Q. I have been to several psychiatrists, therapists, etc. Years ago I took prozac 20 mg with a sleeping pill every night. for nine months. this changed my life. I got married . was so in love, then I stopped the meds. was okay for a while then started not sleeping losing weight, nothing made me happy. I fell into a deep depression, I all of a sudden looked at my husband one day and could not stand him. I was sent to a dr. who tried Paxil, made me worse. I tried prozac again I was suicidal. tried Effexor small dose would not tolerate more 58 mg. with .75 of Klonopin a day. slept well on this. functioned okay, but did not feel right during the day. I also would spend a lot of money, and look at other men, did not feel satisfied. I got pregnant and went cold turkey off both, I did not sleep for a month had to be put back on Klonopin every other day to get some sleep. I would feel like I could not stand my husband, therefore I could not sleep then when he was not around I wanted him there. Now my baby is two. I am divorced. I stay up for nights panicking until I get so exhausted. I feel like nothing makes me happy. I feel different then everybody. I never know what I want to do with my life. I never finish things. One minute I want my ex, the next I can't stand him. I started back on prozac with 2mg of Ativan at night to get some sleep. I am scared on the prozac, because the only thing I love about not being on meds, I feel so close to my baby. I noticed now, I am falling back into a state of depression with anhedonia. I don't know if I took more prozac, if I should take a mood stabilizer to help me feel more. From everything I have read about bpd, I really think I have this, I keep going downhill. If I stay off meds. I don't sleep at all. Please give me some advice. I tried so much. I am scared and very alone.
A. Sounds like your life has been very grim in parts. There are a number of letters with medication suggestions on this website. The treatments suggested all have been published, except the Serzone which will be out in April or May. Using too low a dose of medication is not going to help. If you have BPD, Prozac needs to be used at 80 mg, Zoloft at a minimum of 200 (average dosage of 325 mg), Effexor XR at a minimum of 300 mg (450 is my usual dose) and Serzone at a minimum of 500 mg at bedtime. Find the one that fits you best from a side effect standpoint and give it a try. You have nothing to lose except your depression. The illness you have is biological, even if it is not BPD, and you need to be on enough medication to work. It is not working based on your symptoms, so either have your doctor increase your dosage or change medications. Talk to your doctor about your options. It does not sound like you have ever been on enough of anything to work.
