Q. I am diagnosed with BPD with depressive symptoms but my mood swings frequently between very low to a bit high. This can happen as rapidly as less than an hour to every couple of days. I am currently taking Prozac 60 mg Tegretol 200mg bd and haloperidol 0.5mg as required. The mood swings were occurring before i started these meds when i was on nothing. Could I be rapid cycling? Also my anxiety levels are up and everything is making me nervous and edgy again this had started to get better I am a 24 year old female from the UK which also makes things difficult from a treatment point of view.

A. The Tegretol will make your Prozac break down quicker, and probably not help much with your illness. The lower your concentration of Prozac, the worse you will feel. The Tegretol decreases mood swings when it works, but usually causes depression. You may want to ask your doctor about being off Tegretol, going to 80 mg/day of Prozac, and even changing medications (Effexor or Serzone are other possibilities). The use of Prozac was covered in my 1991 article in the American Journal of Psychiatry.