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Author Topic: TREATMENT: Medications  (Read 9898 times)
Skippy
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« on: July 12, 2006, 08:20:39 AM »

Updated: December 2017
National Institute of Mental Health
A brief overview that focuses on the symptoms, treatments, and research findings.

https://bit.ly/2dXGG2V

Borderline personality disorder is a mental illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.

Treatment

Borderline personality disorder has historically been viewed as difficult to treat. But, with newer, evidence-based treatment, many people with the disorder experience fewer or less severe symptoms, and an improved quality of life. It is important that people with borderline personality disorder receive evidence-based, specialized treatment from an appropriately trained provider. Other types of treatment, or treatment provided by a doctor or therapist who is not appropriately trained, may not benefit the person.

Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with borderline personality disorder and their loved ones to be patient and to receive appropriate support during treatment.

Psychotherapy

Psychotherapy is the first-line treatment for people with borderline personality disorder. A therapist can provide one-on-one treatment between the therapist and patient, or treatment in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to effectively express themselves.

It is important that people in therapy get along with, and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist.

Two examples of psychotherapies used to treat borderline personality disorder include:

  • Dialectical Behavior Therapy (DBT): This type of therapy was developed for individuals with borderline personality disorder. DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help:
            Control intense emotions
            Reduce self-destructive behaviors
            Improve relationships
   
  • Cognitive Behavioral Therapy (CBT): This type of therapy can help people with borderline personality disorder identify and change core beliefs and behaviors that underlie inaccurate perceptions of themselves and others, and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.

Medications

Because the benefits are unclear, medications are not typically used as the primary treatment for borderline personality disorder. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms such as:

    mood swings
    depression
    other co-occurring mental disorders

Treatment with medications may require care from more than one medical professional.

Certain medications can cause different side effects in different people. Talk to your doctor about what to expect from a particular medication. Read more in NIMH’s Mental Health Medications health topic.
« Last Edit: March 07, 2019, 10:04:30 PM by lbjnltx, Reason: Updated information » Logged


Skippy
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« Reply #1 on: July 12, 2006, 09:06:49 AM »

Updated: March 2019
Medications Studied and Used in the Treatment of Borderline Disorder+
Robert O. Fiedel, MD
https://bit.ly/2XKNCHa

Antipsychotic Agents

This is one of most useful classes of medications for the treatment of patients with borderline disorder.27 They are most commonly used to treat other mental illnesses, especially bipolar disorder and schizophrenia. However, when prescribed at lower doses than used for these two disorders, these agents also have been found to be quite useful in the treatment of many patients with borderline disorder. This class of medications is the most rational starting point for pharmacotherapy in patients with borderline disorder who have cognitive-perceptual symptoms such as a suspiciousness, paranoia, split (all-or-nothing) thinking, and dissociative episodes. The size of these therapeutic effects are often moderate to large. Studies suggest that Abilify has the largest effect size in this class, and that the effects are sustained over an extended period of time.29

If one or more cognitive-perceptual symptoms are present and respond well to an antipsychotic agent, but other symptoms such as impulsivity and poor emotional control persist, the addition of another medication from the class of mood stabilizers discussed below is indicated.

Special Notes: Some patients are concerned about taking a medication that is typically used for people with severe mental illnesses. Also, some physicians are reluctant to prescribe this class of medications because of a specific side effect that they may produce called tardive dyskinesia. This is an abnormal, involuntary movement disorder that occurs in patients typically receiving average to large doses of these agents.

To my knowledge, there is no scientific evidence that indicates these medications, as typically used in patients with borderline disorder, cause tardive dyskinesia. Nonetheless, although the risk appears to be minimal, it should be noted. The new agents in this class appear to carry a lower risk of causing tardive dyskinesia when prescribed at the usual doses for patients with other mental illnesses. Therefore, these newer medications are now more commonly prescribed for patients with borderline disorder than are the ones originally used.

Both older and newer subtypes of medications in this class may produce other side effects. These vary with the medication being used, and include weight gain, nausea and other GI symptoms, headache, drowsiness, insomnia, breast engorgement and discomfort, lactation, and restlessness. Some of these, and other side effects, are temporary, and others may be persistent, requiring a change in medication.  Because Latuda appears to produce less side effects such as weight gain and high lipid levels, I will often begin treatment with this medication. Although its effectiveness for borderline disorder has not yet been reported in the scientific literature, I have found it to be effective for the same symptoms as the other SGA’s mentioned. In addition, because it’s side effect profile is more tolerable for many patients, I have observed that  acceptance of the medication appears to be  higher. Before you start on any antipsychotic agent, or any medication for borderline disorder, you should review its side effect profile with your psychiatrist.

Mood Stabilizers

Another class of medications, referred to as mood stabilizers, has been shown to significantly reduce certain symptoms in patients with borderline disorder.27 These symptoms include impulsivity, anger, anxiety, depressed mood, and general level of functioning. The size of these therapeutic effects range from moderate to large.

Mood stabilizers do not reduce suspiciousness, split-thinking, dissociative episodes and paranoia in borderline disorder. When these symptoms persist after others improve with mood stabilizers, the addition of, or replacement with, an antipsychotic agent is indicated. if the symptoms responsive to antipsychotic agents are controlled, but other symptoms of the disorder persist, I will add a mood stabilizer to the antipsychotic agent in use.

The most commonly used and effective mood stabilizers for borderline disorder are topiramate (Topamax) and lamotrigine (Lamictal). These medications are also referred to as antiepileptic drugs because they are commonly used for people suffering from partial complex seizure disorder. Partial complex seizure disorder has its origin in the  medial temporal lobes of the brain, a brain region important in the generation of emotions and theMike control of impulsive behavior.

Weight gain does not appear to present a problem with Topamax, which may acutally normalize weight in some patients, or with Lamictal. The latter medication rarely may result in a serious dermatological problem, especially if the dose is raised too quickly.

Other Medications

SSRIs

Although recommended in the the Guideline for the Treatment of Borderline Personality Disorder published by the American Psychiatric Association in 2001,30 research since then has failed to demonstrate the effectiveness of SSRIs in treating the core symptoms of the disorder.27 Their primary use now in borderline disorder is in the treatment of co-occurring major depressive disorder, if present.

MAOIs

Another class of antidepressants, the monoamine oxidase inhibitors (MAOIs), may be useful in patients with borderline disorder who are resistant to antipsychotics and mood stabilizers. Two studies of the MAOI phenelzine (Nardil) have suggested that it may be effective in some patients.27 However, orally administered MAOIs have the potential to produce very serious, even life-threatening side effects if used improperly. Therefore, some physicians use an MAOI for patients with borderline disorder only after other medications have been tried, and the physician feels confident that the patient will follow the necessary rules that have been clearly outlined to him or her. A new skin patch delivery form of an MAOI (ENSAM) given at its lowest dose appears to eliminate the usual dietary concerns involved in orally administered MAOIs.

Tricyclic Antidepressants

The tricyclic antidepressants amitriptyline (Elavil, Amitril, Endep) and nortriptyline (Pamelor, Aventyl) may worsen the condition of people with borderline disorder. These and other tricyclic antidepressants should be used with caution in patients with borderline disorder.

Antianxiety Agents and Sedatives

Anxiety, irritability, agitation and poor sleep are common symptoms of borderline disorder. In other disorders, the benzodiazepines are frequently used for these symptoms. These include diazipam (Valium), alprazolam (Xanax), temazepam (Restoril), flurazepam (Dalmane), and triazolam (Halcion). These medications should be used with caution in patients with borderline disorder because of their high addictive potential and a reported capacity to increase impulsive behavior in patients with the disorder.

However, it has now been observed that in patients with borderline disorder who continue to have symptoms of anxiety, irritability and difficulty sleeping, buspirone (BuSpar) is effective in reducing these symptoms when they do not respond to SGA’s and Mood Stabilizers.

Some patients with borderline disorder also experience adverse responses, such as impaired perceptions and greater sleep deterioration, to the non-benzodiazepine sedatives such as zolpidem (Ambien). Therefore, if these medications are prescribed for you, be aware of this possible problem.
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Skippy
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« Reply #2 on: July 12, 2006, 09:54:41 AM »

Updated: March 2019
Three classes of medications have been found to be useful in reducing the core symptoms of borderline disorder:

 Bullet: important point (click to insert in post) Antipsychotic Agents
 Bullet: important point (click to insert in post) Mood Stabilizers
 Bullet: important point (click to insert in post) Antianxiety Agents
 Bullet: important point (click to insert in post) Nutraceuticals


Antipsychotics (FGAs; Neuroleptics)

Symptoms Improved: mood dysregulation (labile & hyper-reactive), self-injury, suicide attempts, hostility, assaultiveness, illusions, suspiciousness, paranoid thinking, psychoticism, poor general functioning.

  • thiothixene (Navane)
  • haloperidol (Haldol)
  • trifluoperazine (Stelazine)
  • flupenthixol (Depixol)

Atypical Antipsychotics (SGAs)

Symptoms Improved:severity, anxiety, anger/hostility, depression, self-injury, impulsive aggression, suspiciousness, paranoid thinking, split thinking, personal sensitivity, interpersonal problems, positive, negative, and general symptoms

  • olanzapine (Zyprexa)*
  • aripiprazole (Abilify)*
  • risperidone (Risperdal)°
  • quetiapine (Seroquel)°
  • lurasidone (Latuda)°
  • clozapine (Clozaril)°

Mood Stabilizers:

Symptoms Improved: unstable mood, anger, irritability, anxiety, depression, impulsivity, interpersonal problems

  • Antiepileptics
  • topiramate (Topamax)
  • lamotrigine (Lamictal)
  • divalproate (Depakote)

Antianxiety agent:

Symptoms Improved: anxiety, irritability, depression, agitation

  • buspirone (BuSpar)

Nutraceutical Agent

Symptoms Improved: severity, anger, depression, aggression

  • omega-3 fatty acids
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lbjnltx
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« Reply #3 on: July 12, 2006, 09:17:35 PM »

Updated: December 2016
Clinical Practice Guidelines for the Management of Borderline Personality Disorder, Australian Government National Health and Medical Research Council.,
https://bit.ly/2J1R8d0

Effects of pharmacotherapy on specific outcomes

Placebo-controlled clinical trials of the following medicines were available for meta-analysis
(Table 5.3 and Section 5.2):

       
  • antidepressant agents including fluvoxaminen (a selective serotonin reuptake inhibitor) and phenelzine (a monoamine oxidase inhibitor)

  • anticonvulsant agentso including carbamazepine, valproate, lamotrigine and topiramate

  • antipsychotic agents including haloperidol, a first-generation (‘conventional’ or ‘typical’) antipsychotic agent, and the second-generation (‘atypical’) antipsychotic agents aripiprazole, olanzapine and ziprasidone. No studies were identified that evaluated the use of quetiapine in people with BPD.

The findings of the meta-analyses should be interpreted with caution due to the small number of trials for most individual agents and pharmacological classes, and inconsistency between trials for some outcome measures. Wide confidence intervals for some studies suggest relatively high variance within those study samples. Included clinical trials do not capture long-term effects of treatment.

Individual agents showed mixed effects on various outcomes compared with placebo, but none showed a consistent, clinically significant benefit across most relevant target outcomes. Overall, aripiprazole achieved the most consistent benefits across several outcome measures, but other agents may be useful in the management of specific symptoms.

Findings of the meta-analyses for specific medicines included the following (versus placebo):

Among the antidepressant medicines:

       fluvoxamine (one trial49) was associated with an improvement in BPD symptoms, but not in anger

phenelzine was associated with an improvement in hostility (two trials53, 209), but not in BPD symptoms (two trials53, 209), general psychopathology (two trials53, 209), depression(two trials53, 209), anxiety (one trial53), or general functioning (two trials 53, 209).

Among the anticonvulsant medicines:

       carbamazepine (one trial41) was not associated with significant improvements in any of the outcomes included (general psychopathology, hostility, anxiety, depression, general functioning, and interpersonal and social functioning)

valproater was associated with significant improvements in irritability (one trial43), depression (two trials42, 43) and in interpersonal and social functioning (one trial42), but not in anger (two trials42, 43), hostility (one trial42), or suicidality (one trial43)

lamotrigine was associated with a significant improvement in anger (one trial48) but not BPD symptoms (one trial207)

topiramate was associated with a significant improvement in general psychopathology (one trial45), hostility (one trial45), anxiety (one trial45) and in interpersonal and social functioning (one trial45), but not in anger (two trials46, 47) or depression (one trial45).

Among the antipsychotic medicines:

       haloperidol was associated with a significant improvement in general functioning two trials53, 208), but a significant worsening of depression (two trials53, 208), and no change in BPD symptoms (two trials53, 208), general psychopathology (two trials53, 208), hostility (two trials53, 208) or anxiety (one trial53)

aripiprazole (one trial59) was associated with significant improvements in general psychopathology, anger, hostility, depression, anxiety, and in interpersonal and social functioning

olanzapine was associated with improvements in BPD symptoms (two trials55, 57), general psychopathology (two trials55, 57), hostility (one trial57) and irritability (one trial57), and general functioning (two trials55, 57), but not anger (three trials54, 55, 57), depression (one trial54), anxiety (one trial54), suicidality (two trials55, 57) or interpersonal and social functioning (two trials54, 55). Based on pooled data from four trials,54-57 olanzapine was not associated with significantly more weight gain than placebo.

ziprasidone (one trial60) was not associated with significant improvements in any  of the included outcomes (BPD symptoms, general psychopathology, anger, hostility, depression, anxiety, or suicidality).

The Committee determined that reliable evidence-based recommendations could not be made about the use of a particular agent to target specific outcomes where fewer than three randomized placebo-controlled clinical trials were available for meta-analysis.

General considerations for the use of pharmacotherapy in BPD

Any pharmacological treatment for a person with BPD should be part of a documented management plan and should be reviewed regularly for therapeutic and adverse effects. When selecting medicines, the prescriber and person with BPD should discuss and agree on specific goals of treatment. Before prescribing any medicine for a person with BPD, prescribers should carefully consider potential interactions with alcohol and other substances, potential drug-to-drug interactions with other prescription and non-prescription medicines, and potential adverse effects in overdose. People with BPD are at elevated risk of attempted suicide using prescription medicines 210 (e.g. monoamine oxidase inhibitors, tricyclic antidepressant agents, lithium).

Use one medicine at a time and avoid polypharmacy. Review its efficacy and discontinue before trialing another medicine.

If medicines are prescribed to manage acute crisis, the management plan should specify dose and duration of treatment. The length of crises may vary.

Health professionals should explain to people with BPD that medicines only have a limited role in the management of BPD and may have unwanted effects.

BPD is not listed as an approved indication for any medicine licensed in Australia by the Therapeutic Goods Administration, nor is any medicine reimbursed by the Pharmaceutical Benefits Scheme specifically for the treatment of BPD.
« Last Edit: March 07, 2019, 10:04:30 PM by lbjnltx, Reason: Updated information » Logged

 BPDd-13 Residential Treatment - keep believing in miracles
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« Reply #4 on: July 20, 2006, 11:00:07 AM »

My BPD husband tried prozac - no noticeable difference.  Then he switched to Wellbutrin and Risperdol .  The doc (family clinician not psychiatrist) insisted that he needed to take it for the rest of his life if he wants to avoid being imprisoned.

I'm amazed we're finally living the life we dreamed of.  The crazy rollercoaster ride stopped, It's a miracle.
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bianda
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« Reply #5 on: December 13, 2006, 10:17:27 PM »

The doctor just added Topamax to my BPDD's meds... .she is taking Effexxor XR.  The doctor is trying to address the rapid cycling mood swings that BPDD exhibits and the binge eating.

Has anyone observed positive results with the use of Topamax?

I appreciate your input... .

Thanks,

Bianda :Smiling (click to insert in post)
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msrose
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« Reply #6 on: December 14, 2006, 02:48:12 AM »

Updated: December 2019


This site is good for getting user responses on drugs:
https://www.drugs.com/topamax.html
« Last Edit: March 07, 2019, 10:04:30 PM by lbjnltx, Reason: Updated information » Logged
trinity_n_fl
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« Reply #7 on: December 14, 2006, 07:22:02 PM »

I was given Topamax for a few weeks and I had to stop it. First, I would sleep an entire day every time they increased the dose. By the third week, I couldn't read out loud, which is very important for my line of work. Some folks call it Stupimax, and I can see why! But everyone's different. One of the good things is that one can lose weight on Topamax. Most psych meds cause weight gain, so that's a plus.
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bianda
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« Reply #8 on: December 14, 2006, 08:47:49 PM »

Thanks for the info.  I have been online looking in on this med. and everything talks about the weight loss, which in my BPDD's case is a good thing because she is a binge eater.  In addition, I read how it is also used to treat migraines which again in her case she also suffers. Also, it has been used with alcohol abusers which is my BPDD's drug of choice.  She demonstrates the rapid cycling Bipolar type and the Topamax is recommended for that particular type.  I know with any medication it is hit or miss because of biological differences so I can only keep my fingers crossed and hope this is the one that matches her.  I did read something about it being dopamax because it makes people act like dopes but I am hoping that won't be the case for her.  Whatever wiring is screwed up in her head I am hoping this med. will reconnect for her.  

Also she has an appointment next Tuesday with a therapist who specialiizes in DBT.  Let's hope she goes as he is an hour away from her college.  

Bianda
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mr_anderson1
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« Reply #9 on: December 15, 2006, 01:22:24 PM »

Mine takes topomax and it hasn't made her stupid or anything. Come to think of it, she is sleeping better. Her migrains have been reduced to one every 1 or 2 months. Both good and bad as I did enjoy the calm times when she's incapacitated. 8)

She has lost weight which has improved her mood immensly. I haven't noticed any change in her uBPD symptoms because of it, but she is working on them separately, without talking about it, by herself.  :Smiling (click to insert in post)
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HarvestJ
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« Reply #10 on: December 18, 2006, 11:06:56 AM »

My BPDwife takes Topamax for migraines, and it has helped to reduce their frequency, duration, and intensity. Her doctor is a very observant, sometimes I think sneaky, health care provider. I wonder if he doesn't suspect BPD and thought the Topamax might have an added benefit of a mood regulator. If so, he's a smart man.
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« Reply #11 on: November 07, 2007, 03:48:10 AM »

The BPD in my life has decided to go off Paxil and is currently drug-free.  He's also decided to forego therapy, as "there's nothing wrong him - it's the rest of the world that doesn't know the difference between Right and Wrong as he does).

My question is, since he's off Paxil, was that really the wrong drug for him to be taking anyways?  He wasn't THAT great on Paxil, except that he didn't care about much and had less 'highs' and 'lows', for the most part.

I wanted to throw this Rx question out there if ever I am in a position to recommend something different to him or his doctor (unfortunately the medical attention he's received has been really lame and he's never taken seriously by medical personnel - he puts up a good front with them, I think).

Any suggestions or comments would really be appreciated!
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« Reply #12 on: November 07, 2007, 08:42:39 AM »

This post reminds me of something that I learned last week in T.  I was telling my T how my exBP is supposedly now on a certain medication that was prescribed to him by his family doctor for depression/bipolar.  Hearing this had made me a little jumpy, why, I am not sure, being that I am not going to ever go back with him, but I can't lie, the thoughts of "What if this gets his mood regulated and he ends up being a pretty good guy",... .you know... thoughts like that.

First, she shook her head and told me that family dr.s OFTEN have no idea what they are dealing with in terms of mental stability/personalities, and push the depression/bi polar dx too much without having any indepth look into the patient.  She then proceeded with this:

She, my T, sat there and held out both of her hands, palm face up, and then closed both to make closed fists.  One fist represented depression and the other fist represented personality.  She said that the medicine that he is on may help to subside his feelings of depression, but that it will not touch his personality.  He is who he is at his core.  That's really something to think about, or at least I think it is.
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« Reply #13 on: November 07, 2007, 01:57:46 PM »

My husband had been on Paxil and Zoloft before he was diagnosed with BPD.  Once he was diagnosed, our doctor put him on Prozac (a higher dose is needed for BPD than what is normally used for depression) eventually building up to 80 mg. where he had the maximum benefit.  Studies have shown that Prozac works better than Zoloft in treating some of the borderline symptoms such as chronic anger and emptiness.  Both work equally well if one just has depression and nothing else.

  He is also on a mood stablizier, Tegretol, medication for his comorbid ADHD and he has an as needed antipsychotic that he uses when he begins to feel overwhelmed, stressed or the beginning of dysphoria.  This medication regimen has worked very well for him. 

  Going off Paxil cold turkey is not recommended as it can cause severe withdrawal side effects.

  Abigail
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« Reply #14 on: November 07, 2007, 09:11:02 PM »

My daughter was first prescribed paxil but had a terrible time with this drug - she had bad headaches and was having visual disturbances (she was seeing flashes of light and having blurred vision).  She was taken off the paxil and put on zoloft and was taking a low dosage for a couple of years.  Though the zoloft certainly didn't cure her illness, I thought her depression and anxiety were eased some.  The doctor had just raised her dosage of zoloft but unfortunately dd decided that she didn't need to be taking that anymore either and now she is taking no medication and having no therapy.  Time will tell, but I don't think her strategy is going to help her deal with her many issues.  I don't think she ever sleeps, either.  I have read, though, that prozac is the drug of choice for treating some of the symptoms that go along with BPD.

Grace
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Abigail
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« Reply #15 on: January 09, 2008, 01:25:42 PM »

  BPD can not be "cured" but it can be managed with the right medication treatment much like diabetes, staying away from alcohol (they are "allergic" to alcohol) and addictive substances, and therapy, especially retraining the brain with positive affirmations and correct thinking.  And of course, getting all of the comorbidities diagnosed and treated as well.

   My husband would be considered "high functioning" and he has been treated by Dr. Heller with medication since he was diagnosed three and a half years ago.  He has improved greatly and has an additional medication that is taken on an as needed basis when he feels stressed or overwhelmed, or even before a stressful event that you are aware of (say, an upcoming situation that you know will be stressful).  If taken soon enough, it calms him down and prevents the development of a rage and eliminates the anger.  You do have to learn to recognize your moods so that you know when you need to take the extra medication.

   Therapy is much more effective and can be accomplished in a lot less time if they are being properly medicated.  Each circumstance and situation is different, but you are more likely looking at months instead of years of therapy.  Without the proper medication, therapy may take numerous years or may not work at all.

   Dr. Heller (https://bit.ly/2tTNTd5) has had numerous success stories of which my husband is just one.  One of my friends and several members of her family have also been helped tremendously by Dr. Heller, along with my neighbor's daughter and a friend of a friend.  My 26 year old daughter is also being treated for BPD but hers is a milder case and with more anxiety problems than anger.

  Abigail
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« Reply #16 on: January 09, 2008, 03:30:02 PM »

I think some are more capable of recovery than others. As has been pointed out A.J. Mahari made her journet before Dialectical Behavioral Therapy even existed and Rachel Reiland apparently had alot of success through old fashioned psychoanalysis.

I'm not one that thinks medication is the answer to this disorder, although it might make the hard work involved in recovery easier. What particularly interests me is that a new type of cognitive/psychodynamic therapy called Schema Therapy has been shown to "cure" a majority of BPs of their core symptoms within 3 years. This is where we need to be focusing our attention. Nothing so far has had these kinds of results.
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« Reply #17 on: January 10, 2008, 07:20:51 PM »

Here's my experience with my xBPD and medication.  He was given Paxil and you know what, it kind of lessened his rages and made him 'snap out' of things a lot faster.  He was more rational, I suppose?  Some of these medications take two or three weeks to kick in, but my ex and I noticed changes within two days.  I just read somewhere that the faster they work, the greater need (the brain has been starved for whatever is in them).

But the problem is - and you'll hear this a lot - is that anybody that has a pysch/mood disorder feels that they are 'cured' after taking the meds.  Heck, they don't need them at all!  They believe they can function just fine without them, and eliminate the very common side effects at the same time.  So nine times out of ten, they wean themselves off.  Or go cold turkey.

All I can say is that it breaks your heart to see the monster return a short while after.  You see it.  They don't.  And future attempts to encourage medication re-start gets more and more difficult.  It's my opinion that after they come off, they get WORSE.  My experience with my ex went from bearable emotional abuse, to devastating emotional abuse, to physical abuse AND damaged-soul-forever emotional abuse.  I obviously can't stick around for the next stage.


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« Reply #18 on: January 12, 2008, 06:27:48 PM »

My DD, my sister and DH's ex all have BPD, all dx'd by appropriate professionals. BPex wasn't buying any of it and never went back, let alone start meds of therapy. BPsis tried a number of meds (she adores medication, and therapy, for that matter), and hit on Pamelor as the one that worked best... .she gained weight, however, and since she's WAY body-dysmorphic that was the end of that, she undiagnosed herself (and is now batshte crazy off everything except opiates, to which she is addicted). DD is on a fairly high does of Prozac, and goes to DBT 2x/wk (1-on-1 and "skills group". We were referred to our/her psych and the DBT group through Marsha Linehan's offices at UW. The people we've met over the last year+, struggling with DD's issues, have all been crystal clear that treating BPD is a 2-punch deal, and that neither meds nor therapy are optional. Gotta have both. Can't dig out from under the burden of dysregulated emotions w/o the meds, can't lean to function normally w/o therapy.

Evien
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« Reply #19 on: February 14, 2008, 03:43:26 PM »

TonyC,

  I don't know if your ex was officially diagnosed with BPD or not but studies have shown that Xanax has been found to make BPD worse!  If a doctor is treating patients for BPD he should know that. 

  The meds my husband is on (prescribed by Dr. Heller) are not any of the ones you listed and are generally not sedating.  The Tegretol can be in the beginning but my husband takes it at night anyways.  One of the meds, Risperdal, is sedating but that only needs to be taken in a severe crisis.  And if you follow Dr. Heller's instructions perfectly, that will be a very rare event.

   Before being treated, my husband slept a lot.  Treated with the right medication, he is awake and productive.  He also has ADHD and takes Adderall for that. 

  Abigail
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« Reply #20 on: February 14, 2008, 04:21:28 PM »

Mrbluesky,

   There is a definite correlation between ADHD and BPD.  Conversely, at least 25% of those with BPD have ADHD as well (according to one study), although Dr. Heller suspects it is higher and so do I.  I know 13 individuals, including my husband and daughter, who have officially been diagnosed with BPD and at least 10 also have been diagnosed with ADHD.  I don't know enough about the other three individuals to know if they have ADHD or not.

   And of those who I strongly suspect have BPD, many of those have ADHD as well.  And the vast majority were untreated for their ADHD. 

   The book, "Attention Deficit Disorder--The Unfocused Mind in Children and Adults " by Dr. Thomas E. Brown is very interesting.  It describes the executive function deficits in those with ADHD and there is a chapter on emotional dysregulation.  When you read it, much of it sounds like BPD.  Check it out if you can find the book at a library.  I began highlighting the references in that chapter that sounded like a description of BPD and there were many.

  Abigail
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« Reply #21 on: February 15, 2008, 01:57:35 PM »

Abigail,

I found your comment regarding Xanax very interesting. During the last couple of months, J was eating Xanax like jelly beans trying to manage the stress that he was under.  I've tried to find some research showing the counterindication for BPD.  Can you help?

Thanks!
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« Reply #22 on: February 16, 2008, 06:01:26 PM »

Well, now that I've read this, I can track back a block of rages to his hitting the Xanax bottle.  He stopped taking Prozac when we met because of the sexual side effects.  When he found out his ex was having an affair when she divorced him (3 yrs later), he got a script for Xanax.  Things went to hell.

He is also a big "straight" vodka drinker.  I wonder if he isn't allergic as Dr. Heller asserts.  He drank enough that I'm not able to correlate the two... .but I wonder.

Hearing descriptions of him and watching him in action as an adult, I would bet the house he's ADHD.  Can't shut up.  Going either 90 or nothing.  Can't finish ANYTHING.

Lastly, and honestly, an issue I might actually be able to discuss with him, are three concussions he suffered as a teen.  He tells the stories of these experiences all the time.

What I would give to get him to Dr. Heller.  Heck, what I would give to lay eyes on him again.

Great thread!
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« Reply #23 on: February 28, 2008, 09:20:30 PM »

I was treated before DBT was created. However, I did, among other types of therapy have a lot of Cognitive Behavioral Therapy which DBT is an off-shoot of. I also wasn't ever suicidal nor did I engage in parasuicidal behaviour so really, even if DBT, in its initial implementation was available I wouldn't have been the type of client most in need of it as it was inititally implemented for and mostly targeted toward those with unending suicidality, parasuicide and severe self-harm. I did engage in self-harm for a period of time when I had BPD, but again, not as majorally as many.

Of course, DBT is much more widely applied to the treatment of BPD now than it was intitally.

I totally believe that pills cannot cure or really effect recovery from BPD at all. They, at best, control some symptoms of some things of some aspects of BPD but that's about it, if that. Not to be controversial here but I do have a lot of concern about all of the medicating of those with BPD going on. I think for some they are over-medicated and not "treated". That's not in anyone's best interest. Also the amount of side effects of lots of medications alone, let alone in the astounding combinations that are increasingly being given to borderlines likely is creating other problems or exacerbating things that may not be well understood in many individual's experience.

I would also like to add again from my own experience that I recovered from BPD without ever being on any psychiatric medication whatsoever. So I wonder how the professionals pushing the pills would explain that?

Interesting, in this thread the usuage of the words "cure" versus "recovery".

I just wanted to say that in my experience as one who has recovered and as one who didn't ever take psychiatric meds or anti-depressants on that journey or since, I know first-hand that "meds for life" aren't necessary.

Your reference to willpower is also interesting. I think that taking personal responsibility, making a commitment, and a stubborn determination were the definite foundational pieces needed in my recovery. Some may call that willpower but willpower is often also associated with the mere controlling of one's impulses and/or actions in terms of "self-control". Those with BPD must first find and ressurect the lost authentic self and cannot hope to have control over what is a lack of self, therefore, I would say that self control isn't a part of the equation until well down the road to recovery. Learning to control impulses is a part of the recovery process but after one recovers, it has been my experience anyway that it isn't any longer about controlling impulses. Recovery means that one has resolved the underlying abandonment trauma that drove the impulses - essentially what I refer to as "the abandoned pain of BPD" - that needed to be controlled in maladaptive and pathological ways so that the borderline false self could continue to keep the abandoned pain at bay and out of the conscious awareness of the person with BPD.

I think you are right on about the need to be stubborn, for sure, however Smiling (click to insert in post)
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« Reply #24 on: February 28, 2008, 09:38:03 PM »

The use of medication in the treatment of BPD is commonly practiced by the leading treatment centers.  Robert Friedel MD maintains a very contemporary schedule of treatment models.  :)r. Freidel is recognized by the NEABPD and he has testified before the US congress. BPDdemystified.com

There is controversy (meaning not all clinicians agree) on which medications are best in the treatment of BPD largely because most of the drugs are prescribed "off label"... .meaning large clinical studies have not been performed to mediate the individual experiences and preferences of different clinics.  Here is the definition of 'off label"  click here

It's interesting to see Mary Zanarini's (Harvard) distinction in the use of the terms recovery and remission in BPD.  Zanari is also recognized by the NEABPD and these are good definitions for our use.

Extended Recovery=remission of symptoms and having good social and vocational functioning during the previous 4 years.

Recovery=remission of symptoms and having good social and vocational functioning during the previous 2 years.

Remission=remission of symptoms

https://bpdfamily.com/message_board/index.php?topic=117735
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« Reply #25 on: March 01, 2008, 11:53:56 AM »

GF had long taken 10mg of Prozac. When generic was prescribed, she unwittingly began taking a 20mg pill every day, effectively doubling dosage.  I noticed that impulsiveness was greatly diminished with the greater dosage, of not eliminated. Has anyone else noticed this improvement from Prozac?
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« Reply #26 on: March 20, 2008, 04:23:56 PM »

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

~AguyD
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AJMahari
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« Reply #27 on: March 21, 2008, 09:51:07 AM »

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.
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« Reply #28 on: March 21, 2008, 10:11:19 AM »

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
https://www.wthr.com/article/state-no-alerts-zyprexa-side-effects

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.
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« Reply #29 on: April 16, 2008, 06:19:54 PM »

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.
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« Reply #30 on: April 16, 2008, 06:51:34 PM »

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.
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« Reply #31 on: April 17, 2008, 08:40:38 AM »

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.
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« Reply #32 on: April 18, 2008, 04:16:54 PM »

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.
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« Reply #33 on: May 08, 2008, 05:03:30 PM »

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.   Smiling (click to insert in post)  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.   :Smiling (click to insert in post)

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.   
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« Reply #34 on: May 08, 2008, 08:34:58 PM »

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
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« Reply #35 on: May 24, 2008, 12:59:09 PM »

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
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« Reply #36 on: June 04, 2008, 07:51:36 PM »

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.
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« Reply #37 on: June 05, 2008, 10:35:55 AM »

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.

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« Reply #38 on: June 12, 2008, 07:40:23 PM »

Well in my experience my ex-BPD would not rage as often when she was stoned... .  Smiling (click to insert in post)

I doubt it would help on a long-term basis to get the "edge" off.
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« Reply #39 on: June 14, 2008, 04:51:07 PM »

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
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« Reply #40 on: June 16, 2008, 11:46:56 AM »

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
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« Reply #41 on: June 19, 2008, 02:37:45 PM »

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

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« Reply #42 on: July 13, 2008, 12:32:27 AM »

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)
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« Reply #43 on: July 13, 2008, 09:43:47 AM »

MDMA (3,4-methylenedioxy-N-methylamphetamine) is Ecstasy (also E, X, or XTC). 

The government approved the use of MDMA in research studies in 2004.  Back in the 1980's, MDMA was used in psychotherapy experiments - it reportedly facilitated self-examination with reduced fear.  These experiments stopped when the drug was outlawed.  It is currently outlawed worldwide (UN provision).

The  risk of permanent neurotoxic damage of the central nervous system is a major concern that is not fully understood.

Skippy

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« Reply #44 on: July 13, 2008, 11:48:27 PM »

From the literature I have read the MDMA PTSD studies (one in the US and one in Israel and Switzerland) are controlling for BPD, but the idea is that if it proves successful in clinical trials they may look into other related disorders such as BPD. I'm sure BPD is going to be much more challenging because of mood instability and ingrained thinking patterns.

From the preliminary findings, with a moderate dose of pure MDMA in a controlled environment (not dancing yourself into heatstroke at a rave) administered 1-3 times spaced months apart no neurotoxicity has been reported. We do know that if you pump rats and monkeys with heavy doses for several days there are at least semi-permanent changes to the seratonin system. And we also know that some ravers who have used street Ecstacy hundreds of times show lower seratonin, defecits in short term memory and mood problems. But then you have to wonder if they were like that in the first place to use the drug so heavily.

It has been shown that using MDMA and can lower your seratonin levels for 2-3 months before returning to baseline and it can mess with a person's mood for a week or two after using.

I am interested to see how this research turns out.
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« Reply #45 on: July 14, 2008, 03:39:06 PM »

Just had to chime in regarding my real-life studies of how X effects my dBPDso... .When she's on X she is amazingly calm and expressive and able to discuss things that otherwise are very upsetting in a calm fashion--never mind how the X takes away her incest-induced sex issues! It is still amazing to me how different she is on X, as if the drug really levels out the natural drugs she's missing in her brain. She gets depressed when coming down, but who doesn't? I don't see any long-term positive effects, though I'm not sure how I'd know they were because of the drug and not her meds and therapy and her work on herself. (And just for the record, we only take X like 5 times a year or so.)

Peacebaby
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« Reply #46 on: July 24, 2008, 10:01:36 AM »

I would not wish to advocate the use of an illegal sustance under any circumstances, but I put this out in hopes that perhaps others have experienced this.  My uBPDw sometimes has pot on hand, and during these times, I notice a very sharp reduction in her irratibility, while the raging becomes non-existant.  She is also easier to talk to and doesn't get sidetracked with fears and worries as much.  This, to me, is noticeable not just when she is actually using it but a day or two later.  It isn't very scientific at all, but there appears to be a correlation in her case.  I was wondering if anyone else had noticed this kind of reaction, or perhaps knows if there have been experimental studies done on the effects of cannabis on emotional illnesses.
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« Reply #47 on: July 24, 2008, 02:28:13 PM »

My girlfriend used marijuana heavily for 2 years.  I mean I don't think I was ever around her when she wasn't high.  I let her do it despite the fact I was really against the whole thing because it did seem to stabilize her moods.  But after heavy use for months on end it would start to have the opposite effect and she'd get angry when high, oddly enough she was still LESS angry than when she wasn't using.  Around this time she'd usually take a break and go clean for a few weeks and then start up again and the marijuana would again stabilize her moods for months.  She was definitely self medicating and I think she knew it.

It made her extremely paranoid though when she was high (which is the reason she eventually quit), and caused extreme anxiety which has not gone away even though she has been clean for months.  I guess it takes awhile.  I'm worried its not going to change though.

As for her moods now, if anything they've gotten a lot better.  I think that marijuana helped her understand her true feelings.  It was like I could tell her things or she could feel things without that intense wave of emotion that blocks her from understanding her real thoughts and feelings.  She used to tell me she could think without feeling when she was high.

It does seem that she is going back to the way she was though. Its only been 4 months since she stopped using and every month that goes by she seems to regress further.  My guess is she forgets what she learned about herself, its not maintained or whatever and losses the effect it had on any change she was making.

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« Reply #48 on: July 29, 2008, 09:29:50 PM »

Can anyone explain what the purpose of prescribing Risperdal to a person who may have BPD? My mom fits most of the criteria for BPD and has been in psychotherapy for over 35 years. I just found out she is on Risperdal. Can anyone tell me why someone with BPD might be prescribed this medication? She is on Xanax, Effexor and Risperdal. I suspect she is BPD. She won't tell me, so I am trying to put these pieces together on my own.

In my opinion, she matches several criteria for BPD, PPD and NPD. Would the anti-psychotic be for the paranoid delusions which she exhibits or something else.?

Thanks,

cieeciee
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« Reply #49 on: July 29, 2008, 09:31:56 PM »

Risperdal should help her with the irrational thoughts which might trigger rages. It can also be used as a mood stabilizer. I have had many students taking this.

Not sure how effective/wise it is to give stuff this strong to teens, but that's another story!

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« Reply #50 on: July 29, 2008, 10:38:35 PM »

My mother was on Risperdal after she attacked my brother with a hammer.  She was having delusions and thinking he was out to kill her, talking to "hit men" that weren't even there, thinking bombs were planted in her room... .you get it.  It calmed her down to where she didn't act this way anymore. 

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« Reply #51 on: July 29, 2008, 11:01:45 PM »

Risperdal is an anti-psychotic medication usually prescribed to schizophrenics. It blocks dopamine receptors in your brain because an over-abundance of dopamine can cause paranoid and psychotic thinking. Too little can manifest itself in depression and parkinson's-like symptoms.

I've read some doctors are into prescribing BPDs risperdal and haldol because it apparently can help with the reality breaks and paranoia. Anti-seizure medications are also popular since there are claims they help with the rages.
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« Reply #52 on: July 30, 2008, 12:54:00 AM »

So I am in the same situation as cieeciee, and my uBPD mom says she is on Risperdal for anxiety.  From what I'm reading, it sounds like the only reason Risperdal would be prescribed is for schizophrenia, bipolar disease, delusions, paranoia, BPD, or irrational thoughts.  So am I correct in assuming that if my mom has been given this medication by a doctor, then she has a diagnosis of mental illness?  The only thing she will ever admit to is depression and anxiety.  I am pretty convinced that my mom is BPD, but I obviously can't ask my mom. My sister and I have thought about trying to contact her therapist, but knowing there is a confidentiality issue stops us from thinking it could be helpful.  My mom definitely exhibits behaviors of BPD, paranoia, delusions, and NPD now, even on all the medications she is on.  She doesn't seem to exhibit the rages she used to when I was younger but I always assumed that was because now that she has grandkids she has more to lose if she makes me mad.  Also, I've learned myself how to deal with her better.  But maybe if she weren't on Risperdal she would still be having the rages.  I wish that saying she was on the meds would make her a better mom, but it hasn't.  I just don't have to listen to her midnight rantings anymore.

Has anyone else ever contacted a BPD's therapist for more information? Did you get anywhere? was it useful at all?

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« Reply #53 on: July 30, 2008, 06:18:27 PM »

Risperdal is also frequently utilized to potentiate antidepressants.  It helps enhance the effect of the antidepressant in folks who have a somewhat resistant depression.
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cieeciee

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« Reply #54 on: July 30, 2008, 11:07:28 PM »

Thanks everyone for your help. So, if she is on this medication, what does it mean that she is still have paranoid delusions that people are "out to get her." or thinking bad things about her? She truly believes that these are these people's motives.

Does an anti-psychotic med just reduce the severity of these symptoms or is it supposed to stop the delusions all together?

I am very concerned because my mom has minimal communication with her Psych (once a week) and therefore, it seems that medication is her main form of treatment. Meanwhile, even though she seems better than in the past, she still has paranoia, anxiety and compulsive spending behaviors.

Should her meds be helping this or if she is still exhibiting these behaviors could that mean seeing a psych once a week isn't the best treatment?

I know no one can diagnose or treat my mom in this forum, but I am trying to figure out if she is getting the helps she needs, but can't ask her or her doctor. Any experience from someone else would be helpful.

Thanks for any insight, or thoughts about this.

cieeciee
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« Reply #55 on: July 30, 2008, 11:16:06 PM »

how does she act on the drugs... tired , lethargic... .

It is very hard to separate out all of her maladies from what side effects may be occurring from a drug. She is on several meds for all kinds of physical problems, beyond mental health issues. It is also possible, I suppose, from what I have read, that her diabetes and morbid obesity may have been complicated or induced by taking the Risperdal. I have no idea how long she has been taking the drug.

I do think her mental illness is severe enough to warrant meds, but didn't see Risperdal written about in connection with BPD very often. In fact, most of what I have read indicates that psychotherapy is the most critical component of treatment for BPD. My mother has been in psychoanalysis for 35+ years and I am still not sure after all this time that it is really effective in her case.

Since Risperdal doesn't seem to be very common with regard to a BPD diagnosis, it makes me wonder if she has another condition. Just trying to put the puzzle pieces together.

Thanks.

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« Reply #56 on: July 30, 2008, 11:48:04 PM »

The big key for recovery from BPD... .  meaning the symptoms are improved enough that the person can live a reasonably "normal" life... .  is that the person him or herself must realize he/she has these issues, he/she must take responsibility for disordered thinking and behaviors, and he/she must be committed long-term to recovery.  Meds alone can help with some of the symptoms, but they are no panacea.  There are several effective therapies, the most effective is dialectical behavioral therapy.  Here's a post on what it means to fix BPD:  https://bpdfamily.com/message_board/index.php?topic=76487.0 
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« Reply #57 on: July 31, 2008, 09:46:54 AM »

The big key for recovery from BPD... .  meaning the symptoms are improved enough that the person can live a reasonably "normal" life... .  is that the person him or herself must realize he/she has these issues, he/she must take responsibility for disordered thinking and behaviors, and he/she must be committed long-term to recovery.  Meds alone can help with some of the symptoms, but they are no panacea.  There are several effective therapies, the most effective is dialectical behavioral therapy.  Here's a post on what it means to fix BPD:  https://bpdfamily.com/message_board/index.php?topic=76487.0 

Thanks JoannaK. That was very helpful.
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« Reply #58 on: August 16, 2008, 10:48:17 PM »

My son and daughter-in-law visited with my exuBPDh last night, and DIL (a medical student) told me there was an RX for Zoloft with his name on it on the table. Which frankly amazes me because he flatly refused to even consider asking for any type of meds for his mental state in the fifteen or so years that I felt he could benefit from them, and condemned me to no end for once, in 1994, taking prescription antidepressents. He even brought it up in court last Spring in an effort to make the judge order me to get drug tested, too.  ? (Which btw didn't work out so well for him... .) I guess he preferred his own self-medication with opiates and benzos to something that might actually help him... .

Anyway, just wondering if Zoloft has any effect on BPD beyond the obvious depression-related symptoms.
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« Reply #59 on: August 16, 2008, 10:58:27 PM »

Hi Duet.

It is my understanding that there is no specific drug to treat BPD per se as it is a disorder not a mental illness. I am sure you are aware of this.

As you are also aware, zoloft is an anti depressant. If taken correctly, and likely the initial dose will need to be increased, you may find that some symptoms that are related to depression may abate.

The things that could possibly change are (in my un-medical understanding); his suicidal threats/tendencies may lesson. It may balance out his moods to a degree, although I am a little iffy on whether it would actually stop anger outbursts. He MAY get to a point where he is able to more objectively see some of his issues (given that he is no longer looking through the haze of depression). While as I'm sure you know these are symptoms of depression they are also intertwined with the outward displays of BPD.

It may not change him externally in the slightest.

BPD as you know is a coping mechanism that involves deep and extended therapy to develop new ways of coping with internal turmoil. There is no quick fix unfortunately.

I hope that in your situation, the zoloft, if even taken, turns out to be helpful in even the littles way. Every bit counts I guess.

bornskippy. 

EDIT: Duet, obviously not knowing the specifics of your situation I was talking in a very general sense about how the medication might effect a person with depression and BPD. Some of those things I mentioned might not even be applicable to your exh.
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« Reply #60 on: September 10, 2008, 12:38:41 PM »

Well the meds I have some knowledge because I have tried so many.

1. zyprxea has and will keep there mind calm (like the sink drain he would respond uh oh need to fix that instead of ripping it our and then I fixed that.

2. Prozac works like a hit of speed for him because the zyprxea makes him feel sleepy in thought but that is a good thing for him after a while he seems to remember how he meds calmed him down and now he is not taking any but he does say I need that meds

3. Suggestion find a dt.That has a history of this chaos in his life and he will be able to help instead of just doping them up try to help kick them off there horse re-learn how to respond
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« Reply #61 on: December 12, 2008, 08:56:55 AM »

I am curious if there are "good" medications that help in the treatment of this disorder?

Are there standard medicines that should or should not be used?

If a person is diagnosed with PTSD, BPD and Clinical Depression are numerous medicines needed?

What adverse side effects should a person be watching for?

Can a person be on numerous medicines and the combination is not working, how do they figure out what one might be a problem?

How long should a person be on medicines to notice any postive changes?

Can the medicines listed below be abused, become addictive or can someone get a "buzz" from them and begin to abuse them?

I have not been allowed to discuss some of these questions with my husbands doctors so I am in the dark per say as to his medicines besides what I can read online.

They have him on a combination of Wellbutrin and Zyban for mood taking 2 Zyban in the morning plus one wellbutrin, and then the seriquel to help him sleep at night plus his allergy medicines. I have seen his behavior, mood and anger issues get worse in the 2 years he has been on these medicines and when things got really bad they increased his dosages. The Seriquel caused him to sleepwalk, bed wet and he is way "drunk" acting and sounding when he takes it. Always tired and can fall asleep at a drop of a hat especially when driving. Increasingly forgetful, more so then normal, complains of hot flashes or being warm all the time. Increase in weigh gain causing him to feel worse about self image, snacks ALOT, even getting up in the middle of the night to eat and does not remember doing it. Forgets to take his medicine, takes to many and there is an issue with the mail order medicines coming in way to often and the doctor/pharmacy not catching this? Have almost 6months worth of medicine hidden not counting bottles of pills I have thrown away.

Lastly the VA is sending him pills for the wrong dosage and requiring them to be cut in half but I am worried he will not remember and will take to much.

Any thoughts or suggestions as to what to do is appreciated. I have been promised by my hubby that I can finally come to his next VA appointment next week and I think I am going to make a short list of questions to ask them as well.
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« Reply #62 on: December 15, 2008, 11:18:15 PM »

 Bullet: comment directed to __ (click to insert in post) jul496

These are all good questions but unfortunately, there are no cut-and-dry answers to them and no standard medications prescribed for BPD, PTSD, or depression.  Mood stabilizers are sometimes used for BPD, sometimes anti-depressants, often both - sometimes even antipsychotics.  Psychopharmacology is not precise.  So much depends on the person being treated, the skill and experience of the psychopharmacologist, etc.  

It sounds to me like your husband is terribly overmedicated.  The lethargy and weight gain are most definitely coming from the Seroquel.  How many milligrams is he on?  Why was he prescribed an antipsychotic?  For sleep or for extreme anger?  I'm also very confused as to why he's taking both Zyban AND Wellbutrin - they're the same thing, Buproprion Hydrochloride.  What is the combined dosage he's taking?  The maximum dosage is 450 mg/day.  If he's taking more than that, it could certainly explain his anger issues.    
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« Reply #63 on: December 20, 2008, 08:47:14 AM »

I just want to echo's blissgirl's response.  It seems that medical treatment for BPD is a bit trial and error and what works for one person doesn't work for the next.  Now, BPD is not considered to be primarily a physiological disorder, which means that therapy (and appropriate therapy) is much more important than medications alone in controlling this disorder.  The person needs to be committed to looking at him/herself and working towards recovery... .  vs. just taking meds.  Many with BPD wind up using the BPD diagnosis as an excuse for poor behavior... .   "I have BPD, therefore I can't help it if I cheat/rage/don't work/fight/fill in the blank."  There are some doctors out there who believe that BPD can largely be controlled with meds, but they aren't mainstream. 

But the questions you are asking here do need to be asked of his doctors.  And look up all of the meds online to see what you can find out about dosages, drug interactions, and other contraindications to taking these drugs.
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« Reply #64 on: December 20, 2008, 11:56:53 AM »

My dBPD wife (who only recently has been diagnosed BPD and for much longer was diagnosed bipolar) has been on lots of meds for years. 

All I can really conclude from what I've seen of her is that it's very, very hard to tell if, how, and how much they help her. It doesn't help that the meds and dosages change over time, as attempts are made to regain lost effectiveness or to mitigate side effects.

I'd say that at best they blunt the edges of her worst depression or anxiety.

I don't want to be blindly anti-medication - genuinely bipolar people, for example, have to be on meds. But in our case (where I believe that BPD is the dominant, if not possibly only, mental problem) they are of limited help at best.
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« Reply #65 on: January 23, 2009, 01:54:46 PM »

Your asking about lithium orotate (vs lithium carbonate and lithium citrate). Just a word of caution...

Lithium toxicity from an Internet dietary supplement.
Pauzé DK, Brooks DE.
Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. pauzedk@upmc.edu


INTRODUCTION: The widespread availability of medications and herbal products on the Internet has increased the potential for poisonings. We are reporting a case of mild, acute lithium toxicity occurring after the intentional misuse of a lithium-containing "dietary supplement" (Find Serenity Now) obtained over the Internet. CASE REPORT: An 18-year-old woman presented to our emergency department (ED) after ingesting 18 tablets of Find Serenity Now; each tablet contained, according to the listing, 120 mg of lithium orotate [3.83 mg of elemental lithium per 100 mg of (organic) lithium orotate compared to 18.8 mg of elemental lithium per 100 mg of (inorganic) lithium carbonate]. The patient complained of nausea and reported one episode of emesis. Her examination revealed normal vital signs. The only finding was a mild tremor without rigidity. Almost 90 minutes after the ingestion, her serum lithium level was 0.31 mEq/L, a urine drug screen was negative, and an electrocardiogram (ECG) showed a normal sinus rhythm. The patient received intravenous fluids and an anti-emetic; one hour later, her repeat serum lithium level was 0.40 mEq/L. After 3 hours of observation, nausea and tremor were resolved, and she was subsequently transferred to a psychiatric hospital for further care. Prior human and animal data have shown similar pharmacokinetics and shared clinical effects of these lithium salts. DISCUSSION: Over-the-Internet dietary supplements may contain ingredients capable of causing toxicity in overdose. Chronic lithium toxicity from ingestion of this product is also of theoretical concern.


       
Promotional Material
Lithium orotate
www.smartbodyz.com/Lithium-Side-Effects-Orotate-Carbonate-Medication-Benefits-Toxicity.htm

Lithium is a mineral with a cloudy reputation.  It is an alkali metal in the same family as sodium, potassium and other elements.  Although lithium is highly effective for supporting those who experience depression or foul moods, its pharmaceutical (prescription) versions, lithium carbonate and lithium citrate, must be used with caution.  The reason for the caution with prescription lithium is because lithium in these forms is poorly absorbed by the cells of the body — and it is within the cells that lithiums' therapeutic effects take place.  Lithium ions are believed to act only at particular sites on the membranes of intracellular structures like mitochondria and lysosomes.

Consequently, because of this poor intracellular transport, high dosages of pharmaceutical forms of lithium must be taken in order to obtain a satisfactory therapeutic effect.  Unfortunately, these therapeutic dosages cause blood levels to be so high that they border on toxic levels.  Consequently, patients taking prescription lithium must be closely monitored for toxic blood levels.  Serum lithium and serum creatinine levels of prescription lithium-treated patients should be monitored every 3-6 months.

Toxicity effects of lithium may include hand tremors, frequent urination, thirst, nausea, and vomiting.  Even higher doses may cause drowsiness, muscular weakness, poor coordination, ringing in the ears, blurred vision, and other symptoms.

There has been concern that long-term lithium treatment may damage kidney function, but data in this regard are equivocal.  Renal insufficiency without a known cause has occurred in the general population, and the incidence of renal failure among manic-depressive patients not treated with lithium remains unknown.

Most patients treated with lithium are also taking other medications and it is just as likely that the few known cases of renal failure in patients taking lithium were due to other medications that they were simultaneously taking.2-5

Nevertheless, with potential side effects like this, why in the world would anyone want to take lithium?  It is because lithium has been found to be one of the most effective support medications for those who experience "the blues."

Mood Disorders

Mood disorders are characterized by mood swings that usually cycle back and forth between up cycles and down cycles.  The down phase is characterized by sluggishness (inertia), loss of self-esteem, helplessness, withdrawal and sadness, with suicide being a risk.  The up (or manic) phase is characterized by elation, hyperactivity, over-involvement in activities, inflated self-esteem, a tendency to be easily distracted, and little need for sleep.  In either phase there is frequently a dependence on alcohol or other substances of abuse.  The disorder first appears between the ages of 15 and 25 and affects men and women equally.  The cause is unknown, but hereditary and psychological factors may play a role.  The incidence is higher in relatives of people with the disorders.  A psychiatric history of mood swings, and an observation of current behavior and mood are important in the diagnosis of this disorder.7

Orthodox Treatment

Hospitalization may be required during an acute phase to control the symptoms.  Antidepressant drugs may be given; anticonvulsants (Carbamazepine, Valproic acid, Depakote) may also be used.  (These substances deplete body stores of L-carnitine and Taurine.  Supplementation with several grams daily of these supplements greatly ameliorates adverse side effects of these drugs).

Lithium, however, is the treatment of choice for "the blues," serving as a consistent mood enhancer in 70-80 percent of people.

Mortality-lowering, Anti-suicidal Effect of Lithium

The mortality of people with "ups and downs" is markedly higher than that of the general population.  The increased mortality is mainly, but not exclusively, caused by suicide.  Studies have shown that the mortality of these patients given long-term lithium treatment is markedly lower than that of patients not receiving lithium.  The frequency of suicidal acts among treated patients is significantly lower than patients given other antidepressants or carbamazepine.  The results of mortality studies are consistent with the assumption that lithium-treatment protects against suicidal behavior. 8-13

Recurrent Major Affective Disorder

In addition to its well-recognized benefits in the management of "mental ups and downs," trials have conclusively demonstrated that lithium is also an effective treatment for recurrent major affective disorder.14-16  Although physicians in Europe have successfully used lithium for this indication for many years, American psychiatrists do not share their appreciation of lithium's safety and effectiveness for conditions.  Perhaps it is due to a difference in the lithium preparations they have at their disposal.

Superiority of Lithium Orotate

The lithium salt of orotic acid (lithium orotate) improves the specific effects of lithium many-fold by increasing lithium bio-utilization.  The orotates transport the lithium to the membranes of mitochondria, lysosomes and the glia cells.  Lithium orotate stabilizes the lysosomal membranes and prevents the enzyme reactions that are responsible for the sodium depletion and dehydration effects of other lithium salts.  Because of the superior bioavailability of lithium orotate, the therapeutic dosage is much less than prescription forms of lithium.  For example, in cases of severe mental maladjustment, the therapeutic dosage of lithium orotate is 150 mg/day.  This is compared to 900-1800 mg of the prescription forms (carbonate).  In this dosage range of lithium orotate, there are no adverse lithium side effects and no need for monitoring blood serum measurements.17

Other Uses for Lithium Orotate

Lithium orotate has also been used with success in supporting those with migraine and cluster headaches, low white blood cell counts, juvenile convulsive disease, alcoholism and liver disorders.18  Nieper also reports that patients with myopia (nearsightedness) and glaucoma often benefit from the slight dehydrating effect of lithium on the eye, resulting in improvement in vision and reduction of intraocular pressure.17

Warnings

    * Keep lithium orotate out of reach of children
    * Do not exceed recommended dose
    * If you have a bad reaction or experience negative side-effects, discontinue use immediately
    * When using lithium orotate, please inform your physician.
    * Lithium should not be used by individuals with significant renal or cardiovascular diseases, severe debilitation or dehydration, or sodium depletion, and by individuals who are taking diuretics or ACE inhibitors.
    * Consult your doctor before use if you are taking anti-hypertensive drugs, anti-inflammatory drugs, analgesic drugs or insulin.
    * Lithium should not be used by pregnant women and breast-feeding mothers.

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melski

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« Reply #66 on: January 23, 2009, 02:11:18 PM »

Wow! Thank you VERY much Skip! that was very illustrative and interesting!  Smiling (click to insert in post)

xoxo
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« Reply #67 on: April 09, 2009, 10:28:31 PM »

My uBPDmom has been on heavy meds since she was 18.  The tranquilizers were the worst because it gave her (in her words) "license" to be mean to people and to not care.  Life for me was hell when she was on tranquilizers because whatever conscience she might have had was stripped away.  Pretty scary stuff.  However, once she got off of the tranquilizers, she was still on pretty heavy antidepressants, and these did mellow her a bit.  She has these times, though, where her disorder "breaks through" the medications and turns her into a raging you-know-what.  She is so heavily medicated that her doctor doesn't want to give her more, even though he is aware that she breaks through what the drugs are supposed to do.  These meds are no cure by far.  I think they just put the savage beast to sleep - for awhile, but I never know when the beast will awake despite the drugs. 

Like most who have posted already, she doesn't remember her rages or the bad things she has done to those around her.  What freaks me out is that she does like to be told about these incidences.  It's almost as if she gets a rise out of knowing the pain she has caused.  Yuck!
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« Reply #68 on: April 10, 2009, 01:54:43 PM »

Oh wow, waybird, I have seen that too.  My stpD uses the pretense of making amends to here about how she hurt us.  Then she sits back and smiles and uses the new information to do it again only better.  When she started AA 4 yrs ago she wrecked havoc on our family.  She tried to cut me out and split us all up.  She used AA for an excuse.  She said if she was around me she might drink. 
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« Reply #69 on: May 05, 2009, 02:19:53 PM »

My daughter in law was diagnosed with BPD by a psychiatrist and was prescribed with Seroquel. She seems to be taking the anti-psychotic regularly. She was recently evaluated  by a psychologist and she reported that my daughter in law does not show any mayor symptoms related to BPD. Is this possible? Has anyone had this experience? I am very puzzled.

Thanks in advance

Sadanty
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« Reply #70 on: May 06, 2009, 02:06:04 PM »

My BPD S has been diagnosed with "traits" of it by the psychiatrist. He also took Seroquel for micropsicotic episodes and to overcome a terrible crisis.  He started seeing a CBT psychologist, and he insisted that he DOESNT like to give any kind of diagnosis because he doesnt want to "label" the person, and because he didn't want to reinforce my son's self image of a "sick person". He preferred to focus on the problem itself rather than the diagnosis. For a long time, the psychologist had strong concerns about the diagnosis. He though my son was NOT BPD. He thought that S has strong internal and emotional doubts and conflicts, which needed hard work. My S was, by then (all of this happened from july 2008 up to this day) overcoming a crisis, but has never been on drugs, bad sexual behavior nor any of those behaviors. His worst problem is rage. He was a great student and started swimming a lot.

But he hated Seroquel. He said it has side effects that were very hard for him. He pushed so much that he was taken out of it slowly. I noticed some changes (bad ones) when going from 150 mg every nite, to 100 mg. His anxiety grow, he became violent again and against me up to the point that I left home. It happened 2 months ago. His relationship with therapist, though continues, is deteriorated and doesnt have the same influence on him like before. Since Seroquel helps sleep, now he is having problems for it. He quit the university and is not doing anything, just stay home, since his anxiety is very strong. He is completely socially isolated now. He says he sees himself as a strange person and doesnt like it, and seems not capable of working on himself and take the road again... .We haven't talked for 2 months though I communicate often with Therapist and my older son and my husband live with him and keep me informed.

I dont know if his situation not is being worsen by my absence, and it hurts me a lot when I think about it, but I couldnt stay anymore after 2 physical attacks and one kicking of my car doors until they became useless, just because he was mad... .at someone else... .not at me... .

At this point, though the psychologist (therapist) still doesnt focus on the diagnosis, I feel he is starting to think about it... .My son was on of his "brightest and most colaborative" patients, and didnt need too much reassurance... .But after quieting Seroquel, I thing the therapist is reevaluating his initial idea of "just a person with some emotional disturbances but available to function".

SO, I think Seroquel made the difference, and the therapist also changed his mind through all the process.

Hope it helps you.
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« Reply #71 on: May 11, 2009, 06:04:44 AM »

Great thread. My BPDw refuses to takes meds because she claims they will make her fat. 
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« Reply #72 on: May 11, 2009, 04:32:44 PM »

Great thread. My BPDw refuses to takes meds because she claims they will make her fat. 

In some cases she might be right.  For example Seroquel (quetiapine) is known to have that effect.

Sadanty
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« Reply #73 on: May 14, 2009, 02:46:21 PM »

Great thread. My BPDw refuses to takes meds because she claims they will make her fat. 

Many psychiatric meds do cause weight gain, in some cases quite dramatic.  After being diagnosed with BPII, my wife went from a very slight woman to being significantly overweight in maybe a year. I didn't notice what a huge change it was at the time (and I didn't care from a looks staNPDoint anyway) but it's quite startling to see in photographs now.  Due to some med changes and hard work, she's back to a more reasonable weight now in between.

I think we do need to be realistic that side effects can be a very big deal, and it's the person taking the meds, not us, who gets to weigh their importance relative to the benefits.
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« Reply #74 on: May 14, 2009, 05:49:47 PM »



Yes. Some drugs DO cause weight gain. My BPD was on Ciprexa (olanzapine), which was wonderful !  It helped him a lot. But he was always hungry ! My God he used to be so thin, but with ciprexa he never stopped eating... .   After being size 31, he was almost 36. So he quit. And before taking any medication, the first thing he asks is if it will make him fat. Now he is back to his size.

I think that people with BPD need both medication and therapy. My son needs Lamictal for mood stabilization. He is not on antidepresives now. Seroquel made him more stable, and even though therapist doesnt like medication, he says in some cases, they are necessary to keep patients stable enough to improve with the therapy.

But, in my S case, his hate to Seroquel was so strong, that it was taken off. Fortunatelly, he has kept his mind clear. No bizarre thinking, though sleeping is a problem now (Seroquel is strongly sedative).  Now his therapist is working hard for him to understand that Seroquel was not the problem, that the problems is inside him and that he was to work with himself. Since son doesnt want Seroquel anymore, well, he has to follow therapist instructions.

So, my conclusion is: if your daughter in law stays with Seroquel, its ok, but it is equally important that she has therapy. And so does the family. Therapy for myself has saved my mind.
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« Reply #75 on: May 19, 2009, 05:00:10 PM »

Recently my (previously diagnosed and in therapy for two years) BPD was given Gabapentin in addition to Zoloft. This was after a major episode and the therapist recommeded a new Doctor to prescribe the meds. He had taken Tegretol with a small improvement but quit taking it because he thought it caused his weight gain. The Zoloft that the new Doctor insisted he start with did nothing in my opinion.  The Doctor added a fairly strong dose of Gabapentin twice a day about a month after the Zoloft and let me tell you it is like night and day.  This dramatic change happened shortly before he confronted his abusive Momster and saw her for what she is. I believe (Although I am no expert) that the Gabapentin helped him to confront some of his issues with her.  So, I can not say it was only the medication that changed him but more a combination of the medication, two years of therapy, and realizing he does not have to deal with her anymore.  All I can tell you is that it has been a Godsend. I am still realistic in the fact that he has BPD and the black cloud could return any time, so I will not let my guard down.  But, I do believe that there is a chance for us now.  After the last major episode, I was seriously preparing to leave. Actually made some of the arrangements. I am happy now that I did not go through with it. Six months from now may paint a different picture.  We will see.
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« Reply #76 on: May 25, 2009, 12:58:19 AM »

My h takes Lamictal, and it does flatten out his moods. A couple of times, he forgot to fill his scrip and went without it for a few days, and his moods got MUCH worse. He'd go from screaming in anger to weeping with remorse several times throughout the day.
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« Reply #77 on: May 28, 2009, 01:08:08 PM »

I am following this with interest.  My wife started Zoloft three weeks ago and just told me about it last night (by waking me up at 1:00 AM by turning on the light and throwing the bottle at me).  So, I haven't seen much effect yet.  Any experiences with Zoloft or other ADs interest me greatly.  Thanks.

-BC
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« Reply #78 on: May 28, 2009, 01:45:00 PM »

Years ago, when XBPD was on Zoloft, she became pregnant with our first child together.  The OBGYN changed her to Prozac.  It was like night and day (although she was being treated for depression at that time).  She did great.  When our baby was 9 months old, she wanted to go off the medicine.  We discuss, also talking about going back on if she had difficulties.  Within two weeks she was cycling with BPD rages, never to go back on Prozac again.

Dr. Helen swears by Prozac.  Maybe he has a point in some cases.  So if you can have any input, try to get her changed to Prozac.

MIS
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« Reply #79 on: May 28, 2009, 02:34:21 PM »

my uBPDexgf was on 60m of Paxil and 10m of wellbutrin and it didnt seem to do much. According to her, she was on the Paxil for severe depression but it didnt help with the other mood issues and definitely did not help with the anger and the other behavioral issues. she did stop taking it at some point though and the depression got quite severely worse. I'm also certain her drug use didnt help these medications be effective at all either. but she didnt go to therapy. she said she had a therpaist for 12 years but i only took her 3 times in the nearly 2 years we were together. i'm a strong believer that meds without therapy is kind of a waste.
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« Reply #80 on: May 29, 2009, 08:17:17 PM »

Years ago, when XBPD was on Zoloft, she became pregnant with our first child together.  The OBGYN changed her to Prozac.  It was like night and day (although she was being treated for depression at that time).  She did great.  When our baby was 9 months old, she wanted to go off the medicine.  We discuss, also talking about going back on if she had difficulties.  Within two weeks she was cycling with BPD rages, never to go back on Prozac again.

Dr. Helen swears by Prozac.  Maybe he has a point in some cases.  So if you can have any input, try to get her changed to Prozac.

MIS

 

My husband and both of our children all have BPD and see Dr. Heller.  Yes, the Prozac is very helpful (unlike the other antidepressants it helps with certain BPD symptoms like emptiness and some of the hostility).  Prozac alone doesn't take care of it all but it is an important part of the treatment.  Learning to recognize when you are beginning to crash (feeling overwhelmed, stressed, upset) and taking the "as needed" additional medication Haldol (a low dose anti-psychotic that works quickly and well, IF you are able to recognize when you need it and take it) is equally important.  If you let it go on for days without treating it, you may have to resort to a third medication that usually makes one too drowsy to function for 24 hours--great in an emergency but relying on it too often can be problematic if you have a job and responsiblities. 

Therapy is important as well and learning to change your thinking and poor coping mechanisms.  But it is easier if you are able to control your emotions more effectively with the proper medication.  Sometimes Tegretol (an anti-convulsant or mood stabilizer) is needed as well--my husband and children take that also.  Fortunately, the generic versions of the Prozac, Tegretol and Haldol are each only $4 ($8 for certain dosages) at Walmart or Target--without insurance.  That's a big life saver.  I should have stock in Eli Lilly (makers of Prozac).  Another plus with Prozac is that you can't overdose on it--you might get sick but you won't die.  That's not true with a lot of the other antidepressants.

Abigail
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« Reply #81 on: June 02, 2009, 11:45:12 AM »

The psychiatrist that BPDh saw put him on Zoloft and he hated the sexual side effect and stopped taking it. He was in his late 50's at the time. Taking Abilfiy removed all moods it seemed to me. Neither happy or unhappy, and he had the coldest expression on his face I'd seen, bordering on contempt every time we spoke. I noticed some facial tics, and being unsure if he'd had them before, the doctor stopped prescribing it.

Therapy stopped the rages when BPDh bonded with the counselor who was a former director of an abusers' treatment program. Thinking crazy things and acting unstable continues, and recently he has convinced himself that I'm the problem, so that's what he tells his therapist.
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« Reply #82 on: June 03, 2009, 02:23:03 PM »

My therapist has also told me that what W really needs is Prozac, but the GP family doc she saw gave her the Zoloft.  I have noticed a difference in her on Zoloft, but I am not sure yet if it is because of the meds or my telling her I wanted a divorce. 
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« Reply #83 on: June 04, 2009, 07:06:09 AM »

Not at all. My ex-girlfriend (BPD & manic depressive) was given Seroquel 25 and Cypralex, took these for about half a year and it seemed to make our situation worse than better. Our communication was more difficult, she seemed to deal with her job much worse then before, she seemed somewhat outflying to me, was tired a lot and had crazy ideas about her life even more often. Not good. On the other hand, I suspect she stopped taking this medication for a couple of days several times. She also used to drink alcohol, but not too much. So that also might be the reason - not the medication itself. She does not take medication for about two months now and is very much against beginning again (she is pregnant anyway). I don't know if she got better or worse afterwards, but at least she seems much more *present* if I talk to her and that is a small good change at least from my perspective.
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« Reply #84 on: June 12, 2009, 05:46:37 PM »

YES!  my 15yo MUST take his meds everyday or he is truly unbearable.  He is on 40mg fluoxetine (generic Prozac) and Abilify (15mg I think)  we jsut recently upped his prozac and it has made a HUGE difference.  I still think we could up it a bit more, but his psychiatrist is very conservative with meds.  I've actually been the one to initiate the increases about 2 weeks before our next visit for the last few months.

Since he's growing so much we've been seeing the Dr. every 2 months to adjust meds.  He still has a long way to go, but it is better.  He's not quite as angry and is a bit easier to control.

So, I highly recommend the meds we are on... .at the right dose of course.

btw... .he is diagnosed with childhood depression, ODD and mood disorder... .the BPD they won't diagnose until he is older... .but he fits everything I have read about it to a T
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« Reply #85 on: June 12, 2009, 10:56:59 PM »

YES!  my 15yo MUST take his meds everyday or he is truly unbearable.  He is on 40mg fluoxetine (generic Prozac) and Abilify (15mg I think)  we jsut recently upped his prozac and it has made a HUGE difference.  I still think we could up it a bit more, but his psychiatrist is very conservative with meds.  I've actually been the one to initiate the increases about 2 weeks before our next visit for the last few months.

Since he's growing so much we've been seeing the Dr. every 2 months to adjust meds.  He still has a long way to go, but it is better.  He's not quite as angry and is a bit easier to control.

So, I highly recommend the meds we are on... .at the right dose of course.

btw... .he is diagnosed with childhood depression, ODD and mood disorder... .the BPD they won't diagnose until he is older... .but he fits everything I have read about it to a T

My son is 17 and he was diagnosed with BPD.  Of course, his dad had already been diagnosed and so had his older sister.  It can be diagnosed in teenagers--its just that most clinicians are not that knowledgeable or comfortable with being able to accurately recognize and diagnose it in teenagers.  Fortunately, our doctor is an expert in diagnosing and treating BPD, and I recognized the symptoms, having dealt with it already with his father and older sister.  All three of them are on 80 mg. of Prozac--my daughter had been on 40 mg. but she had to be increased to 80 mg.  Generally, a higher dose of Prozac is needed for those with BPD, as opposed to just having depression. 

Here is a quote from the book, "Shorter Term Treatment for Borderline Personality Disorders" by John D. Preston, Psy. D.  He's also written books on psychopharmacology. 

      "A study by Markovitz, et. al. (1991) suggested that adequate behavioral control with moderate-to-severe BPD clients required high doses of fluoxetine (80 mg. per day).  Salzman, et. al. (1995) found that fluoxetine at lower doses (40 mg. per day) may be adequate for treating mild-to-moderate BPD; however, it must be noted that this dosing is higher than that generally used to treat major depression (i.e., 20 mg. per day)."


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« Reply #86 on: July 13, 2009, 04:08:34 PM »

Recent studies have shown that Lamictal is effective in flattening out the extreme emotionality in some people with BPD. I know that it helps my husband.
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« Reply #87 on: July 13, 2009, 04:25:15 PM »

My BPDh has definitely shown to be more stable on Lamictal (Lamotragine).
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« Reply #88 on: July 13, 2009, 06:01:39 PM »

Meds don't cure BPD like cough medicine doesn't cure a cold, but they both reduce the symptoms. My DBPDSO takes/has taken meds for depression, anxiety, anger, and psychosis. They do indeed help her with those symptoms. But the DBT is what is changing her thought processes and *that's* what really helps the BPD. I also believe that taking meds can cause changes in someone with BPD that could lead them into therapy and DBT.

Peacebaby
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« Reply #89 on: July 13, 2009, 06:49:54 PM »

My husband takes Zoloft (depression), Klonopin (anxiety), Concerta (ADHD/impulse control) and just recently started Lamictal (mood stabilizer).  One thing that I have learned, is that while these meds help him a GREAT deal, they are almost useless without him going to WEEKLY therapy.  He recently slipped back into a very bad low about a month ago, and while he started Lamictal since then (which probably hasn't taken effect yet), it was the getting back into therapy that improved things for him the most.
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« Reply #90 on: July 13, 2009, 08:59:00 PM »

My wife has taken a changeable mix of psych meds for years.  Her most consistent diagnosis is actually bipolar II, though she has twice been diagnosed with BPD, both times during hospital stays last year during her big crisis. So she was actually originally put on the meds for bipolar.

My opinion is definitely mixed. They seemed to help a lot initially, and there's no doubt that she was more functional for the next couple of years. But in retrospect, while they helped some with "moods" (lifting her out of depression, backing her down from feeling like she couldn't slow down, etc.) they didn't help with the twisted thinking, blaming, etc.  And she didn't have any therapy until her big crisis last year.

So ... .I just don't know. Maybe things would be worse without the meds. Maybe not.

Even with bipolar (i.e. with no BPD present) - a supposedly more purely chemical disease where meds are considered a must - it is very difficult to get them right, and they often have to be tweaked for years and years.
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« Reply #91 on: July 14, 2009, 08:19:38 AM »

My BPD partner has been "in the system" for a long time.  He has been previously diagnosed with depression, PTSD, disassociative identity disorder, bi-polar, ADHD, various addictions, and has been on different meds for all of these. He has tried a variety of different anti-depressants - after a while they seem to be less effective... .

So right now he is on Wellbutrin and Celexa (they work in concert), valproic acid (Depakote) for mood stabilization, and for real, full-blown rages, he takes Risperidone. Also for depression he takes a B-vitamin complex and a multi-vitamin.  It has taken a lot of adjustments to get to a helpful therapeutic level. And if he missses for a few days - well, I have learned to leave until he gets back on the meds.

It seems to me (but I am not a professional) that it just hasn't been studied enough in terms of chemical analysis of the condition. 

Definitely, nothing "really" improves until he is in continuous therapy. Of course, that has it's pitfalls too. As the therapist gets to the heart of his background, uncomfortable things are uncovered, and he can be overwhelmed, and need therapeutic breaks just to deal with all the personal discovery happening.

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« Reply #92 on: August 05, 2009, 02:33:17 PM »

 Hello everyone.

   My BPD wife takes Benzodiazepam (to calm her nerves). She also smokes pot and has taken speed off and on. I believe this can make things worse! Can anyone confirm this?
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« Reply #93 on: August 05, 2009, 11:59:44 PM »

Ken,

I'm not a doctor and I have no special knowledge of this stuff.

I assume the Benzo... .is prescribed?

Even if it is - and I think we all know that doctors prescribe stuff they shouldn't sometimes - surely she didn't tell the doctor that she smokes pot and uses speed.  My ex, who suffers from BPD, used to smoke pot (behind my back) when we were married, and when I found out I didn't say anything, because I thought it might be helping her control her rage.  But the amphetamines can't be good, and of coure they tend to be addictive.

What is your wife's behavior like?

And do you have kids?

Best,

Matt
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« Reply #94 on: August 06, 2009, 10:18:45 AM »

  We don't have kids. She also would "hide" from me when she smoked pot... .but near the end she would just try to make me feel bad like I was trying to stop her from living when I would tell her how concerned I was about her pot. I noticed lately she forgets things. She left me and lives with a guy who sells pot for a living... .go figure!
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« Reply #95 on: November 23, 2009, 12:43:01 AM »

I  have a sister who is taking Lamictil ... all these years I was told she was Bi-Polar... she is currently in the hospital because she is having seizures... I spoke with one of her friends who also takes it... just as I suspect she feels my sister is lying... but we can't pinpoint why or what she is lying about... My sister drinks while on this drug... Is there any chance at all sh eis taking Lamictal for BPD and does not want to admit? Her friend is Bipolar and I was trying to explain to her about BPD... She think my sister loves all the attention... I also think it is odd she purposely has doctors treating her that she does not know...
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« Reply #96 on: November 23, 2009, 01:48:07 PM »

My daughter takes it as a mood stabilizer. She is 17 and has been diagnosed with RAD, BPD traits, bipolar traits among other things. She takes it in conjunction with other prescribed medications.

It works in the part of the brain where seizures start, the limbic system. The limbic system is also described here as a pos. site for abnormality for a person with BPD:

theory of etiology consists of three different biological explanations for the development of BPD. The first one is that there is a problem in the limbic system, specifically in the amygdala and the hippocampus, in a person with BPD. Both the amygdala and the hippocampus are in charge of regulating the expression of emotions and particularly the expression of "fear, rage, and automatic reactions". All of these are very important components in BPD, where the people have excessive anger and also fear in their relationships, which is demonstrated through impulsive acts like self-mutilation, which is an example of an automatic reaction. The limbic system in general is considered the "emotional centre" of the brain. It has been found in studies that the volume of the amygdala and of the hippocampus are significantly smaller in people with BPD than in people who do not have any mental illness, indicating that there could be a link between BPD and a dysfunctional amygdala and hippocampus.

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« Reply #97 on: January 20, 2010, 12:54:58 AM »

Apparently there is a word limit here, so I will try to make my inquiry brief:I am almost 100% certain that my adult daughter suffers from borderline personality disorder.  After years of crises, dramas, dui-s, you name it,she has finally been seeing the same therapist for 5 or 6 months.

Even though she has been on Wellbutrin for that long, she cannot control her rage.  This morning she raged at her 7-year old daughter,felt remorse, and told her therapist about it.  He said that he thought she needed an anti-anxiety drug like Xanax or Klonapin (sp), as well as the Wellbutrin.I question Xanax because she is an alcoholic and I fear addiction to it.Does anyone here know of a psychotropic (sp) drug that would help her to control the rage?
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« Reply #98 on: January 20, 2010, 08:54:02 AM »

is she an alchoholic still drinking... or recovered? not drinking

tony
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« Reply #99 on: January 20, 2010, 09:09:33 AM »

My daughter drinks. She was prescribed klonopin for anxiety. The results of her combining alcohol and klonopin were devastating; she would become very aggressive . Klonopin ( I think all benzos) is also one of the most addictive drugs (including illegal) out there. My daughter has been attempting to wean off for months now. I strongly suggest looking up the drug interactions on these meds as well as looking into benzo withdrawal sites... .It changed my daughter's life but not for the better and it made her anger worse! She now takes wellbutrin also along with zoloft (an anti depressant) which I think has some sort of impulse control component. Good luck!
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« Reply #100 on: January 20, 2010, 09:24:40 AM »

all of these meds... from reading my exes bottles and reading on line about the meds... she was taking...

drinking is an absolute no no... .

most of these drugs cant even be mixed cause of... .the interations...

they target things in the brain... and alchohol... .it dont allow the drugs to do that... .

i would think that for eany of these drugs... to work as prescribed... .there cant be any drinking... none...

my ex wanst an chronic drinker... but when she had a few... (cause she said she could)

i never knew what mood to expect... .cause the sedated... g/f wasnt so sedated after 3 beers... .

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« Reply #101 on: January 20, 2010, 09:33:19 AM »

Absolutely right. Drinking is a no no with any of these meds... .I think drinking with BPD is a no no too! I guess everyone's altered by alcohol BPD or not. Unfortunately my daughter has not chosen to stop drinking so I was just relating how much worse the klonopin in particular made her while drinking.
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« Reply #102 on: January 20, 2010, 10:06:41 AM »

Heartfelt thanks to both of you.

Daughter would say that she is no longer drinking, but she insists that

she is able to have (deserves) "a cocktail or two" when she goes out.  She comes home almost literally comatose.  She is a binge drinker -- and since I only see her return home when I am taking care of my granddaughter, I don't know how often this happens.

Years ago she did stay in AA and stay sober for a year, but (according

to her) I caused her to start drinking again.

Now I am frightened that she will try the Klonopin.

Thanks again.
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« Reply #103 on: January 20, 2010, 10:24:12 AM »

My daughter is on zoloft and abilify when she chooses to take them  ?.   The abilify seems to help control the aggression and rages.   She has also been on lithium, lamictal, depakote.  She was on the lamictal and depakote together for years.  
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« Reply #104 on: January 20, 2010, 10:29:02 AM »

i took the liberty of looking it up this is a cut out from one of the sites i got when i put alchohol and klonopin in a search... and also dont spell this good...

Combining Klonopin (clonazepam) & alcohol can kill you. They both act on the exact same brain cell receptors (GABA receptors), so combining the two can be too much for the brain. They cause the brain to slow down, & when it slows down that part of the brain in charge of breathing enough, then you can stop breathing & die. Combining Klonopin & alcohol can also make someone more likely to have seizures.

 dearest... i know no more than you when it comes to meds... .i know what i know from experience... with the meds... .and my curoisity... .

drugs... like zoloft and many of the mind drugs... have to reach a level from regular daily dosages it could take a month... for the drugs to reach the level that your prescriber wahts her to reach,... .skipping days and or periods of time...

wont do what the drugs are suppodes to do...
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« Reply #105 on: January 20, 2010, 10:32:49 AM »

You and I know that.   I wish I could make her realize that.   She takes it when she is in the RTC but when she is not highly supervised like the IOP program she doesn't take them even though she tells me that she is.  Hence why she is now sitting in jail on assault on an officer charges because she hadn't taken her meds for over three weeks and becomes very agressive when not on her meds.  Gotta love it
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« Reply #106 on: January 20, 2010, 07:28:50 PM »

These are some of the side effects listed on the klonopin website. I wish I'd checked this before my daughter started taking it!


Psychiatric: Confusion, depression, amnesia, hallucinations, hysteria, increased libido, insomnia, psychosis,(the behavior effects are more likely to occur in patients with a history of psychiatric disturbances). The following paradoxical reactions have been observed: excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams

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« Reply #107 on: January 21, 2010, 07:33:31 AM »

all of these side affects and klonopin is an anti anxiety drug?   

since alcohol is a depressant that's got to go    of course!

in my BPD13's case prozac for depression seems to work well when combined with abilify as a mood stabilizer and aid to prozac's affectiveness.  we have had to adjust the abilify over time since she started in july of 09.

the experts say the most affective treatment is medication when combined with therapy. 

i would like to add to that (personally) consequences!

best to you all

lbjnltx
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« Reply #108 on: January 21, 2010, 08:21:53 AM »

Does anyone here know of a psychotropic (sp) drug that would help her

to control the rage?

Is your daughter being treated by a psychiatrist or a general practitioner?  Are they aware of the drinking issues?  That might be the first thing to tackle.

There are no specific drugs approved by the FDA for the treatment of BPD.  But, there are numerous drugs approved to treat the symptoms evident in those with BPD.  According to several published reports, SSRIs are considered to be the appropriate initial psychotropic medication prescribed to a person with BPD. Here is one reference: www.ajp.psychiatryonline.org/cgi/content/abstract/159/12/2048/f/SSRIworks.htm

SSRIs and related antidepressants   Symptoms Improved by One or More Medications in the Class - anxiety, depression, mood swings, impulsivity, anger/hostility, self-injury, impulsive-aggression, poor general functioning

  • fluoxetine (Prozac)*
  • fluvoxamine (Luvox)*
  • sertraline (Zoloft)°
  • venlafaxine (Effexor)°

Several of these serotonin uptake inhibitors, including the long-acting fluoxetine, have been found to decrease alcohol intake in moderately dependent alcoholics. These are not the primary drugs for treating alcohol dependence, it may be a better direction than Klonopin.  It's worth exploring with the prescribing physician.  Of course, no drug will help unless she tries.

www.ncbi.nlm.nih.gov/pubmed/7814825

As for the Klonopin, generally, when their are problems with a drug, the practice is to try an alternate from the group - other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax)  Addiction-prone individuals (such as drug addicts or alcoholics) should be under very careful surveillance when receiving Klonopin because of the predisposition of such patients to habituation and dependence. As you pointed out, these drugs are addictive in there own right - as much as alcohol.  Is he giving her renewing prescription of this drug - or just a little to help with moments of anxiety?  Dod she request it?

None of this is to make a prescribing recommendation. This is just some information I have - and my knowledge base is not broad.  Hope this helps in your own research and in your discussion with the prescribing physician.

Skippy
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« Reply #109 on: January 22, 2010, 08:24:17 PM »

IMPORTANT: Just about any p drug is considered a no-no with alcohol. A lot of people ignore this prohibition and do okay. BUt I can tell you that Klonopin and alcohol can be a REALLY REALLY BAD mix.

As mentioned elsewhere on this thread, aggressive and even violent behavior is a common effect.

There's also, also elsewhere mentioned, the fact that alcohol and benzos can inhibit breathing and can even lead to death.

I know someone who, as a young person, was very cavalier about mixing drugs and alcohol and never had problems. Then one night he combined alcohol and Klonopin, and then found himself in the hospital strapped to a table with everyone giving him weird looks and his friends furious at him. To this day, he can't remember what he did. That's just one story, but it's apparently VERY common to act violent but then lost all memory about it.
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« Reply #110 on: January 23, 2010, 09:40:54 AM »

Alcohol and the benzos are central nervous system downers... .  but they also act as disinhibitors.  Many people do things that they wouldn't normally do.  This is why some people just fall asleep after a couple of drinks and others get violent or act nutty in some other way.   Benzos have a similar affect.  They also cause memory problems, so that a person drinking and/or taking benzos may do something "bad" and then not remember it.

Also, many addicts take too many.  Even if not drinking, if the prescription calls for 3 X a day, a person with addictive tendencies may take "one or two more"... but... combine that with memory problems, and the person may be taking many more than he/she thinks he/she has taken.  People with addictive tendencies should not have control over a bottle of a benzo.  If it is necessary prescription, somebody else should hold their prescription for them and only give them the pill at the prescribed time.  (Try to get someone with BPD or someone who is an active addict to agree to that!    .) 
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Andarial

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« Reply #111 on: February 12, 2010, 06:28:56 AM »

It seems a common thing for BP's to smoke pot... .am I right? It likely has something to do with brain chemistry (seratonin), and I certainly hope that researchers are taking this into consideration. My partner always says that all he needs is a medication that will mimic pot. He smokes on and off, when he smokes pot he is delightful, loving, empathetic and thoughtful... . the problems come when he stops smoking, after smoking it for a few days. It has happened time and time again - when he stops smoking, he will go through what he himself calls a 'psychosis' where he will have uncontrollable rages, become irrational (much more than usual) and usually ends in him breaking our valuables and trying to get me to leave... .basically the standard BP behaviour, just magnified significantly.

The thing is, in a rare moment of clarity, he told me what it is like when he smokes pot. He says that it allows his 'walls' to come down, and he is 'allowed' to feel and respond and accept, and the walls that he usually puts up to protect himself from hurt are removed, to allow him to 'feel'. The conversation was so heartfelt and in-depth that it made me cry, and makes me teary just thinking about the raw and rare emotions he expressed.

He knows he can't smoke pot because of the 'psychosis' he experiences when he stops. As I said, I assume it is a brain chemistry thing that makes him more (and I hate to use the word) 'normal', but what would cause the sudden and predictable 'psychosis' and rages as soon as he stops? These rages will last a couple of days after he stops smoking then he will go back to his standard BP self.
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« Reply #112 on: February 12, 2010, 08:17:09 AM »

Hi, I know what you are going through with this one! My BF is also like this with pot. When he has it he is calmer, but still has BPD episodes, but when he does not have it the rage is 10 times worse. If he has it, it is just an easy way out of the BPD, but when he does not have it... .woah! He has stopped for a week, and everything seems ok at the moment, but I am just waiting for the next and final flair up... .
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« Reply #113 on: February 12, 2010, 12:19:56 PM »

 Bullet: comment directed to __ (click to insert in post) Andarial

Withdrawal from drugs is excruciating.  I used to smoke so much pot that if I ran out I would go insane.  I seemingly outgrew this.  I can take it or leave it these days.  

that said my ex doesnt like getting high she says.  but we did get high several times and it was amazing.  she laughed with her belly and was genuinely happy in those moments.  she never raged at me when high.  there were no eggshells.  it was just normal being high with a friend.  
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« Reply #114 on: February 20, 2010, 07:34:33 PM »

Just wanted to add to this thread.

When growing up-early teens with my BPD/NPD(since childhood) older sis, I would revel in the occasions of her being stoned on pot. They were the times when I could exert my personality freely... .it actually became a joke. She was very mellow and happy, not at all feeling threatened by me and I had some freedom to be. This was before I started to defend myself ofcourse.

In recent years, if my sis takes anything natural that may have some neurological benefit like cordyceps or Nuerozyme (Vitamin combinations), she will get totally whacked out for the day-often can barely function and that is that. It is the weirdest thing. Her brain must be so unstable. Of course she would never go on meds and more than one experience with any natural supplement for the brain, doesn't happen due to the effect she feels-out of control.

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« Reply #115 on: February 20, 2010, 09:19:25 PM »

Are there any actual medications that they prescribe for BPD? My ex had Prozac geodom and something else. A downer. None of it helped... .(he smoked pot too but it didn't make a lot of difference)
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« Reply #116 on: April 05, 2010, 01:05:22 PM »

My stbxw, who has been dx'd with depression, ADD and bulimia (claims to be in recovery, but I still see bingeing) is on the following:

200 mg/day lamictal
90 mg/day cymbalta
90 mg/day buspar
2 x 20 mg/day adderall (xr)
.5 mg xanax prn
ambien at night for sleep.

Isn't this heavy duty stuff, and is it good/bad/irrelevant to BPD?

Comments from anyone with med expertise or experience would be appreciated.
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zero0zero0zero0
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« Reply #117 on: April 05, 2010, 01:20:13 PM »

I just saw this link posted by another member.  It's a start.   Smiling (click to insert in post)
https://www.healthyplace.com/personality-disorders/borderline-personality-disorder/borderline-personality-disorder-articles/

It says xanax is a no no as well... Alexis
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« Reply #118 on: May 15, 2010, 03:39:54 PM »

I haven't tried anything yet.  My homeopath charges about $325.00 (includes meds) but I wanted to just put it out there if anybody else has tried anything with any success.  I have used homeopathics for years, and I know that the results can be amazing.  It's just right now between the psychologists, the boot camp I am looking into for the summer ($$$) and the possible boarding school for the fall ($$$$$) I'm trying to be very careful and don't want to waste the money if it won't be effective.   I also don't think that she would be co-operative about even taking the meds right now.  Tried some from the psychiatrist, and she would take them at our insistence,and then just throw them up. 

I'm feeling a little desperate in these days.  Thanks for your reply.  And good luck!

Tenacious
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« Reply #119 on: May 17, 2010, 08:30:19 AM »

He refuses to take the meds prescribed by the psych because he is afraid of their effects.

The way I look at it is: any substance with a powerful enough psychoactive effect to even possibly treat serious symptoms is also going to likely have side effects and risks.

It's not as if over here you have "natural" things that can only do you good and no harm, but over there you have "artificial" things that can only do you harm but no good.  Being cool (click to insert in post) 

In both cases we are talking (if there's any point in using them at all) about substances with powerful effects on the brain and nervous system.
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« Reply #120 on: October 03, 2010, 05:48:41 AM »

My dBPDm was put on this a few weeks ago.  She is strangely happy almost to the point of being inappropriate.  Her affect is weird.  She is giddy.  She has also been falling a lot.  

It is almost like a weird type of mania.  Still making terrible financial decisions, but that no longer is my worry.  

Excerpt
ABILIFY

Schizophrenia  ABILIFY is indicated for the treatment of schizophrenia. The efficacy of ABILIFY was established in four 4-6 week trials in adults and one 6-week trial in adolescents (13 to 17 years). Maintenance efficacy was demonstrated in one trial in adults and can be extrapolated to adolescents [see Clinical Studies].

Bipolar I Disorder

Monotherapy


ABILIFY is indicated for the acute and maintenance treatment of manic and mixed episodes associated with bipolar I disorder. Efficacy was established in four 3-week monotherapy trials in adults and one 4-week monotherapy trial in pediatric patients (10 to 17 years). Maintenance efficacy was demonstrated in a monotherapy trial in adults and can be extrapolated to pediatric patients (10 to 17 years) [see Clinical Studies].

Adjunctive Therapy

ABILIFY is indicated as an adjunctive therapy to either lithium or valproate for the acute treatment of manic and mixed episodes associated with bipolar I disorder. Efficacy was established in one 6-week adjunctive trial in adults and can be extrapolated to pediatric patients (10 to 17 years) [see Clinical Studies].

Adjunctive Treatment of Major Depressive Disorder

ABILIFY is indicated for use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD). Efficacy was established in two 6-week trials in adults with MDD who had an inadequate response to antidepressant therapy during the current episode [see Clinical Studies].

Irritability Associated with Autistic Disorder

ABILIFY is indicated for the treatment of irritability associated with autistic disorder. Efficacy was established in two 8-week trials in pediatric patients (aged 6 to 17 years) with irritability associated with autistic disorder (including symptoms of aggression towards others, deliberate self-injuriousness, temper tantrums, and quickly changing moods) [see Clinical Studies].

Agitation Associated with Schizophrenia or Bipolar I Mania

ABILIFY Injection is indicated for the acute treatment of agitation associated with schizophrenia or bipolar disorder, manic or mixed. "Psychomotor agitation" is defined in DSM-IV as "excessive motor activity associated with a feeling of inner tension". Patients experiencing agitation often manifest behaviors that interfere with their diagnosis and care (eg, threatening behaviors, escalating or urgently distressing behavior, or self-exhausting behavior), leading clinicians to the use of intramuscular antipsychotic medications to achieve immediate control of the agitation. Efficacy was established in three short-term (24-hour) trials in adults [see Clinical Studies].

Special Considerations in Treating Pediatric Schizophrenia, Bipolar I Disorder, and Irritability Associated with Autistic Disorder

Psychiatric disorders in children and adolescents are often serious mental disorders with variable symptom profiles that are not always congruent with adult diagnostic criteria. It is recommended that psychotropic medication therapy for pediatric patients only be initiated after a thorough diagnostic evaluation has been conducted and careful consideration given to the risks associated with medication treatment. Medication treatment for pediatric patients with schizophrenia, bipolar I disorder, and irritability associated with autistic disorder is indicated as part of a total treatment program that often includes psychological, educational, and social interventions.

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« Reply #121 on: October 03, 2010, 04:38:37 PM »

My uBPD mom also has depression and was given Abilify about a year ago.  She reacted the same way.  It was over the top, but better than the alternative.  It was very short lived though.  I'm not sure if she went off of it or if the initial effects wore off.
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« Reply #122 on: October 04, 2010, 03:56:03 AM »

My dBPDm was put on this a few weeks ago.  She is strangely happy almost to the point of being inappropriate.  Her affect is weird.  She is giddy.  She has also been falling a lot. 

It is almost like a weird type of mania.  Still making terrible financial decisions, but that no longer is my worry. 

I'm not a medical doctor but those sound like the kind of side effects that the physician who supplied them to her should know about. I am not BPD but I reacted to a completely different psychoactive drug once in a similar way as my system would not tolerate the drug. Staying on it longer made me more and more ill.

I don't want to alarm you - but I think a doctor should be made aware of unwanted side effects. He/she may see them as temporary, and view that they will pass, but they should still know. Maybe you could write and let them know. I know there are confidentiality issues (ie they will not tell you whether they plan to change her treatment or disclose anything about her condition) but at least you will feel you've done something constructive. Or you could write down the changes you've seen in your mother since the meds on a piece of paper and ask her to read it out to her doctor. That way, she gets to take responsibility.

I know drawing boundaries with BPD parents is hard, so I don't want dictate what anyone should do, or where their responsibilities lie. Also note: I am coming at this from a perspective of experiencing the UK health system where you sometimes have to be very demanding and very informed to get the level of treatment you need. My parents are both mentally ill, and even though their behaviour has been abusive and neglectful in the past, I feel very protective of them (and angry on their behalf) when I feel they are not getting the medical care they need.

I think though, the fact that you have posted on this board shows you are very worried. Maybe if you 'hand the problem over' to a health professional you will feel you have 'done your bit' and can rest easier.

I don't want to preach so please feel free to ignore this... .

Annie
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« Reply #123 on: January 18, 2011, 02:59:36 PM »

Is medication enough to treat the aggressive behavior/acting out? Many posts indicate that BPDs have too much emotions. Looks like we all liked the "good" loving behavior and dislike the "bad" negative emotions.

My ex was put on anti-anxiety drugs and got much better for a while. It helped him focus and reflect over his actions and it certainly calmed him down. He stopped taking the pills and then the raging and mood swings started again.
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« Reply #124 on: January 19, 2011, 02:50:32 PM »

Is medication enough to treat the aggressive behavior/acting out?

The general consensus in the psychiatric world seems to be that medication alone is not enough for treating BPD.
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« Reply #125 on: March 29, 2011, 07:47:33 PM »

Has anybody ever tried or heard of lithium carbonate for BPD?  I was just reading about it being used for impulsive behavior and rash judgements.
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« Reply #126 on: March 30, 2011, 12:08:04 PM »

Back when I was in-patient (and that's a good 35 years, kiddies Smiling (click to insert in post)), lithium carbonate was the drug of choice for bipolar, called manic-depression then. There's a lot of overlap between BPD and Bipolar. Its a HARD drug. very ugly side effects, and I remember the people on lithium all had "the walkies", where they rock from side-to-side or sort of march inplace because they couldn't be still. Also they tended to get a flat effect (little facial expression). However... .as is often the case with psychotropic meds, for SOME people, lithium was a godsend. Oh, and I remember a doc telling me that lithium was the definitive test for wether or not a patient had bipolar- if you give them lithium and they get better, then your dx was right... .if you gave them lithium and it made them worse, you dx'd wrong. That same sort of philosophy is still in play, tho less specifically. reassuring, no?

There are new gen drugs that usually are preferred over lithium, these days.

vivgood
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« Reply #127 on: March 30, 2011, 12:32:21 PM »

Hi ccb,

My BPDd was on Lithium for a while.  At first, it seemed to help, but she was back to her normal self (out of control) in a few weeks.  There is no drug that can help my d right now - she's too determined not to get well. 

Vivgood is right - there are newer drugs that doctors like to try first, but Lithium can be used when all else fails.  People taking it can experience some pretty nasty side effects.  In addition, routine lab work must be done to make sure the Lithium level is therapeutic.  If the level is too low, it doesn't work... .A high level can lead to toxicity. 

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« Reply #128 on: May 08, 2011, 03:01:30 PM »

Latuda(antipsychotic & schizo) and Stelazine(antipsychotic/schizo) used for anxiety

The latuda has really made a difference.  We tried Sapphris but the taste was making her puke.

Latude is new.  Stelazine is a try before we go to Thorazine(which they're holding out for obvious reasons)
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« Reply #129 on: May 08, 2011, 06:20:32 PM »

Two antipsychotics is risky ... watch out for Neuroleptic Malignant Syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726098/

Presumably the psychiatrist is watching out for this ... just keep an eye out.
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« Reply #130 on: September 07, 2012, 04:04:32 AM »

I think it really depends on the individual and how the disorder manifests itself. For example, I've read that Seroquel (Quetiopine) is effective for helping balance out mood from some BPD sufferers but with everything it is about what works for that person. There is no right or wrong answer. There isn't a specific medication designed to deal with BPD like there is depression or anxiety but both these types of meds can be used to alleviate some of the symptoms of or problems caused by BPD. I personally tried many different meds until I knew what was right for me.

I hope this was helpful.
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« Reply #131 on: January 17, 2013, 03:23:35 PM »

my BPD partner is on moclobomide150mg 2 twice a day, carbamazapine 400mg 1 twice a day and quetiepine 100mg 1 five times a day but after a recent breakdown episode which had been slowly building for months with bad mood swings Jekyll and hyde behaviour his psychiatrist is now thinking of introducing lithium ( jsut awaiting blood results) and gradually reducing the carbamazapine just hoping the lithium will help stabalize his moods as they are real bad at the moment but he dosen't recognize it himself he has to be told they are. but at the time he wont admit it telling him just makes him worse, but when he sees his psychiatrist he will tell him 'my wife has told me my moods are bad but i dont realize they are' fingers crossed for lithium
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« Reply #132 on: January 27, 2013, 01:28:47 PM »

Hi,

I was wondering if anyone had any exp with medications called Phenelzine (phenelzine nardil) for BPD dont know much about it at all but was reading some information on line and reviews were good for depression and other types of illness.  Has there been any studies done on this drug for BPD and it guess this is a older drug and it is not used to quickly ,again i don't know much about it so be aware.
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« Reply #133 on: March 08, 2013, 07:27:05 AM »

Mine is on them for depression and I wondered if they help with BPD. He is coming off them at the moment and his BPD is geting worse.

Thanks
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« Reply #134 on: March 08, 2013, 08:23:47 AM »

Mine has been on anti-depressants for years, I certainly notice the difference if he decides to stop for a few days ( in the narcissistic phase when he thinks there's nothing wrong with him) I wouldn't say they've improve the BPD they just stop him from being quite as volatile.
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« Reply #135 on: March 08, 2013, 01:05:11 PM »

My SO was on a maintenance dose of Prozac the she told me it had been prescribed for depression.

I discovered some months ago that she had chosen to come off it herself. Strangely enough I had noticed an increase in her irritability and anger about a year ago and I am guessing that was about time she stopped taking it.

I have only recently learned that she most likely surfers from BPD. She is seeing a T but wont speak to me since she started going 5 weeks ago, never mind tell me the diagnosis!

Although knowing what I do now I can still see signs of BPD in her over a year ago I do think that the Prozac probably helped balance her mood swings somewhat.
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« Reply #136 on: August 23, 2013, 04:02:09 PM »

I have a mother w/BPD who has sisters that display similar symptoms. They are all on Prozac and say that it has kept them from indulging in the rage episodes. They all seem much happier. They have never been in therapy and it seems to have worked wonders! Yet I have a friend w/BPD on Prozac and it has made absolutely no difference. It is such a frustrating disorder!
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« Reply #137 on: October 20, 2013, 08:10:07 PM »

Skip, My uBPDw has the classic behaviors as described in SWOE. At a point, about 15 years ago, she started taking Paxil. The effect was dramatic : my perception was that Paxil restored her to normal. She became the woman I married. Unfortunately, like so many others, she did not like some of the side effects especially weight gain , and ultimately discontinued use. Well, it was nice while it lasted.
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« Reply #138 on: November 19, 2013, 10:05:41 AM »

Short question in addition to my (overlong) post above:

What effect will lithium have on a person that is not bipolar, but is in fact BPD?

My wife has clearly been mis-diagnosed because her doctor is not familiar with her situation. She's not even convinced herself that she is bipolar, she just talked her way to a situation where she could have "better medication", i e a bipolar diagnosis (this out of desperation apparently). Only afterwards does she realize that she may be medicating for something she does not have.
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« Reply #139 on: January 05, 2014, 05:57:32 AM »

Has anyone had any experience with the new drug Lurasidone (Latuda)?

My daughter started taking it a little over two weeks ago and she just had her first meltdown in months which ended up with having to have her admitted on Wednesday.

I heard there were very few if any side effects so I just wanted to see what any of you might have to say.

Googie
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« Reply #140 on: January 05, 2014, 06:49:11 PM »

It appears that is is not a brand new drug, Latuda (we have a mention of it here from 2011):
https://bpdfamily.com/message_board/index.php?topic=145158.msg1415932#msg1415932

So hopefully some members may have some real-life reports about it. NAMI has a description of it:
https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications/lurasidone-(Latuda)

Another site quotes that there is only minimal risk of weight-gain as a side-effect (that's a plus!)
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« Reply #141 on: January 12, 2014, 11:38:07 AM »

I know I'm posting in an old thread, but wanted to relay my experiences.

My DD has been on this medication roller coaster for about 2 years now, starting with Zoloft for depression, a number of anti-anxiety meds, Welbutrin, Abilify, Lexapro, lithium, and most recently Saphris.  Of all these, the Abilify was the first to show any sign of positive change in her, helping her to at least stabilize emotionally somewhat.  She still had depression, anxiety and  self harm tendencies but not as frantically.   After a suicide attempt a year ago, the hospital decided to take her off all the antidepressants and start lithium.  After about 3 weeks she was a completely different person with very few signs of the depression and anxiety.  The problem was the weight gain, and so the doctor switched her to Saphris.  Although she still exhibits all the classic signs of BPD, her suicidal ideation and self harm are almost completely gone.  
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« Reply #142 on: January 14, 2014, 08:11:37 AM »

My 18yo DS has been diagnosed with PTSD, mood disorder, ADHD, and BPD.  BPD was the most recent.  Prozac is commonly used to treat PTSD, and we see a remarkable improvement in just about all areas but not until he reaches a dosage of 60 mg.  Recently his dosage was decreased to 40 mg and all hell broke loose.  Back at 60 and things are much better, it is clear that it helps him manage his BPD as well.  BUT at 60 he felt flat, so 150 mg of Wellbutrin was added, which did the trick and gave him back his energy.  He also takes 20 mg of Ritalin LA, which has been a godsend and has reduced his school-related rage.  As noted, there seems to be at least some relationship between ADHD, executive functioning and BPD.  His neuropsych tests showed that, despite normal IQ, his working memory was in the FIRST percentile, I can't even imagine how frustrating that must be, I'd rage too with those kinds of challenges.  Just recently he has been prescribed a low dose of Abilify, as some triggers have made his BPD more obvious and his therapist believes it's time and he's ready to start coming to terms with the trauma he experienced with his birth mother.  Aerobic exercise helps, when he does it.

So... . this process alone, of figuring out dosages/diagnoses while having weekly therapy sessions, has taken a year and a half.  So far his team feels that individual therapy is best for him, and I see improvement both from therapy and meds, but this is no short-term process.
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« Reply #143 on: January 18, 2014, 09:23:56 AM »

my BPDw takes clonazepam and seroquel, but not for BPD, which can't be medicated in itself and which so far as i know no-one has mentioned to her anyway. and whatever these medications have done they haven't touched her BPD traits.
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« Reply #144 on: April 23, 2014, 06:08:42 PM »

Just saw this thread -

My GF has been put on Latuda.  She's also on Lithium and Wellbutrin.  

The Dr started her on Latuda because of potential side effects with other mood stabilizers - birth defects if she got pregnant (supposedly Latuda is safer) and weight gain.  I also seem to remember another mood stabilizer she was on was also causing restless leg syndrome, so they switched to Latuda.

I can't really say anything positive or negative.  Her rages have been less violent since she went on medication, but that could be the Lithium, or could just be her being more accepting of her situation.  But, there haven't been any negative changes.  Personally, I haven't seen enough positive change to say the mood stabilizing drugs are doing any good.  The Wellbutrin seems to have helped some, but she is far from being happy.  She was also diagnosed Bipolar - and the meds should help her with that.  But since there hasn't been much of a change, I'm thinking she isn't bipolar at all - just really bad BPD.
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« Reply #145 on: May 28, 2014, 10:27:50 PM »

Maxsterling- My DD16 is bipolar as well.  Latuda was discontinued due to the fact her med (trileptal) was working just fine, my dd just wanted to control her own care and the doc was willing to change things up without knowing her med hx.  

She has recently convinced her doc to half the trileptal and has since started down the all too predictable slippery slope.  Her treatment team thinks she is fine, but I see big trouble right around the corner.  Going to post about it and hope to hear some great advice from you guys.

Googie
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« Reply #146 on: January 30, 2015, 02:12:52 PM »

I take Paxil for panic disorder and depression, and I've been on it for over 10 years. (Dosage is usually upped every 4 years or so.)

For the first few months, I had zero libido and couldn't achieve orgasm, but fortunately those side effects went away after about month 6 in my case. The only side effects that have lasted are occasional night sweats and the weird "brain zaps" that happen if I miss a day's dosage. (Yes, Paxil has seriously heinous withdrawal symptoms.)

I've tried other meds, but they didn't work on my anxiety and depression like Paxil. Just the nature of my body chemistry, I guess. Everyone's wired a little differently. Smiling (click to insert in post)

So, I definitely think it's worth a try for someone struggling with anxiety and/or depression. Watch for the side effects, because if they last, then I'm not sure the tradeoff is worth it. And before anyone starts on Paxil or a similar SSRI, they should be aware of just how difficult the withdrawal is -- and if they want to stop it once they've started, they will need to do so under the supervision of a doctor. It's not good to just stop an SSRI cold turkey.
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« Reply #147 on: November 04, 2018, 10:26:40 PM »

I’m am feeling great ever since my ex and I are using Dr Frizzettis Validating techniques. It has made a huge difference in how we all interact.

And the 3 Ketalar (ketamine) treatments have gone very well and my daughter has not mentioned suicide once she she started the ketamine despite a big blow up one day with her sister.

She has one more week of ketamine and then she starts a 5 week DBT program.

I am extremely optimistic that we have finally found a great way to manage her condition—ketamine and DBT.

Fingers crossed. It’s still early. But this is the first hope I have had in 15 years.

MomofadultBPD
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« Reply #148 on: March 09, 2019, 10:57:42 AM »

When the doctor put my mom on Paxil, it was like having a completely different mom. It seemed to take effect far more quickly than what I had expected. About a week after she began the meds, I went over to her house and she was SINGING!

I hadn't heard her sing since I was a child. She was far happier and much less agitated, until the dementia increased.
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“The Four Agreements  1. Be impeccable with your word.  2. Don’t take anything personally.  3. Don’t make assumptions.  4. Always do your best. ”     ― Miguel Ruiz, The Four Agreements: A Practical Guide to Personal Freedom
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« Reply #149 on: March 13, 2019, 01:51:26 AM »

My uBPD H was put on Zoloft for about a year when he was misdiagnosed with PTSD.  This is a common misdiagnosis because BPD is seen as a "women's illness."  He went off the Zoloft after a year.  
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