Q. I'm diagnosed BPD and bipolar disorder. I'm also hearing voices and smelling things other people don't. Is there a relation between BPD and hallucinations of this kind? I'm using prozac and tegretol, but they don't dispel the voices making my live a mess.

A. In a nutshell, there is a higher incidence of hallucinosis in BPD. Overall, however, it is hard to tell what is going on without interviewing you. I would make sure that there is medial problem causing the hallucination of smell. Our studies suggested folks using Prozac need at least 80 mg/day to treat BPD. If you are on less than this, you need more. Also, Tegretol will cause the Prozac to be broken down more quickly, so you could need even more than 80 mg/day to work. Interestingly, in our American Journal paper, folks with hallucinosis did just as well as folks without. If you are not obsessive-compulsive, Serzone would also be a good choice. It is very effective in folks with hallucinosis.