Medical Literature

Is There Hope For Vestibular Migraines?

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.

Is There A 12 Step Program For BPD?

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?

    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.

Separator (Biological Unhappiness)

 

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Is Prozac Addicting?

QUESTION:

Dear Dr. Heller,

Good morning.  I’ve been on this medication for over 10 years (Prozac).  Is this drug addicting?  I would like to get off of it, but I tried twice and it didn’t work.

ANSWER:

Prozac is not an addicting medication.  All the medications in the SSRI class can have withdrawal symptoms, although Prozac has the best profile in this regard.  In fact it’s often recommended that patients temporarily switch to Prozac when discontinuing the other drugs in the SSRI class (Zoloft, Paxil, Luvox, Celexa). What could easily be happening is that you simply need to keep taking Prozac, and that the symptoms you had prior to taking the Prozac have returned.  This is particularly true if unhappiness or the BPD were a problem before the Prozac was started.  Approximately 40% of depressed individuals only get depressed once.  The rest need additional treatment in their lifetime, many permanently.

Is My Medication Hurting The Liver?

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.

Is There Hope For This Abusive Mom With BPD?

QUESTION:

Dear Dr. Heller,

First I am giving you only one side the story, knowing that…My wife is a child abuser and undergoing a court mandated Psychological Exam (in 1 of 2 court proceedings that she has been accused of Child abuse in).  She has been abusive to children even under supervised visit situations taking them off away from the supervisors and mentally tormenting them (they are in therapy now, disclosing horrible events from the past, both 6yrs old.)

My wife’s past is atrocious, filled with so much junk that you feel very sorry for her (I mean bad).  But currently we have an infant together and I fear for his safety.  What kind of future may this hold.  She WILL NOT get help, she lies almost compulsively, Dysphoria, gaslight, etc.  She is a 9 of 9 in the DSM-IV with many extreme case examples, and other PD’s also.

I have been coordinating with many professionals and I am looking for as many resources as possible to help the infant now because of my mistake (the other boys are from a previous marriage of hers and a non-marital pregnancy while she was exotic dancing).  What dangers does a 9/9 BPD person pose on an infant?  According to the boys counselor she has deeply damaged the boys psychologically over several years and now they suffer identity disorders, anger mis-management, on and on.  I have copied your cover, and your message to BPD’s because first she needs help, and I haven’t been able to help her, but I also could not watch her attack and beat children.  This has been very difficult.  But it seems so text book, as long as your reading a BPD or addiction text.

 

ANSWER:

Certainly some individuals with the BPD are significantly tougher to manage than others, and hers seems a prime case.  I’ve seen many “severe” borderlines go on to become stellar human beings, and those with “mild” cases become extremely abusive, manipulating, hurtful, and destructive.  It’s very hard to predict, and I’m extremely reluctant to pre-judge. Fitting 9/9 criteria doesn’t suggest to me that someone is a higher abuser risk than others.  There’s no direct correlation with number of criteria.  If she has been abusive in court appointed supervised visits, the courts may choose to step in and stop the visitations for a while.  Your best approach for now is likely to take care of yourself and become happy and serene.  This will do more for your own children than anything a court can do.  Focusing on your wife, her problems, and her behavior will likely make everything worse for all of you.  You’ve probably done all you can at this time.  Therapists and attorneys will likely need to guide you through the maze you and the children are now caught in.