i dont know , but there are many ways to try. Im not sure about saying your on the last possible med, dont give up hope do you do any talk therapy, or any other kind of therapy?
Have you tried mindfulness for the cuttung urges, i hear that they are having sucess with that as a form of cbt or brain training. I would recomend talking to someone who knows alot about it though.
I know these suggestions are made time and time again but what about art or journaling as a distraction or blogging online?
I know the thoughts can be overwhelming
Try to be kind to yourself
Xx