Ok , thanks for the reply .
Well, the patient has been rightly placed on the current mix of drugs , so he shall continue the same , but as far as CBT is concerned , on this i would suggest that for a borderline personality patient , Dielectical behaviour therapy ( DBT ) is a better psychotherapy type than Cognitive behaviour therapy . DBT is a 4 stage therapy , with special attention given to the acts of self harm and self destructive traits which are shown by borderline patients , with later stages dwelling on better adaptability to the surroundings .
So, the patient shall seek DBT for Borderline personality while continuing the above mentione drugs for adhd and borderline .
Also, since the patient is already placed on 2 anti depressants such remeron and milnacipran , which are quite effective themselves in treating GAD , so the use of lyrica , which is an anti seizure drug somehow bothers me , because of its side effects , although agree it is also used in GAD , but when one is already placed on sufficient drugs to treat the same , so why unnecessary over load the patients with drugs and make him succeptible to side effects ..
So, you shall discuss the use of pregabalin with his doctor , citing the already use of 2 anti depressants , which themselves are anxiolytic agents used effectively in GAD.
Kindly kook at the links below , which support my claims..
So, i suggest that the patient should seek Dialectical behaviour therapy ( DBT) , rather than CBT , for borderline disorder , while continuing on the above mentioned drugs , it is just that the use of pregabalin should be discussed again with the doctor , whether it is of any consequence or not .ALSO, IF SOMEHOW , DBT practicing psychologist is difficult to find , then you shall go for CBT , as a second option.
I hope this helps..
I wish the patient all the best...
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