QUESTION:

I am diagnosed with BPD, among other things (schizophrenia, bipolar, PTSD, adjustment disorder--different doctors, different times over seven years). Presently I am on Paxil for severe depression. My doctor prescribed Paxil over Prozac because of the agitation and anxiety I also experience. I was finding it very effective until I went on a trip, during which I became quite sick (at one point hallucinating). I have been back for over a week, and still feel unstable. What do you think of Paxil for BPD, and do you find Buspar is generally better somehow? Thank you.

DR. HELLER'S ANSWER:

Buspar is for the generalized anxiety disorder (GAD), not the BPD. If both conditions are present Buspar can be profoundly effective. Every person I've treated for the past three years who complained of agitation and anxiety on Prozac had the GAD - particularly the cognitive component.

Paxil is not as effective as Prozac. It's excellent for Panic Disorder, particularly when combined with the BPD. Some individuals need both Paxil and Prozac.

The hallucinations are likely due to severe dysphoria, which can cause psychosis. Tegretol is the key medication for chronic dysphoria and other psychotic symptoms.

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