Paxil, anyone?

[Cole]

Finally got BPD/bipolar wife to contact her psychiatrist. P is adding Paxil to the Depakote to help with severe depression and core shame issues. Still have an uphill battle to get her to counseling, but at least this is a little step forward.

Anyone have experience with a pwBPD taking Paxil?   

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[HowCouldYou]

My BPDW was on it for many years. Prescribed for Fibromyalgia pain initially, It helped reduce her outbursts a good bit but they were bad when she did have them. Also when she decided to stop taking them, it was a month of hell until it got out of her system!

Oh yeah and her Libido was severely reduced while on it.

Overall I think it numbed her emotions which "helped" in day to day interactions, but probably allowed her to repress more feelings until they finally were triggered and then, Bam!

[sadeyes]

Mine takes it, and I think it helps a good bit with his anxiety (which in turn helps w/ outbursts). He used to not think that he benefited much,  & decided to quit taking it. It was really bad to the point that the doc put him on round the clock xanex for a few days until it could get back in his system. 

He has also run out before, and it is pretty bad.

He now calls them his attitude pills & takes them happily, which knowing him means he feels better  taking them.

[Hawk Ridge]

My expwBPD took it for 20+ years - zero libido, flat affect, sleeping hours every afternoon. I am quite aware it is not designed for use longer than 7 years, asked her to see a psychiatrist to evaluate its effectiveness.  After months of verbal abuse, no physical component to r/s, my accommodating of the moods and sleep, she left me when I kindly and empathetically asked her to see a psychiatrist because she deserved to live again. I din't know what i dislike more, long term paxil use, BPD the disease, or both. Likely, both

[maxsterling]

Good info.  My wife is possibly seeing a new P tomorrow.  Her experience with meds is mixed.  Benzos do stem the downward spiral of dysregulation.  Nothing seems to help much with her pain issues.  Depression?  I think I have seen her on 4-5 different things (not sure if Paxil was one of them), some kinda worked, but she quit because they didn't solve all her problems and didn't like the low libido (to me, her depression leads to low libido anyway, so it's not like anything changed there).  The big change I saw was when she quit a med cold turkey.  HUGE VIOLENT AND SUICIDAL RAGES within a week or two. 

My feeling with BPD and meds - it's a crap shoot.  You are lucky if one helps, but it is a long trial and error.  Luckier still if the pwBPD actually stays on it.  Because of their black/whit thinking, I think many quit because they want something to make them feel 100% good.  Instead, they have a bad day, some depression, and they declare the med useless and decide to quit. 

[sadeyes]

Hawk,

Can you elaborate on the 7 yr Paxil thing? I have not heard this, and would like to look into it further.

[Cole]

W had it mixed up. P talked with her about both Paxil and Wellbutrin and rx the Wellbutrin, not Paxil.

Day two of Wellbutrin and she says she feels much better. 

[maxsterling]

Cole - Wellbutrin is the one that I think my W has had the most success with.  Unfortunately, she claims it kills her libido and after a few months wants to quit.  If the new P wants to put her on something, I need to try and convince her that depression itself kills her libido.

[Hawk Ridge]

In Re: Paxil time lines, you likely will get different thoughts from different professionals - one of my colleagues and a honest friend to me is a gifted psychiatrist with many years of experience.  He sited studies whereby Paxil usage, beyond the 7 year mark, becomes basically a placebo with the continued unpleasant effects of zero libido, irritability,  and the horrific withdrawal symptoms.  Long term Paxil usage side effects deserve more publication and educatio.   when withdrawing, it is important it become a gradual process.  My expwBPD had a comorbidity of major depression, hadn't met with a therapist or a psychiatrist for the last several years so kept taking the same doseage for years, even though her age, her hormones, her body changed.  She is an alcoholic who quit drinking during that time period. All those variable change thus the doseage should be examined for effectiveness and possibly a med change.  We are not doctors but when the BPD doesn't see one, we are left with the effects.   BPD is not necessarily changed by the med but the comorbid diagnosis is so hopefully the severity altered.  It was frustrating to watch and to be harmed by the self neglect.  I am learning i cannot judge or change it but I can accept the impact it had on me and what I find unacceptable in a relationship. Staying on a 20 year old prescription is not acceptable to me.  It harmed me and i won't let it hurt me again

[Cole]

Cole - Wellbutrin is the one that I think my W has had the most success with.  Unfortunately, she claims it kills her libido and after a few months wants to quit.  If the new P wants to put her on something, I need to try and convince her that depression itself kills her libido.

Depression itself kills the libido is right on the mark. My W lost interest in sex when she started to get depressed and have core shame issues. Figure Wellbutrin can't hurt in that respect.   

[eyvindr]

Anyone have any experience with a pwBPD on Latuda?

[Jessica84]

Mine started taking Wellbutrin again for his depression/suicide ideation. His suicidal thoughts are nearly gone now, but his E.D. is back... .which makes him frustrated and depressed. His sex drive is fine, but the meds won't let him... .perform. He just can't win.

Is there no drug that doesn't have this libido-killing side effect?

[EaglesJuju]

My bf was on Paxil for a brief period of time. He said it made him feel like he "was skin crawling."  I had a similar feeling and an adverse reaction when I was prescribed it too.

I think medication with a pwBPD is like trial and error. My bf has taken and tried a wide range of medication including SSRI's, antipsychotic medication, mood stabilizers, TCA's, and SNRI's. It took awhile to find the right medication. Lexapro seems to help him the best. 

[maxsterling]

Latuda was another one my wife was in for awhile, and another one she claimed did not work.  I think this is one that when she quit she got worse wor a few weeks.

I dont think it is the drugs arent working, it is that she wants something to take it all away.  Shes not yet capable of seeing how emotions are part of life and happen for a reason, something to work with rather than a hinderance.  I get sad, too, but i explore and embrace the sadness and let it play out.  My wife dwells and spirals downward.