BPDFamily.com

Medication cocktails

I have very mixed feelings about medication and worry that they might be making things worse instead of better . I've read that they are basically inducing a chemical lobotomy and if a patient didn't have severe mental health issues beforehand , they certainly will after being on meds . My husband would have her off meds completely if he had his way but that scares me equally as much as her being on them.

Currently my daughter is on 15mg Abilify (atypical antipsychotic )and mood stabilizers lamictil 250mg and trileptal 900mg. ( mood stabilizers) She also takes Propanolol to help manage the akisthesia she gets from the abilify .

We have just returned from her psychiatry appointment , first one since her recent hospital discharge and her Dr wants her back up to 20mg Abilify and is upping the Lamictil to 300mg ( which is apparently the mood elevator part of the mood stabilizers she's on)

My daughter isn't happy about the increase in Abilify again , she says she hates this drug as while it manages her suicidal thoughts ( she's recently said these thoughts are actually voices ) she says it also suppresses and blunts all her other thoughts and emotions too and makes her very tired all the time . She told the Dr this but he said for now his priority is to keep her safe following her recent hospitalization ( she took an overdose of her psych meds ! The irony !)

What are everyone's experiences and views on the medications used to treat this condition ?

The psychiatrist my daughter has been seeing regularly is still referring to her condition as bipolar but I just don't see it that way ... .

I feel as you do and the title of the thread 'cocktail' is very apt. Although my BPD is 33 she has only recently been diagnosed with BPD after going into crisis. She too was given a cocktail of drugs added to the codeine to which she was addicted and which I believe exacerbated many of her problems. The anti-psychotic quitiapine had horrible side effects while not seeming to do anything to help her be less psychotic.  She turned into a zombie without seeming to benefit from any of them.

Then along came another consultant and struck off most of the drugs and changed another to an old anti depressant (a very cheap one too - I'm rather cynical about some of the motivations behind prescribing the new and expensive ones) and the improvement in my daughter was almost instant. She, while still struggling in some respects and relapsing a couple of times is alert and much more 'herself'.

Everyone told me that getting the medication right is so important and from what I have observed, they were right. It is a difficult process though. My BPDd is very prone to the 'a pill for every ill mentality though and I strongly believe that less is more in this respect. Like yours, my daughter has also overdosed (once with nearly fatal results) and that is also a constant worry.

Sorry for the ramble. Not really sure I have helped answer the question either. Very late in the night here in the uk too. That's my excuse!   

This is a toughy.  We were lucky in some ways in that the situation was not life threatening so medication was not essential.  It could have been helpful as my daughter did report that she was depressed.  But the SSRIs were intolerable to her (stomach pain).  Wellbutrin made her very mean and abusive to me which was fine with everyone else (my husband, her therapist and psychiatrist) but was difficult for my mental health and it did not feel like she was getting better.  After 2-3 months of the abuse the psychiatrist said it would not get better and eventually she decided to stop the medication and was much less abusive but still making poor choices about other things .

One thing I did find helpful was to write everything down.  Eventually I wrote down every recommendation by the doctor about what to expect when.  Then I kept a daily journal of my daughter's behavior.  The psychiatrist asked my daughter to keep a mood journal to see how the medication was working but my daughter refused to do this.  She also did not take the medication regularly without reminders and since I was getting abused I was not about to remind her to do this.  My husband was a big advocate for the medication so I let him to the reminding.

I would have been pro-medication had I seen an improvement in her observable mood, but I did not.  In fact, it was worse.   But, keeping a journal , like a scientist, might help sort this out.   

Hi,

If I could turn back the clock 3+ years ago I would say "no" to drug therapy.  I said "yes" because D threatened to go farther than self cutting and said she would commit suicide. She had been in 2X a week therapy for over a year by then.  She said she wouldn't continue living in her pain the way things were.  Fast forward, beyond all the cocktails she's taken in the past three years.  :)uring her most recent hospitalization they took her off anti-depressants and put her on Abilify to supplement Lamictil.  I see a big difference in just three weeks in her ability to get to baseline after she encounters a trigger and becomes upset.  Sleeping better but has tremors and the Psychiatrist this week cut the night dose in half. I have read a lot of material on drug therapy for BPD. All medications seem to be "Off Label".  There is no "go to" medication for BPD.  The drugs will only "tone down" the racing thoughts, the black and white thinking, the depression for some people.  Hopefully, long enough to learn new ways of thinking, battling impulses, learning new coping skills to deal with the triggers and waiting until "Executive" brain development kicks in. I hope this was helpful.    

Thankyou all for your responses. I feel right now I don't have much choice , the options are to have a 16 year old who is constantly suicidal or have a 16 year old who is rather flat in affect and yawning all the time but at least getting through the day .

I think given that it's still only a few months into  this pit of hell , I need to have trust in the Dr that he knows what he's doing. Maybe a year or two from now, after she's had a chance to mature a little more, has been participating in her DBT therapy , and has had a chance to settle into her new life here  then we can review how things are looking and look to wean her off the drugs or at least reduce the doses. I'm also hopeful that she can find some success with the online school she'll be starting in August and get her grades back up as not fitting into her new school and her grades plummeting has also been a major stressor for her .i can but hope and keep my positive pants on!

I have to say I feeling exhausted all the time ! We are pretty much dealing with this completely alone . Our family are all in the UK though I do FaceTime my mum and dad regularly , and we've not been here in our new State to make good strong friends that I can share with and truely open up to. But hey ho, we brought this on Ourselves , can't be whining about it now !

Hi Yepanotherone,

My BPDD24 has been on different medicines for the last 4 years. Currently on seroquel and pristiq with some success. Lamictal improved her motivation but increased aggression was not worth it. Some tips:

Always get the same medication ... .Don't swap pharmacies some generic brands do make a difference

Warn your child re alcohol and lack of sleep

If your child's behaviour changes always check meds before anything else ...

Always keep a few extra tablets yourself in case they lose prescription etc

Medication can help but forgetting tablets can provoke a crisis

I find myself often shaking my head in disbelief that my D too is on so many meds. I have always raised my children eating whole, organic, nutritional food with no additives, preservatives and basically farm to table lifestyle.

Over the last 19 months she has been on several different combos and unfortunately I have to agree with your dr that her safety is paramount. Once things settle down a bit, therapy and meds have a chance to work well then she'll be more stable and hopefully be able to begin tapering and lessening the cocktail.

I think it is important that she be involved along with yourself in having a conversation w/the psych. on how she feels on the various meds. My d had been up to 20 mg on Abilify and HATED the way it made her feel. The doc finally listened and shook up her meds and she is doing much better now. Good luck and know there are many of us who can lend a kind ear and have walked similar paths.