Are SSRIs Always Necessary for BPD? * Dr. Leland Heller is a family physician who has treated thousands of patients with the Borderline Personality Disorder. BPD is a medical disorder and that this and other Biological Unhappiness disorders are treatable with medication first and then by retraining the brain * Biological Unhappiness * BiologicalUnhappiness.com

ARE SSRIS ALWAYS NECESSARY FOR BPD? Are SSRIs Always Necessary for BPD? Ask The Doctor Dr. Leland Heller Biological Unhappiness Are SSRIs Always Necessary for BPD? Are SSRIs Always Necessary for BPD? ARE SSRIS ALWAYS NECESSARY FOR BPD? Are SSRIs Always Necessary for BPD? Question: Dr. Heller, I have been dating a girl for about 1 1/2 years (now my fiancé) who I believe was misdiagnosed as Bipolar.  When we first started dating she was taking a small army of drugs: Abilify, Lamictal, Risperdal, Cogentin, & (I believe) Lorazepam (it was a benzodiazepine, that I know for sure).  Anyways, with all of these drugs, she was basically a zombie most of the time. Issues I noticed were: shuffle walk, excessive tiredness, bad memory, periodic hand shaking, lack of pain response to high temperatures, and occasional bursts of anger. I spoke to her psychologist, and initially she agreed to work to reduce these drugs.  I got the feeling she wanted my girlfriend to fail, because she insisted almost all of these drugs could be quit cold, and that any resulting problems would be “proof” that she needed to take the medicine.  Regardless of her recommendation to quit cold, we tapered off the drugs one at a time. After my fiancé managed to successfully quit a couple of these drugs with no problems, her psychologist did something strange, and refused to see/speak to me any more. Anyways, despite her psychologists’ refusal to work with us, we have managed to get her off daily use of all of the above listed drugs.  Her psychologist still believes she is taking Abilify and Risperdal daily. All of the side effects listed above have resolved, with one exception, the periodic bursts of anger.  Initially her anger bursts got more intense, but we experimented with several different combinations of amino acids/OTCs with known effects on Serotonin, Dopamine, and epilepsy while using the Risperdal as needed to keep things under control. She now takes 100mg 5-HTP, 500mg L-Taurine, & 50mg Benadryl once daily in the evening.  This combination seems to work best for her, and greatly minimizes the severity and duration of her anger outbursts when they occur.  Actually, what seems to be the most effective ingredient in that list may surprise you (L-Taurine).  At 1000mg it works better, but makes her more tired, so we are staying at 500mg for now. Anyways, after about a year of being off her drugs, I am more sure than ever that she is BPD instead of Bipolar.  I read your list of BPD issues, and it matches her almost perfectly.  I have never seen any hint of depression at any point in time. Currently, the only prescription drug we still use from her original group of drugs is Risperdal.  We found that 0.5mg usually helps prevent an episode if it is an imagined problem or obsessive thinking about problems from her past.  However, when an episode is triggered by a perceived rejection by me, 1.5mg to 2mg (in extreme cases only) is needed to get things under control. We also discovered (the same as your other clients) that chewing/crushing the Risperdal and dissolving it in her mouth does speed up the response time.  However, the problem, as you might expect is the hour before the drug really starts to kick in can get a bit out of control. We are considering trying the Haldol after reading your site, perhaps at a little lower dosage based on the fact that she usually needs only 1.5mg of Risperdal vs. your 3mg recommendation. My main question for you that I have not been able to answer from your web site is: have you seen a case of BPD where daily prescription SSRI’s were not necessary, and your recommended list of treatments for episodes was enough to do the job? Thanks, Dr. Heller’s Answer: If she does indeed have the BPD the right medications make a huge difference.  SSRI’s don’t work equally as a class.  Prozac (fluoxetine) is profoundly superior, likely due to its effects on the glial cells.  The right dose of Prozac stops the unproved mood swings, chronic anger or irritability, emptiness and boredom.  Prozac (fluoxetine) is inexpensive and rarely has side effects.  If a patient just can’t take Prozac (fluoxetine), I will usually prescribe high dose Effexor (venlafaxine).  The symptoms Prozac (fluoxetine) stops, will otherwise destroy a borderline’s life.  Almost everyone I’ve treated for the BPD with Prozac, and subsequently stopped taking it, eventually wished they hadn’t stopped. The as needed medications are different.  Haldol (haloperidol) is cheaper, works more quickly and doesn’t cause weight gain. Being groggy most or all the time to me is not an acceptable medication regimen.  It may happen in the early stages of treatment or during episodes of severe dysphoria (anxiety, rage, depression and despair), but otherwise it’s not acceptable. As with everyone, making the correct diagnoses and treating them comprehensively is crucial. Are SSRIs Always Necessary for BPD? 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Ask the Doctor Home Are SSRIs Always Necessary for BPD? MENU: Are SSRIs Always Necessary for BPD? 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Click here to find out more about Dr. Heller’s educational videos. Are SSRIs Always Necessary for BPD? “Biological Unhappiness” “Open this book and it will open your mind.  By combining proven medical procedure with hope and inspiration, Dr. Heller has made a significant difference in thousands of patients who had little hope for recovery.  “Biological Unhappiness” contains critical information for those who have lost hope.”Zig Ziglar, motivational speaker, author, See You at the Top, Over the Top, Success for Dummies, Raising Positive kids in a Negative World. Are SSRIs Always Necessary for BPD?    Are SSRIs Always Necessary for BPD? Dr. Leland Heller  Dyslimbia Press, Inc. 1713 US Hwy 441 N, Suite E • Okeechobee, FL  34972 • 863-467-8771 Email: Hours: M-Thu. 8:30AM-5PMFri. 8:30AM-12 Noon*(*During November through April, the office is open until 3PM on Fridays.) All material not explicitly credited otherwise is copyrighted © 1999-2011 Dr. Leland Heller. 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