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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 4WD on June 21, 2008, at 12:30:52
I was recently in the hospital because I fell (fainted) in the middle of the night (due to nardil and low blood pressure spell) and had a compression fracture to my spine. While in the hospital they did a routine EKG and discovered that my QT interval is prolonged. I know it is from the Geodon (80mg a day total)because I had the EKG before going on it and it was normal then. I don't know how prolonged it is - I will find out when I see my internist next week but I looked it up on Google and it sounds like a very scary problem.
My question is this. Do I discontinue a medication which is helping me greatly and risk sudden death from afibrillation or do I stop the Geodon (after suitable tapering) and go back to not sleeping well, waking up scared and feeling more depressed and anxious?
I will know more when I request a new EKG from my doctor next week but in the meantime I am quite scared. I don't know what to do. Is this as serious as what I read? How likely am I to develop an abnormal heart rhythm? My pdoc didn't seem too concerned about it when I told him but then his focus is not on my physical health; it is on keeping me out of depression and anxiety.
Is a prolonged QT interval something I can live with? Or should I stop the Geodon? Please, somebody give me some advice.
Marsha
Posted by Phillipa on June 21, 2008, at 13:17:03
In reply to Prolonged QT interval from Geodon, posted by 4WD on June 21, 2008, at 12:30:52
Let me do some more research as I'm sure there are meds for it. Some of the TCA's Do the same so there must be an answer Love Phillipa
Posted by Jeroen on June 21, 2008, at 13:40:30
In reply to Prolonged QT interval from Geodon, posted by 4WD on June 21, 2008, at 12:30:52
yea this geodon sh*t gave me brain damage
this might not sound positive but its the truthbe carefull with this crap, it might just give you the sudden death side effect i ignored seems
Posted by Phillipa on June 21, 2008, at 14:03:48
In reply to Prolonged QT interval from Geodon, posted by 4WD on June 21, 2008, at 12:30:52
Marsha geodon can cause it and the med looks like it should be changed. Google Dr Bob QT interval Lar lists drugs. My search was Meds to treat QT interval. Love Phillipa
Posted by 4WD on June 21, 2008, at 14:03:50
In reply to Re: Prolonged QT interval from Geodon » 4WD, posted by Phillipa on June 21, 2008, at 13:17:03
> Let me do some more research as I'm sure there are meds for it. Some of the TCA's Do the same so there must be an answer Love Phillipa
I read that beta blockers can help with heart arrythmias. So maybe that's what I'll do. I'll leave it up to the doctor whether to try that or not.
marsha
Posted by yxibow on June 21, 2008, at 18:13:51
In reply to yea this geodon sh*t gave me brain damage, posted by Jeroen on June 21, 2008, at 13:40:30
> yea this geodon sh*t gave me brain damage
> this might not sound positive but its the truth
>
> be carefull with this crap, it might just give you the sudden death side effect i ignored seems
It is distinctly not positive to a poster and I won't say anything about the truth.
Jeroen, I wrote a posting earlier about generalizing. Again, yes, you have had some unfortunate experiences both with medication and with mental illness, which we have all shared, and you have perhaps in your mind or may very well be 200% true , since I am not your doctor, these one line posts can scare people who are NOT in your situation and who may BENEFIT from medication when it OUTWEIGHS the RISKS.Now here we have a risk scenario. So someone can easily be scared more.
And Geodon doesn't give someone "brain damage" any more than any other psychotropic.
Neurological consequences, maybe, in some rare situations, but that isn't brain damaged or you wouldn't be speaking here. Brain damage is an organic condition, like a stroke.
That's a little polemical. And yes -- we also all have felt psychological polemical too.
Posted by yxibow on June 21, 2008, at 18:36:01
In reply to Prolonged QT interval from Geodon, posted by 4WD on June 21, 2008, at 12:30:52
> I was recently in the hospital because I fell (fainted) in the middle of the night (due to nardil and low blood pressure spell) and had a compression fracture to my spine. While in the hospital they did a routine EKG and discovered that my QT interval is prolonged. I know it is from the Geodon (80mg a day total)because I had the EKG before going on it and it was normal then. I don't know how prolonged it is - I will find out when I see my internist next week but I looked it up on Google and it sounds like a very scary problem.
>
> My question is this. Do I discontinue a medication which is helping me greatly and risk sudden death from afibrillation or do I stop the Geodon (after suitable tapering) and go back to not sleeping well, waking up scared and feeling more depressed and anxious?
>
> I will know more when I request a new EKG from my doctor next week but in the meantime I am quite scared. I don't know what to do. Is this as serious as what I read? How likely am I to develop an abnormal heart rhythm? My pdoc didn't seem too concerned about it when I told him but then his focus is not on my physical health; it is on keeping me out of depression and anxiety.
>
> Is a prolonged QT interval something I can live with? Or should I stop the Geodon? Please, somebody give me some advice.
>
> Marsha
Combining the two medications can give a moderate CNS depressant effect. But that does not sound what happened.Remember, if there was any food consumed that affected the Nardil, heart effects can also occur.
Geodon was returned to the market after a 4000 patient double blind trial and noted to be again, at a low QTc interval risk. Mellaril has a much higher one and to my knowledge is still out there, I'm not sure.
But 80mg is a high amount of Geodon, if I recall so that could raise the bar.
You also noted that there was a low blood pressure spell. When there is a low blood pressure incident, falling is (obviously) quite possible and some atypicals have more of a risk of this --
Geodon is less than Zyprexa and Seroquel but it does have dizziness as a side effect too.I'm not particularly familiar with Nardil, but there could be a risk there too.
Once you went to the hospital, the QTc could have, as they say, correlation is not always causality, gone awry because of sheer terror. But this was probably factored in to the equation by the doctors there.
Yes, you do not want torsades de pointes, the major high risk issue of Geodon. It is somewhere in the 1/4000 range -- there are warnings about it, it is true.Regular EKGs are still recommended with Geodon.
I believe this is an issue that possibly a cardiologist might need to examine or consult with your doctor.
Did you have a consultation with one in the hospital?
Even if there was an agent out there to take to continue with Geodon -- a beta blocker is not one of them, only sotalol possibly, you are talking major heart medications, like amiodarone and the like which have their own serious side effects and are meant for heart patients.
In a way, its like trying to avoid serotonin syndrome with 6 serotonergic medications stacked on top of each other and some "magic drug" to stop it.
So -- perhaps I have not assured you, I'm just trying to describe it a little more scientifically. If your own psychiatrist, who has also gone to medical school, has told you that it isn't a concern then maybe it isn't. But you don't seem convinced.In the meanwhile with the new EKG, and I don't know how to tell you otherwised -- I can't say "dont feel scared", because you are and who wouldn't be? -- try to minimize stress, which can be an inducer to any syndrome.
The elonged QTc could be due to a super exaggeration of something faintly organic already existing, or it could be a one-off event that doesn't occur again.
In the final run, if Geodon has created a msec (QTc value) different now, then I would say, despite how much it has helped you, critical organic parts of you outrule psychotropics. You may have to find a balance of another atypical, even if it hasn't been as effective or has other side effects that you don't desire.The body as a whole has to be in some reasonable sync and reasonable evidence based medical opinion, if that sounds holistic, it doesn't mean to be one way or the other, its just common sense.
Take care and best wishes
-- Jay
Posted by 4WD on June 21, 2008, at 21:02:46
In reply to Re: Prolonged QT interval from Geodon » 4WD, posted by yxibow on June 21, 2008, at 18:36:01
Thank you for your considerate and well thought out post. I appreciate the information. I have been unable to take any other atypical or have not had good results.
The fainting was, I believe, definitely from the Nardil. I have had blood pressure issue since week 10 or so on Nardil. But I am willing to tolerate it. Nardil gave me my life back and I'm not giving it up. Geodon helps to some extent, well, to a great extent but if I had to give up one of them, it would be Geodon.
What I have decided to do is lower my Geodon dosage from 80 to 60 mg day in the meantime until I can talk to my doctor and find out just how severe the QT prolongation is. If it is mild, I will live with it. If it is, severe, I will get off the Geodon, with suitable tapering.
In any case I can't stop it right now anyway. I have been on Percocet for 10 days and switched this afternoon to Darvocet. I anticipate a rough couple of days as I make the transition. The Percocet really made me feel good. The Darvocet has no CNS effects that I can tell- no warm fuzzy, "everything is great" lots of energy feeling that I got from Percocet. So I have enough on my plate for the next few days just making that transition
I am going to see an old doctor tomorrow who has done a lot psychiatric prescribing and is highly intelligent and well versed in psychiatric meds. I am going to find out what he says and then see my internist next week. After all that I should be able to weigh the benefits versus risks and make an informed decision.
I skipped the Geodon last night and woke up this morning feeling rather rough. Actually my dosage is fairly low. According to SLS's chart, dosage range for Geodon is 40-120 mg.
Thanks for your post.
Marsha
This is the end of the thread.
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