Q. I have been trying to find out information regarding the long term use of Tegretol. I have been taking Tegretol for almost ten years now for my borderline personality disorder, along with the use of various other medications over the years, and my symptoms seem to be worsening the past couple of years. My doctor has just switched me from one med to another, or increased dosages on meds, but nothing seems to be helping. I've been on the same dose of Tegretol, 600 mg a day, for ten years and I am wondering if the drug just is not working anymore due to its long term use. My doctor does not want to take me off of it, but I just don't think it is working anymore and am wondering if anything else may help better at this point.

A. I only used Tegretol for a short period of time in the mid to late 1980s. I do not know of any data exploring long-term use in BPD, albeit the side effects should be the same as in seizure patients. Whether the drug stops working or your illness is getting worse is the real question here. I would continue to work with your current doctor as it sounds as if he and you have been together for at least ten years, which is almost unheard of in this age of managed care and preferred providers.

Tegretol's major problem in the early studies is that it caused depression even if your mood was more stable. But, prior to SSRIs, it was the best treatment option available, and many doctors still like it and its conjoiners (Lamictal, Neurontin, Depakote, Topamax).