Posted by Sunnely on August 6, 2001, at 23:45:59
In reply to Can anyone give reassurance re: Geodon and nausea?, posted by grapebubblegum on August 6, 2001, at 9:53:25
Not sure exactly as to the mechanism of Geodon-induced nausea. I surmise it may have something to do with its reuptake inhibition of serotonin and norepinephrine, similar to some classes of antidepressants (example, Effexor). Serotonergic stimulation of certain serotonin receptors such as 5HT3 may lead to nausea. Certain 5HT3 antagonists such as ondansetron (Zofran) and granisetron (Kytril) are effective anti-nausea/emetics.
During clinical trials, more than 4,500 patients have been treated with Geodon, and over 900 have been treated for more than 6 months. (Since its introduction, March 2001 in U.S., approximately 100,000 scripts for Geodon have been written. No wonder Lilly [Zyprexa] is sleepless in Indy.) In short-term trials, very few patients (4%) discontinued because of treatment-emergent adverse effects. Nausea is one of the most common reported adverse effects: 10% with Geodon vs. 7% with placebo.
Peter J. Weiden, MD (NY), reported initial nausea occurring in about 20% of his outpatients when they were first switched to Geodon. Nausea tends to occur during the first 2 weeks of treatment and then to subside on its own. The nausea appears to be sensitive to dosing adjustments and responds to a lowering of the dose or giving Geodon with meals. (You should take Geodon with food, anyway. Food makes it work better.) In his experience, Dr. Weiden never had to discontinue Geodon because of nausea, although in several patients the dose had to be lowered.
Good Luck.
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> I am really afraid of nausea; it sets off intractable panic attacks in me which seem intolerable. I took zoloft for a long time with no problem despite the warning that it can cause nausea. It did cause nausea at times but it was transitory (meaning about 30 seconds per day) and since the feeling passed, I could handle it easily with no trauma.
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> Now my doctor is thinking of trying Geodon. I have heard the same thing about possibility of nausea. If it is transitory and related to stomach acid (i.e., eating a few crackers with it will alleviate the nausea) I can handle it, but if it is more of a systemic nausea which persists, then I will be afraid to even try geodon for fear of being in psychic misery until it wears off. Can anyone shed some light on the mechanism of the purported nausea risk?
poster:Sunnely
thread:73765
URL: http://www.dr-bob.org/babble/20010804/msgs/73886.html