Q. I've just been diagnosed with BPD, after the consultant tried to fit me with lots of other diagnoses that blatantly weren't working (schizoaffective, depression, psychotic illness, anxiety). About the same time lots of issues from my past came to the surface (abuse and rape) and now I'm having flashbacks, bad memories, not sleeping and sometimes the sensation of being touched as I was during the abuse. It all feels really real. My mood is very unstable, I go from near euphoria to majorly depressive states. My family think that I'm going mad and don't know what to expect. I'm on 6mg Risperidone, 150mg Venlafaxine SR and 100mg Mellaril PRN as well as a sleeper which they started me on today. Any ideas what might help?

A. Sounds like your doctor has got you on some good medications. My first choice would be to talk to your doctor about how you are feeling and talk about other treatment options. Effexor XR is a good choice, and increasing the dosage to 300 or 450 of the XR would be my first choice, if your doctor agrees. They know a lot more about you, and are in a better position to decide what to do. There are reports of Serzone helping a great deal with the flashbacks/PTSD aspect of the illness, and this might be an option, too. The dosages in the study were in the 500-600 mg at bedtime range.