Q. What are your comments on the combined use of: Depakote, Desipramine, Lorazepam, and Dexedrine in the treatment of BPD? The patient is by her own admission addicted to the Dexedrine and seemed much better to family members prior to adding the Dexedrine to the other medications.

A. I do not know anything about the patient, so it is hard to say much that will be specific about this case. In general, addictive medications are to be avoided. There is no data to show either Lorazepam or amphetamines help in BPD, and both can be addictive.

Depakote will decrease mood swings, but frequently can lead to depression or lethargy, too. Weight gain and hair loss with it can be problems in BPD patients. Desipramine is probably not a good medication in BPD for the vast majority of patients. It works poorly, has numerous side effects, and can kill in overdose.