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Re: 3rd day on Geodon 20mg for GAD, should I quit? » Agomelatinehope

Posted by SLS on August 29, 2012, at 18:58:33

In reply to Re: 3rd day on Geodon 20mg for GAD, should I quit?, posted by Agomelatinehope on August 29, 2012, at 17:49:44

> Thank you for replying
>
> This is an update since I got strange news...
>
> Today I felt awful, worst than 1st two days and I had already decided to quit today but the last two hours I felt again that strange feeling of being high, in which I have enjoyed pretty much being self-confident, impulsive and with my sex drive back (didn´t feel this way since teenage). It has lasted about 2 hours, now (0.45pm Spain) I just feel like if I had taken 10 coffees
>
> I also experienced more side effects like tachichardia, cramps and muscle stiffness
>
> May it be possible that this "high" feeling is what the drug makes you feel when it has kicked in?
>
> I'm 30min from taking my 4th dose and I don't really know what to do :S
>
> Thank you again

Steven Stahl has pointed out that Geodon (ziprasidone), at dosages below 40 mg/day, can produce activation and agitation. These things disappear at 40 - 60 mg/day:

http://www.medscape.org/viewarticle/484929

"Here's a very interesting thing about ziprasidone. Have you ever given ziprasidone at 20 mg and had a patient become activated and agitated? If you have, the reason is that the dosing is too low. Because this is such a powerful 5HT2C antagonist, at low doses, that's all it does. It doesn't have any dopamine antagonism, so it's potentially activating â' at least for those people whose genes don't want to have their 5HT2C receptors blocked. Have you ever given a dose of fluoxetine (Prozac) to a patient and had them have an activation? Fluoxetine is the only other drug that has powerful 5HT2C antagonist properties; in fact, fluoxetine has more powerful antagonist properties than reuptake blocking properties. To prevent this, you've got to do a counterintuitive thing, which is to stop using 20 mg, because you're going to make patients "go bonkers." You've got to use probably 60 mg to have enough robust D2 on board so that the patient doesn't get activated. This is an art. Some patients tolerate different doses than others; but the counterintuitive thing is that you raise the dose, you get less activation. If you've had bad experience with this particular drug, that might help you understand how to dose it."


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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