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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by HMK on March 11, 2002, at 13:53:11
I've posted several questions about Geodon on this website and here's another. I'm having a horrible time sleeping ever since I've started taking it. I take a fair dose- 40 mg. twice a day and feel like it's regulating my mood fine but I can't sleep??
Has anyone else had the same symptom initially and had it later wear off? I really want to stick with this medicine, especially if I know other people have had this side effect taper off with time. Thanks!
Posted by xjs7 on March 11, 2002, at 16:00:42
In reply to GEODON: does anyone sleep on this stuff?, posted by HMK on March 11, 2002, at 13:53:11
Hi HMK,
I never experienced sleeplessness when I started Geodon about five months ago. In fact sleeplessness is one of the many symptoms that I use Geodon to treat. I also use the benzodiazepine lorazepam for sleeplessness; you might want to ask your doctor about an adjuctive benzodiazepine if you don't already have one. It is known that because of Geodon's action on seratonin some initial anxiety can occur with Geodon use; perhaps this initial anxiety is causing your sleeplessness, in which case an anti-anxiety medication might be very useful.
You don't say (in this post at least) how long you've been taking the ziprasidone, and what your other medications are. It's possible that your sleeplessness is not related to the Geodon, and is instead a sign of impending trouble with your condition--I really can't say from your post. These things are complicated.
I also take a substantial dose of Geodon, and after five months the side effects have almost all gone away. I have found the Geodon to be a very gentle medication. I hope it works out for you too, and you manage to get some good sleep soon.
xjs7
> I've posted several questions about Geodon on this website and here's another. I'm having a horrible time sleeping ever since I've started taking it. I take a fair dose- 40 mg. twice a day and feel like it's regulating my mood fine but I can't sleep??
>
> Has anyone else had the same symptom initially and had it later wear off? I really want to stick with this medicine, especially if I know other people have had this side effect taper off with time. Thanks!
Posted by Hawkeye on March 12, 2002, at 21:54:14
In reply to GEODON: does anyone sleep on this stuff?, posted by HMK on March 11, 2002, at 13:53:11
Hi,
I have been taking Geodon for several months and have had similar sleep problems. I take Trazadone as a sleeping pill (I have done so for many years). Now I find that the trazadone is not enough (I take 100 mg at bedtime). I have had to self-medicate with a fairly large dose of Kava at bedtime in addition to the Trazadone. It does seem to work.
I had an appointment with my psychiatrist today. He meets with the Pfizer Rep. approximately once a month. He says that according to the Pfizer Rep, at lower doses Geodon is more energizing. At the higher range of dosing, it is more sedating. For those who experience anxiety, restlessness and/or sleeplessness, Klonopin is said to be effective. I am taking 40mg twice a day. This is in the middle of the range.
Antipsychotic responses are generally from a dose starting at 30mg twice per day. (there is conflicting evidence of its effectiveness at a dose of 20 mg twice per day.) Antidepressant responses have been documented at 40mg twice per day and at 80 mg twice per day.
I am bi-polar with recurrent, treatment-resistant depression predominant. (I have tried everthing). I believe that the Geodon has been a very effective antidepressant FOR ME at 40 mg. twice per day. But remember, EVERYONE IS DIFFERENT and you are going to have to experiment to find the most effective overall dosage FOR YOU.
Hopes this helps.
Posted by SLS on March 13, 2002, at 11:42:23
In reply to The inside poop on GEODON dosage., posted by Hawkeye on March 12, 2002, at 21:54:14
> I am bi-polar with recurrent, treatment-resistant depression predominant. (I have tried everthing). I believe that the Geodon has been a very effective antidepressant FOR ME at 40 mg. twice per day. But remember, EVERYONE IS DIFFERENT and you are going to have to experiment to find the most effective overall dosage FOR YOU.
>
> Hopes this helps.Hi Hawkeye.
I'm glad to see that Geodon has been helping you. I, too, suffer from treatment-resistant bipolar depression. I tried Geodon for a few weeks, but could not increase the dosage beyond 40mg/day without feeling like a zombie. The thing is, it was starting to help. I had the same experiences with Risperdal and Zyprexa. I hung in there for a few weeks with each, but the cognitive side effects did not lessen.
Any thoughts?
Thanks.
- Scott
Posted by petters on March 14, 2002, at 2:23:08
In reply to Re: The inside poop on GEODON dosage. » Hawkeye, posted by SLS on March 13, 2002, at 11:42:23
Dear Scott.
So nice to see you are back. I really hope that you not feeling to badly for the moment.
Have you make an trial on citalopram yet?
I am a bit depressed for the moment. You know it is spring now in my country, and my depression always get worser in these period of time.
I have replaced the mirtazapin, with nefazodene because of the side effect. Nefazedon was great in the beginning, but pooped out after a week or two. I know you also have this problem, with severel meds.
Advantages for me with mirtazapin:
Very good for sleep.
Good for sexual side effect from venlafaxin. It also raise the libido as well.Advantages nefazodone:
No weigt gain
Better for small amount of social phobia, that I have from the former mix.Disadvantages:
Remeron cause weight gain.
The main reason for stop it was reccurent infections. I had approximately 4 infections per year. Sore throat, Sinut etc despit normal bloodcells. Cortisol level up?? Hypotesis. I don´t think it is the venafaxin, because i had it as a mono terapi for one year without this pattern
Photophobia? And sun sensetiveNefazodone cause cognetive disturbance. Especially memory disturbance. Not so good for sleeping as Remeron. I have to take propiomazin as an add on to nefazodone. Not so good for sexual side effect as Remeron. Especially desire.
Any thoughts of replacing Serzone with?
It´s a crual joke with this poop out. I definitely think I`m a rapid metabolizer, because I tolerated high dosage.My current mix:
T. Litium
T. Lamictal 100 mg
T. Effexor 300 mg
T. Serzone 400 mgI really hope you stay well.
Sincerely
Petters
Posted by SLS on March 15, 2002, at 7:04:36
In reply to Re: The inside poop on GEODON dosage.))) SLS, posted by petters on March 14, 2002, at 2:23:08
Hi Petters.
> So nice to see you are back. I really hope that you not feeling to badly for the moment.
I received your email. I’m sorry that I haven't responded to it yet. I have felt a little better the past few days, so I'll write to you soon.
> Have you make an trial on citalopram yet?
I haven't tried it yet. I must first try combining imipramine + venlafaxine. It is logical, although I am not expecting miracles. I spent too much time with nortriptyline + venlafaxine. Nortriptyline produced episodic improvements, but no single dosage worked for more than a few days. 75mg is too low and 100mg is two high. There is no therapeutic window for me. My doctor claims that this is the case in as much as 20% of people. That is a huge number. I have never seen any published statistics regarding this.
> I am a bit depressed for the moment. You know it is spring now in my country, and my depression always get worser in these period of time.
Have you ever tried light therapy? Some people with seasonal affective disorder (SAD) exhibit a cycle that is reversed from the typical case.
> I have replaced the mirtazapin, with nefazodene because of the side effect. Nefazedon was great in the beginning, but pooped out after a week or two. I know you also have this problem, with severel meds.
Can you get memantine from Germany? Some people on Psycho-Babble think that memantine might help prevent antidepressant poop-out (tachyphylaxis). Like amantadine, it works to modulate NMDA receptors. It also has neuroprotective properties.
> Nefazodone cause cognetive disturbance. Especially memory disturbance. Not so good for sleeping as Remeron. I have to take propiomazin as an add on to nefazodone. Not so good for sexual side effect as Remeron. Especially desire.
> Any thoughts of replacing Serzone with?
I forget what drugs you have tried. Do you want to block 5-HT2a receptors? The atypical neuroleptics (aripiprazole, risperidone, olanzapine, ziprasidone) are potent antagonists at these receptors. They might be worth trying at low dosages.
Atypical Neuroleptic Binding Profiles:
http://sl.schofield3.home.att.net/medicine/aripiprazole_binding.pdf
Also, there is a drug named ritanserin that is a very selective "clean" 5-HT2a antagonist that has remained experimental for a long time. Maybe it is available in Europe or Japan. I don't know. I doubt it, though. Eastern (Sufrexal, Aseranox, Ketensin, Ketanserina, Perketan, Serepress) is also a 5-HT2a antagonist, but it has more side effects. It is available in Europe and it is used to treat hypertension.
> mirtazapin:
> The main reason for stop it was reccurent infections. I had approximately 4 infections per year. Sore throat, Sinut etc despit normal bloodcells. Cortisol level up?? Hypotesis. I don’t think it is the venafaxin, because i had it as a mono terapi for one year without this pattern
When I first began taking Lamictal, I experienced a persistent sore throat. Blood tests, throat culture, and endoscopic examination were all negative. It lasted for about six months, then it disappeared. I haven't had any recurrences over the last 4 or 5 years. Lamictal continues to produce dandruff (flaking dry scalp) and patches of dry, red scabbing skin on my face. Shampoos containing zinc pyrithione prevent the dandruff and moisturizing skin creams help with the facial dryness.
> It? a crual joke with this poop out.
YES.
> I definitely think I'm a rapid metabolizer, because I tolerated high dosage.
>
> My current mix:
> T. Litium
> T. Lamictal 100 mg
> T. Effexor 300 mg
> T. Serzone 400 mgI must take 300mg of Lamictal. When I try to reduce the dosage to 200mg., I lose the small benefit it gives me. (It only helps me when I take a tricyclic at the same time).
How much lithium are you taking? I am thinking about taking 300mg. I think it exerts neuroprotective and neurotrophic effects at this low dosage. Maybe it preserves or enhances neuroplasticity. I don't know.
Take care, Petters.
- Scott
Posted by JohnX2 on March 15, 2002, at 9:54:27
In reply to Re: The inside poop on GEODON dosage.))) SLS » petters, posted by SLS on March 15, 2002, at 7:04:36
>
> Can you get memantine from Germany? Some people on Psycho-Babble think that memantine might help prevent antidepressant poop-out (tachyphylaxis). Like amantadine, it works to modulate NMDA receptors. It also has neuroprotective properties.
>sorry to intercept. what is tachyphylaxis?
send me an email regarding this, if you care
for more information.best regards.
john
Posted by SLS on March 15, 2002, at 16:45:11
In reply to Re: The inside poop on GEODON dosage.))) SLS » SLS, posted by JohnX2 on March 15, 2002, at 9:54:27
> >
> > Can you get memantine from Germany? Some people on Psycho-Babble think that memantine might help prevent antidepressant poop-out (tachyphylaxis). Like amantadine, it works to modulate NMDA receptors. It also has neuroprotective properties.
> >
>
> sorry to intercept. what is tachyphylaxis?
>
> send me an email regarding this, if you care
> for more information.
>
> john_z_x2@yahoo.com
>
> best regards.
> john
http://www.dictionary.com/search?q=tachyphylaxis;-)
Posted by SLS on March 15, 2002, at 16:54:50
In reply to Re: The inside poop on GEODON dosage.))) SLS, posted by petters on March 14, 2002, at 2:23:08
I don't know where "Eastern" came from.
"Eastern (Sufrexal, Aseranox, ..."
Should be:
Ketanserin (Sufrexal, Aseranox, Ketensin, Ketanserina, Perketan, Serepress) is also a 5-HT2a antagonist, but it has more side effects. It is available in Europe and it is used to treat hypertension.
- Scott
Posted by JohnX2 on March 17, 2002, at 1:59:30
In reply to Re: The inside poop on GEODON dosage.))) SLS, posted by SLS on March 15, 2002, at 16:45:11
> http://www.dictionary.com/search?q=tachyphylaxis
>
> ;-)thanks. I suppose you want to wipe that word from your vocabulary! I usually use www.m-w.com.
John
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