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Seroquel or Xanax for BPD? (boost to Lamictal)


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I found this board via a Google search and it seemed like a good place to get some personal feedback for the information I'm looking for.

I'm Borderline, and in a tumultuous relationship that causes me a LOT of stress and results in many violent freak-outs.  Whenever something happens that upsets me, I go off the wall and am screaming/sobbing, hitting myself & everything around me, feeling like I'll never come down from this bad mood spike.  Right now my doctor has me on 200mg Lamictal, which seems to do a decent job of keeping my day-to-day mood relatively stable.  But it hasn't done anything to calm the violent episodes when I run into a bad event.  Previously the doc tried giving me a low dose of Risperdal to take on an as-needed basis, that I could take in the midst of an episode and hopefully it would calm me down quickly and stabilize me enough that I could go to DBT skills to work out the rest.  Well, it didn't.  I tried .5mg, 1mg, and then 2mg, and none of these dosages were helpful.  It also inflamed my nasal passages so that I couldn't breathe through my nose anymore (keeping me from being able to fall asleep at night, which is keeping me from the only other resource I have for escaping my mood).

 

At my last visit, we discussed multiple alternate options: Seroquel, Abilify, and Xanax.  I took the Xanax scrip for now, but after the way he talked about it as "alcohol in a pill," I'm afraid to try it.  I completely abstain from alcohol and drugs because I don't want to feel out of my head.  Plus, I'm very concerned that I'd quickly become dependent.  (My sister is also borderline and has a problem with alcohol, so I have a very close example of what it could do to me.)  I'm concerned that Xanax will either make me feel too out of myself that I won't like it, or that I will overly like that I can take a quick pill to calm me down whenever I'm upset and I'll develop an addiction to popping them at the slightest upset.  However, I felt like if the Risperdal didn't do anything for me, the Seroquel probably wasn't going to either, since they're in the same drug class.

Does anyone have any advice or experience about taking any of these drugs as a single dose, as-needed basis for immediate calming of violent depressive episodes?  Did anyone find that Seroquel (or Abilify) worked for them over Risperdal?  Anyone with a similar mindset as mine (towards wanting to remain fully aware and avoid mood-altering substances) have any experience with Xanax?

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Well, even though Risperdal, Abilify, and Seroquel are in the same class, different people react differently to each one. You might have to go through a trial of each to see how you feel on them. Xanax being a benzo is in a different class, but there again different people have better success with different meds. I think Xanax and the other benzos are considered as more quick-acting, "as-needed" to calm anxiety, whereas Risperdal, Seroquel, etc. are more apt to be long-term meds that have to be taken for a while to kick in, and taken every day to get their full effect.

 

Did you discuss with your doc your concerns about addiction? It's good that you're aware of the potential problem and determined to avoid it. Knowing this, your doc would be able to tailor your meds accordingly.

 

I'm speaking in generalities because I don't want to give the impression that one med is "better" than another. I think everyone here would agree that they had to try a few different things till they hit the combo that worked for them. That is where you and your doc have to work together. Be honest with your doc and yourself, and give each med a fair trial and see how it works for you. You seem motivated to get things under control, and that is a great thing to have going for you.

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Xanax isn't as bad as you'd think. Small doses PRN (as needed) won't hurt you long run. I took Xanax on a regular basis (0.5mg's 4x's a day) for 2 years. I was taking it PRN at the end of the 2 years I was on it, at a max of 1mg a day, or two pills. Now I take clonazepam, which is longer acting and has a longer half life. It's less of an as-needed drug. Yes, benzos can be addictive or habit forming, but you've got good insight on your potential for addiction. Definitely discuss that with your pdoc if you need a really good opinion. I find benzos make me feel much more normal and blast the anxiety. A small dose of Xanax (0.25 or 0.5mg) might make you drowsy the first few times you take it.

 

Seroquel is my favourite med. I take 400mg XR every night and it helps me sleep and I'm not drowsy during the day, it takes away psychotic symptoms. I'm on a dose more for mood stabilization and mild psychosis, and low doses are definitely helpful in calming down and sleep. It can have some annoying effects if you stop it eventually, but as with most meds, they're relatively mild, annoying, and go away without harm. Abilify was quite activating for me, but I am bipolar. Rispderal is great for agitation, but has shitty side effects, I agree.

 

With BPD the best treatment is therapy. One to one therapy, DBT (in groups, or one to one) are really helpful. There are a lot of great books out there. I've read "The Buddha and the Borderline" and enjoyed it and found it useful. (I am not dx'd borderline, but I have traits) I've been through DBT classes and found them quite useful too, even though the tdoc in charge sucked. I have DBT books as well. It's great for anyone, it teaches a lot. Definitely look into it. If you can't get into therapy, there are online site, apps for phones and tablets, and lots more where you can kind of coach yourself.

 

Medication with BPD is generally used to handle symptoms temporarily. That can be from months to years. Therapy is the best bet.  It's a misunderstood diagnosis by a lot of people and that can be a huge piss-off. It's got a bad rep, but it is workable, and there is a lot of hope. I hope you're able to get into DBT soon. It will make a difference, but you will have to do some work. Check out bookstores for workbooks and stuff. It can't hurt. You sound like you have a lot of insight and you know what's going on in your head.

 

http://www.patientslikeme.com is a great site to track your mood, meds and lots of other things, and interact with others. 

 

Also, welcome to the funny farm of CB. We (the mods and admins) just ask you read the rules.

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  • 2 weeks later...

Hi. I take Klonopin usually when I get really anxious and panicky, but I also work in a prison & obviously can't take benzos in there. So my psych prescribes me 25 mgs of Seroquel immediate release pills to take up to 3 times a day for that situation. They don't work quite as well as the Klonopin but there is a definite improvement. If you're worried about the Xanax, I would certainly check the Seroquel out.

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seroquel is the first antipsychotic i've taken.

previously all i've taken is antidepressants,  so when i first starting taking sero, i was just....YES. FREAKING FINALLY.

i used to have crying jags - of like crying for the bulk of a day. i would yell at myself in the mirror, because i was so angry about things in my past that i couldn't change. i would call suicide hotlines and suchlike on a daily basis for months - i got to know the people answering the phones.

 

thankfully, now i'm on seroquel - i do very little of that. i had a little crying jag last week, took a seroquel during the day, took a nap, and then went on with my day.

much better than just being a crying mess for hours.

sleep happens - much better, usually interrupted, and now, with dreams! hurrah!

it's the first drug that i would recommend to people wholeheartedly.

the main thing to watch out for is blood sugar levels and cases of the munchies - oft reported side effect.

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I can't recall taking Xanax but my memory can be shitty sometimes.  Never Abilify but I am on Seroquel.  I used to be anti meds (mostly because I was afraid I would lose control and no longer be a functioning human being, yada yada) but came to discover that they really do have their place in part of a treatment plan, preferably not alone but with therapy etc.  Generally you would be starting on a low dose anyway and if the side effects are too unpleasant, you just talk to your  doc and see what other options you have.  In the end you will see that it is nothing you can't handle and can potentially be very helpful for you.  Best wishes!

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