Posted by SLS on January 29, 2016, at 11:54:59
In reply to med poop out- where to go next (Latuda?), posted by bp peanut on January 27, 2016, at 21:18:32
One of the more common side effects of Geodon (ziprasidone) is insomnia. This might be amplified when added to Parnate, since Geodon is a reuptake inhibitor of serotonin. As you were titrating Geodon, how did you come to such a high dosage? I read that 320 mg/day was no more effective in schizophrenia and schizoaffective disorder than 160 mg/day after enough time passed for blood levels to settle - 8 weeks.
http://www.ncbi.nlm.nih.gov/pubmed/23775057
Have you ever tried valproate or Trileptal for mood stabilization mixed/states? You might be able to drop the Geodon in favor of one of these two drugs, thus reducing insomnia. I have even seen Topamax 100-200 mg/day work well for hypomanic mixed-states. Cognitive side effects can be minimized by using a very gradual titration.
Another idea is to get rid of the Geodon in favor of Saphris (asenapine). Saphris is not known for causing insomnia, and can exert an antidepressant effect along with antipsychotic effects.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1085749
URL: http://www.dr-bob.org/babble/20151225/msgs/1085782.html