Following medication instructions

[Akita]

My BPDw was on celexa.  She upped the dose herself then weeks later refused to take it at all.  Now she is on lamictal and she has upped her dose by a small amount, half a pill.  Should I care?  She did message her dr but he didn't respond so she went ahead with her plan.  She had previously asked to double her dose and he said no.  Is this a problem for me?

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[schwing]

first of... I am not a pharmacist.  

But Celexa is an SSRI (selective serotonin reuptake inhibitor) which is used to treat depression.  As I understand it, anti-depressants can help people with BPD (pwBPD) take the edge off of the intensity of some emotions, but it doesn't necessarily address *why* they might be dealing with intense (disordered) emotions.

Lacmictal, on the other hand, is an anti-convulsant medication and is sometimes prescribed for epilepsy and bipolar disorder.  *but* seems to be used also off-label in treating clinical depression.  Seems to have some effect as a mood stabilizer.

I guess as long as she is willing to take medication to regulate her moods, this can be seen as a good thing.  Just keep in mind that medication in and of itself probably won't address her personality disorder.  But it's a nice additional buffer.

I don't see this as a problem for you.  That said, how is she doing on the new medication?

[Akita]

Schwing

She has only been on the lamictal for 2 weeks.  I haven't noticed any changes.  I was worried about her changing the dose of her medication without the doctor's approval.  She is also in psychotherapy with a psychologist.  She has been getting help for over a year but I haven't seen any change except for her getting worse.  Guess patience is key.

[Naughty Nibbler]

Akita:

Everyone is different and the dosage she is taking, when she starts and stops either of those meds, will come into play.  If she was on the lowest dose of Celexa and stopped it abruptly, perhaps there are no side effects for her.  If she were on a higher dose, she might be more apt to experience some temporary withdrawal side effects.  It usually takes a few weeks for someone to gain the full benefit of a particular dosage.

The best way to avoid short-term side effects, is to titrate onto these types of meds and to do the reverse when you go off of them.  The doctor likely has a plan to up the dose of Lacmictal, over a certain time period and get to a target dose. 

Might just want to keep observing her behavior (perhaps making some private notes).  It is still early in the process for the Lacmictal and her body may still be processing a withdrawal from the Celexa.    Hopefully, she will touch base with her doctor.

[Akita]

Celexa ended in January and she was on 40 mg when she stopped.  She sees her dr on Tuesday the pill guy and her therapist.  We will see what they think.  She doesn't want to be on any of it.

[Naughty Nibbler]

Celexa ended in January and she was on 40 mg when she stopped.  She sees her dr on Tuesday the pill guy and her therapist.  We will see what they think.  She doesn't want to be on any of it.

What is her reason for not wanting to take meds, is it side effects?  Being that she went off Celexa in January, she is likely over any withdrawal effects for that med. (as well as any benefits)

I found it interesting when I read a post recently, where someone had a pwBPD in their life that didn't want to take meds either.  Their reason was that "they wouldn't be who they are now".  It's hard to understand that logic. 

My dad needed meds for depression.  We had a hard time getting him to stay with a med long enough to get any benefits.  He did stay on one med for awhile.  He wouldn't admit to any benefit from the med, but family could tell a difference - he wasn't as angry as usual.  Any time he had a physical discomfort, he would blame it on the depression meds. 

Hang in there.  I hope it works out.

[Akita]

She is fearful of becoming someone else!  She also says having to takes meds gives concrete proof there is something wrong with her brain.  She just wants an ah ha moment in therapy and then lead a normal life.  Being on medication says something about her and she doesn't like what it says.  She dislikes therapy for the same reason but it isn't changing her chemically so it's more tolerable.  She wants ppl to stop treating her how they do.  She wants to be happy instead of always feeling like she just doesn't quite belong.  She just doesn't know how to get there and is having struggles trusting these drs to get her there.  Thank you for your story that is enlightening that others could see change when he couldn't.

[schwing]

She is fearful of becoming someone else! 

This might be an expression of identity disturbances which is associated with BPD.

She also says having to takes meds gives concrete proof there is something wrong with her brain. 

This is part of the rub.  This is why people with BPD (pwBPD) have great difficulty recovering from BPD.  Without the emotional tools to accept that something might be wrong with you, you are inclined to prefer the denial that nothing is wrong with you.

She just wants an ah ha moment in therapy and then lead a normal life. 

I don't think it works this way.

Being on medication says something about her and she doesn't like what it says. 

If you had a medical problem and required taking medication to address the problem, would you stop taking the medicine because it says something about you you don't like?

She wants ppl to stop treating her how they do. 

Do people treat her differently from how they would treat anyone that behaves like her?

She wants to be happy instead of always feeling like she just doesn't quite belong. 

This sounds like a great discussion in therapy.

She just doesn't know how to get there and is having struggles trusting these drs to get her there. 

I'm sorry but I don't know how to help on this regard.  This is at the heart of the motivation needed for recovery - to want to get better.