Q. Dear Dr.

I have been diagnosed with Borderline Personality Disorder and am anxious to get onto the right meds to help me. But I have an immediate problem:

I have been taking 50 mgs. of Trazodone for 4 years now. It is very uncomfortable each time I try to get off it even by reducing as little as half a dose at night. I get anxious and feel disoriented the next day and those bad feelings increase with each new day without the full dose.

I get an overwhelming rush of tension and anxiety if I try to take the Prozac on top of the Trazodone. But I had success with Prozac 8 years ago when I had no other antidepressant already present in my bloodstream.

So my dilemma and question to you:

(My doctor has no advice - he said just quit, and I could not function cold turkey). So, knowing I have to get off of Trazodone slowly, can you recommend -

How slowly should I reduce off of the 50 mg. a night to avoid the anxiety, disorientation, hang-over type feeling?

Thank you very very much for answering this question.

A. The Prozac may be interacting with the trazodone because of your particular metabolism. An alternative to Prozac is Zoloft or Effexor since they work as well as Prozac and do not interact with the trazodone. You could just stay on the trazodone with either of these. Serzone is also very good, but only if you have no OCD. Since Serzone and trazodone are fairly close chemically, once you got up to 500 or 600 mg of Serzone, you could easily stop the trazodone.