Q. We have a 15 year old daughter with Tourette's Syndrome, O.C.D., A.D.H.D and her psychiatrist has been reluctant to label her with BPD but has done so. Rachel just came through a Stevenson Johnson ten reaction to Lamictal. All drugs were removed to correct the problem. Now she is being increased on Luvox etc. In this case we are having severe problems finding a DBT clinic and Therapist that will deal with a 15 year old. We live in Toronto, Ontario Canada. Can you give us some direction or leads to who is available and what we should be looking for?
A. The University of Toronto has a great psychiatric program for adolescents by reputation, and I would start there. She clearly needs medications, and Luvox at 300 or 400 mg daily is a good choice since it has no dopaminergic activity at higher dosages, and will not worsen the Tourette's Syndrome.