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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by amyaub on November 27, 2007, at 10:26:00
Is a starting dose of 80 mg/day insanely high? Could it be dangerous or result in scary episodes?
Posted by Phillipa on November 27, 2007, at 11:52:04
In reply to Geodon, posted by amyaub on November 27, 2007, at 10:26:00
I've read and others have posted that 20mg is the starting dose. But this pdoc here wanted me to start at 120mg no that is insane?????Phillipa
Posted by Phillipa on November 27, 2007, at 12:00:51
In reply to Re: Geodon » amyaub, posted by Phillipa on November 27, 2007, at 11:52:04
A bit more info Phillipa
GeodonIndications & Dosagefont sizeAAAINDICATIONS
Schizophrenia
Ziprasidone is indicated for the treatment of schizophrenia. When deciding among the alternative treatments available for this condition, the prescriber should consider the finding of ziprasidone's greater capacity to prolong the QT/QTc interval compared to several other antipsychotic drugs (see WARNINGS). Prolongation of the QTc interval is associated in some other drugs with the ability to cause torsade de pointes-type arrhythmia, a potentially fatal polymorphic ventricular tachycardia, and sudden death. In many cases this would lead to the conclusion that other drugs should be tried first. Whether ziprasidone will cause torsade de pointes or increase the rate of sudden death is not yet known (see WARNINGS).The efficacy of oral ziprasidone was established in short-term (4- and 6-week) controlled trials of schizophrenic inpatients (see CLINICAL PHARMACOLOGY).
In a placebo-controlled trial involving the follow-up for up to 52 weeks of stable schizophrenic inpatients, GEODON was demonstrated to delay the time to and rate of relapse. The physician who elects to use GEODON for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient.
Bipolar Mania
Ziprasidone is indicated for the treatment of acute manic or mixed episodes associated with bipolar disorder, with or without psychotic features. A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood. A mixed episode is characterized by the criteria for a manic episode in conjunction with those for a major depressive episode (depressed mood, loss of interest or pleasure in nearly all activities).The efficacy of ziprasidone in acute mania was established in 2 placebo-controlled, double-blind, 3-week studies in patients meeting DSM-IV criteria for Bipolar I Disorder who currently displayed an acute manic or mixed episode with or without psychotic features (see CLINICAL PHARMACOLOGY).
The effectiveness of ziprasidone for longer-term use and for prophylactic use in mania has not been systematically evaluated in controlled clinical trials. Therefore, physicians who elect to use ziprasidone for extended periods should periodically re-evaluate the long-term risks and benefits of the drug for the individual patient (see DOSAGE AND ADMINISTRATION).
Acute Agitation in Schizophrenic Patients
Ziprasidone intramuscular is indicated for the treatment of acute agitation in schizophrenic patients for whom treatment with ziprasidone is appropriate and who need intramuscular antipsychotic medication for rapid control of the agitation. “Psychomotor agitation” is defined in DSM-IV as “excessive motor activity associated with a feeling of inner tension.” Schizophrenic patients experiencing agitation often manifest behaviors that interfere with their diagnosis and care, e.g., threatening behaviors, escalating or urgently distressing behavior, or self-exhausting behavior, leading clinicians to the use of intramuscular antipsychotic medications to achieve immediate control of the agitation. The efficacy of intramuscular ziprasidone for acute agitation in schizophrenia was established in single-day controlled trials of schizophrenic inpatients (see CLINICAL PHARMACOLOGY). Since there is no experience regarding the safety of administering ziprasidone intramuscular to schizophrenic patients already taking oral ziprasidone, the practice of co-administration is not recommended.DOSAGE AND ADMINISTRATION
Schizophrenia
When deciding among the alternative treatments available for schizophrenia, the prescriber should consider the finding of ziprasidone's greater capacity to prolong the QT/QTc interval compared to several other antipsychotic drugs (see WARNINGS).Initial Treatment
GEODON® Capsules should be administered at an initial daily dose of 20 mg BID with food. In some patients, daily dosage may subsequently be adjusted on the basis of individual clinical status up to 80 mg BID. Dosage adjustments, if indicated, should generally occur at intervals of not less than 2 days, as steady-state is achieved within 1 to 3 days. In order to ensure use of the lowest effective dose, ordinarily patients should be observed for improvement for several weeks before upward dosage adjustment.Efficacy in schizophrenia was demonstrated in a dose range of 20 to 100 mg BID in short-term, placebo-controlled clinical trials. There were trends toward dose response within the range of 20 to 80 mg BID, but results were not consistent. An increase to a dose greater than 80 mg BID is not generally recommended. The safety of doses above 100 mg BID has not been systematically evaluated in clinical trials.
Maintenance Treatment
While there is no body of evidence available to answer the question of how long a patient treated with ziprasidone should remain on it, systematic evaluation of ziprasidone has shown that its efficacy in schizophrenia is maintained for periods of up to 52 weeks at a dose of 20 to 80 mg BID (see CLINICAL PHARMACOLOGY). No additional benefit was demonstrated for doses above 20 mg BID. Patients should be periodically reassessed to determine the need for maintenance treatment.Bipolar Mania Initial Treatment
Oral ziprasidone should be administered at an initial daily dose of 40 mg BID with food. The dose should then be increased to 60 mg or 80 mg BID on the second day of treatment and subsequently adjusted on the basis of toleration and efficacy within the range 40-80 mg BID. In the flexible-dose clinical trials, the mean daily dose administered was approximately 120 mg (see CLINICAL PHARMACOLOGY).Maintenance Treatment
There is no body of evidence available from controlled trials to guide a clinician in the longer-term management of a patient who improves during treatment of mania with ziprasidone. While it is generally agreed that pharmacological treatment beyond an acute response in mania is desirable, both for maintenance of the initial response and for prevention of new manic episodes, there are no systematically obtained data to support the use of ziprasidone in such longer-term treatment (i.e., beyond 3
Posted by Zyprexa on November 28, 2007, at 11:03:04
In reply to Re: Geodon » amyaub, posted by Phillipa on November 27, 2007, at 11:52:04
4 pills, 20, 40, 60, 80mg. You take 2 a day. Those are the recomended doses. I have taken 5 of the 60mg pills a day for a while. Its not that strong. But at higher doses made my vision blurry. Just some thing to watch for, it does go away when I stoped.
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