QUESTION:
Dear Dr. Heller,
I have been diagnosed with BPD within the past year. I had taken Zoloft, with positive results, and than switched to Celexa, with not so positive results. My doctor has now prescribed Lamictal. Though I can now get off the couch for more than 30 minutes at a time, my mood swings seem to be back again for the first time since before the Zoloft. Is there anything that can relieve all the symptoms, or can SSRI’s and anti convulsants be taken together? If Lamictal takes a short amount of time to feel its effects (I have been taking it for 3 weeks) then why do I still have to battle the severe mood swings?
ANSWER:
The SSRI’s are not interchangeable. In my experience the best is Prozac. If one works better than another, then clearly you should be taking the more effective medication. All of the “mood stabilizing” epilepsy medications (Depakote, Tegretol, Lamictil, Neurontin) can help some individuals with the BPD. I’ve found Tegretol to be the most effective by far. I’ve been very disappointed with Lamictil, and it can be difficult to take. In general the Prozac / Tegretol combination has been the best for my patients. Whatever other diagnoses that are also present need to be treated as well. The medication sheet I give to my patients is available at: http://pks.947.myftpupload.com/20a.htm