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Hello I believe I can help you with your concerns
Thank you, XXXXX XXXXX a wonderful psychologist whom I meet with once per week but my anger episodes and BPD in general is ruining my life.
Well medication is one approach to BPD, but it needs to be in combination with Dialectical Behavioral Therapy (DBT) as this is the best therapy to treat BPD. But usually the best type of medications for BPD is a mood stabilizer like Depakote or Lamictal, which an additional use of an antidepressant (e.g. Lexapro)
Ok are those the ones you would recommend that I have not tired?
In addition, sometimes depending the severity of this disorder the use of a low dose antipsychotic medication (Abilify). A mood stabilizer is better for treating Borderline Personality Disorder because it is not simply treating depression and anxiety, but also trying to treat irritability and mood swings as well. Since you used so many antidepressant medications, I think a mood stabilizer would be a better approach for you, but in combination with the DBT therapy that I mentioned too
Ok so no antidepressant just a mood stabilizer? Would I use Abilify too
Well I would use a mood stabilizer and an antidepressant to start and then see if that helps to stabilize your symptoms. If it does not then you can look at the Abilify to help augment the medications. The goal is trying to find the least amount of medications at the lowest dosage possible that is effective for your symptoms to help minimize any side effects or interaction effects.
Do you have any questions or concerns?
Ok thanks should I be asking to switch from Cipralex?
I have been on it since May with no change 20 mg
No stay on the Cipralex, but add the mood stabilizer. Both of those in combination should help a lot. I would start with Depakote as a mood stabilizer first
Is there anything else I can assist you with?
ok thank you
You are most welcome, I wish you treatment all the best and I hope that your symptoms resolve quickly for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much