Q. I am a 19 year old girl from Norway (so forgive me for writing bad English). I have been diagnosed with BPD and two others which I don't know the English name on...sorry. But it has to do with psychotic depression and psychologically disturbed due to drugs. I'm taking 300 mg Effexor, 80 mg vallergan, 15 mg zyprexa, 300 mg largactil and 500 mg tegretol. Of course I get a lot of side effects but that's not really the problem. I think the medicine is helping me, but of course I have my ups and downs. I mentioned I also take drugs. I have quit taking morphine, amphetamine and ecstasy so all I do now is smoking pot a couple of times a week plus I eat a lot of pills (benzodiazepines). I was not smoking pot for about 2 weeks and then I became a lot worse. I started yelling and arguing, self-destruction, suicide attempts and so on. My problem now is that I don't want to quit smoking, it helps me a lot. I'm afraid of getting a much worse condition without it. (and the benzodiazepines).
I just got a new doctor. I don't like him, but that's irrelevant. He tells me I have to quit smoking. And now he will put me on new medicines: truxal, tolvon and tegretol (I can't remember the milligrams). He will take away Effexor, vallergan, zyprexa and largactil (which has been quite a help to me).
Questions:
1.Do you think he is right about the pot? Do I have to quit in order to get better??
2.Do you agree with him about the new medications?? Or was the "old" better?
3.I was hospitalized 6 months ago because I was psychotic (I heard voices and saw all kind of stuff). Will that return if I stop taking Zyprexa??
4.Do I HAVE TO follow his "plan", or can I go find another doctor?
5.Will I ever be okay? Am I sick for the rest of my life? Cause if that's so it's not really worth it.
A. 1. He is right about the pot for two reasons. First, it is not good to take a substance that impairs your ability to think. Pot makes people stupid and paranoid while they are high. Second, the smoke itself causes your other medications to be metabolized more quickly, so the Effexor and other drugs will not work as well or as long during the day.
2. I do not know enough about your case to comment on the medications. Most borderlines need 450 to 600 mg of Effexor XR daily, particularly if they smoke pot and/or cigarettes.
3. I do not know if stopping Zyprexa will cause a return of your psychosis. Go over this with your doctor. Since Zyprexa is used to treat psychosis, I definitely would not stop it on your own.
4. If you cannot follow his plan, get a second opinion or at least discuss your concerns with the current doctor. Keep as many options open as possible. Remember, borderlines have black-white thinking, so he may be a much better doctor than you give him credit for being.
5. Since borderline personality is looking like a biological illness with no permanent loss or damage to brain tissue, you will someday be okay. Before Prozac, no one got much better. With all the new antidepressants wellness should not be all that far off. Keep trying. Something will work now or in the near future.