Q. I am 25 female, and diagnosed as BPD. However things
are getting worse in particular the mood swings. After
doing some reading I believe that as well as BPD I may
be bipolar rapid cycling with dysphoric mania.
I am currently taking
20mg Prozac 3xday
200mg Tegretol 3xday
100mg Trazodone 3xday
and at least 0.5mg haloperidol3xday
but often more.
Please could you tell me if there is a way to differentiate
between the BPD and the bipolar mood swings as I wish
to be certain of the diagnosis in order to try to obtain
the correct treatment.
A. No way to differentiate which is which since the diagnoses overlap so much. The Tegretol will cause the Prozac to break down faster than normal, and even so, 80 mg/day seemed to be the minimum effective dosage we used in borderlines. I would ask your doctor what is being treated, and see what they say. Discuss the treatment options with the doctor, and why they are doing what they are doing.
Alternatives to Tegretol include lithium, Depakote, Topamax, and Neurontin. Topamax is advantageous since it causes weight loss, and the others cause weight gain.
