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Author Topic: TREATMENT: Medications  (Read 6994 times)
Skippy
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« on: July 12, 2006, 08:20:39 AM »

National Institute of Mental Health

A brief overview that focuses on the symptoms, treatments, and research findings. (2001).


www.wwwapps.nimh.nih.gov/health/publications/borderline-personality-disorder.shtml

Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior.

Treatment

Treatments for BPD have improved in recent years. Group and individual psychotherapy are at least partially effective for many patients. Within the past 15 years, a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed specifically to treat BPD, and this technique has looked promising in treatment studies.6 Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and/or labile mood. Antipsychotic drugs may also be used when there are distortions in thinking.7

Recent Research Findings

Although the cause of BPD is unknown, both environmental and genetic factors are thought to play a role in predisposing patients to BPD symptoms and traits. Studies show that many, but not all individuals with BPD report a history of abuse, neglect, or separation as young children.8 Forty to 71 percent of BPD patients report having been sexually abused, usually by a non-caregiver.9 Researchers believe that BPD results from a combination of individual vulnerability to environmental stress, neglect or abuse as young children, and a series of events that trigger the onset of the disorder as young adults. Adults with BPD are also considerably more likely to be the victim of violence, including rape and other crimes. This may result from both harmful environments as well as impulsivity and poor judgement in choosing partners and lifestyles.

NIMH-funded neuroscience research is revealing brain mechanisms underlying the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. Studies suggest that people predisposed to impulsive aggression have impaired regulation of the neural circuits that modulate emotion.10 The amygdala, a small almond-shaped structure deep inside the brain, is an important component of the circuit that regulates negative emotion. In response to signals from other brain centers indicating a perceived threat, it marshals fear and arousal. This might be more pronounced under the influence of drugs like alcohol, or stress. Areas in the front of the brain (pre-frontal area) act to dampen the activity of this circuit. Recent brain imaging studies show that individual differences in the ability to activate regions of the prefrontal cerebral cortex thought to be involved in inhibitory activity predict the ability to suppress negative emotion.11

Serotonin, norepinephrine and acetylcholine are among the chemical messengers in these circuits that play a role in the regulation of emotions, including sadness, anger, anxiety, and irritability. Drugs that enhance brain serotonin function may improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs that are known to enhance the activity of GABA, the brain's major inhibitory neurotransmitter, may help people who experience BPD-like mood swings. Such brain-based vulnerabilities can be managed with help from behavioral interventions and medications, much like people manage susceptibility to diabetes or high blood pressure.7

References

1Swartz M, Blazer D, George L, Winfield I. Estimating the prevalence of borderline personality disorder in the community. Journal of Personality Disorders, 1990; 4(3): 257-72.

2Soloff PH, Lis JA, Kelly T, Cornelius J, Ulrich R. Self-mutilation and suicidal behavior in borderline personality disorder. Journal of Personality Disorders, 1994; 8(4): 257-67.

3Gardner DL, Cowdry RW. Suicidal and parasuicidal behavior in borderline personality disorder. Psychiatric Clinics of North America, 1985; 8(2): 389-403.

4Zanarini MC, Frankenburg FR. Treatment histories of borderline inpatients. Comprehensive Psychiatry, in press.

5Zanarini MC, Frankenburg FR, DeLuca CJ, Hennen J, Khera GS, Gunderson JG. The pain of being borderline: dysphoric states specific to borderline personality disorder. Harvard Review of Psychiatry, 1998; 6(4): 201-7.

6Koerner K, Linehan MM. Research on dialectical behavior therapy for patients with borderline personality disorder. Psychiatric Clinics of North America, 2000; 23(1): 151-67.

7Siever LJ, Koenigsberg HW. The frustrating no-mans-land of borderline personality disorder. Cerebrum, The Dana Forum on Brain Science, 2000; 2(4).

8Zanarini MC, Frankenburg. Pathways to the development of borderline personality disorder. Journal of Personality Disorders, 1997; 11(1): 93-104.

9Zanarini MC. Childhood experiences associated with the development of borderline personality disorder. Psychiatric Clinics of North America, 2000; 23(1): 89-101.

10Davidson RJ, Jackson DC, Kalin NH. Emotion, plasticity, context and regulation: perspectives from affective neuroscience. Psychological Bulletin, 2000; 126(6): 873-89.

11Davidson RJ, Putnam KM, Larson CL. Dysfunction in the neural circuitry of emotion regulation - a possible prelude to violence. Science, 2000; 289(5479): 591-4.
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Skippy
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« Reply #1 on: July 12, 2006, 09:06:49 AM »

Medications Studied and Used in the Treatment of Borderline Disorder+

Robert O. Fiedel, MD


www.BPDdemystified.com/index.asp?id=21#2

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

    * Neuroleptics and atypical antipsychotic agents

    * Certain antidepressants

    * Mood-stabilizing agents

Antipsychotics

   

Neuroleptics Symptoms Improved by One or More Medications in the Class - anxiety, obsessive-compulsivity, depression, suicide attempts, hostility, impulsivity, self-injury/assaultiveness, illusions, paranoid thinking, psychoticism, poor general functioning

   

  • thiothixene (Navane)*


  • haloperidol (Haldol)*


  • trifluoperazine (Stelazine)*


  • flupenthixol*


Atypica  Symptoms Improved by One or More Medications in the Class - anxiety, anger/hostility, paranoid thinking, self-injury, impulsive aggression, interpersonal sensitivity, low mood and aggression.

  • olanzapine (Zyprexa)*


  • aripiprazole (Abilify)*


  • risperidone (Risperdal)°


  • clozapine (Clozaril)°


  • quetiapine (Seroquel)°


   

Antidepressants

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)°


MAOIs  Symptoms Improved by One or More Medications in the Class - depression, anger/hostility, mood swings, rejection sensitivity, impulsivity

  • phenelzine (Nardil)*


Mood Stabilizers   Symptoms Improved by One or More Medications in the Class - unstable mood, anxiety, depression, anger,

irritability, impulsivity, aggression, suicidality, poor general functioning

  • divalproex (Depakote)*


  • lamotrigine (Lamictal)*


  • topiramate (Topamax)*


  • carbamazepine (Tegretol)°


  • lithium°





Neuroleptics and Atypical Antipsychotic Agents


The group of medications that has been studied most often for the treatment of patients with borderline disorder are antipsychotic agents (neuroleptics and atypical antipsychotics). Neuroleptics were the first generation of medications used to treat very serious mental illnesses, especially bipolar disorder and schizophrenia. The atypical antipsychotics are the second generation of medications developed to treat these disorders. When precribed in lower doses than ususal, these agents have been found to be quite useful in the treatment of many patients with borderline disorder. In my clinical experience, this is the most effective class of medications for the disorder, and the most rational starting point for pharmacotherapy. But is there any scientific data to support this contention?

In 2001, the American Psychiatric Association published a Practice Guideline for the Treatment of Patients with Borderline Personality Disorder. 3 Based on research available at the time, low doses of antipsychotic agents were recommended for patients with borderline disorder with symptoms of severely impaired thinking and behavioral control, anger, hostility, assault and self-injury. Research reported since 2001 has supported the findings that these medications appear to be effective in decreasing these and other symptoms of the disorder2 . They reduce over reactive emotional responses such as anger and anxiety, decrease impulsivity, improve the ability to think and reason, and enhance relationships. All but one published placebo-controlled study of antipsychotic agents in patients with borderline disorder have shown positive results. In these and in other studies,  medications in this class found to be useful in borderline disorder include the neuroleptics thiothixene (Navane), trifluoperazine (Stelazine), and flupenthixol, and the atypical antipsychotics aripiprazole (Abilify), olanzapine (Zyprexa),  and risperidone (Risperdal). Medications studied and used in the treatment of Borderline Personality Disorder.

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, and some patients are reluctant to take this class of medications because of a specific side effect that antipsychotics may produce called tardive dyskinesia. It is an abnormal, involuntary movement disorder that typically occurs in patients receiving average to large doses of neuroleptics.

To the best of my knowledge, there is no scientific evidence that indicates low doses of neuroleptics cause tardive dyskinesia in patients with borderline disorder. Nonetheless, although the risk appears to be very small, it should be noted. The atypical antipsychotic agents appear to carry a lower risk of causing tardive dyskinesia than neuroleptics when prescribed at the usual doses for patients with  severe mental illnesses. Therefore, these newer medications are now probably more commonly prescribed for patients with borderline disorder than are the neuroleptics.

Atypical antipsychotics and traditional neuroleptics may both produce side effects, some more than others. These include weight gain, headache, drowsiness, insomnia, breast engorgement and discomfort, lactation, and restlessness. Some of these, and other side effects, are temporary, and others may be persistent. Before you start on any antipsychotic agent, or any medication for borderline disorder, you should review its side effect profile with your psychiatrist.

Antidepressants

The second group of drugs studied for the treatment of the symptoms of borderline disorder are the antidepressants. Medications Studied and Used in the Treatment of Borderline Personality Disorder.



SSRIs and Related Antidepressants


In the APA Practice Guideline3, a class of antidepressants referred to as SSRIs (selective serotonin reuptake inhibitors), and related medications, are recommended as the initial pharmacological treatment when patients with borderline disorder are suffering from depressed mood, mood instability, sensitivity to rejection, inappropriate intense anger, depressive “mood crashes,” or temper outbursts. This conclusion was reached primarily on the basis of three placebo controlled clinical studies that utilized higher than normal doses of medications in this class. A recent placebo controlled trial of another SSRI, fluvoxamine (Luvox), in women with borderline disorder demonstrated that the medication improved rapid mood shifts, but not impulsivity and aggression.

Some of the enthusiasm for the use of SSRIs in borderline disorder derives from a number of research studies that have demonstrated disturbances in serotonin function and genetic abnormalities in patients with borderline disorder.  These findings provide the scientific rationale for the use of SSRIs in the treatment of this disorder, as the SSRIs increase serotonin activity in the brain4. Therefore, it is surprising that so few studies with these agents have been performed in subjects with borderline disorder, and that those demonstrate a relatively narrower range of therapeutic effect than antipsychotic agents. Although there are not as many studes demonstrating the effectivenss of SSRIs in borderline disorder as there are of antipsychotic agents, these medications appear to be useful in treating some symptoms of the disorder.

The main side effects encountered by many patients taking an SSRI are decreased sexual interest, motivation, and capacity to perform and respond sexually, weight gain, a flattening of emotional response, and the precipitation of hypomanic symptoms in patients who have co-occuring bipolar disorder. Not all patients taking SSRIs experience these side effects, and some who do consider them a tolerable trade off to the reduction of their symptoms. Current concern also has arisen about the possible increase in suicidal behavior of depressed people treated with SSRIs, especially adolescents.

MAOIs

Another class of antidepressants, the monoamine oxidase inhibitors (MAOIs), may also be useful in patients with borderline disorder. Two placebo-controlled studies of the MAOI phenelzine (Nardil) have suggested that it may be more effective than SSRIs. However, orally administered MAOIs have the potential to produce very serious, even life-threatening side effects if used improperly. Therefore, most 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

Some antidepressants appear not to be useful in treating patients with borderline disorder. The tricyclic antidepressants amitriptyline (Elavil, Amitril, Endep) and nortriptyline (Pamelor, Aventyl) may even worsen the condition of people with borderline disorder. Other tricyclic antidepressants should also be used with caution in patients with borderline disorder.

Mood-Stabilizing Agents

Not all patients with borderline disorder respond adequately to antipsychotic agents or antidepressants. Under these circumstances, other medications may be useful, either used alone or in conjunction with one or more of the other medications described above. A group of medications referred to as mood-stabilizing agents has been shown to help reduce symptoms in some patients with borderline disorder.

Antiepileptics

One class of mood-stabilizers includes divalproex (Depakote), topiramate (Topamax), lamotrigine (Lamictal), and carbamazepine, (Tegretol). These medications are referred to as antiepileptic drugs as they are commonly used for people suffering from partial complex seizure disorder. Partial complex seizure disorder has its origin in the temporal lobes of the brain, a brain region important in the generation of emotions.

Four placebo-controlled studies of medications in this class in patients with borderline disorder have now been reported, three with topiramate and one with divalproex. These studies consistently found that these drugs reduce impulsive, angry and hostile behavior. One study, with topiramate, also demonstrated decreases in anxiety, interpersonal sensitivity and general severity of symptoms. In borderline disorder this class of medications does not appear to reduce depression, paranoid thinking or psychotic behavior.

Medications studied and used in the treatment of Borderline Personality Disorder.

Antianxiety Agents and Sedatives

Anxiety and poor sleep are common symptoms of borderline disorder. In other disorders, the benzodiazepines are most 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.

Some patients with borderline disorder also experience adverse responses, such as impaired perceptions and greater sleep deterioration, to the non-benzodiazepine sedative zolpidem (Ambien). Therefore, if this medication is prescribed for you, be aware of this possible problem.




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flex55
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« Reply #2 on: July 12, 2006, 09:54:41 AM »

Dr. Heller Discusses BPD

www.biologicalunhappiness.com/4h.htm

"...Epilepsy was once thought to be a psychiatric problem, until the underlying neurological abnormalities were understood.  Researchers have uncovered medical and neurological abnormalities in borderlines.  Many symptoms are likely due to malfunction in the brain's limbic system.  In my opinion, the borderline personality disorder is primarily a medical problem.  It can now be treated.

The Borderline Experience


Imagine you are faced with a minor stress - a flat tire, a clogged-up sink, or a trivial disagreement with your spouse, friend, lover, child, etc.  Instead of finding an acceptable solution, your mind seems to panic.  A sense of unease develops, possibly causing discomfort in the stomach or chest.  Feelings of anxiety complicate the increasing sense of uneasiness and restlessness.  This is followed by progressively worsening anger - eventually becoming a rage so strong it overwhelms you - even though you realize it's excessive.  Over the next few minutes to hours, other negative sensations creep in - including memories of past hurts - until you are experiencing virtually every bad emotion a human can feel.

You feel trapped and vulnerable.  Your psychological defenses are overwhelmed by unbearable emotional pain.  You feel depressed.  You find yourself unable to cope as your mind and body are now in a full scale panic.  You lose proper perception of reality - jumping to erroneous conclusions in a futile effort to make sense of what's happening.  As the pain continues to intensify the nervous system creates bizarre sensations such as emptiness, numbness, and unreality.  You become incapable of rational thinking as the panic continues to worsen.

Your mind now desperately tries to find a way out of the pain and searches for solutions.  It recalls past activities that have made you feel better.  Once a method is found, your mind frantically forces you to pursue that activity to a self-destructive excess - finally resulting in a biochemical rescue.  Brain chemicals are released that stop the pain and let you feel 'normal' again.

But how can you ever feel normal again knowing that such a horrible experience will return?  How can you feel normal again when your self-destructive and inappropriate behaviors are witnessed by family, friends, employers and/or co-workers?  How can you feel normal again when those behaviors result in financial, interpersonal, physical, or legal trouble?

For those not afflicted with the Borderline Disorder this is a nightmare we hope never happens to us.  Borderlines experience it over and over - especially when confronted with stress.  While individual borderlines may feel some symptoms differently, the horrible feelings described in the first paragraph (called 'dysphoria' intrude frequently into a borderline's life.

Borderlines will do almost anything to make dysphoria go away.  Most impulsiveness and self-destructiveness is an effort to relieve dysphoria.  Some borderlines, especially those suffering very severely, will literally cut their bodies during dysphoria.  The self-mutilation is itself painless (the cuts don't hurt), yet it relieves the dysphoria.

Borderlines also suffer from intense, frequent and unpredictable mood swings that can cause 'dysphoria' even without stress.  The mood swings cripple a borderline's efforts to live a happy, successful life.  Borderlines are victims of an incredibly painful illness...

Like victims of epilepsy, muscular dystrophy, and neurofibromatosis (the 'Elephant Man's' disease), victims of borderline neither asked for, deserved or caused their affliction.  The symptoms can be so unpleasant to those interacting with borderlines that feelings of compassion and understanding may be difficult or impossible to feel.  Borderlines desperately want to be loved, but their illness makes them at times seem unlovable.  They are terrified of being abandoned, yet are powerless to keep the illness from destroying relationships.

This is the borderline experience.


The Facts

...Genetic factors are important - borderline tends to run in families.  The risk of developing borderline is 6 times higher when a close relative has the disorder.  In studies of identical twins, researchers have discovered that many personality traits are genetically determined.  There is an association between some personality characteristics and blood type (called 'blood group antigens'.

Borderlines commonly suffer from other disorders as well.  PMS, depression, hypothyroidism, vitamin B 12 deficiency, other personality disorders, anxiety, eating disorders, and substance abuse problems are the most common.  Intelligence is not affected by the disorder, but the ability to organize and structure time can be severely impaired.  There is no association with Schizophrenia.

...While many borderlines suffered from abuse or neglect in childhood, some developed the disorder from head injuries, epilepsy, or brain infections.  Early parental loss and incest are commonly associated with borderline.

The facts indicating a medical origin are impressive: Brain wave studies are frequently abnormal.  Neurological physical examinations are abnormal.  Sound interpretation is impaired.  Memory and vision are impaired.  Glandular function may be abnormal.  Sleep is abnormal.  The response to some medications is bizarre.  When injected intravenously, the medication procaine normally causes drowsiness, but a borderline will feel the 'dysphoria' described in the first paragraph.  If borderline was exclusively an emotional illness, why would all these medical neurological abnormalities be present?

Borderlines likely have abnormalities with the neurotransmitter 'serotonin' - an incredibly important brain chemical.  Serotonin problems can cause anxiety, depression, mood disorders, improper pain perception, aggressiveness, alcoholism, eating disorders and impulsivity.  Excess serotonin can depress behavior.

Serotonin deficiencies can cause many problems, especially suicidal behavior.  Low levels of serotonin increase the risk of self-destructive or impulsive actions during a crisis.  The most violent suicides (hanging, drowning, etc.)  are usually committed in patients with low serotonin metabolite (waste product) levels in the spinal fluid.  In those who attempted suicide unsuccessfully, 2% will likely be dead within one year.  If the serotonin metabolite level is low, that risk increases to 20%.

Treatment

Due to new developments in medicine, borderlines can now be treated and often cured.  The medication fluoxetine (Prozac) usually stops most of the mood swings in a few days.  It is, in my opinion, as big a breakthrough for borderlines as insulin was for diabetics.  Borderlines generally see themselves very profanely.  I frequently tell my borderline patients 'you're not an *#%@*, your brain is broken.' Once this concept is understood, the borderline patient usually feels an enormous sense of relief.  They need to know they have value as a human being.  Feelings of desperation and hopelessness are often replaced by optimism and motivation once Prozac stops the mood swings and the patient begins to realize that a happier, more successful life is possible.

All borderlines need psychological counseling.  It's almost impossible to live for years as a borderline and not need psychological help.  While the underlying problems are probably structural within the brain, the borderline is left with a lifetime of bad experiences and inadequate skills for recovery.

No medication should be given without proper medical supervision.  This is particularly true for the drugs used to treat the borderline disorder.  Some medicines make the symptoms of borderline worse, especially amitryptilline (Elavil) and alprazolam (Xanax).  Possibly a third of borderlines may suffer from low thyroid (hypothyroidism) - despite a normal 'TSH' blood test.  They may need to take thyroid medication.

The antidepressant fluoxetine (Prozac), a serotonin increaser, virtually eliminates the mood swings.  Feelings of anger, emptiness and boredom are often eliminated or reduced as well.  Most borderlines I've treated consider Prozac to be a miracle.  While some need the medication indefinitely, many have been able to stop it after a year without the mood swings returning.  Side effects are rarely a significant problem.

Neuroleptics...have been proven effective.  They are remarkably helpful for treating dysphoria and psychosis, and can be preventive when the borderline is undergoing stress.  They seem to 'put on the brakes' when the thoughts are racing.  They should only be used as needed, like using an antacid for heartburn.  These medications can be effective at low doses, and must be taken with great caution.

While medications can help with some symptoms, the brain is clearly broken.  After a stroke, the brain needs therapy to let the healthy areas take over for the broken ones.  The same is true for recovering borderlines.  I feel strongly that the brain must be retrained.  Affirmations...will work, as the human brain can believe almost anything if told it enough times...

The psychology of positive thinking is very helpful.  I strongly recommend massive brain re-education.  Devote as much time as possible for 3-6 months reading positive self-help books and listening to motivational tapes - especially those by the motivational speaker Zig Ziglar...

Sometimes symptoms of 'temporal lobe' involvement (similar to epilepsy) complicate the disorder.  Common symptoms include unawareness spells, feeling like things are unreal, and numbness of body parts.  These symptoms are more common under stress, depression, severer dysphoria, and incest crisis.  They can be treated with the epilepsy medication carbamazepine (Tegretol)...

Borderlines are VICTIMS - they did not cause their illness.  They do not want their illness.  They want to be treated and possibly cured.  They deserve that opportunity.

The National Institute of Mental Health (NIMH) has been the single most influential source of unbiased study and information regarding the true biology behind the borderline personality disorder.

Landmark studies, such as those produced by Drs. Cowdry and Gardner in 1987 showed the effectiveness of Tegretol (carbamazepine) and neuroleptics, and the dangers of Xanax (alprazolam).  This article was published in the Archives of General Psychiatry Feb 1988.  A subsequent article showed that conclusions of low brain serotonin in the BPD were erroneous, low levels were associated with suicide, not the BPD.

Dr. Cowdry was the acting director of NIMH for the last few years, and will likely be involved with further research."



Leland M. Heller, MD

WJNO Radio: Monthly radio show for 4 years, ":)octor on Call"

Multiple local television news spots in Palm Beach County 1992 - 1995

"The Geraldo Show" - December 1, 1992 

University of Michigan, Ann Arbor, Michigan

9/72 - 12/74 No degree - accepted to medical school after 28 months

Medical School:

University of Miami School of Medicine, Miami, FL

September 1975 - June 1979 Doctor of Medicine Degree

Internship and Residency:

Tallahassee Memorial Regional Medical Center

Family Practice Residency Program

July 1979 - June 1982
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Ashlynn
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« Reply #3 on: July 12, 2006, 04:29:47 PM »

Wow - thanks for posting these articles.  I do think of my BPDs as victims of their disorder.  Many nons on this board have been abused and deeply hurt by their BPDs (especially the children of), so it is hard for them to see BPDs as victims themselves.  With all of the venting and talk of NC it is good to be reminded that the BPD's pain is worse than ours.  At least I know that is so for my mother and my daughter.  This knowledge has allowed me to get past the anger and to feel compassion.  After all, it could easily have been me.

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Serenity.
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« Reply #4 on: July 12, 2006, 09:17:35 PM »

Wow, Thanks for sharing these articles with me. You might of just saved my ex-fiance's life and I'm not kidding, he said he was on zoloft and wellbutrin and he was really close to killing himself on these meds. They were making him worse because they were the wrong prescription. He told me if I hadn't left him two months ago, he would have continued taking those pills and who knows what the end result would have been. I was so upset when he told me he decided to quit them but he said nothing was wrong with him and after I left he didn't care no more and he wouldn't take the meds. i have read so many things on BPD for the past couple weeks and nothing to show my ex-fiance to pinpoint EXACTLY what he was feeling and why he would take off out the door and leave for days. It would be over  things I considered 'nothing' that would set him in these raging moods. He was filled with hate, anger, rage and uncontrollable emotions that flooded him. He would tell me he was very depressed than finally suicidal all the time and felt so much sadness and pain when i 'triggered' him. Well that's who he'd blame constantly for his troubles; ME. After trying to explain to him I did alot of reading on BPD and that my counselor believed his pyschiatrist misdiagnosed him (with 'clinical depression'   He says after I sent your article to him, he wonders how many other victims are out there that she misdiagnosed! ) i saw your article by this Doctor that summed up everything he's been doing to me and his behavior was identical to this! First one to fully explain his dramatic over emotional mood swings and rages over very minimal everyday events. I emailed it to him and was afraid he might get very angry with me for claiming he had a mental illness and was surprised at the voice at the other end of the phone. He told me that is exactly what he's been feeling and finally something put it into actual words that it felt like how he always felt. He tried to tell his psychiatrist he was way more than depressed and he knew something else was 'wrong' with him and the pills weren't working. They only made him dizzy and feel drugged. (he was on zoloft for two yrs she prescribed, then wellbutrin these last few months on top of that which made him mean, that's why I took the kids and left him; he threatened to kill me on these meds; they were making him more bizzare and more suicidal like the article said.) I told her of my concerns, suicidal threats to me and suicidal harm to himself and she just said he was fine in my office a few days ago and I'd have to file the concern with the courts to make him go the the hospital or whatever. Nice concerned woman huh? ;==

He's very mad that she didn't know to diagnose him with BPD since he's told her of many of the symptoms and rages. How can she minimize that down to depression? Well, I just want to say, his is taking the path to recovery now and wants to try the prozac even though he was afraid it might not work like the zoloft didn't. I am happy he's admitting this illness sounds like what he has. He also said he was going to make a copy of this so that he could show his counselor. What a difference you made to one life I know of, thanks so much! God bless us all in hoping these cures start working.
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hope
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« Reply #5 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 #6 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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« Reply #7 on: December 14, 2006, 02:48:12 AM »

www.crazymeds.org/topamax.html
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trinity_n_fl
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« Reply #8 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 #9 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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« Reply #10 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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« Reply #11 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 #12 on: December 18, 2006, 04:01:02 PM »



   I have taken Topomax for migraines. Seems to work really well, don't seem to be any crazier than before?
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« Reply #13 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 #14 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 #15 on: November 07, 2007, 09:55:30 AM »

Staff only

Going off meds without dr supervision I have heard is very dangerous, especially cold turkey.

None of us are medical professionals or in any capacity qualified to expense medical information.

I suggest you contact another medical practitioner who can help you here with qualified advice.

Good luck

Peace4us
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« Reply #16 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 #17 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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« Reply #18 on: January 08, 2008, 11:49:39 PM »

ok..I gave The Eggshells book to 2 people..a friend and  a family member..Both of them said after raeding it they conclude that this disorder can be cured with medication..My correct understanding after reading that book and other books is that meds help with anxiety a bit but on tHE MOST  PART if one truly has BPD any cure wil takea good 8-10 years of intense therapy..I conclude that by specifically nothing those that write about their recovery,most notably A.J Mahari.How did we see 2 diffrent things from this book? So i was also accused (the BPD who has been diagnosed) that this forum is brainwashing me..I feel like I have never been so clear in my thinking..Thats how I feel..so of course I stuck up for all you guys..I had a really hard day.Hope yall had a better one!
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« Reply #19 on: January 09, 2008, 02:08:31 AM »

AJ Mahari was treated before DBT was created, I believe... DBT is having great results and some people are better within a year if they are serious and comitted to the therapy.

google it...

Mostly, it is the determination of the patient to get through it and to get healed.

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« Reply #20 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 (www.biologicalunhappiness.com) 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 #21 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 #22 on: January 09, 2008, 08:17:02 PM »

Please remember that if the BPD in your life was "cured" (or even recovered), you might not find them as fetching.  The intense "goodness", the lack of boundaries that makes them "fun", the often child-like vulnerability that is appealing in some ways, is as much a symptom of the disorder as the difficult stuff... and that kind of stuff might change dramatically if the BPD person recovers.  Also, many nons can't really appreciate someone who is kind and loving and stable..  they need chaos due to family of origin issues.  If the BPD becomes stable and consistent... well, he/she might not be as exciting anymore.
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« Reply #23 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 #24 on: January 12, 2008, 02:52:52 AM »

Good observation, JoannaK.  I now remember reading in a clinical article about the fact that the person you were originally attracted to may or will not be the same if on medication (and/or treatment).  What drew you to them originally will be dampened and you might not feel the same way.

Also, when I think of my ex when he was on Paxil, I felt a bit disconnected from him in a bored kind of way.  The emotions that I grew to live with and EXPECT, were now dulled because of the medication.  Him and his personality became a stranger to me.  I know for a fact that I wouldn't have been drawn to this guy if I was not vulnerable at the time.  He just wasn't my time in every, every way.  I guess that says something about me and my mind.

I also wanted to clarify that no, this can't be cured.  Just controlled.
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« Reply #25 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 #26 on: January 27, 2008, 08:06:00 AM »

I've taken St John's Wort for mild depression.  It was very effective, and I had no trouble with side effects.

Here's a great page from the Mayo Clinic website.  They give St. John's Wort an "A" (as in the grade) for treating "mild to moderate depression".  Of course interactions are an issue with any medication, and should be taken very seriously. 

www.mayoclinic.com/health/st-johns-wort/NS_patient-stjohnswort
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« Reply #27 on: February 12, 2008, 09:31:30 AM »

ok..I gave The Eggshells book to 2 people..a friend and  a family member..Both of them said after raeding it they conclude that this disorder can be cured with medication..My correct understanding after reading that book and other books is that meds help with anxiety a bit but on tHE MOST  PART if one truly has BPD any cure wil takea good 8-10 years of intense therapy..I conclude that by specifically nothing those that write about their recovery,most notably A.J Mahari.How did we see 2 diffrent things from this book? So i was also accused (the BPD who has been diagnosed) that this forum is brainwashing me..I feel like I have never been so clear in my thinking..Thats how I feel..so of course I stuck up for all you guys..I had a really hard day.Hope yall had a better one!

My SIL (who is now divorcing my brother) has BPD. I have bipolar disorder.

Here are the differences I have noticed between us over the years:

I always knew something was REALLY wrong with me.  It scared the heck out of me and I knew that my brain wasn't working right.

She seems oblivious to the fact that she is ill, no matter how many people try to reason with her, tell her gently whatever.  The problem is never her.

Regarding medication:

I was a major PITA before I was diagnosed with bipolar disorder, but when I got on the right medication, I became much easier to deal with and just stopped doing a lot of the things I used to do.  Meds (when she has agreed to take them), have not seemed to change her outlook. For me it was like turning on a light switch on I went on the meds.

I also wanted to go to therapy and still like to go.  I do get mad occcasionally when the therapist tells me something I don't want to hear, but we always work it out.  I have been with the same therapist and psychiatrist for 18 years.

Same with AA.  I went to a meeting 18 years ago and have been sober ever since.  I knew that I was messed up.

SIL loves the therapist as long as they agree, but as soon as they don't, they turn into an incompetent jerk.  She has been through many mental health professionals.

So, I think that those are some of the differences between someone with a mood disorder and a personality disorder.

The symptoms can mimic each other, but my experience has been that the difference is in how the person responds to treatment.  When I got on meds, the things people were trying to tell me made total sense.  Pre medication, you could have taled to me until you were blue in the face and it would not have mattered.

And when I start getting unreasonable now, the first thing my therapist does is call the psychiatrist and we up my meds.  I just started a new graduate program and I was getting really tense and snarky with hubby, insecure etc.  One med adjustment and the symptoms went away.
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« Reply #28 on: February 13, 2008, 04:10:23 PM »

Cured with meds?  All the data says no like Johanna says.  However they may be helpful in dealing with it.  Abigail mentions Dr. Heller's web site and research.  I spent a lot of time reading thru it.  The guy knows his stuff.  My take is that he sees the meds as tools to address problems with talk therapy and other tools being used to retrain one how to think.  This is where Resouces for Individuals with BPD is great.  The creator of the site is a recovering BPD.  I think they are really on to something.  They are all about re-training the BPD how to think. 

On Dr. Heller's site one thing I found most interesting is his research suggests that as much as 50% of folks with undiagnosed or "undertreated" adult ADD go on to get BPD.  www.biologicalunhappiness.com/31.htm

When you consider that research shows about 70% of all BPDs are female then I should have known I was in trouble when I married an ADD woman.  She joked about it 13 years ago when we were dating. NOTE: she wasn't diagnosed ADD until she saw a Psychiatrist about 18 months ago.  Dr. Heller may be on to something. 

Can I get a copy of the ADD diagnosis handbook before I start dating again?  Smiling (click to insert in post)  I think I memorized the BPD symptoms. 

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« Reply #29 on: February 13, 2008, 04:31:34 PM »

my ex last i knew was on 12 pills a day. lithium. zanex, valium..topaz... and other stuff...

all they did was sedate her...

she walked around like a lion shot in the ass with a tranquilizer dart...her dresser looked like a pharmacy...

she was a zombie...3 pm slurred, 4 pm slept

she did not change her thinking...

i think if a pitbull took her meds it would become a lap dog...
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« Reply #30 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 #31 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 #32 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 #33 on: February 15, 2008, 02:12:40 PM »

apparently I didn't search this correctly the first time through:

www.toddlertime.com/dx/borderline/integrated-treatment-BPD.htm

Thanks for pointing this out Abigail.
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« Reply #34 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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AJMahari
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« Reply #35 on: February 28, 2008, 09:20:30 PM »

AJ Mahari was treated before DBT was created, I believe... DBT is having great results and some people are better within a year if they are serious and comitted to the therapy.

google it...

Mostly, it is the determination of the patient to get through it and to get healed.

Yes I am really that ancient Smiling (click to insert in post) 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 #36 on: February 28, 2008, 09:38:03 PM »

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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 #37 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 #38 on: March 01, 2008, 01:31:00 PM »

That would almost undoubtedly happen. They're emotions are blunted too which I suppose would be a positive if the only other choice was volatile.
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« Reply #39 on: March 01, 2008, 05:49:42 PM »

www.sciencenews.org/articles/20080209/fob1.asp

This article might be of interest to you.  It is brand new research on the effect prozac has on the neurons in mice brains.  Basically says it causes the neurons in the hippocampus to mature faster.  Since people with BPD have smaller than usual hippocampi, prozac may be something that counteracts this.
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« Reply #40 on: March 20, 2008, 03:18:46 PM »

Pennsyvania area study for anyone interested in this information.

Regional Expert:

Emil F. Coccaro, M.D.

Dept. of Psychiatry

Eastern Penn Psych. Institute

Medical College of Pennsylvania

3200 Henry Ave.

Philadelphia, PA 19129

215-842-4192

VOLUNTEERS NEEDED FOR A BORDERLINE PERSONALITY DISORDER STUDY:

Do you have symptoms of feeling abandoned, anxiety, anger, feeling bad about yourself and difficulty in relationships with others? Eli Lilly is conducting a research study assessing whether the antipsychotic drug Zyprexa (olanzapine) will be effective in controlling symptoms of borderline personality disorder (BPD). The study is looking for men or women 18 to 65 years of age, with this diagnosis. The study will last-up to 24 weeks. Subjects who qualify will be closely monitored by a faculty psychiatrist and receive study medication at no charge. They will be compensated up to $600 for participation in the study. For more information, or to see if you qualify, call Louise  at 1-888-602-9900.
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Abigail
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« Reply #41 on: March 20, 2008, 04:13:45 PM »

   Thanks for the info.   don't know anyone with BPD in the Philly area.

                                                                                                                                                                  Dr. Heller sometimes uses Zyprexa for periods of dysphoria, but I think they only take it for a week.  My daugher took it for a week, I believe, and so did one of my friends who has BPD and bipolar.  One of the biggest problems with it is that it causes weight gain.  But it does help for the dysphoria.
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« Reply #42 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 #43 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 #44 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

Zyprexa Lawsuit


Risperdal and Seroquel Lawsuit

Psych Drug Truth

Seroquel

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

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

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

Alaska is one of nine states suing Lilly over Zyprexa and the first go to trial. The others are Utah, Pennsylvania, West Virginia, Montana, Louisiana, New Mexico, Mississippi and South Carolina.
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« Reply #45 on: March 22, 2008, 09:29:56 PM »

New to BPD, previously misdiagnosed as MDD and BP II, mid-50s, meds notwithstanding, does an individual with BPD need therapy for life - very expensive - interested in experiences of others
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« Reply #46 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 #47 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 #48 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 #49 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 #50 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 #51 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 #52 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 #53 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 #54 on: June 05, 2008, 10:35:55 AM »

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

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

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

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

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

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

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

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« Reply #55 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 #56 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 #57 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 #58 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 #59 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 #60 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 #61 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 #62 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 #63 on: July 15, 2008, 12:37:57 PM »

this is exactly how it's been with my dBPDgf the one time we've done x together (i've done it about 10 times, she used to do it on a regular basis). all the paranoia, accusations and jealousy disappeared, and she seemed to genuinely appreciate the things i said and did for her. the effects weren't long term, but this was before her diagnosis and subsequent therapy and medication. i do wonder how it would affect her now given her recovery situation.

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 #64 on: July 15, 2008, 06:11:50 PM »

I have seen similar effects as other people have described in my own life, but in the end they seemed to change very little. The difficulty is getting a BP to sustain that level of introspection and honesty and not lapse back into the same thought patterns or deny the experience which are not as much of a problem with ptsd. 

This is not to say that there isn't promise for such a treatment. IMO think that MDMA therapy sessions could be very effectively included into DBT therapy. I went to a training session Marsha Linnehan had on Mindfulness and Radical Acceptance and I thought that MDMA (yes from limited personal experience and what literature is available) would be an amazing adjunct to a long term DBT therapy.
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« Reply #65 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 #66 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 #67 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 #68 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 #69 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 #70 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 #71 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 #72 on: July 30, 2008, 12:58:49 PM »

See  www.en.wikipedia.org/wiki/Risperidone

There are some docs that have prescribed risperdal for those with BPD..  it apparently can help with the rages, which some doctors see as a form of dysphoria.  Check out www.biologicalunhappiness.com .
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« Reply #73 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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« Reply #74 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 #75 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 #76 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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TonyC
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« Reply #77 on: July 31, 2008, 07:37:35 AM »

im no pharmacist ... but i think risp is contrainticated with diabetes...

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cieeciee

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« Reply #78 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 #79 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 #80 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 #81 on: September 10, 2008, 12:38:41 PM »

WELL THE MEDS I AHVE SOME KNOWLEDGE BECAUSE I HAVE TRIED SO MANY.

1. ZYPRXEA HAS AND WILL KEEP THERE MIND CALM (LIKE THE SINK DRAIN HE WOULD RESPOMD 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 SLEPPY 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 JUSY DOPING THEM UP TRY TO HELP KICK THEM OFF THERE HORSE RE-LEARN HOW TO RESPOND
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« Reply #82 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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blissgirl
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« Reply #83 on: December 15, 2008, 11:18:15 PM »

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.

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 #84 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 #85 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 #86 on: January 23, 2009, 12:11:17 PM »

Hello everyone,

I ran into a website yesterday that offer non-prescription mood management pills called Serenity and got me wondering if those could help my mom with her BPD in anyway... at least with her mood swings or depression?

www.feelserenity.com/

Has anybody tried these or has heard anything about them? and if so, would you please share what your experiences have been?

Thank you very much!

xoxo

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« Reply #87 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

References (this article only):

1. Aronson JK, Reynolds DJM. ABC of monitoring drag therapy: lithium. BMJ. 1992;305: 1273-1276.

2. Schou M, Effects of long-term lithium treatment on kidney function: an overview. J Psychiat Res, 1988;22.,287-296.

3. Waller DG, Edwards TG. Lithium and the kidney: an update. Psycliol Mod. 1989; 19:825-83 1.

4. Gitlin MJ. Lithium-induced renal insufficiency., J Clin Psychopharmacol. 1993) 13:276-279.

5, Kallner G,.Petterson IJ. Renal, thyroid and parathyroid function during lithium treatment: laboratory test in 207 people treated for 1-30 years. Acta Psychiatr Scand. 1995;91:48-5 1.

6. Baastrup PC, Schou M. Lithium as a prophylactic agent: its effects. Arch Gen Psychiatry. 1967; 16:162-172.

7. Goodwin FK, Jamison KR. Manic-Depressive Illness. Oxford, England: Oxford University Press; 1990.

8. Mueller-Oerlinghausen D, Ahrens B, Volk J, Grof P, Grof E, Schou M, Vestergaard P, Lenz G, Sinihandl C, Tlau K, Wolf R. Reduced mortality of patients in long-term lithium treatment, an international collaborative study by IGSLI. Psychiatry Res. 1991;36:329-331.

9. Ahrens B, Mueller-Oerlinghausen 3, Schou M, Wolf T, Alda M, Grof. E. Grof P, Lejiz G, Simhandl C, Thau K, Vestergaard P, Wolf R, Moeller H. Cardiovascular and suicide mortality of affective disorders may be reduced by lithium prophylaxis. J Affect DI-Y, 1995;33:67-75.

10. Mueller-Oerlinghausen B, Mueser-Causemam B, Volk J. Suicides and parasuicides in a high-risk patient group on and off lithium long-term medication, J Affect Dis. 1992;25: 261-270.

11. Felber- NV, Kyber A. Suizide und Parasuizide wachrend und aubetadserhalb einer Lithiumprophylaxe. In-, Muclicr-Oerlinghausen B, Berghoefer A, eds. Ziele und Ergebnisse der medikagivitoeseyi I-i-opiiylaice affektiver Psychoseii. Stuttgart, Germany, Thieme; 1994:53-59.

12. Thies-Flechtner K, Seibert W, Walther A, Greil W, Mueller-Oerlinghausen B, Suizide bei rezldlvprophylaktisch behandelten Patienten mit affektiven Psychosen. In: Mueller-Oerlinghausen B, Berghoefer A, eds. Ziele und Ergebnisse der medikamentoesen Prophylaxe offekliver Psychosen. Stuttgart, Germany. Thieme; 1994,61-64.

13. Schou M.. Mortality-lowering effect of prophylactic lithium treatment, a look at the evidence, Pharmacopsychiatry. 1995;28: 1.

14. Souza FGM, Goodwin GM. Lithium treatment and prophylaxis in unipolar: a meta-analysis, Br J Psychiatry. 1991; 158:666-675.

15. Johnstone EC, Owens DGC, Lambert MT, Crow TJ, Frith CD, Done DJ. Combination tricyclic and lithium maintenance medication in unipolar and bipolar. J Affect Dis, 1990;20:225-233.

16. Prien RF, Kupfer DJ, Mansky PA, Small JG, Iuason VB, Voss CB, Johnson WE. Drug therapy in the prevention of recurrences in unipolar and bipolar. Arch Gen Psychiatry, 1984;41.1096-1104.

17. Nieper HA The clinical application of lithium orotate. Agressologie 14(6). 407-411, 1973.

18. Sartori HE, Lithium orotate in the treatment of alcoholism and related conditions, Alcohol 1986 Mar; 3 (2): 97-100.

19. Nieper HA The effect of a combination of Calcium-orotate and Lithium orotate on primary and secondary chronic hepatitis and primary and secondary liver cirrhosis. From lecture Intl Acad of Prevent Med, Washington, DC March 9, 1974.

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 #88 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 #89 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 #90 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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Jade
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« Reply #91 on: April 19, 2009, 03:56:01 AM »

I've noticed quite a few peoples SO's on this board smoke marijuana. I am aware that BPDs have a higher than normal substance abuse problems.

The way my partner uses and responds to pot appears to be different to other people I've known who smoked. Kind of 'rob his own mother to get it' type. He is absolutely obsessively addicted, and much less rage prone when he is stoned. Does anyone else find this?

It has been an ongoing 'drama' in our long drawn out saga.< ha ha that sentence seems to sum up our relationship pretty well. And one of the reasons I am leaving.

I know some sufferers of bipolar consider it a slight mood stabiliser. Like a form of self medication. Since he has started on antidepressants he tells me he doesn't need it as much as they make him more sleepy and slow him down.

Or does anyone know of any studies on the effects of marijuana on BPDs?

P.S sorry if I posted this in the wrong place.
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Randi Kreger
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« Reply #92 on: April 20, 2009, 10:12:13 AM »

I have never seen any studies, nor any discussion, about using pot to treat BPD. Every expert I can think of would say it would do the opposite--add substance abuse to the problems faced by the person with BPD.Perhaps you are thinking of the symptoms: for example, does pot make someone less like to rage? Someone eating sweets may not want to! But there are much better, constructive and effective ways of dealing with BPD traits.Randi Kreger Author, "The Essential Family Guide to Borderline Personality Disorder"  
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Jade
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« Reply #93 on: April 20, 2009, 06:02:21 PM »

No, you are right. For a long time I considered that probably it was the problem he had. That it was what was causing him to be deranged and mentally ill. It was only recently when a doctor said to him that he thought the pot smoking was to alleviate/cover the symptoms of the acute distress of his mental illness/imbalance whatever it was, (nobody knew at this stage).

The doctor through also strongly went on to say that there are much better ways to treat his distress with proper medication.

But yes the substance abuse issue has compounded the whole sorry scenario as when he starts to get stressed he starts smoking more, then it makes him more depressed/desperate/suicidal when he isn't actually stoned, gets rageful when he can't get any, and then only finds relief when he has it. Vicious cycle.

Thanks for responding.
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Sadanty

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« Reply #94 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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shimauta
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« Reply #95 on: May 06, 2009, 02:06:04 PM »

My BPD S has been diagnosed with "traits" of it by the psyquiatrist. He also took Seroquel for micropsicotic episodes and to overcome a terrible crisis.  He started seeing a CBT psycologist, 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 psycologist 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 Terapist 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 psycologist (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 quiting 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

xoxox
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« Reply #96 on: May 06, 2009, 05:46:47 PM »

I am sorry about your experience with your son.  It cannot be easy. My son was attacked several times  by my daughter-in-law and are now separated. I guess the use of the anti-psychotic does interfere with a psychological evaluation. The effect of the drug may be able to mask or minimize the personality problems of the person taking it and affect the results of the psychological evaluation. My daughter-in-law is now taking the position that she is fine and that the first diagnosis was flawed...

I sometimes feels psychologists can be come part of the problem instead of part of the solution...

Anyway, I will keep my fingers cross she continues taking the Seroquel. I fear that convincing her that she needs therapy in addition the medication is not going to be easy.

Thank you for your response

Sadanty

 
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« Reply #97 on: May 09, 2009, 05:32:10 PM »

I think sometimes the use of medicines is seen as a cure all for mental health issues, and something of a sticking plaster. Whilst in some cases they may be far more necessary for continuing balance and control, think schizophrenia here, as from what little I know about schizophrenia, it leans more towards chemical imbalances in the brain rather than childhood abuse and subsequent behvioural issues. In other mental health issues where the origins seem to lean more towards abuse in childhood, I get the impression they are used as a dampening effect to stabilise and dull the emotions to enable people to cope better, until the person can get to a place of undergoing therapy.

So in the case of BPD where behaviours is the main underlying issue, there is no doubt that medication is useful to get the BPD sufferer to a more stable state, chemically in the brain and emotionally, and  to hopefully then progress into therapy to  learn about and change the destructive behaviour patterns. One without the other in my opinion is not as effective, although it may be far easier for doctors to write out a prescription happily for years, it's of little long term value to the BPD sufferer and their SO, and being on medications for any length of time must surely bring with it, detrimental effects to the body.


People have mentioned St John's Wort on here, and whilst this may relieve the taboo that mental health medication may hold, and does indeed work for many people, I think it receives a lot of bad press, and one of the reasons it receives bad press is because there have been tests done on St John's Wort, that show it has ranged in containing varying amounts of the active ingredient that is supposed to help with depression, with having absolutely none in it, to potentially dangerous levels. I believe it is this fact of non regulation that has given it bad press, probably by the big pharmaceutical companies, but it is worth bearing in mind, that as far as I am aware, there is little or no regulation on 'natural drugs', so we are taking a chance on exactly what amount, if any, of the active ingredient is actually in the natural remedy. It is also important not to take both St John's Wort AND prescribed medication, as there is a risk of an overdose.

If you think about it, we are a mass of chemicals, and when that balance gets skewed all hell can break loose. So therefore it needs to be re-balanced with the correct chemicals. The use of illegal drugs such as marijuana and other stronger drugs, obviously messes up this delicate balance of chemicals, and introduces new chemicals to our systems that really shouldn't be there, so it's no wonder there are links to drug use and mental health issues.
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« Reply #98 on: May 10, 2009, 08:24:07 AM »

Hi

Is there a doctor (psychiatrist ) on this board? Perhaps you can help me here. I am aware that drugs will substitute therapy, but anyways here is my situation. My wife has anxiety disorders, ADHD, and according to her psychiatrist, strong elements of BPD. She has tried various drugs, and they are not particularly effective. The drugs she tried are as follows:

- Celexa (makes her extremely sleepy and tired)

- Paxil (makes her extremely sleepy and tired)

- Wellbutrin (makes her extremely hyper, and impairs her ability to concentrate or make judgement)

- Prozac (makes her tired, impairs her judgement).

So given this situation, does anyone have any suggestions of what might be effective in her case?  She will not be willing to take any drug that significantly increases her weight, and will check information about the prescription before agreeing to take it. She is having difficulty concentrating in therapy sessions, and sometimes she feels even offended by what was discussed with her psychiatrist, so I really think that something has to help control her moods, concentration before there can be any chance that she can respond well to therapy.

Anyone have any thoughts?
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« Reply #99 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 #100 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 #101 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 #102 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 #103 on: May 15, 2009, 09:44:32 AM »

Excerpt
I think that people with BPD need both medication and therapy.

The common feeling among most professionals who deal with patients with BPD is that therapy, in particular DBT (dialectical behavioral therapy) is the gold standard in treatment of BPD.  (There are a couple of other therapies that are now getting good reviews.)  But it's therapy that is essential.

Meds can help with to get the person grounded so that the therapy can be effective, but meds aren't the answer in the way that rewiring the brain through appropriate therapy is.

Usually doctors have to try several meds or combinations of meds to get a handle on the symptoms.  But much depends on the person with BPD.  If the person with BPD either won't take the meds or expects a miraculous cure, then you may not see much difference in their behavior.

There is a website out there,  www.biologicalunhappiness.com in which a doctor in Florida (not a psychiatrist) talks about medications for those with BPD.  We had a few members here who have their loved ones treated by this man and feel that he has helped.
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« Reply #104 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 #105 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 #106 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 #107 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 #108 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 #109 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 #110 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 #111 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 #112 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 #113 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 #114 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 #115 on: June 13, 2009, 12:57:32 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)."

THANK YOU!  Our Dr is extremely conservative with meds and I think I wrote already that most of his increases have been initiated by me.  (just so no one yells at me, I have a close friend who is an MD and so I have made sure that I am not OD'ing him before I do any of that)  Anyway, I told them I thought we could increase it some more and they want to wait and see 2 months.  I will give it a bit more time, things have made dramatic improvements just in the last month since upping him to 40...but still a long way to go.

I need to find someway to teach him how to interact with the family tho.  He still jsut does NOT get it.  Extremely intelligent, but jsut can not understand how his actions set things off.  I know part of it is denial.  The whole black and white thing/...no grey areas for him at all.  Drives me NUTS sometimes.  Anyway, thank you so much for you feedback on this.  Glad there is someone with similar experience for me to go off of!
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« Reply #116 on: July 13, 2009, 12:04:58 PM »

 There are no meds out there that will specifically help someone with BPD. If the person with BPD also has depression or bipolar or mania or anxiety..there are meds to treat those illnesses. There are also meds that can regulate mood disorders. No medication actually treats BPD however.

DBT is still the gold standard, treatment of choice.

Why do you ask?

Steph
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« Reply #117 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 #118 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 #119 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 #120 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 #121 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 #122 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 #123 on: July 19, 2009, 03:24:42 PM »

My Dh was diagnosed approximately 7 years ago and was on meds for approx 1 1/2 years. 

At first they seemed to help in that they de-escalated his over-reaction due to his heighted level of feeling shamed.  It toned his mind and actions down.

But after awhile it became apparent the meds also toned down his connection (his ability to feel tied) to his thoughts and actions. 

It became clear that any hope to get to the bottom of his disorders and to make true, long term progress was hampered by their effects (even when he experimented with lower dosages).
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« Reply #124 on: July 19, 2009, 04:06:27 PM »

My Dh was diagnosed approximately 7 years ago and was on meds for approx 1 1/2 years. 

At first they seemed to help in that they de-escalated his over-reaction due to his heighted level of feeling shamed.  It toned his mind and actions down.

But after awhile it became apparent the meds also toned down his connection (his ability to feel tied) to his thoughts and actions. 

It became clear that any hope to get to the bottom of his disorders and to make true, long term progress was hampered by their effects (even when he experimented with lower dosages).

Which medication was he using?
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« Reply #125 on: July 20, 2009, 03:15:24 PM »

He had experimented with different kinds.  I believe one was a type of "anitseziure" med.  He also tried several types and dosages of antidepressents.  Honestly, I don't know the particulars of the actual brands or names (I try to stay out of the details of this).   Notes from his T indicate meds were being prescriped for PTSD and depression. 
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« Reply #126 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 #127 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 #128 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 #129 on: August 08, 2009, 01:40:30 AM »

Wow, that is a deadly combination!  She is obviously constantly tense, so the benzos and the pot..  but then she is a zombie, so the speed.  Benzos can be very difficult for certain people, especially those with BPD.  If taken in high amounts, they can have paradoxical effects.. instead of calming the person, they can agitate the person.  But she's also smoking dope and taking speed..   what a mess!

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« Reply #130 on: August 10, 2009, 11:01:02 AM »

God help her!
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« Reply #131 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 #132 on: November 23, 2009, 09:37:11 AM »

Here is some information posted in a workshop here:

Mood-Stabilizing Agents

Not all patients with borderline disorder respond adequately to antipsychotic agents or antidepressants. Under these circumstances, other medications may be useful, either used alone or in conjunction with one or more of the other medications described above. A group of medications referred to as mood-stabilizing agents has been shown to help reduce symptoms in some patients with borderline disorder.

Mood Stabilizers   Symptoms Improved by One or More Medications in the Class - unstable mood, anxiety, depression, anger,

irritability, impulsivity, aggression, suicidality, poor general functioning

  • divalproex (Depakote)*


  • lamotrigine (Lamictal)*


  • topiramate (Topamax)*


  • carbamazepine (Tegretol)°


  • lithium°

Lamictal is used primarily for epilepsy and for the long-term treatment of bipolar I disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine (that didn't work well).

It is usually used in conjunction with other drugs.

It has off label use for some BPD patients.
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« Reply #133 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 #134 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 #135 on: January 20, 2010, 08:54:02 AM »

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

tony
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« Reply #136 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 #137 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 #138 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 #139 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 #140 on: January 20, 2010, 10:24:12 AM »

My duaghter 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 #141 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 alsodont 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 #142 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 #143 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 #144 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 #145 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?

Here is a discussion workshop: https://bpdfamily.com/message_board/index.php?topic=44786.msg414215#msg414215

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 #146 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 #147 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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« Reply #148 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 #149 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 #150 on: February 12, 2010, 12:19:56 PM »

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.

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 #151 on: February 13, 2010, 07:25:19 PM »

<chop>

she never raged at me when high.  there were no eggshells.  it was just normal being high with a friend. 

Yes! That is exactly what it is like - being with a friend! If only things could be like that for my partner even half the time without pot then I would be on my way to being happy. But I am thankful he doesnt smoke it often as the post-pot rages are the worst.
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« Reply #152 on: February 14, 2010, 03:13:09 AM »

i think.. for some people w/mental issues.. weed can make psychotic features worse..

tho.. my partner has issue w/all drugs.. so.. could be him. i do know.. that most dbt programs.. require people be clean.. and not drinking.. bc drugs can mask features.. or make some things worse.. ends up.. being avoiding working on the underneath issues anway
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« Reply #153 on: February 14, 2010, 09:05:47 AM »

I found an interesting article from McGil University that might explain the behaviors you describe in your boyfriend.  Apparently THC, the active ingredient in marijuana does have an antidepressant effect but only in very low doses.  At higher doses, it has exactly the opposite effect

Here's the link to the study:

www.psychcentral.com/news/2007/10/24/mixed-results-with-thc-antidepressants/1447.html

I found this part of the article to be the most relevant to your boyfriend's behavior:

":)r. Gobbi and her colleagues were prompted to explore cannabis’ potential as an anti-depressant through anecdotal clinical evidence, she said.

“As a psychiatrist, I noticed that several of my patients suffering from depression used to smoke cannabis. And in the scientific literature, we had some evidence that people treated with cannabis for multiple sclerosis or AIDS showed a big improvement in mood disorders. But there were no laboratory studies demonstrating the anti-depressant mechanism of action of cannabis.”

Because controlling the dosage of natural cannabis is difficult – particularly when it is smoked in the form of marijuana joints – there are perils associated with using it directly as an anti-depressant.

Excessive cannabis use in people with depression poses high risk of psychosis,” said Dr. Gobbi."

From my family's experience, my elderly BPD/NPD mother was prescribed some kind of mood-altering drug by her doctor (I'd have to ask Sister if it was an anti-anxiety drug or an anti-depressant or an anti-psychotic or what) and after mom started taking it Sister said she noticed a remarkable improvement in our mother's behavior.   Sister said it was like a quiet kind of miracle.  But of course, our BPD/NPD mother didn't like taking the drug.  She said it made her feel "weird", so when the prescription ran out she didn't renew it.    Back when my Sister was in very frequent contact with our mom that drug (whatever it was) made a big difference to Sister, but now that Sister is in very low contact it doesn't matter so much.

All I know is that when I was in contact with our mom, I'd have to drug myself (practically knock myself out) with alcohol to be able to be around her for more than a few hours, I find her presence so anxiety-inducing in me.

-LOAnnie 





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« Reply #154 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 #155 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 #156 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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« Reply #157 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)  www.healthyplace.com/personality-disorders/life-at-the-border/can-pms-trigger-BPD-episodes/menu-id-1459/

It says xanax is a no no as well...

Alexis
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« Reply #158 on: May 04, 2010, 01:59:26 AM »



Just wondering if anybody out there as tried Homeopathic Medicines as a part of a treatment plan for their BPD.  And if anybody has...did it work to any degree? 

Just trying to consider all of my options. 

Tenacious
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« Reply #159 on: May 12, 2010, 12:32:02 PM »

My BPD DH takes Vitamin D to help with SADD, 5HTP for depressive symptoms, melatonin and l-tryptophan to help with sleep, and many other vitamins for other things.  Nothing actually homeopathic, just natural things we use.   His SADD was better this winter, not much change in depression (lots of situational stuff going on, though), and his sleep starts out fine, but he awakens around 3 or 4am and doesn't usually get back to sleep.  He refuses to take the meds prescribed by the psych because he is afraid of their effects.

Are you trying anything?  How is it going for you?

God bless,

JDoe
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« Reply #160 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 #161 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 #162 on: May 17, 2010, 09:09:00 AM »

 Happily, the most effective treatment for BPD is a therapy called Dialectical Behavioral Therapy, which is not a med regime.


Steph
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« Reply #163 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 #164 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 #165 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 #166 on: October 11, 2010, 11:06:38 AM »

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.

You can always communicate with the treatment professionals on a one way basis ... or try to, anyway.

Leave them a phone message, send them a letter, fax them a note. You can't make them listen to you, and they don't have to tell you anything in return, but you can communicate the info.
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« Reply #167 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 #168 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 #169 on: March 11, 2011, 07:45:34 PM »

Hey all. My partner has BPD, has done lots of DBT, and is doing quite well. Lately she's having some serious issues with agression, and is looking at potentially changing her meds. She wants to handle it on her own, but does not want to end up in jail, so figures she needs extra help. Right now she's just on risperdone, and her psych dr has upped it, but is suggesting a mood stabilizer as well.

Anyone got any experience on what medication helps people with BPD with their agression and impluse control?
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« Reply #170 on: March 14, 2011, 01:19:30 PM »

Very happy to find this post.  Hubby in a weeking anger management program for about 2 months, but therapy alone is not working.  Having a hard time finding a doctor to treat my husband as he is an extremely difficult patient. Also the docs he has seen do not seem familiar with these meds.  Anyone know a doc in northern nj?
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« Reply #171 on: March 14, 2011, 05:04:56 PM »

The best source of info on meds is www.BPDDemystified.com. See the section on meds.
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« Reply #172 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 #173 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 #174 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 #175 on: September 06, 2012, 11:50:20 AM »

Just wondering...my bf was told by his therapist that medication is not effective for BPD.  Is this true?
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« Reply #176 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.
« Last Edit: September 07, 2012, 04:09:36 AM by jsdun5 » Logged
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« Reply #177 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 psychatrist 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 dosent recognise 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 psychatrist he will tell him 'my wife has told me my moods are bad but i dont realise they are' fingers crossed for lithium
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« Reply #178 on: January 27, 2013, 01:28:47 PM »

Hi,

I was wondering if anyone had any exp with medications called 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 #179 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 #180 on: March 08, 2013, 07:52:59 AM »

My BPDh is taking mood stabilizer but not anti depressents.
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« Reply #181 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 #182 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 #183 on: May 09, 2013, 01:24:40 PM »

From the Clinical Practice Guidelines for the Management of Borderline Personality Disorder, Australian Government National Health and Medical Research Council., 2013

www.nhmrc.gov.au/_files_nhmrc/publications/attachments/mh25_borderline_personality_guideline.pdf

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,p lamotrigine and topiramate

• antipsychotic agentsq 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 (details in Appendix H). 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

medicines210 (e.g. monoamine oxidase inhibitors, tricyclic antidepressant agents, lithium).

Use one medicine at a time and avoid polypharmacy. Review its efficacy and discontinue before trialling 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.
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« Reply #184 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 #185 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 #186 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 #187 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

Lurasidone (Latuda)

Prescription drug

Consult a doctor if you have a medical concern.

Treats schizophrenia and BiPolar disorder

Side effects - Warnings - How to use

National Library of Medicine

Brand name: Latuda

Pregnancy risk: Category B (No evidence of risk in humans)

Drug class: Atypical antipsychotic

Other drugs in same class: Aripiprazole, Asenapine, Quetiapine, More
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« Reply #188 on: January 05, 2014, 06:49:11 PM »

It appears that is is not a brand new drug (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 from the College of Psychiatric and Neurologic Pharmacists from January 2013:

www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=51&ContentID=119465

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 #189 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 #190 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 #191 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 #192 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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Googie
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« Reply #193 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 #194 on: December 13, 2016, 03:14:56 PM »

Good day, I was just wondering if there was any medicine or vitamins that have been shown to work for people with BPD?  Fr example my son has ADHD and when he is on his medicine he behaves himself and can focus in school.  My wife had BPD and I am wondering if anything has been developed in terms of medicine or is science still learning a lot about BPD and how it works?
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