PTSD, BPD: Overmedicated or not?

I am desparate to find help for my 41 year old brother who is suffering from PTSD and a BPD.  His psychiatrist is currently prescribing Zyprexa (10 mg), Risperdal (2 mg/2X a day), Paxil (60 mg/1X a day), Gabapentin (250 mg in the am; 500 mg in the pm); Topamax (100 mg; 2X per day) and Xanax (50 mg am; 50 mg pm).  He is constantly sedated and has terrible symptoms of tardive dyskinesia, swelling of the tongue, hallucinations, restless sleep etc.  He has gained a LOT of weight and has elevated cholesterol requiring treatment with a statin.  His appetite is insatiable (primarily carbs.).  We have a family history of coronary disease and diabetes so this is very disturbing.  My brother is now home-bound due to his meds and anxiety.  The doc has never suggested cognitive-behavior therapy along with meds.  My brother has gone from being a very successful professional to a zombie with these treatments.  His problems began 8 years ago when he began having flash-backs associated with childhood trauma.   What can the family do to help?  Is he overmedicated or am I over-reacting.  

[Mark TX]

Is your brother making his own decisions or is he under the care of family or a guardian of some sort?  Who's making the decisions as to what doctor he sees and what treatments he accepts?

I'd get him to see several professionals for second opinions.  Or if he's unable or unwilling to see anyone else, get some consultations yourself and obtain outside opinions about this course of treatment.

I have no idea how all those drugs might interact.  But I understand they are very potent and definitely nothing to play around with.  If your brother is on six powerful psychotropic drugs at once, it's no wonder he's a zombie.

Something is very wrong there, IMHO.

Good luck!

mark

[ILADVOCATE]

Has he been clinically diagnosed with tardive dyskinesia? The two antipsychotics he is on in combination will worsen it. You should have him see a movement disorders specialist who can diagnose the tardive dyskinesia and then a psychiatrist if that is confirmed would switch him to Clozaril which is the only antipsychotic that cannot cause tardive dyskinesia that is a current medication. As well a movement disorders specialist who is a neurologist would provide treatment for the tardive dyskinesia. And you should be aware of new antipsychotics in development such as glycine which I am on in Phase II FDA study which is a glutamate antagonist a new class of antipsychotic which cannot cause or worsen tardive dyskinesia or diabetes and has been shown to promote a full recovery. But the most important thing is to take him to a movement disorders specialist to have the tardive dyskinesia diagnosed and treated.