Posted by Solstice on September 4, 2011, at 14:11:22
In reply to Geodon, posted by floatingbridge on September 4, 2011, at 11:55:35
> I have heard (from my pdoc) and seeing some posters here work with it, that Geodon is good while being very tricky to dose. Anyone have any comment on that?
I'm not sure what characteristics might make it qualify as tricky, but I think most psych meds require a lot of fooling around and adjusting. My daughter started with a starter pack, if I remember correctly. It also took patience to wait for the side effect of extreme sleepiness to wear off. I think she slept through a couple of weeks of school when she first started. She has bipolar. Before treatment, she spent the majority of her time in a hypomanic state. Some of her time was spent in what I would consider a 'normal' state, and then she'd have these crazy irritable rages that were generally short - but were quite alarming. When she was finally diagnosed and treatment began, she went through a significant period of grief over losing the hypomanic state. I'm not kidding. She resented losing it, and she would get angry with both me and her doctor about it. This went on for several months. Then she went through a period of 'wonder' - because for the first time in her life (I think she was 14), her mind had slowed down enough that she began to really be aware of the feelings of others, and of her own feelings as well. It was very startling to her to figure out how to deal with the emotions. It was amazing for me to watch. It was like watching a gift unfold, to see a daughter I loved and believed in arise from the rubble and confusion of hypomanic bipolar. After she stabilized, she could give these hysterical descriptions of how her racing thoughts worked. And it wasn't until after she finished grieving over losing hypomania.. and started to find pleasure in experiencing normal emotions and attachments to others.. that she could really explain what went on inside herself before treatment began.
So I think bipolar in general is 'tricky.' My daughter's most difficult symptoms were concentration, racing thoughts, and impulsivity. It's hard to say whether it's a chicken or egg thing. As for dosing, after she stabilized, we had to deal with how her developmental age contributed. She entered puberty later than most, and her body underwent a ton of changes that no doubt affected the geodon. After a good 8 - 12 months, everything felt like it landed on two feet. She was able to tell her doctor and I when she felt bipolar symptoms.. and she developed a sense of her threshold for when she needed a medication adjustment. Somewhere in the middle, she suggested splitting her dose, and that worked wonderfully. Right now she takes 60mg in the morning, and 60mg at night. She's been on it now for almost three years. Her doctor added Intuniv about seven months ago to see if it would smooth out the shifts in mood that she complained about, and her difficulty with concentrating. The geodon did a great job eliminating the impulsivity. Her racing thoughts have been significantly reduced, allowing her to function much better in school. However, the racing thoughts and inattention continue to periodically rise to the surface.. and that is what has prompted adjustments in the geodon, and eventually adding intuniv. She's in a good spot right now. She takes advanced placement subjects for all but math and Latin. She's an extremely dedicated student, and has been successful socially.
Anyway, I think bipolar itself is tricky.. so it might not be the medication itself, as much as it's the trickiness of what the medication is attempting to treat. Even if you don't have a bipolar diagnosis, if geodon is being started to address mood instability - it might be that treating mood instability is tricky - regardless of what medications or med combos are attempted.
Best wisdom I can offer is to look at it from a 'long haul' perspective. Don't expect it to be easy or quick. Be attentive to your symptoms. There are great mood charts online - find one you like and use it to keep track of everything; your doctor will love you for it. And hang in there. Be sure to give med trials lots of time (unless you experience dangerous side effects) - for example, a med like geodon will make you terribly sleepy - but if you get impatient and don't give your system long enough to bounce back, you might abort the perfect treatment. My daughter was very frustrated with the extent of her initial sleepiness - and it lasted so long that we thought it might never go away. Then it started to improve, little by little. It reappears every time her dose is raised, but now only lasts a few days. We just try to schedule med changes during breaks from school.
Well.. that was more than 2cents worth :-)
Solstice
poster:Solstice
thread:995790
URL: http://www.dr-bob.org/babble/20110902/msgs/995833.html