Borderline Personality Disorder and Correct Medication

Q. I have been diagnosed with BPD for nearly 6 years, but have had it ever since I can remember. I have been in and out of therapy, but had to stop because of financial problems. My marriage is failing rapidly because I am so unhappy and I can’t seem to find a place to center my life on. I have taken Zoloft, but eventually developed atypical cardiac symptoms and was forced to change. I tried Paxil, it was severely sedating to me. I tried Serzone, it gave me horrible migraines. I was on Risperdal for a short time, and developed urinary retention. My doctor finally tried me on Effexor. I have taken it for about 18 months. I feel reasonably sane on it, but it doesn’t control the mood swings or the depressions very well. It allows me to think and that is about all. I take 300mg a day, plus 25mg trazodone at night to help me sleep. I don’t know if there is anything that can be done for my marriage, I think he’s pretty tired of me, but is there anything I can do for myself medication wise that will help more than the Effexor that doesn’t have many side effects? Help, I am getting desperate for a solution to this emptiness I have.

Thank-you.

A. Actually, you haven’t been on the important BPD medications at all. Risperdal is used by me when patients are in crises.

Effexor is a good antidepressant, and absolutely sensational for chronic pain. I prescribe it a great deal.

Prozac is the best antidepressant, because it works on moodiness, chronic anger, emptiness, boredom, and emotional pain – like feeling your best friend died all the time. It markedly reduces the frequency of dysphoria (anxiety, rage, depression and despair). It improves irritability (it’s even being given to pit bull dogs!), rejection sensitivity, and a chronic sense of unhappiness. I believe the BPD is caused by damage to the brain’s “glial cells” – and some scientific research has shown prozac improves glial cell function.

Prozac and possibly tegretol added to it are virtually always front line treatments for me.

I have some borderlines who are ALSO on Effexor, but for chronic pain.

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