TREATMENT: Medications

[BPDFamily.com]

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

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

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

3. Suggestion find a dt.That has a history of this chaos in his life and he will be able to help instead of just doping them up try to help kick them off there horse re-learn how to respond

[sonya]

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

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

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

3. Suggestion find a dt.That has a history of this chaos in his life and he will be able to help instead of just doping them up try to help kick them off there horse re-learn how to respond

[jul496]

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.

[blissgirl]

  jul496

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

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

[JoannaK]

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.

[Auspicious]

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.

[Skip]

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

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

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

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

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

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

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

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

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

Mood Disorders

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

Orthodox Treatment

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

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

Mortality-lowering, Anti-suicidal Effect of Lithium

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

Recurrent Major Affective Disorder

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

Superiority of Lithium Orotate

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

Other Uses for Lithium Orotate

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

Warnings

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

[melski]

Wow! Thank you VERY much Skip! that was very illustrative and interesting! 

xoxo

[waybird]

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!

[stpmom]

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. 

[Sadanty]

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

[shimauta]

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

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

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

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

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

Hope it helps you.

[GENERAL ANNOUNCEMENT]

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

[Major_Dad]

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

[Sadanty]

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

[Auspicious]

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.

[shimauta]

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.

[1lasttime]

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.

[Anna17]

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.

[briefcase]

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

[makeitstop]

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

[MxMan]

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.

[Abigail]

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

[At Bay]

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.

[briefcase]

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. 

[Jakub]

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.

[J0270]

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

[Abigail]

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)."

[Anna17]

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.

[pk]

My BPDh has definitely shown to be more stable on Lamictal (Lamotragine).

[peacebaby]

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

[HappyCandi]

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.