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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by jay on April 3, 2005, at 4:02:59
Thought you all might find this interesting. I got this bit from a few websites...(I have had sucess with the Risperdal 3mg at once dose. It brings you down *nicely*) Please post any other experiences/formulas...
--------------------------
Dysphoria Instruction Sheet
People with borderline personality disorder (BPD) experience "dysphoria (anxiety, rage, depression and despair)...at times, as well as...suicidal thoughts, self destructive impulses, or stress related symptoms."
Dr. Leland Heller in Florida treats those with the BPD. I went out to visit him several years ago and was given this instruction sheet which I lazily did not follow. Just recently however in dealing with dysphoria I got some haldol and discussed this plan with my psychiatrist. We agreed to try it.
Most of the time, remarkably this plan has worked for me! I've been on the verge of, or in dysphoria and the haldol has brought me out of the episode completely. I had to share this plan with you and received permission from Dr. Heller to post it.
His instruction sheet that he gives to his patients include the following:
"Haldol (haloperidol) -
Haldol 1-2mg. If it doesn't work, repeat the dose 10-15 minutes later - don't take more than 4mg in an hour. If 4mg of Haldol doesn't work, go on to the next step below. If Haldol works you may continue taking it, but the maximum dose is 8mg in a 24 hour period. When taking 4 or more mg of Haldol in a 4 hour period, take 25-50mg of Benadryl to prevent a dystonic reaction.
When Haldol doesn't work....
Take Tegretol 200mg once...(take an extra one if you're already on it)
...if three hours later not doing better, take Risperdal 3mg
During the most severe crises.....
Take Tegretol 200mg plus Risperdal 3mg at the same time
(You may need to take 25-100mg of Benadryl to prevent a dystonic reaction)."
Personally my psychiatrist instructed me to take 25 mgs. of benadryl with each 1 mg tablet of Haldol.
I recommend you go over this instruction sheet with your Dr. if you are not presently being treated appropriately.
Patty E. Fleener M.S.W.
*************
Courtesy of Leland M. Heller, M.D.
http://www.biologicalunhappiness.com
Posted by SLS on April 3, 2005, at 6:42:44
In reply to Borderline Personality..PLS read..., posted by jay on April 3, 2005, at 4:02:59
Hi.
That's a nice little algorithm.
Zyprexa + Tegretol is becoming more popular as first line treatment for BPD. I have seen it work wonders for a few people. Of course, psychotherapy is indicated as well.
- Scott
Posted by banga on April 3, 2005, at 9:45:36
In reply to Re: Borderline Personality..PLS read..., posted by SLS on April 3, 2005, at 6:42:44
Do you know in what manner the benadryl is supposed to help?
Posted by ed_uk on April 3, 2005, at 12:34:21
In reply to Re: Borderline Personality..PLS read..., posted by banga on April 3, 2005, at 9:45:36
Hi B!
Diphenhydramine (Benadryl) is anticholinergic, it can treat/prevent dystonic reactions.
Ed xxx
Posted by Spriggy on April 3, 2005, at 14:45:04
In reply to Re: Borderline Personality..PLS read... » banga, posted by ed_uk on April 3, 2005, at 12:34:21
Wow, some of those symptoms sounded like me.
So what is the distinction between borderline personality disorder from Bipolar 2?
I suppose, in my ignorance, when I hear borderline personality disorder I think of people with multiple personalities (which of course, when I have PMS is the case around here!).
Any clarification between the two?
Posted by Phillipa on April 3, 2005, at 16:57:57
In reply to Re: Borderline Personality..PLS read..., posted by Spriggy on April 3, 2005, at 14:45:04
Spriggy, there is a big difference. Not to insult anyone with BPD I will just post a little of what I know about it. I'm sure those with a true DX of BPD will correct me if I am wrong and add a whole lot more than I will say. But, those with BPD can be explosive with moods. They become suicidal very often. They use what is known as splitting. I'm not getting into any more because I don't wish to anger anyone. Please accept any apologies in advance. Fondly, Phillipa
Posted by zero on April 4, 2005, at 15:17:39
In reply to Re: Borderline Personality..PLS read..., posted by Spriggy on April 3, 2005, at 14:45:04
I think Leland Heller is on to something.
Some, however, think there is no such separate entity as "Borderline", or at best, lots of overlap between "Borderline" and "Bipolar". Good discussion of that here:
http://www.psycheducation.org/depression/borderline.htmBest regards,
Zero> Wow, some of those symptoms sounded like me.
>
> So what is the distinction between borderline personality disorder from Bipolar 2?
>
> I suppose, in my ignorance, when I hear borderline personality disorder I think of people with multiple personalities (which of course, when I have PMS is the case around here!).
>
> Any clarification between the two?
Posted by B2chica on April 5, 2005, at 11:15:48
In reply to Re: Borderline Personality..PLS read... » Spriggy, posted by Phillipa on April 3, 2005, at 16:57:57
not offensive Phillipa,
but i was categorized with BPD-depressive type a while ago so i'm going to add my 2c. i have asked several T's and pdocs for definitions cuz what i was finding on the web and DSM didn't sound like me. My pdoc describes it as a person who has very difficult time controlling their reactions toe their emotions (keeping them in check or like their emotions were a separate entity). their mood changes occur due to outside stimulus and can change many times throughout a single day from way high to way low, or super rage/anger. though these emotions do not tend to last longer than an hour, also described as Great fear of abandonment, difficulty maintaining relationships.
My T when he put me in this category says he and many other psychologists greatly disagree with the DSM for dx descriptions (also others dx). the main kicker that put me in this category was that i Self-injure. this 'automatically' puts you here, however i have since read that those with mixed BP have a high statisticc of SI. but anyway, my T explained my Dx of BPD-depressive type similar to dysthymia. that it's an underlying depressive type that does not allow a person to 'elevate' between everyday surface stuff to deep contemplation (neurotic vs. psychotic levels). no you don't need to be either. but he described it as the elevator being broken. and that i need to learn to control the elevator again.
i thought it very interesting description. i used to call them my WOW days (weight of the world). somedays even looking at other people i felt that they were in danger or that they had a loved one just pass away. i always thought it was just extreme empathy-which i still believe to a point.-anyway, i really wanted to point out that many T's and pdocs don't agree with the dsm for descriptions but that there needs to be some type of quantifiable description for Dx.
my 2c.
b2c.
> Spriggy, there is a big difference. Not to insult anyone with BPD I will just post a little of what I know about it. I'm sure those with a true DX of BPD will correct me if I am wrong and add a whole lot more than I will say. But, those with BPD can be explosive with moods. They become suicidal very often. They use what is known as splitting. I'm not getting into any more because I don't wish to anger anyone. Please accept any apologies in advance. Fondly, Phillipa
> Spriggy, there is a big difference. Not to insult anyone with BPD I will just post a little of what I know about it. I'm sure those with a true DX of BPD will correct me if I am wrong and add a whole lot more than I will say. But, those with BPD can be explosive with moods. They become suicidal very often. They use what is known as splitting. I'm not getting into any more because I don't wish to anger anyone. Please accept any apologies in advance. Fondly, Phillipa
Posted by jay on April 5, 2005, at 16:57:05
In reply to Re: Borderline Personality..PLS read..., posted by banga on April 3, 2005, at 9:45:36
You will want to take the Benadryl to prevent a dystonic reaction, which can include twitching, a feeling of inner restlessness (akathasia)sp??. A one time dose of Haldol shouldn't cause this, but it's got to just be on the safe side.
Jay
Posted by ed_uk on April 5, 2005, at 17:17:50
In reply to Re: Borderline Personality..PLS read...andBenadryl, posted by jay on April 5, 2005, at 16:57:05
Hi Jay,
Have you been diagnosed with borderline personality disorder?
Regards,
Ed.
Posted by jay on April 5, 2005, at 18:28:02
In reply to Re: Borderline Personality..PLS read...andBenadryl » jay, posted by ed_uk on April 5, 2005, at 17:17:50
> Hi Jay,
>
> Have you been diagnosed with borderline personality disorder?
>
> Regards,
> Ed.Hi Ed (and sorry for not getting back to everyone else...)
No I have a BP2 with rapid cycling diagnosis, but I have found relief for many of my symptoms from more of the unconventional treatments for Borderline Personality. For me, I feel my best when I get symptomatic relief, so it doesn't really matter the med. I imagine that is the case with most of us, actually, and maybe a direction we should be looking in. (If not for the narrow-minded doctors..lol)
Best and take good care,
Jay
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