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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Vince on August 31, 2001, at 21:56:02
Has anyone heard of anxiety rebound with discontinuing or lowering the doses of either Geodon or Neurontin. I'm experiencing the worst anxiety and panic that I've ever went through. I've tried to alleviate the symptoms with benzodiazapines but I get extremely depressed when the benzo wears off. I don't want to start back on these meds if they are that hard to kick. Can someone please help with a suggestion, please.
Vince
Posted by SalArmy4me on August 31, 2001, at 22:15:27
In reply to Anxiety rebound with Geodon or Neurontin - Help, posted by Vince on August 31, 2001, at 21:56:02
I think the only way you're gonna be able to kick this rebound anxiety thing is with other medication. BuSpar at high doses would kill two birds with one stone: get rid of the anxiety and depression.
I read this article and it was interesting: Sontheimer, Daniel L. MD. Ables, Adrienne Z. PharmD. Is buspirone treatment effective in patients wishing to discontinue long-term benzodiazepine use? Journal of Family Practice. 50(3):203, March 2001.
I'll e-mail it to you if you want.
Posted by Vince on August 31, 2001, at 22:58:33
In reply to Re: Anxiety rebound with Geodon or Neurontin - Help, posted by SalArmy4me on August 31, 2001, at 22:15:27
> I think the only way you're gonna be able to kick this rebound anxiety thing is with other medication. BuSpar at high doses would kill two birds with one stone: get rid of the anxiety and depression.
>
> I read this article and it was interesting: Sontheimer, Daniel L. MD. Ables, Adrienne Z. PharmD. Is buspirone treatment effective in patients wishing to discontinue long-term benzodiazepine use? Journal of Family Practice. 50(3):203, March 2001.
>
> I'll e-mail it to you if you want.Sure, please email me the article.
Thanks, Vince
Posted by Mitch on August 31, 2001, at 23:43:28
In reply to Anxiety rebound with Geodon or Neurontin - Help, posted by Vince on August 31, 2001, at 21:56:02
> Has anyone heard of anxiety rebound with discontinuing or lowering the doses of either Geodon or Neurontin. I'm experiencing the worst anxiety and panic that I've ever went through. I've tried to alleviate the symptoms with benzodiazapines but I get extremely depressed when the benzo wears off. I don't want to start back on these meds if they are that hard to kick. Can someone please help with a suggestion, please.
>
> VinceOh yeah, I had a personal experience with sudden discontinuation of 900mg/day of Neurontin and it was not nice at all. I got very agitated and photophobic, interestingly. You definitely need to taper that one down slow. It seems anything that you need to take more than once a day can give you a bad jag if you stop it suddenly.
Posted by ChrisK on September 1, 2001, at 4:08:39
In reply to Anxiety rebound with Geodon or Neurontin - Help, posted by Vince on August 31, 2001, at 21:56:02
See if you can replace the Geodon with Zyprexa. They are similar drugs but the Zyprexa can be sedating and relax some of your anxiety problems. My own experience is that you can overlap the two for a week and then go solo on the Zyprexa without much of a problem.
> Has anyone heard of anxiety rebound with discontinuing or lowering the doses of either Geodon or Neurontin. I'm experiencing the worst anxiety and panic that I've ever went through. I've tried to alleviate the symptoms with benzodiazapines but I get extremely depressed when the benzo wears off. I don't want to start back on these meds if they are that hard to kick. Can someone please help with a suggestion, please.
>
> Vince
Posted by vince on September 1, 2001, at 19:16:55
In reply to Anxiety rebound with Geodon or Neurontin - Help, posted by Vince on August 31, 2001, at 21:56:02
Could this be akathasia that I'm experiencing with Geodon. When I try to cut back on the Neurontin I start feeling really anxious. I can't quit pacing and I feel all up tight inside. Sometimes I even feel this way when I'm taking Neurontin. At first I thought it was all related to Neurontin withdrawal, but now I'm wondering if the Neurontin was the only thing that was treating the akathasia caused by the Geodon.
If this is the case, how fast should I try to get off the Geodon without causing withdrawal problems. I can't really take this feeling any more. I want to just drop Geodon as fast as I can to see if the feeling will go away!
Vince
Posted by Chris A. on September 1, 2001, at 23:14:33
In reply to Help - Could this be akathasia?, posted by vince on September 1, 2001, at 19:16:55
Yes, particularly if the feeling is different from the anxiety/panic you've experienced in the past. I had to quit Geodon at day twelve because I felt like jumping out of my skin. It was unbearable to sit still, similar to the pacing you mentioned. At the same time I was exhausted, but trying to rest didn't work either. My husband said I was acting very strangely. As far as reducing the dose, talk to your pDoc first if at all possible. My dosage was still low and getting off was a relief. It was disappointing because I had high hopes that it would be the ideal medication for me. It didn't occur to me that it was akithasia until later. It was new to me.
Blessings,
Chris A.
> Could this be akathasia that I'm experiencing with Geodon. When I try to cut back on the Neurontin I start feeling really anxious. I can't quit pacing and I feel all up tight inside. Sometimes I even feel this way when I'm taking Neurontin. At first I thought it was all related to Neurontin withdrawal, but now I'm wondering if the Neurontin was the only thing that was treating the akathasia caused by the Geodon.
>
> If this is the case, how fast should I try to get off the Geodon without causing withdrawal problems. I can't really take this feeling any more. I want to just drop Geodon as fast as I can to see if the feeling will go away!
>
> Vince
Posted by Mitch on September 2, 2001, at 0:44:05
In reply to Help - Could this be akathasia?, posted by vince on September 1, 2001, at 19:16:55
> Could this be akathasia that I'm experiencing with Geodon. When I try to cut back on the Neurontin I start feeling really anxious. I can't quit pacing and I feel all up tight inside. Sometimes I even feel this way when I'm taking Neurontin. At first I thought it was all related to Neurontin withdrawal, but now I'm wondering if the Neurontin was the only thing that was treating the akathasia caused by the Geodon.
>
> If this is the case, how fast should I try to get off the Geodon without causing withdrawal problems. I can't really take this feeling any more. I want to just drop Geodon as fast as I can to see if the feeling will go away!
>
> VinceOh yes, it sounds quite classic. You can get some OTC Benadryl to treat the restlessness (and some diazepam helps too, if you got it). Start withdrawing the Geodon and add some Benadryl (25mg 3x day). Don't worry too much about *withdrawal* from the Geodon-unless of course you were taking it primarily to stop psychotic symptoms (hallucinations, etc.) I remember the most horrific restlnessness in my life was from one tab of Haldol someone gave me back in the early 80's to calm me down from an early mixed state I had-and it was horrible-I couldn't get comfortable anywhere! All I could do was shuffle, and shuffle. And then the next day-dystonia-I couldn't walk for 12 hours!
Posted by Tony P on September 2, 2001, at 1:32:26
In reply to Re: Help - Could this be akathasia? » vince, posted by Chris A. on September 1, 2001, at 23:14:33
I'm not familiar with the term akathasia (although I'm sure familiar with anxiety < bg >) - anyone care to enlighten me?
Chris A's description of "wanting to jump out of his skin" makes me think of my bad experience with Remeron. Although it did indeed sedate me, at the same time I felt incredibly restless - I would fall asleep for a minute or less, then wake with that intolerable sensation of just HAVING to move. I would kick and jerk about to try and get relief. It was like restless leg syndrome over my entire body, or an internal itch that there's no way to scratch.
Is this the same as, or related to "akathasia"? It would be nice to have a word for it, since it seemed to be quite an unusual side effect for this med., although I have since seen one other posting from someone who had a similar reaction. I
also notice the product info now mentions "restless leg" as a posssible side effect. That, to me, rates as the understatement of the year! It would also be useful to have a word so that if I saw the term in the list of side effects of a med I could cross it instantly off my personal list.Tony P
> Yes, particularly if the feeling is different from the anxiety/panic you've experienced in the past. I had to quit Geodon at day twelve because I felt like jumping out of my skin. It was unbearable to sit still, similar to the pacing you mentioned. At the same time I was exhausted, but trying to rest didn't work either. My husband said I was acting very strangely. As far as reducing the dose, talk to your pDoc first if at all possible. My dosage was still low and getting off was a relief. It was disappointing because I had high hopes that it would be the ideal medication for me. It didn't occur to me that it was akithasia until later. It was new to me.
>
> Blessings,
>
> Chris A.
>
> > Could this be akathasia that I'm experiencing with Geodon. When I try to cut back on the Neurontin I start feeling really anxious. I can't quit pacing and I feel all up tight inside. Sometimes I even feel this way when I'm taking Neurontin. At first I thought it was all related to Neurontin withdrawal, but now I'm wondering if the Neurontin was the only thing that was treating the akathasia caused by the Geodon.
> >
> > If this is the case, how fast should I try to get off the Geodon without causing withdrawal problems. I can't really take this feeling any more. I want to just drop Geodon as fast as I can to see if the feeling will go away!
> >
> > Vince
Posted by Mitch on September 2, 2001, at 10:27:53
In reply to Re: Help - Could this be akathasia?, posted by Tony P on September 2, 2001, at 1:32:26
> I'm not familiar with the term akathasia (although I'm sure familiar with anxiety < bg >) - anyone care to enlighten me?
It just means "restlessness-unable to sit still".
Usually associated with a lot of pacing and shuffling about/agitation.>
> Chris A's description of "wanting to jump out of his skin" makes me think of my bad experience with Remeron. Although it did indeed sedate me, at the same time I felt incredibly restless - I would fall asleep for a minute or less, then wake with that intolerable sensation of just HAVING to move. I would kick and jerk about to try and get relief. It was like restless leg syndrome over my entire body, or an internal itch that there's no way to scratch.I think that is the drug (Remeron) blocking the alpha2-adrenoreceptor (associated with norepinephrine-not directly with dopamine). This can cause muscle weakness/dizziness in people (asthenia). I have also heard of people that are about to fall asleep on Remeron and also have this "sudden-wake-up episode" accompanied by racing heartbeat. That is really wild because when I was taking a TCA (doxepin) a long time ago the same thing happened to me. I can't tolerate more than a tiny dose of Remeron-but I like it for sleep. There is something that Remeron does that is unique with regard to levels of consciousness/dreaming. I can wake up and do things for up to an hour and misplace stuff and have total amnesia about what I did.
>
> Is this the same as, or related to "akathasia"? It would be nice to have a word for it, since it seemed to be quite an unusual side effect for this med., although I have since seen one other posting from someone who had a similar reaction.I suppose it is possible, but I think they are two different things. Remeron doesn't block dopamine receptors (which can result in a specific type of restlessness related to antipsychotics). I think the similarities have to do with the prominent antihistamine drowsiness draped on top of the med that make you so sedated while at the same time you have this norepi enhancement taking place at the same time-like you were on stimulants and depressants at the same time. Kind of like a "wired-foggy" feeling. Antipsychotics like Geodon, etc. also have prominent antihistamine effects as well.
> I also notice the product info now mentions "restless leg" as a posssible side effect. That, to me, rates as the understatement of the year! It would also be useful to have a word so that if I saw the term in the list of side effects of a med I could cross it instantly off my personal list.
Interesting how people can react so differently to meds.
>
> Tony P
Posted by Vince on September 3, 2001, at 19:16:10
In reply to Re: Help - Could this be akathasia? » vince, posted by Mitch on September 2, 2001, at 0:44:05
> > Could this be akathasia that I'm experiencing with Geodon. When I try to cut back on the Neurontin I start feeling really anxious. I can't quit pacing and I feel all up tight inside. Sometimes I even feel this way when I'm taking Neurontin. At first I thought it was all related to Neurontin withdrawal, but now I'm wondering if the Neurontin was the only thing that was treating the akathasia caused by the Geodon.
> >
> > If this is the case, how fast should I try to get off the Geodon without causing withdrawal problems. I can't really take this feeling any more. I want to just drop Geodon as fast as I can to see if the feeling will go away!
> >
> > Vince
>
> Oh yes, it sounds quite classic. You can get some OTC Benadryl to treat the restlessness (and some diazepam helps too, if you got it). Start withdrawing the Geodon and add some Benadryl (25mg 3x day). Don't worry too much about *withdrawal* from the Geodon-unless of course you were taking it primarily to stop psychotic symptoms (hallucinations, etc.) I remember the most horrific restlnessness in my life was from one tab of Haldol someone gave me back in the early 80's to calm me down from an early mixed state I had-and it was horrible-I couldn't get comfortable anywhere! All I could do was shuffle, and shuffle. And then the next day-dystonia-I couldn't walk for 12 hours!
Thanks for your help. I'm only on 80mg of Geodon, and the inner tension is killing me? The one thing that seems to help the most is neurontin. Benzo's help but leave me extremely depressed when they wear off. How do you know about the benadryl? Are you sure that it's safe.Do you think it is better just to stop taking the medication that is causing the akathasia? Or should I taper down. It seems to me that the affects of akathasia have to be worse than most withdrawals but I don't know, I was told that Geodon is a very powerful anxiolic, if so you would think that it would have strong anxiety withdrawals like benzo's. That's why I'm so confused about what is going on and what I should do. Vince
Posted by Mitch on September 3, 2001, at 23:35:20
In reply to Re: Help - Could this be akathasia? » Mitch, posted by Vince on September 3, 2001, at 19:16:10
> Thanks for your help. I'm only on 80mg of Geodon, and the inner tension is killing me? The one thing that seems to help the most is neurontin. Benzo's help but leave me extremely depressed when they wear off. How do you know about the benadryl? Are you sure that it's safe.
It's just an over-the-counter antihistamine that has been around forever. The anti-cholinergic effects are what reverses the EPS (restlessness, akathisia).
>
> Do you think it is better just to stop taking the medication that is causing the akathasia? Or should I taper down. It seems to me that the affects of akathasia have to be worse than most withdrawals but I don't know, I was told that Geodon is a very powerful anxiolic, if so you would think that it would have strong anxiety withdrawals like benzo's. That's why I'm so confused about what is going on and what I should do. VinceThis is what I would do:
1) Take 25mg of Benadryl now, and then start tomorrow taking 25mg of Benadryl every 4-6 hours or so. The Benadryl will also have some sedative effect that should offset most of the anxiety surrounding the restlessness as well.
2) Right now leave a message to your pdoc on their machine or whatever telling them what you are doing and why, ask for an appointment ASAP to discuss these issues, or at least request they call you tomorrow early as they can to advise you on what to do.
3)If you were being treated with Geodon for psychotic symptoms (hallucinations, delusions, etc.) continue to take the Geodon as prescribed along with your other meds.
Otherwise, if you want to attempt to reduce the dose, skip a dose, or just stop the Geodon that is up to you.
Hope this gets straightened out soon, it is pretty scary when this crap happens but it usually resolves fairly quickly. If you really feel that it is an emergency go to an ER and tell them what the hell is going on, they will know what to do. When I had the EPS from the Stelazine (the first time it happened to me), I was at home eating dinner and everything was fine. I was eating dinner with my parents, was feeling unusually panicky for some reason, and I started having muscle spasms really bad. My mom freaked thought I was having a seizure. They took me down to the ER, gave me an intravenous shot of Benadryl and it resolved rapidly. They sent me home with a Benadryl script, and I stayed out of school for two days.
You'll be ok!
This is the end of the thread.
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