Q. I am a 31 year old female who has suffered over the last 10 years and have finally been diagnosed as BPD with slight bipolar disorder earlier this year. I have recently come home after spending the past 5 months at a state hospital where I was treated for the above.

I am very eager to get on with my life as I have never felt better, and am quite sure that this diagnosis is finally correct. My only problem seems to be excessive shaking to the point that my handwriting is hardly legible.

My medication is as follows:
Epilum (200mg) 2 tablets twice a day (morning and night)
Lithium (400mg) 1 tablet twice a day " " "
Haloperidol (5mg) 1 tablet at night
Lorazepam (1mg) 2 tablets at night
Prozac (20mg) 2 tablets per day (morning and lunchtime)
Akeneton 3 tablets per day (morning lunchtime and night)

In an attempt to alleviate the shaking my doctor suggested changing Haloperidol to Zyprexa (5mg - one tablet at night) The shaking was better, but I was not clear headed and felt slightly out of control.

Is there another alternative (as good as haloperidol) without the side effects (particularly the shaking) or possibly something to alleviate the shaking. I have heard about a drug called Seroquel.

  A. It is difficult to tell what is causing the shaking. My guess would be the lithium. But, this is only a guess. I usually add a beta blocker to control shaking. Sometimes it helps. The usual beta blocker medication used is sustained release propranolol at 60 mg twice per day, but I have gone a lot higher than this. Talk it over with your doctor and see what the or she has to say.