off.

[Cynmari]

I have to say that my husband is much cooler to be around when he's stoned...he's always been that way for the 11 years I have known him.  As a matter of fact, I know that I have enabled him to keep on smoking because it keeps the peace for the most part around here.   When he doesn't have any, he becomes a real ass and no one wants to be around him.  That's when the real BPD traits come out...

So, maybe it's different in everyone...

C

[peacebaby]

My dbpdso takes meds for her condition, but she also self-medicates with mary jane on a regular basis. In general, it works for her--when she's feeling really anxious or depressed or she can't stop thinking in a way that makes her feel really negative, smoking some weed will calm her, get her focused on something other than her negative thought process, and then put her in a place where she can either calmly talk about what's bothering her, or say she'll think about it later when she's calm and sober 'cause in that moment she's feeling too good to ruin it.

At the same time, it's weed, so it not only takes the edge off her symptoms, it takes the edge off her drive to do stuff. But for now, I'd rather see her calm and not incredibly productive, than more productive and totally stressed out of her mind to the point of madness.

Smoking weed also takes the edge off being around her sometimes! 

Peacebaby

[black2thefuture]

this post couldn't be more true to my own experience with my gf. sometimes, i think that it's the most effective medication she's taking.

My dbpdso takes meds for her condition, but she also self-medicates with mary jane on a regular basis. In general, it works for her--when she's feeling really anxious or depressed or she can't stop thinking in a way that makes her feel really negative, smoking some weed will calm her, get her focused on something other than her negative thought process, and then put her in a place where she can either calmly talk about what's bothering her, or say she'll think about it later when she's calm and sober 'cause in that moment she's feeling too good to ruin it.

At the same time, it's weed, so it not only takes the edge off her symptoms, it takes the edge off her drive to do stuff. But for now, I'd rather see her calm and not incredibly productive, than more productive and totally stressed out of her mind to the point of madness.

Smoking weed also takes the edge off being around her sometimes! 

Peacebaby

[ian]

Cannabis can make some people more mellow while on it, and others more agitated. Of those who react well to it I have seen habitual use makes them really cranky when they stop smoking because they have lost their ability to cope with things.

I don't really think THC would help BPD. On the other hand another illegal drug called MDMA is apparently having some pretty profound (initial) results when used in psychotherapy for PTSD. I think there have been a few articles about this (Washington Post is one)