Q. I was switched from Elavil and Depakote to Neurontin and Remeron in December. Have had a bumpy ride and don't know how much is outside stressors (there have been many) or the new meds. I was taken off of Depakote because of reports of fatal pancreatitis. I have also been having breast pain and have been diagnosed with costochondritis. I've been told that one of these meds may cause breast soreness. Am on anti-inflammatories for this. Please tell me what you know about the switch from old to new meds and whether they could be causing any side effects.

  A. Anything is possible, but I really do not know enough about you to give you an answer here. If you have BPD, and if those bothersome symptoms are all new after starting the medications, it is safe to assume the meds are either causing the symptoms or at least doing something that is not helping. Costochodritis is often associated with fibromyalgia, and if you have fibromyalgia, you need to be on other medications to maximize your chance of getting better.

My philosophy is simple. If you are doing something and it is not working, talk to your doctor about making changes that might help. Since I do not know you, it may be that you have been on all the medications discussed at this site for BPD, and there is nothing left to try. In short, the current meds are as good as it gets. It you have not been on the meds listed in the archives, you may wish to discuss them with your doctor. Always talk over medications and any changes with your doctor. Do not try to treat yourself or decide to diagnose and treat yourself. It is dangerous and will alienate your caregivers. If you have qualms about your treatment and the doctor will not make changes, get a second opinion.