Q. My daughter is 21 and has been diagnosed with BPD and severe depression. She has also been self mutilating for a few years. She is currently being treated by a psychiatrist and a therapist, but is not getting any better. She is taking 50mg of Zoloft and 800 mg. of Tegretol (400 mg twice a day). She also takes Cylert to help her concentrate and Thyrolar for a hypo-thyroid condition. She has previously been on Effexor but stopped due to severe night sweating. She was also on Paxil and Serzone (do not remember dosages) which did not help.

Do you have any comments about this combination of medicine? Specifically, does it make sense to take Tegretol and Zoloft at the same time?

Also, How can we find a doctor in our area that specializes in BPD and Self Injury? Is there a referral service we can talk to?

A. It is tough to know if the medications your daughter is on are right or not since I do not know anything about her. I would suggest calling the National Institute of Mental Health for a referral in your area, or going to the closest medical school hospital in your area, as they usually have some that specializes in borderline PD.