QUESTION:

I was diagnosed with BPD about two years ago. I also have bipolar, major depression, and psychosis. I was put on Depakote and I gained 135 lbs, needless to say I went off of it and now my psychiatrist wants to put me back on it because of my mood swings. What should I do? I also self-injure and would like to know what to do about that, if there is anything that I could go on to help stop the urges. Please help me this is my last option.

DR. HELLER'S ANSWER:

There are other medication options. I've never seen Depakote cause that kind of weight gain, although it may be possible. If the BPD is present with bipolar and the person can't take Depakote, the combination of Prozac, Tegretol, and either or both Risperdal or lithium may be helpful. The urges to self mutilate must be controlled, and I've never found a combination more successful than Prozac combined with Tegretol, with Haldol and Risperdal as needed.

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