Q. I've been diagnosed with BPD, ADD, major depression, GAD and hypothyroidism. I'm on Prozac 40mg, Ritalin, 60mg, Levoxyl .15mg, Tegretol, 200mg 2xday, BuSpar 15mg 3xday and Premarin. My major symptoms described by Dr Leland Heller have subsided but now I'm in a state of nothingness. I don't care and I'm overwhelmed by the mess I've created. Is this simply an existential issue or are my meds mixed up? How to know?

A. Tough question with no easy answer. I am a proponent of one medication treatments when possible. If you have not been on 80 mg/day of Prozac, I would suggest you try it. The Tegretol can do two things which are bad and one which is good. It can cause the nothingness feeling and can also lower your Prozac levels, neither of which is good. Some folks also get depressed on it. On the positive side, many folks with BPD get a modicum of mood stability with it. Effective dosing of Prozac may allow you to get rid of the BuSpar, Ritalin, and Tegretol. Talk with your doctor about this before trying anything. I do not know the particulars of your case, and hate to second guess your physician.