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Pharmacy and Medications

Mixed Medications Help

12/22/2011

Question:

My mom has been seeing a therapist for 2 years and has only gotten worse. Here is a list of medications she is currently taking on a daily basis. Valium 40mg, Prozac 50mg, Geodon 160mg, Lamictal 300mg, Suboxone 8mg. She has been on different medication cocktails for the past 2 years with this doctor. Is this hurting her and making her worse? She was diagnosed with borderline personality.

Answer:

There are no obvious "therapeutic duplications" amongst the medications you have listed; in other words, each medication works in a different way and each can be used for a different medical problem. The medications you mention also do not have any drug interactions between them with the potential to cause something that resembles the worsening of a chronic disease state like borderline personality disorder (BPD).

Lamictal® is a "mood stabilizer" that has been studied in BPD and found to be effective compared to placebo ("sugar pill"). Second-generation antipsychotics, such as Geodon®, have been studied and found to have a beneficial effect in BPD. Fluoxetine is an antidepressant that has been studied in BPD and found to be effective compared to placebo. Valium and Suboxone are not medications typically used in treatment of borderline personality disorder; however, there are many medical problems for which they might be prescribed. In the treatment of BPD, medication is usually an "adjunctive" or add-on therapy. Psychotherapy and counseling are typically the primary treatment method.

Non-medication steps that can be taken to improve progress in mental-health treatment are rearranging schedules in order to attend psychotherapy sessions regularly, avoiding states of physical exhaustion, maintaining good nutrition, exercising regularly, sleeping adequately, and using stress-reduction techniques. The links below may provide some other general information on your mother's condition that may be helpful.

Related Resources:

Personality Disorders (MedlinePlus)
Borderline Personality Disorder (NAMI)

For more information:

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Response by:

Sarah Hudson-DiSalle, PharmD, RPh
Specialty Practice Pharmacist of Outpatient Pharmacy
College of Medicine
The Ohio State University