Medical Literature

QUESTION:

Dear Dr. Heller,

I believe I am suffering from vestibular migraines.  I searched your index and found nothing!  I really need this information.  It seems the site is mostly about BPD, which is fine, but the add I followed lead me to believe you had lots of information about vestibular migraines.  I have been suffering for a year now with dizziness and pressure in my ears looking for answers.  HELP!

ANSWER:

I’ve never heard of that term before.  I’m assuming you have a problem with your balance, probably in association with headache.  It’s starting to look as if migraines have a neurological rather than blood vessel or “vascular” basis.  Many individuals respond to novocaine injections in the top of the neck, or to medications like Vioxx and some epilepsy medications (particularly Neurontin and Depakote).  The best headache specialist I know of is Dr. Steve Wheeler in Miami, FL.  In my “interesting tidbits” section you’ll find information about headaches, and Dr. Wheeler’s site can be found from there.  Many patients have a mental health cause to their headaches – particularly due to the profound muscle tension that develops in the neck and jaw.  Doing the screening test might give you some clues there.  Everything that a person has wrong with them makes everything else they have wrong worse – so making all the diagnoses is crucial.

QUESTION:

Dear Dr. Heller,

I have recently come to suspect that my husband may have the BPD and finding you is no less than a miracle!  Your site has helped me gain great insight and I thank you so much.  He displays most of the symptoms you describe (does not self mutilate) and was physically, verbally and emotionally abused as a child.  Unfortunately, he does the same to me.  I have also come to realize that I have codependency traits and feel this is a direct reaction to try and keep “peace.”  We are now separated, (I finally got the courage to do it and he’s not happy) and are both in therapy.  My question is whether there is such a thing as a 12 step program for people with the BPD or people who display these kinds of behavior.  It seems to me that this would be extremely beneficial for people like this.  Thank you so much.

ANSWER:

Thank you for your kind words.  Not that I’m aware of, but it certainly makes sense.  Many of the principles of the 12 step programs are built into my approach.  The 6 week treatment programs we did involved a higher power and I use this concept regularly – we’re a 3 legged stool (mind, body, spirit).  The approach I use has worked very well if the individual really wants to get better.  It involves making all the diagnoses and treating them comprehensively, have a formal plan for stress, and retraining the brain.  Zig Ziglar’s “How to Stay Motivated” tape series will likely be of enormous help to both of you right away.  Without the right medication, it is highly unlikely that an individual with the BPD will get well enough to have a great life.  In the talks I’ve given to AA groups, I was repeatedly told the equivalent of “wow, those are the folks who usually fail.” This is because they so desperately need medication.  The BPD is likely a form of epilepsy that needs medication.

Is Serzone Effective For The BPD?

QUESTION:

Dear Dr. Heller,

My wife has been on Prozac for many years and has visited several therapists.   About two months ago our family Physician changed her from Prozac to Serzone.  She recently found a therapist familiar with BPD and diagnosed her as such.  The Serzone did not seem to be working so our family physician referred her to a psychiatrist.  He increased the dosage of Serzone.  It has  not seemed to help.  I have reviewed many websites and read books, and it  does not appear Serzone is an effective drug.  What are your thoughts on this, and if it is not effective what information is available to convince her psychiatrist to try something else.  Thanks.

 

ANSWER:

Like you, I have not found Serzone to be that effective a medication and I rarely prescribe it.  I have never found it of use for the BPD.  In the BPD section of my Website are many literature articles about the BPD and it’s treatment – particularly Prozac and Tegretol.  This information is a decade or more old and is still the best combination in my experience.  Making all the diagnoses using the screening test may be of enormous use as well.

 

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QUESTION:

Dear Dr. Heller,

I am under a physicians care and receive 25mg.  Tenormin daily (blood pressure) and 1mg Xanax up to 4X/day if needed.  I have had extreme success with this combination as I tend to have a somewhat explosive temper which is greatly relieved when I take this medicine (my family thinks so too!).  I was also diagnosed with HEP C in 1992.  I saw a liver specialist and treatment to me was unacceptable.  I know the cure is coming soon( I have bio-tech friend in the business).  My question is: What medication is least harmful to my liver?  My ongoing research shows Xanax metabolizes very quickly, thus less exposure to liver will cause less damage?  I tried Paxil and Zoloft.  Prozac is out of the question (sexual dysfunction big time, mood swings, on all those drugs).  Please respond ASAP as I am to see my Doctor on 05-22-00.  Buy the way, I’m a 48 y/o self-employed construction contractor and am in good physical condition – except for the HepC fatigue episodes I experience on occasion, and I consume no alcohol.  —John

ANSWER:

No, neither Xanax nor Tenormin will injure your liver.  The problem is that your body is slower to metabolize the Xanax – meaning you have progressively higher blood levels as time goes on. I’d highly recommend you look at the screening test I use for my patients – it may explain what’s happening to you with these other medications.