Tag: Addiction

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 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.

Is Breast-Feeding Safe When Taking Zoloft?

QUESTION:

Dear Dr. Heller,

My Sister-in-law is concerned that: 1.  She may have to stop breast feeding her daughter after taking Zoloft.  2.  She can’t take another drug (I don’t know the name but has a similar effect as Valium) which was prescribed in concert with a Prozac or a Zoloft prescription which accelerated her recovery from previous crises events and still breast feed.  (The second drug was Xanax) She appears to me to be at a crisis stage where in her own words “she can’t take anymore”.  As you can imagine, the family reaction is mixed from “Get over it” to “If I could just be there to hold her”.  My Mother-in-law has similar problems and is on medication and I’m sure my wife at times has concerns of her own.  We’ve counseled her to talk to her pediatrician but in any case she should understand that her well being is more important to her daughter than the breast feeding.

ANSWER:

Like all other medical problems, it comes down to risks against the benefits.  There is no significant data regarding breast feeding when taking Zoloft.  Zoloft is used for children 6 and older. Xanax has the high possibility of causing addiction in the baby as well as the mother. The consequences of depression and raging while breast feeding – or not breast feeding at all – also need to be taken into consideration.  Maternal/infant bonding is a very, very important time.  Prozac is considered safe during pregnancy, so it might be a reasonable alternative during breast feeding.  In my experience, Prozac is more effective than Zoloft for most people as well.

Why Is My Husband Worse?

QUESTION:

Dear Dr. Heller,

My husband was diagnosed three times this year by three separate psychiatrists.  First as Post Traumatic Stress Disorder, then ADD & Depression, and finally as Bipolar II & (tested with mild) ADD.  He went for help with depression, anxiety and drug addiction.  Now he is being prescribed Zyprexa as a mood stabilizer, Paxil for depression and Adderall for ADD.

The problem is that my husband has more problems with addictive behaviors now than six months ago.  He has become increasingly disinterested about work, our relationship, family, life in general, and completely lustful when it comes to eating, drinking and smoking pot (Zyprexa?).  He takes his Zyprexa after work and checks out. I am unsure about his diagnosis and treatment.  He and the doctors believe medication is working for him.  The doctor told me that diagnosis are never simple and clear cut, that PTSD was a catch-all and my husband was not in anyway Borderline.  But this treatment has changed our life together, entirely for the worst.  It would not matter as much to me if it were just he and I, but we have five children, and I need a husband, friend and partner in this.

Please help me.

ANSWER:

I would be highly suspicious of the generalized anxiety disorder.  This genetic “disorder” has an elevated 5HT1 receptor – which gets stimulated by Paxil and Adderall, increasing his anxiety.  I often have success with this population by adding BuSpar and then Remeron for a while. It’s important to know all the diagnoses, and I urge you to look at the screening test I use for my patients.

Should Tegretol use be as needed only?

QUESTION:

Dear Dr Heller,

I have read your first book and am very grateful for all your research and work that you have done in regards to this debilitating illness.

My son now in his early 20’s has had problems with anger management from a young age and after seeing numerous psychologists and psychiatrists through the years has been diagnosed BPD.  He has been on Prozac at various strengths 20mg up to 60mg only for the last 6 years and even with psych visits lost it completely a couple of years ago, starting a trend of self destructive behavior involving gambling/alcohol addiction that led to lying stealing and bizarre rages.

After reading your book 2 years ago I tried and failed to get the treatment you recommend until now.  I have returned to my former physician who thinks your treatment plan is sensible and safe and is willing to give it a try.  Yay!  He is very interested in your procedure and has prescribed Prozac, Haloperidol, Tegretol and Risperdal as per your patients’ dysphoria instruction sheet.

My question is in reference to your good results with Tegretol.  Should he start using it on a regular basis or just according to the instruction sheet?

Also in regards to Haloperidol when is it a good idea to use this as a preventative?  His dramatic mood change comes soon after a personal upset and there’s no predicting them.

ANSWER:

Thank you for your kind words.  Chronic Tegretol use depends on the patient and the symptoms.  Based on what you wrote he probably would benefit from it – the goal is to get the level in the upper third of normal.

It’s an excellent idea to use Haldol as a preventive treatment.

What about Diet and Nutrition?

QUESTION:

Dear Dr. Heller,

Why do I see no mention of diet & nutrition in your web site’s discussion of mental illness? This is a major factor in the biological imbalances that may be present, and just prescribing drugs is a mere cover-up that often exacerbates the underlying problem while creating drug dependency/addiction, since the patient will be worse than they were to begin with if they stop their medication. By eliminating certain foods and adding others, as well as giving appropriate supplements of vitamins, minerals, and amino acids, you can often bring about dramatic improvement. Why are you so anxious to make drug slaves out of your patients?

 

ANSWER:

Diet and nutrition play a key role for everyone. I do go into this in my book “Biological Unhappiness.” I don’t think the tone of your letter would be as hostile if you understood how much I believe in nutrition and taking care of one’s health. The positive changes medication can make cannot be ignored. Based on your last sentence, have you considered that you might be deficient in something yourself – whether it be nutritionally, medically, or in compassion and understanding for your fellow man? That degree of hostility, misinformation and demeaning of those who need medications is not a sign of good health – nutritionally or mentally.

For many individuals with “Biological Unhappiness” diagnoses, nutritional and poison problems are indeed a problem. Hair levels of lead worsen AD(H)D, as do deficiencies in fruits and vegetables. Hypoglycemia can worsen mental health diagnoses. Sometimes the insulin/sugar system is so out of balance that temporarily stopping carbohydrates (e.g. Atkin’s or Sugarbusters) is an excellent idea, particularly for those with carbohydrate cravings. Many people poison themselves with tobacco, alcohol, excess food, a bad diet, lack of exercise and various other things. They often actually are “treating” their medical problems with the “wrong drugs.”

We’re a three legged stool – mind, body, spirit – and clearly all three need to be working well. Whatever can be done nutritionally should be done. Nutrition won’t change mental health genetics, however, nor will it change the mind of someone who’s interpreting danger that there really is no danger. Being healthier in every way – including nutritionally – is a wise choice.