QUESTION:

Dear Dr. Heller,

My daughter has been in drug treatment for almost 2 years, has therapy everyday and is on Prozac and Wellbutrin for depression. She is 17 years old.

She was doing well for a while and took a turn for the worse. The doctor at the center says now that she has BPD and wants to treat her with Seroquel. Have you ever heard of this treatment? I don't especially like this drug or its side effects when I read about it.

Thank you for any information or your professional opinion. Thank you very much.

DR. HELLER'S ANSWER:

I prescribe Seroquel when a chronic antipsychotic medication is temporarily needed. It's terrific for sleep. I haven't seen it do much for BPD symptoms when taken chronically, except during severe crises. In my experience, Risperdal only works as needed in the BPD, not chronically. These patients are the ones I prescribe Seroquel for. It's a reasonably safe medication.

In my experience BPD patients do much better with Prozac and Tegretol, with Haldol 2mg / extra Tegretol 200mg / Risperdal 3mg as needed for dysphoria (anxiety, rage, depression and despair).

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