QUESTION:

I was in the ER again this past Friday and received over 50 stitches from cutting. They are getting to know me (which in itself is embarrassing} and do not try to commit me anymore. At least my psychiatrist is aware that his institution can't help me. In fact being admitted to the hospital only makes things worse.

I do have a real question though. My doctor has been doing some homework on the issue on BPDs etc. Although I usually try all of suggestions this time I'm a bit leery. He prescribed Revia and wants to include Lamictal soon. I am extremely tired of trying new meds. I swear I was better off before I started taking all of this stuff.. I guess my question would be.....Have you or anyone you know heard of treating BPD or self injury with Revia or Lamictal?

I can only find info on what they are usually used for (addiction and seizures) I still take Prozac, Elavil, Klonopin, Levoxyl and Prilosec and of course I see my doctor at least once a week. You can see why I don't want to keep taking things. Even after all that I still cut up my own arms. Obviously something isn't working.

Actually, although maybe my imagination, I seem even more irritable since I’ve started taking the Revia.

Please let me know if you’ve ever heard of this type of drug therapy. I would greatly appreciate any input or perhaps an article written on the subject somewhere.

DR. HELLER'S ANSWER:

I like the idea of using Revia for alcoholism, but only after the other problems have been successfully treated. Self-mutilation is a result of trying to stop your horribly painful dysphoria (anxiety, rage, depression and despair). Revia to a degree stops your body's own natural painkillers which could theoretically make BPD dysphoria worse.

Your med list does not show the combination that virtually always works for my patients - Tegretol added to Prozac at least a week later. Successful treatment requires the right medications, in the right doses, in the right sequences, at the right time of the day. All the diagnoses must be correctly identified and treated successfully for the BPD to get under control. This is particularly true for cutters.

There are three areas that must be addressed chronic symptoms, stress symptoms, and retraining the brain. I teach my BPD patients to treat dysphoric spells with as needed non addicting medication, and what to do when that doesn't work. Borderlines want relief from the pain, not to cut. Cutting is used to stop the pain because it works, no matter what the cost. It's only after the episode that the individual wishes he/she did not cut.

next: Is My BPD Son Taking Too Many Medications ~ back to: Borderline Personality Disorder FAQs Table of Contents