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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Hi i have been diagnosed with BPD and i am taking 225mg venlafaxine

Customer Question

Hi i have been diagnosed with BPD and i am taking 225mg venlafaxine and 200mg chlorpromazine and 80mg propranalol a day i wondered if this combination is ok to take
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe I can help you.

Elliott, LPCC, NCC :

I am checking those interactions now and I have several things that I would like to discuss with you as well concerning BPD.

Elliott, LPCC, NCC :

Give me a few moments.

Elliott, LPCC, NCC :

Please

Customer:

no problem

Elliott, LPCC, NCC :

First of all, the combination itself is relatively safe with some possibilities of some interactions but not high risk ones.

Customer:

thats good wasnt sure

Elliott, LPCC, NCC :

Let me give you a few details first.

Customer:

ok thanks

Elliott, LPCC, NCC :

There is more.

Elliott, LPCC, NCC :

Propranolol and venlafaxine can combine to lower your blood pressure. If you feel light headed or changes in pulse or heart rate let your doctor know. Don't change drugs or stop them.

Elliott, LPCC, NCC :

Prop. and chlor. combined can increase the effects of both and so your doctor should be aware of this.

Customer:

ok i will do

Elliott, LPCC, NCC :

more

Customer:

oh didnt know that my dr didnt say anything im taking propranolol for a fast heartbeat

Elliott, LPCC, NCC :

Chlorpl. and venl. may increase side effects such as dizziness, drowsiness, and difficulty concentrating. You may also develop some impairment in thinking and judgment.

Elliott, LPCC, NCC :

Now to the most important part of the discussion.

Customer:

yes have noticed that thinking is a bit woolly

Elliott, LPCC, NCC :

You have a personality disorder, BPD, which is best treated with a certain kind of psychotherapy known as Dialectical Behavioural Therapy, rather than assaulting you with symptom suppressing drugs, particularly Thorazine (Chlorproazine) which was a substitute for shock therapy or other radical procedures when it came out. It is for psychoses rather than BPD.

Elliott, LPCC, NCC :

Yes, it will calm you down, but so will surgery.

Elliott, LPCC, NCC :

You may need some circuit breakers but not a chemical lobotomy.

Customer:

my dr perscribed it to deal with my high levels of anxiety and my self harming

Elliott, LPCC, NCC :

You have abandonment issues and they must be addressed as well.

Elliott, LPCC, NCC :

Is the doctor a psychiatrist?

Customer:

yes he is

Elliott, LPCC, NCC :

Have you researched the treatment for Borderline Personality Disorder?

Elliott, LPCC, NCC :

And most of all, are you satisfied with the treatment, if so then you can rest assured that the interactions will not be harmful. Just check your blood pressure.

Customer:

a little but my psych has only perscribed meds no therapy or treatment im not sure just giving meds is helping any

Customer:

yes my gp is checking my bp regularly

Elliott, LPCC, NCC :

This is very old school treatment.

Customer:

think he is very ineffective

Elliott, LPCC, NCC :

You could check into DBT (Dialectical Behavioural Therapy).

Customer:

ok

Elliott, LPCC, NCC :

Thorazine is an old drug, miracle drug of 62 years ago.

Elliott, LPCC, NCC :

Let me recommend you a book.

Customer:

was perscribed when i was in hospital

Elliott, LPCC, NCC :

To calm you down. You were treated with the maximum drug for wild psychotic behaviour. It if effective.

Elliott, LPCC, NCC :

So is a hammer over the head.

Customer:

i wasnt even that worked up def not a threat to the staff maybe a bit towards myself

Elliott, LPCC, NCC :

Cutting or hurting yourself?

Elliott, LPCC, NCC :

Ever do that?

Customer:

both didnt want to be there still doing it now

Elliott, LPCC, NCC :

Screaming rages ever?

Customer:

no screaming

Elliott, LPCC, NCC :

Anger. Lots of anger.

Customer:

only at myself

Elliott, LPCC, NCC :

Maybe reckless behaviour as well. Spending, driving, sexual.

Customer:

no none of them

Elliott, LPCC, NCC :

Triggered by abandonment or rejection, real or imagined?

Customer:

yes-real abandonment

Customer:

and rejection

Elliott, LPCC, NCC :

And fear of that triggers you?

Customer:

not really, triggers are thoughts of suicide and burying my emotions so i dont show anything

Elliott, LPCC, NCC :

What would cause you to have an "episode"?

Customer:

just want to be invisible

Customer:

its all the time at the moment caused by problems with abusive mother

Elliott, LPCC, NCC :

Why were you diagnosed with BPD and not with Depression or with Adjustment Disorder with Depression and Anxiety?

Customer:

i dont know they diagnosed it i think because of the self harm

Elliott, LPCC, NCC :

Describe the self harm. You didn't say earlier.

Customer:

it was diagnosed when i was in hospital was told to google it

Customer:

i cut my arms repeatedly with knives and razors very deeply usually once a day sometimes more also scratch myself until i bleed

Elliott, LPCC, NCC :

OK. It is probably BPD but you internalise your anger.

Elliott, LPCC, NCC :

I have TWO books. The first one was published about 4 days ago.

Customer:

ok

Elliott, LPCC, NCC :

 


The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance by Matthew McKay

Elliott, LPCC, NCC :

the other one is:

Elliott, LPCC, NCC :

 


The Dialectical Behaviour Therapy Skills Workbook for Anxiety: Breaking Free from Worry, Panic, PTSD, and Other Anxiety Symptoms by Alexander Chapman

Elliott, LPCC, NCC :

I would also like you to read a book that will help you understand your disorder.

Customer:

ok

Customer:

worried my pysch wants me back in hospital because i cant stop self harming

Elliott, LPCC, NCC :

This one was just republished a few days ago: an old classic made for others about living with BPD but worth reading.

Elliott, LPCC, NCC :

 


Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by Randi Kreger and Paul T. Mason

Customer:

i have that book and have read it

Elliott, LPCC, NCC :

Good.

Elliott, LPCC, NCC :

Can you be safe or do you need to go back to hospital?

Elliott, LPCC, NCC :

Can you find a therapist to help you?

Elliott, LPCC, NCC :

I know some websites where you can search.

Customer:

i dont know, saw my psych yesterday he upped meds dont feel safe

Elliott, LPCC, NCC :

http://www.psychfinder.co.uk/


Here is another:

http://members.psychotherapy.org.uk/find-a-therapist/


Here is a third place:

http://www.itsgoodtotalk.org.uk/therapists/

Customer:

yes am looking for a therapsit, my husband goes back to work tomorrow and my daughter is back to school

Elliott, LPCC, NCC :

What do you prefer to do? Take a chance or go to hospital?

Elliott, LPCC, NCC :

Can you resist these urges? I know hard that is.

Customer:

i hated being in hospital dont want to go back just struggling to resist the urges to harm, am trying hard

Customer:

have nothing left

Elliott, LPCC, NCC :

I know you are.

Elliott, LPCC, NCC :

Have you tried ECT or TMS?

Customer:

no what is tms?

Elliott, LPCC, NCC :

TMS = Transcranial Magnetic Stimulation, using electromagnets held against your upper forehead to produce an electric current in your brain for the purpose of affecting those same mood centers. This also does not shock your brain.

Elliott, LPCC, NCC :

Safe and very effective in many cases. It is used in the most prestigious hospitals in USA and is NOT quackery.

Customer:

not sure it is avalable over here in the uk as never heard of it, know about ect

Elliott, LPCC, NCC :

It should be available in UK but medical system is different, or was until now (2013 Obamacare).

Elliott, LPCC, NCC :

Another option is the implantation of a micro-pulse generator that stimulates the vagus nerve to affect the brain's mood centers. This is yet another way of treating chronic depression that is resistant to treatment. This does not put you at the same risk as ECT, and is a viable alternative.

Customer:

havent heard of that either, only been told that BPD is untreatable and will have to be on meds for rest of my life

Customer:

sorry dont mean to be a nusiance

Elliott, LPCC, NCC :

You are not a nuisance by any means and I have great concern for you.

Elliott, LPCC, NCC :

People DO make progress with DBT. You must also get away from those situations and people that trigger you.

Elliott, LPCC, NCC :

Please do not think that you are trapped for life with drug treatment and endless self-harm This cycle can be broken.

Customer:

what do you think ii should do?

Elliott, LPCC, NCC :

Find an experienced DBT therapist that deals mostly with BPD clients.

Elliott, LPCC, NCC :

Investigate the other treatments, even ECT which is not brutal as in the past Very different and milder.

Elliott, LPCC, NCC :

Ask for other antidepressants if the venlafaxine is not working.

Customer:

venaflaxine is my 5th attempt to find one which works

Elliott, LPCC, NCC :

There are the drugs of the MAOI class on your list. (Monoamine Oxide Inhibitors). Such drugs would include tranylcypromine and phenelzine sulfate, and they are often prescribed as a last resort because they can have dangerous side effects and cannot be mixed with certain foods (aged cheeses, pickles, wine) and some other medications, such as some decongestants.

Elliott, LPCC, NCC :


A newer, very promising MAOI is worn as a skin patch and has fewer side effects; it is called selegiline HCl.

Customer:

ok

Elliott, LPCC, NCC :

My last method: I will keep you in my prayers.

Customer:

dont think my psych takes me seriously only when i do serious self harm, thanks

Customer:

he is the top one at my hospital

Elliott, LPCC, NCC :

I would try a new psychiatrist. One with empathy and compassion. That is EXACTLY what you need from a therapist and what DBT is about It also has substance.

Customer:

ok

Elliott, LPCC, NCC :

Think of all of the top dogs who have fallen because they weren't really "top" at all.

Customer:

my previous psych was even worse he did nothing and left it to my gp who is great

Elliott, LPCC, NCC :

Work with your GP and do some research to help him since he is pressed for time.l

Elliott, LPCC, NCC :

Present him with some of these options.

Elliott, LPCC, NCC :

I have seen some great people at the top, and monstrous ones too. Narcissists often gravitate to the top.

Elliott, LPCC, NCC :

If they don't have emotional intelligence then they do not have the full spectrum of qualifications.

Customer:

was told i am over reacting and attention seeking and should pull myself together

Customer:

will go see my gp when they reopen at least she listens to me and wants to help

Customer:

thanks for listening

Elliott, LPCC, NCC :

You are very welcome.

Elliott, LPCC, NCC :

I hope that I helped a little.

Customer:

you have know more about my options now, if i get worse will go see my gp straight away

Elliott, LPCC, NCC :

So I did help?

Customer:

yes you have

Elliott, LPCC, NCC :

Thank you so much.

Elliott, LPCC, NCC :

I will continue to keep you in my prayers and wish you great success in moving past this stage in your life.

Customer:

thank you

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you

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Elliott, LPCC, NCC
Elliott, LPCC, NCC
Mental Health Professional
7663 Satisfied Customers
35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.