Can you help with observations.

[m1946]

I guess my question is : is my daughter being weighed down by unnecessary medications which are being prescribed to her so that a box can be ticked. I am concerned about the health of her liver etc. She is 45 and has been suffering since the age of 15. It is a form of BPD . The problem as I see it is the system is unable to allow sufficient time or research to provide a satisfactory remedy and feels the boxes can be tivked if s tablet is prescribed no matter how long they have been prescribed!!The medication is as follows:

Lamotragine 300mg (150mg twice a day)

Pregabaline 300 mg (150mg twice a day)

Venlafaxine 300mg

Promethazine up to 100mg per day

ARIPIPRAZOLE 10mg per day (30mg max)

antipsychotic medication

clonazepam-to help calm, sedate and

help with anxiety) won't be given these for

long due to the risk of addiction

Valaciclovir 2000mg (1000mg a day)

ConcernedDad

[Dolphin14]

Hi

How is your daughter doing on these medications?

🐬

[m1946 in reply to Dolphin14]

Unfortunately she seems to be getting worse. When looking into her eyes they are lifeless. She carries on and masks her condition well and that of course is the problem as the people who see her do not fully understand her condition. Fortunately she has on one occasion broken down in front of one the Care Team who sought assistance & arranged an appointment with the Crises team but they discharged her back to the Care team some weeks before the recommended time !! The Care team fought to overturn their decision. Its a mess out there without any real control and with overworked staff. She has been self harming making a bloody mess of both arms! I am a distraught Dad

[moxoni237 in reply to m1946]

Hi Sorry to hear about you’re daughter and the overwhelm she is going through l understand the medication crises and the self care if you feel that she as exceeding the cause and efficiency of it you can ask for a review of medication with Gp management or care coordinator if so and explained the circumstance and also for self care you can ask for assistance with mental clarity with the Mental health service or some thing more therapeutic hope you find a solution with the best of interests coping

[Dolphin14 in reply to m1946]

I am so sorry to read this. It must be so hard to see her this way.

I don't live in the UK so I'm not sure what your next steps could be.

What about a GP? I don't really agree with them getting involved with psych issues but you need someone to intervene if she is hurting herself.

I commend you for coming here and looking for help for her. Many people don't tune into us at all.

[Kinlay]

Whoa! I had my insurance, Kaiser here in the US, try to do the same with me, but I kept refusing when they tried to add a third med. Instead, I started weaning OFF my meds. I am now taking only one, while almost done weaning down on a second (on 1/4 of the lowest dose). I do have an as-needed for severe anxiety, but only take half a dose no more than once a day due to concerns about addiction. I am getting new insurance and plan to take my own advice and consult a new doctor once I am off of the second med if I am still struggling. I did consult/inform my current doctor before weaning down so she could help me with a plan. Then I went even lower and slower than her recommendation (smaller cuts in doses and longer time at each).

First of all, this is just my opinion based on my own experiences and the meds I have been prescribed and researched. I am NOT a medical professional. Still...

I can see taking possibly two meds tops for the bipolar, with an as-needed for anxiety (likely the clonazepam). If it were me, I'd ask to start weaning down ASAP. Likely the aripiprazole OR lamotragine could be a mood stabilizer that also helps with depression, but I wouldn't stay on both and certainly not in addition to the venlafaxine, which is likely for the depression and may help with BPD (bipolar disorder, correct?). In other words, if it were me, I'd want only one of these three, whichever works best for her or causes her the least side effects. If she's not sure, I'd try weaning off of the one she's been on longest first, because my assumption would be that if that was working, she wouldn't have had to add the other two. Again, consult with a new doctor or pharmacist first.

Promethazine can be used for sleep and/or anxiety, but if she is taking it every day, I would ask a doctor if it is safe with all of the other meds. Pregabalin is also for anxiety, so if it were me, again I'd use one or the other. For sleep, good old melatonin or benadryl might be safer than the promethazine, but again, I would speak with a NEW doctor or pharmacist about this as they understand interactions better.

Valacyclovir is for herpes suppression not BPD, but HALF that dose (500 mg 2x daily) is usually sufficient (I have done a ton of research because I also have herpes). I just got a pill splitter and cut them in half, so the insurance covers a longer course at the same price. I go up to the full dose for three- five days when I have an actual outbreak. As for the rest, I would have her ask to see a NEW doctor and tell him she wants to go to less medication and get his recommendations on weaning down. It should be a SLOW process, with 3-4 weeks at each lower dose, likely only weaning off of one at a time, to prevent withdrawal and worsening of her symptoms. Good luck!

[m1946 in reply to Kinlay]

Very much appreciated . Thank you. The BPD stands for in this case! Borderline Personality Disorder but Masked!!

[Kinlay in reply to m1946]

I would use the same rationale from my perspective. Some folks still tend to use BPD for bipolar even though the newer technical term is Bipolar I, II or cyclothymic disorder.

[Pitrovski]

please do NOT attempt weaning off any med without expert advice. Incorrectly decreasing psych meds can causeMAJOR mental crisis. unfortunately I speak from experience.

I do agree she's on quite a list of meds.

Only thing I can advise is to find a physician who is willing to listen and try to make changes to her meds, not just adding or increasing.

I'm lucky to have a Psychiatrist that listens and works with me to have the most effective combo with minimal side effects.

Mind you, I don't think I'll ever find a great solution and be 'cured'

Love

P

[Felinity]

I have BPD ( borderline, not bipolar!) and I'm only taking generic Prozac (fluoxetine) 40 mg daily. This not only helps with the BPD but also with depression and anxiety. I've tried lots of other anti-depressants, plus some mood stabilizers and even anti-psychotics, but none of those really helped me, just gave me lots of side effects. Of course we're all different, what works for one of us might not be what someone else needs. Oh, and in the past I took Xanax for anxiety and Ambien to help me sleep. Unfortunately I got addicted to those meds, which was no picnic!! I did, finally, get off both Xanax and Ambien, so now I'm just down to the Prozac. I think the fewest possible meds are best since they all have side effects, and you have to be careful of med interactions. But that naturally has to be determined by your doctor.

[m1946 in reply to Felinity]

Thank you so much. She has a meeting with one of her doctors!!!! at 12 noon today to review all her meds so your contribution was very much appreciated. Can you tell me how you came off the addictive meds