Do you still recommend Prozac and Tegretol and are there treatment centers? * 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

DO YOU STILL RECOMMEND PROZAC AND TEGRETOL AND ARE THERE TREATMENT CENTERS? Do you still recommend Prozac and Tegretol and are there treatment centers? Ask The Doctor Dr. Leland Heller Biological Unhappiness Do you still recommend Prozac and Tegretol and are there treatment centers? Do you still recommend Prozac and Tegretol and are there treatment centers? DO YOU STILL RECOMMEND PROZAC AND TEGRETOL AND ARE THERE TREATMENT CENTERS? Do you still recommend Prozac and Tegretol and are there treatment centers? Question: Dear Dr. Heller: I was impressed with your interview about treatment of BPD on healthyplace.com.  My daughter has been diagnosed with BPD and my purpose in writing is to solicit advice with her treatment.  I was particularly impressed with the success of Prozac and Tegretol in treating BPD.  I was unsure of the date of your interview and wanted to know if you currently recommend Prozac and Tegretol as a 1st line of treatment.  Alex is a 26 year old who is presently living at home with us in the Boston area.  She is unable to work and has great difficulty functioning at this point in time.  She has been in regular treatment since September 2005 but has not made any real progress despite several different medications and psychotherapy 2x per week.  I understand some of the difficulties involved with BPD and do not envision a miracle pill but am looking for some progress.  Alex had symptoms of depression and mood disorder in high school but did not begin any real treatment until college and graduate school.  She had had trichotillomania since the 1st grade plucking out her eye brow and lashes and this is still a big problem for her.  She graduated from Washington University in St. Louis in 2002 and began an MSW at the UChicago in September 2003.  During the fall of 2003 she “crashed” at the beginning of her MSW program in the context of a deteriorating relationship with her boyfriend.  Since that time she had worse social anxiety, panic attacks, worsening trichotillomania, and an abuse of pain medicines during late 2004 into 2005.  She began treatment in Chicago, and managed to graduate but could not look for a job and had to move home in July 2005 where she has been in treatment.  Her medications most recently have been on Cymbalta 120 mg from May 05 thru current although she is being taken off to try another anti-depressant.  She is also on Lithium 1200 mg since January 2006 along with the Cymbalta.  She seems to have some elements of bipolar also.  Her 3rd med is Risperdal .5 mg since September 2005.  Previously Tegretol 600mg was used in conjunction with the Cymbalta from October 2005 to January 2006.  Before going on the Cymbalta she was on Effexor300 mg. while in Chicago along with Lamictal 100 mg.  In high school she was on Paxil and earlier in Chicago was on Zoloft before her “crash”. Alex seems to need some type of stimulant in addition to her anti depressant in order to focus, energize and motivate her.  However, the stimulant seems to aggravate her anxiety condition and interferes with her sleep at night and increases her urges to pull out her lashes and brows.  She has had some periods when she would not sleep for 72 hours when on the stimulant. I know there is additional information I can provide but I have probably gone on too long already.  If you can provide any information (including whether the Prozac, which she has never tried, in conjunction with the Tegretol may be a useful approach), advice or know of anyone in the greater Boston area or in the Northeast that you could recommend we would be most appreciative.  If you think coming to Fla. would be helpful or know of any residential programs we would consider any proposals which may offer help.  Thank you for your anticipated assistance. Dr. Heller’s Answer: There is no better combination than Prozac (fluoxetine) and Tegretol (carbamazepine).  Prozac and Zyprexa is also effective (but Zyprexa usually causes massive weight gain and I use it primarily for extremely short periods of time). The medications she’s been on are unlikely to be of much benefit.  I use Lamictal occasionally when drug allergies to Tegretol are a problem and it works for a small number of people. Tegretol alone helps to reduce the severity of behavioral dyscontrol (Arch Gen Psychiatry Feb 1988) and improves stress tolerance, but without the Prozac the improvement is disappointing overall for most patients. She probably has at least the generalized anxiety disorder which will also need to be treated.  ADHD is 50/50 with the BPD and if present will need to be treated.  The sequence of treating the diagnoses is often as important as the medication itself.  Treating all the diagnoses is crucial – everything you have wrong with you makes everything else you have wrong with you worse. I would love to set up a residential and/or outpatient treatment program for the BPD, but I don’t have the financial resources to do this yet.  The three 6 week programs we did in the 90’s had spectacular MMPI test results.  It’s badly needed and I get requests all the time.  It would emphasize recognizing dysphoria episodes so they can be treated, learning to think and interpret better, and would deal aggressively with self-esteem and spiritual issues (spirituality would be individualized based on the person’s beliefs or lack of them, it would not be focused on any one religion or religious basis).  Hopefully some investor or philanthropist who wants to fill this need will be interested some day. Do you still recommend Prozac and Tegretol and are there treatment centers? 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Ask the Doctor Home Do you still recommend Prozac and Tegretol and are there treatment centers? 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Do you still recommend Prozac and Tegretol and are there treatment centers?   Video DVDs now available!   Do you still recommend Prozac and Tegretol and are there treatment centers? You can watch and listen to Dr. Heller in the comfort and convenience of your own home.  Provides full explanations and treatment descriptions of Borderline Personality Disorder (BPD) – 90 minutes, other Biological Unhappiness disorders – 90 minutes. Click here to find out more about Dr. Heller’s educational videos. Do you still recommend Prozac and Tegretol and are there treatment centers? “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. Do you still recommend Prozac and Tegretol and are there treatment centers?    Do you still recommend Prozac and Tegretol and are there treatment centers? 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. All Rights Reserved.  May not be duplicated without the permission of Dr. Leland Heller or Dyslimbia Press. Biological Unhappiness™, BiologicalUnhappiness.com™, & Dyslimbia Press™ are trademarks of Dr. Leland HellerDesigned and/or hosted by the webmasters at: US-Webmasters.com (TM) Start here to find it FAST!(TM)