Can Beta Blockers Like Inderal Help with the BPD?

Written by Dr. Leland Heller

QUESTION:

Dear Dr. Heller,
My spouse is diagnosed as BPD, but our therapist decided not to offer her that label yet. I do like the Dyslimbia idea. Her routine medication is Lexapro, 20mg. During her rages, I've occasionally persuaded her to take a 1/3 pill of BuSpar, which has shown quick efficacy (but with subsequent rebound of some kind, which she disliked). The new emergency recovery agent of choice at our house is now 10-20mg Inderal. She says things like: 'wow, I don't feel hot anymore', approximately 7-8 minutes after administration, as she suddenly drops the screaming...

If it is placebo, it is a hell of a strong one. Luckily, this is even an 'approved' indication (as the BPD person is 'on stage' and experiencing tremendous fear...) I notice that most psych docs don't mention Inderal, as perhaps it is deemed to be a heart med. Anyway, perhaps another option when it is time to get out the tranquilizer dart gun to get someone back down onto the ground, and maybe less scary than psych meds. It is not like the big wet blanket of the 'anxiolytics'.

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PS:, I encourage you to drop your diffidence and push the renaming issue. Having temporarily worn "Manic Depressive", I can say that "BPD" is definitely a gratuitous barrier to therapy. My employer should take a cue from the White House, which insisted on calling Mr. Cheney's implant a "Power Pacemaker", not our multi-negative "Implantable De Fibrillator". What's in a name? Quite a lot actually.

PPS:, please forgive me if this is in the FAQ somewhere, I couldn't find it...

DR. HELLER'S ANSWER:

Many of my BPD patients take beta blockers like Inderal. They help some more than others but are not the solution. They block the adrenaline that makes the condition intensify and worsen. I go over this in the GAD section of "Biological Unhappiness". I've been trying to name it Dyslimbia for 15 years with no success, despite hundreds of patients writing in for that name. I've written numerous letters to this effect. A number of other names are just as bad such as "impulsive aggressive disorder" or "impulse dyscontrol disorder", or to include it as a form of bipolar - which it clearly isn't.

There are very few people that improve quickly with BuSpar, you are one of the lucky ones. Prozac is far superior to Lexapro, once the BuSpar has been taken for two weeks first (assuming the cognitive GAD is present). I think the BPD is primarily due to glial cell malfunction and only Prozac has been shown to make those brain cells work better.

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