Posted by bob on October 6, 2001, at 0:14:40
In reply to Re: Geodon really works and I won't shut up about it, posted by SLS on October 5, 2001, at 23:06:40
> Sorry, I forgot.
>
> I don't think Sal is taking Geodon anymore.
>
>
> - Scott*****************************
Scott:
Your post was extremely informative and helpful. I have a number of questions/comments, as it was highly technical.
1. Isn't it tough for you to switch from drug to drug? You seem to go through a lot of meds. I've been on my share, but it has always been extremely tough to taper and switch for me. I mean REAL difficult. Maybe that's because I've largely done solo trials in the past and come almost completely off of one before going on another, but I don't know how I'd understand what's doing what otherwise.
2. What is EPS? What does that stand for, and what does it mean?
3. Induction of mania, as long as it was a mild hypo-variety would not be entirely unwelcome to me. All of the SSRIs and and related meds (including Depakote) have been very sedating and apathy producing for me. I assume you haven't experienced any mania with these APs? You didn't mention as much.
4. What is the DA2 receptor - dopamine, or norepinephrine?
5. Why do you have a lack of confidence in Geodon's norepinephrine boosting properties? If you haven't seen any investigative results, then where did you hear it?
6. I think I understand reuptake inhibition, but what are antagonism and agonism, and how do they relate to reuptake?
Now I'd like to make a few comments (or maybe more than a few -- this will be long):
You seem to be taking quite a powerful combo: Effexor + Nortriptyline + Lamictal. If I was taking that, I'd probably gain 40% body weight, and not be able to know I had genitals anymore unless I could see them in the mirror with my own eyes. I took Anafranil and it was brutal -- sweating, sedation, significant weight gain, impotence, etc. I took Effexor and I again had significant weight gain, and loss of sexual capability. More insidious though with this drug, was something that I have now found to be a hallmark of all the classic SSRI drugs for me (Celexa, Paxil, Zoloft, Luvox): a severly shifted Circadian rhythm. I begin waking up later and later in the day, COMPLETELY independent of when I go to bed. Eventually, I literally don't hear my blasting alarm clock, and don't get out of bed until mid-afternoon. It's almost like a coma. This is REGARDLESS of when I go to sleep. It was very severe with Effexor, and I am now experiencing it with Luvox. When it gets like this, a 12 hour night is AVERAGE. Nothing I've ever tried has alleviated this effect (stimulants, sleeping pills, having someone call me on the phone etc...). In addition to that, I have started getting waxing and waning "muscle tightness" with these SSRIs, and my body seems to alternate between being overheated, and cold (thyroid disregulation???). I tried Lamictal before this Luvox thing (when I was on Celexa) and got a rash almost immediately. I then tried Topomax and it was rough, but allowed me to make the transition away from SSRIs -- I tapered off of Celexa. Then, for the first time in my life of medicating, I was free of anticholinergic effects and shifted sleep patterns (and the weight and muscle tension problems faded)!!!!!! Alas, it was too good to last. I began getting very aggressive, angry, and emotionally labile. I had a breakdown, and had to back off. While backing off, I had a battle with no less than 4 kidney stones, precipitated by the Topomax. I'm very scared now, as it feels as if my body will no longer tolerate SSRIs, and tricyclics are even worse! Now I've also had a heinous experience with the "newer" anticonvulsants. My doctor has suggested Tegretol. I have significant reservations about this also, as I took Depakote for a long while and was never more tired in my life... not to mention depressed. It's getting harder and harder to switch from drug to drug. I think my condition is deteriorating, and I don't know how much longer I can stand it. Maybe I should taper off everything and try ECT? I can't even try something like rTMS, because the loser FDA is too cost prohibitive for those small manufacturers to pursue approval here in the U.S. They do use that for people who can't tolerate drugs, right?
It just seems that the physical effects of these drugs are so significant I'm not going to be able to put up with it much longer. When all this started about 12 years ago, it was 99% a mental problem. No I'd say its about 40% mental concerns and 60% physical. Maybe it's even more towards the physical side than that. All the side-effects notwithstanding... they don't even always help me mentally. They do, however, eventually lead to a state of minimized physical activity, and endemic apathy. I am very demoralized at this point. The only class I haven't tried is MAOIs, but I hear they are even harder to tolerate than tricyclics, and then there's the diet. Besides, I literally don't think I could survive a washout period.
You don't have to answer the following questions but I'm going to ask them anyway:
1. Do you have any ability whatsoever to have sexual relations any longer?
2. Have you experienced significant weight gain? You mentioned that Geodon didn't cause increased appetite, but don't Effexor and Nortriptyline??? Effexor was a killer for me. I'd eat, and 10 minutes later, I'd be ready for another meal.
3. With 3 significant meds in your cocktail already, why do you need a fourth?
4. How is you tolerablity in general? Do you consider yourself susceptible to side-effects, or can you take large doses without many problem?
5. Isn't Nortriptyline a bear to tolerate?
Sorry for being on such a downer, but that's the way it is right now?
Bob
P.S. I'm in Baltimore right now, and the temp was in the mid-eighties today. However, a cold front is moving through tonight, and they said by Sunday the highs will only be in the fifties. :-)
Sorry to bombard you with all this crap! I'm thinking about posting an involved history of my med odyssey on here as a new thread to see if anyone has any suggestions for me.
poster:bob
thread:66242
URL: http://www.dr-bob.org/babble/20010927/msgs/80416.html