Posted by Tomatheus on October 27, 2006, at 0:56:39
In reply to Medicaion for Borderline Personality Disorder, posted by Amandafran on October 26, 2006, at 21:58:30
Amandafran,
I am getting the sense from reading your posts that your new diagnosis of borderline personality disorder was made based on symptoms that you've developed since you started taking your current medication cocktail (40 mg of Prozac + 100 mg of Lamictal). I don't have a medical degree or even a PhD or master's degree in psychology or a related field, which of course means that I'm not technically qualified to challenge the diagnosis that your doctor gave you. However, considering that you said that you've already been misdiagnosed once (previously with bipolar disorder), I wonder if your doctor might be making the same mistake that she made before: assigning you a diagnosis based on symptoms that are probably being caused by your medications and would likely disappear if you were to stop taking one or more of your meds.
In this thread, you mentioned that you feel the need to calm down, and to clear your mind and thought processes. You also mentioned in another one of the posts that you just wrote that you just recently had your first panic attack. It sounds to me like the borderline symptoms that you described in this thread (the "crazy mind" and lack of calmness) only began to develop after you started taking your current med combo and are probably related to the feelings of panic that you've been experiencing. Am I correct?
Others on this board have reported having panic attacks and anger-control issues while taking Lamictal. Likewise, patients taking Prozac sometimes report a side effect known as akathisia, which is described as a type of inner anxiety characterized by motor restlessness and the inability to stand or sit still. So, if the borderline and panic symptoms that you're experiencing sound like what I've just described and only began to surface after you started taking Lamictal in combination with Prozac, the symptoms are probably side effects of one or more of your medications -- not of a previously undetected personality disorder. Sometimes, these side effects can be controlled by taking other medications. In your case, it is conceivable that an antipsychotic might make you feel more calm, but sedating antipsychotics such as Zyprexa, Risperdal, and Seroquel might also worsen your depressive symptoms, especially if your depression has an anergic/vegetative component to it. However, if you're not experiencing noticeable relief from your original symptoms of depression and anxiety, you might want to consider switching meds instead of adding something like an antipsychotic to a combo that seems like it's doing more harm than good.
As far as determining which medications to take, I think that you need to consider your original symptoms and the responses that you've had to the meds you've taken. Did you ever try taking Prozac or any of the other SSRIs alone? If so, how did you respond to them? Have you ever tried any of the following ADs: Effexor, Cymbalta, Remeron, the tricyclics, EMSAM, or the older MAOIs? What about combining a benzodiazepine with an AD? There are obviously a lot of possibilities to consider, but as I said before, it's important to think about how you've responded to different types of meds in the past.
Personally, I was diagnosed first with dysthymia, then with bipolar disorder after I had a rapid-cycling response to Paxil, and most recently major depressive disorder - recurrent. I have also experienced some symptoms of social anxiety disorder, inattentive ADHD, and non-24-hour circadian rhythm disorder (the last of which has been a problem for me for as long as I can remember), but I've never been diagnosed with any of these three disorders. Interestingly, the response that you're having to Lamictal and Prozac sounds a lot like the response that I had to lithium monotherapy. I experienced complete relief from all of my symptoms for about a month when I was taking a specially prepared version of the Australian Nardil (an MAOI), but that response ended abruptly after the manufacturer of the Australian Nardil stopped putting silica gel inside of their pill bottles. Nothing else has even come close (not for more than a few days, anyway), but I'm optimistic that I might respond reasonably well to either a U.K. version of Parnate, EMSAM, or oral selegiline (perhaps in combination with something else). Of course, even though there seem to be some similarities between our disorders, there's a good chance that your responses to meds will not be the same as mine. But please, consider taking a different approach to the psychopharmacological treatment of your depressive and anxiety symptoms. Not every medication you take is going to work. And yes, some meds will make you feel worse. The meds that produce a partial (or full) response with manageable side effects are those that are worth holding onto and augmenting. Those that don't relieve your original symptoms and cause you to experience the symptoms of a disorder that you never had to begin with usually are usually the ones that need to be discontinued.
Tomatheus
> I need help on knowing what the best medication is for Borderline Personality disorder. I am taking prozac 40 mg and Lamical 100 for depression and anxiety...(this was just diagnosised yesterday...the bpd...do I need an antipsychotic? I used ot be on one when they thought I was bipolar but it was a misdiagnosis. DOes anyone out here know of anything they might have taken that I could talk to my doc about in nov. when I see her next? Do you think i just need to up my dosage of Lamictal and prozac? or add an antipsychotic...I need to clear my mind and thoughts process...it is driving me craszy and now I have an answer...maybe there is a way to calm my crazy mind down!
>
> Anyway help would be great.
> Thaks. If you could include side effect..if not I can always look them up...Thanks!
poster:Tomatheus
thread:698053
URL: http://www.dr-bob.org/babble/20061020/msgs/698099.html