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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by anna on August 26, 2001, at 23:05:23
I am diagnosed as Bipolar II and am on Wellbutrin 300mg, Geodon 80 mg, Topamax 150 mg, and Neurontin 600 mg a day. Also Klonopin as needed for anxiety. My question is: Has anyone else experienced mania with this drug??? (My pdoc has not come right out and said I was BP II, just that he was trying to rule it out, but I know I am, my father is, etc....) Ever since I have been on it I have made dumb decisions, and today I went absolutley out of control with cleaning my house. I am either totally up or comatose. I am miserable. I am about to check myself in somewhere, I can't handle this anymore.
Anna
Posted by SalArmy4me on August 26, 2001, at 23:35:31
In reply to Geodon and mania question, posted by anna on August 26, 2001, at 23:05:23
5. Keck, Paul E. Jr. MD. Ziprasidone in the Short-Term Treatment of Patients with Schizoaffective Disorder: Results from Two Double-Blind, Placebo-Controlled, Multicenter Studies. Journal of Clinical Psychopharmacology. 21(1):27-35, February 2001.
"In these studies, ziprasidone exerted a dose-dependent reduction in psychotic and affective symptoms in patients with schizoaffective disorder. Specifically, ziprasidone 160 mg/day produced significant improvement in the overall psychopathology as measured by reductions in mean BPRS total scores from baseline to endpoint compared with placebo. Ziprasidone 160 mg/day also produced significant improvement in BPRS core symptoms, BPRS manic symptoms, and CGI-S scores compared with placebo. At lower dosages, numerical but not statistically significant superiority of ziprasidone over placebo was evident for all efficacy variables except for CGI-S. On this variable, ziprasidone 120 mg/day produced significant improvement compared with placebo. Ziprasidone, at the doses studied, appeared to exert a more robust effect in the treatment of manic symptoms compared with depressive symptoms during the 4- or 6-week treatment periods studied. This finding was encouraging, given ziprasidone's theoretical potential for inducing mania because of its anti-depressant activity, which is likely associated with its 5-HT1A agonist, 5-HT2 antagonist, and reuptake inhibition of serotonin and norepinephreine.30 Ziprasidone was also associated with reductions in depressive symptoms from baseline to endpoint in both studies. Although these were consistently numerically greater than those associated with placebo (except at 80 mg/day), they were not statistically significant..."
Posted by SLS on August 27, 2001, at 0:07:22
In reply to Geodon and mania question, posted by anna on August 26, 2001, at 23:05:23
> I am diagnosed as Bipolar II and am on Wellbutrin 300mg, Geodon 80 mg, Topamax 150 mg, and Neurontin 600 mg a day. Also Klonopin as needed for anxiety. My question is: Has anyone else experienced mania with this drug??? (My pdoc has not come right out and said I was BP II, just that he was trying to rule it out, but I know I am, my father is, etc....) Ever since I have been on it I have made dumb decisions, and today I went absolutley out of control with cleaning my house. I am either totally up or comatose. I am miserable. I am about to check myself in somewhere, I can't handle this anymore.
> Anna
Dear Anna,I would be afraid to comment on what you are currently experiencing. Try not to get too upset just yet. I'm sure your doctor will get you straightened-out once you describe to him what's happening.
Some antipsychotics can produce anxiety and agitation very early in treatment. It is hard to judge from your description what's going on.
I will not be surprised to see a few reports of people becoming manic with Geodon. It has been known to occur with Zyprexa, a very similar drug. Geodon has been purported to have features similar to antidepressants (monoamine reuptake inhibition). It also blocks the same serotonin receptors that Remeron and Serzone do. That it frequently produces insomnia might be indicative of a potential to cause mania or excitation.
Don't worry. Things will be OK. Just communicate with your doctor as soon as possible and try to have a good patient's patience (stupid play on words). I am not a good example of a good patient. It is a lot harder to be patient when you are frustrated and in pain.
Good night.
- Scott
Posted by judy1 on August 27, 2001, at 1:46:11
In reply to Geodon and mania question, posted by anna on August 26, 2001, at 23:05:23
I've gotten manic on wellbutrin, prozac, paxil, lamictal and risperdal. So geodon wouldn't surprise me at all especially since you are not on an approved mood stabilizer- lithium, depakote, tegretol (topomax is still experimental- most pdocs are using it for weight control and for rapid cyclers who have tried everything else) Neurontin also has had mixed results. So your pdoc is playing with meds to rule out bipolar disorder? Kind of a dangerous game. Maybe you need to find an expert in bipolar disorder and get a proper diagnosis and med regime (unless you've gone that route?) Hope you feel better- judy
Posted by Cam W. on August 27, 2001, at 2:13:06
In reply to Geodon and mania question, posted by anna on August 26, 2001, at 23:05:23
Anna - I have heard a couple of hospital psychiatrists note aggression and hypersexuality in male patients taking Geodon™ (ziprasidone), but have not seen any of this first hand. These two side effects have been linked to hypomania/mania. Scott may be correct about your symptoms being the start-up side effects (lasting a week or two) linked with many of the atypicals (agitation and anxiety).
my 2¢ - Cam
Posted by chloe on August 27, 2001, at 11:41:14
In reply to Re: Geodon and mania question » anna, posted by Cam W. on August 27, 2001, at 2:13:06
> Anna -
This is just my experience. When I started Geodon, I had a hypomanic response. I couldn't sleep more than a few hours and I had to be moving or doing all the time. My house was clean as a whistle, similar to yours it sounds!Though after a weeks time, that agitation and flight into activity and talking (!), i didn't shut up for 4 days!, diminshed and I just felt and AD effect from Geodon. HOWEVER, by the end of two weeks I had to D/C the med due to tongue movements and reemerging TD symptoms. I was very sad to give up this med. It was the first in a long time that help with depression and distorted thinking. I wasn't on it long enough to see if it made my cycling worse...though I did have one very stable week on it, after I had adjusted to it!
This is probably not much help. Just wanted to relay my experience, and tell you to hang in there. Keep in touch with your pdoc and keep a good record of your moods.
I hope things get better for you...
Chloe
Posted by anna on August 27, 2001, at 22:46:43
In reply to Re: Geodon and mania question Anna, posted by chloe on August 27, 2001, at 11:41:14
> > Anna -
> This is just my experience. When I started Geodon, I had a hypomanic response. I couldn't sleep more than a few hours and I had to be moving or doing all the time. My house was clean as a whistle, similar to yours it sounds!
>
> Though after a weeks time, that agitation and flight into activity and talking (!), i didn't shut up for 4 days!, diminshed and I just felt and AD effect from Geodon. HOWEVER, by the end of two weeks I had to D/C the med due to tongue movements and reemerging TD symptoms. I was very sad to give up this med. It was the first in a long time that help with depression and distorted thinking. I wasn't on it long enough to see if it made my cycling worse...though I did have one very stable week on it, after I had adjusted to it!
>
> This is probably not much help. Just wanted to relay my experience, and tell you to hang in there. Keep in touch with your pdoc and keep a good record of your moods.
> I hope things get better for you...
> ChloeThanks so much for all your responses. I talked with my nurse today and she said to give it 2 more weeks. I am going on vacation this next week so maybe it will be a good distraction. Until then I am doubling up on my Klonopin everytime I feel myself going into a severe mania. It felt good to hear about others experiences. Thanks again so much from the bottom of my heart!!!!
Anna
Posted by SST on September 5, 2001, at 12:26:26
In reply to Re: Geodon and mania question » anna, posted by judy1 on August 27, 2001, at 1:46:11
The initial mania (hypomania) that is present at the beginning of a course of Geodon typically fades over the first few weeks, returning to a more level and less hypomanic state. If it can be dealt with, it may be worth waiting out the hypomania, until it settles down.
My p-doc's experience with a dozen or so patients is that this settles, and the AD effect, especially for resistant cases, is worth the wait. He has about 14 pts., me (BP II) included, who have responded to the AD effects of Geodon after decades of resistance to other meds. Best of luck.
SST
> I've gotten manic on wellbutrin, prozac, paxil, lamictal and risperdal. So geodon wouldn't surprise me at all especially since you are not on an approved mood stabilizer- lithium, depakote, tegretol (topomax is still experimental- most pdocs are using it for weight control and for rapid cyclers who have tried everything else) Neurontin also has had mixed results. So your pdoc is playing with meds to rule out bipolar disorder? Kind of a dangerous game. Maybe you need to find an expert in bipolar disorder and get a proper diagnosis and med regime (unless you've gone that route?) Hope you feel better- judy
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