Borderline Personality Disorder: Correct Combination of Medications for BPD & Discussion of Tegretol VS. Depakote

Q. My husband has been taking Depakote for his BPD for about 7 months, he now is starting to “roller coaster” not enough to rush to the hospital but enough to “light up” my danger signals. Is it possible that he needs to have his dosage adjusted and is there anyway to do that with out being admitted to the hospital…. forgot to tell you the amounts 4-250mg in the evening and 1-250 mg at lunch time.

A. I seriously doubt that medication regimen will be very effective. The blood levels need to be high normal all day long if the depakote is needed. From your description he isn’t taking an SSRI like Prozac, nor does he have an antipsychotic medication to use when needed.

Depakote is at best for me a second line medication. Your husband, to me, isn’t on any good front line medication. There was an article in the New England Journal of Medicine in 1992 comparing tegretol to depakote in “complex partial seizures” (which I believe is definitely part of the BPD) – tegretol was much better.

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