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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by psychobot5000 on July 5, 2009, at 16:18:26
Hi all,
What is current thinking on the use of Geodon for hypodopaminergic depression, specifically as regards dosage?
I have severe, hypodopaminergic depression, and currently take 10mg Geodon b.i.d., which has offered some substantial relief for a number of symptoms--anxiety, difficulty concentrating; it's also activating and raises my mood modestly (I would strongly recommend it to other depressives out there). My question is this: since 20mg per day in divided doses has been helpful, it's hard not to think about pushing the dose to 30mg or 40mg, though presumably there will be a ceiling somewhere, where the drug becomes more antipsychotic and less helpful...and it has not escaped my notice that every increase in dose presumably inreases the likelihood of getting various nasty antipsychotic side-effects, even aside from the possibility it might blunt the antidepressant through counterproductive mechanisms like D2-blocking.
So how high is too high? When is the dose likely to become counter-productive? Is there reason to believe 10mg t.i.d or 20 mg b.i.d will be more (or less) helpful than 10mg b.i.d? It's very hard for me to do a comparison, as any increase in dosage will (for me) temporarily elevate my mood for a few weeks, before it settles into its new baseline, whether that new long-term baseline is higher or lower--and in that timeframe, other factors of life come into play which add a lot of noise to the experiment.
I'd very much appreciate any thoughts people have on the subject (and hey, all you anhedonic depressives with difficulty concentrating and low-motivation out there: you might want to give very low-dose Geodon a shot)
Be well,
Psychbot
Posted by Phillipa on July 5, 2009, at 16:29:37
In reply to Low-dose (but how low?) Geodon for depression, posted by psychobot5000 on July 5, 2009, at 16:18:26
I didn't know low doses were used for depression. Phillipa
Posted by SLS on July 5, 2009, at 16:48:27
In reply to Low-dose (but how low?) Geodon for depression, posted by psychobot5000 on July 5, 2009, at 16:18:26
I think the "sweet spot" for using Geodon for depression is 40mg. 20mg might actually make you feel dysphoric and anxious. There is such a thing as going too low with this drug. 40-80mg is about right.
Good luck.
- Scott
Posted by Phillipa on July 5, 2009, at 19:57:52
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by SLS on July 5, 2009, at 16:48:27
Scott as usual just learned something from you didn't know. Thanks Phillipa
Posted by psychobot5000 on July 5, 2009, at 21:40:00
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by SLS on July 5, 2009, at 16:48:27
> I think the "sweet spot" for using Geodon for depression is 40mg. 20mg might actually make you feel dysphoric and anxious. There is such a thing as going too low with this drug. 40-80mg is about right.
>
> Good luck.
>
>
> - ScottI appreciate the advice, Scott. Thanks.
Posted by porkpiehat on September 3, 2015, at 15:07:02
In reply to Re: Low-dose (but how low?) Geodon for depression » SLS, posted by psychobot5000 on July 5, 2009, at 21:40:00
I know this is an old post but I'm feeling desperate and I've never tried Geodon, but I have it in my drawer :)
What does ended up working for you? At lower doses does it have ANY of the better AAP qualities like diminishing negative symptoms, hypervigilance, and paranoia?
I would have already started if I weren't afraid to start off at the wrong dose and miss sleep/work
Posted by psychobot5000 on September 5, 2015, at 19:51:18
In reply to Re: Low-dose (but how low?) Geodon for depression » psychobot5000, posted by porkpiehat on September 3, 2015, at 15:07:02
I do not ultimately consider the form of low-dose, 10mg bid geodon treatment regimen discussed in this thread as to have been successful.
Nothing ended up working, in answer--no, I don't think it does do anything for negative symptoms--though it was never tested against proper antipsychotic negative symptoms, since this is a post on its monotherapy in Depression, thus, I have no idea what its effects on AP negative symptoms.
Posted by herpills on September 6, 2015, at 17:57:13
In reply to Re: Low-dose (but how low?) Geodon for depression » porkpiehat, posted by psychobot5000 on September 5, 2015, at 19:51:18
I tried Geodon at 40-60mg for a couple months...did nothing for my depression symptoms. It was helpful in stopping a "mixed state" that I was in, worked very quickly for that...but I think as an antidepressant Geodon isn't that great.
Have you tried any other antipsychotics for your depression? Seroquel and Latuda both can act as antidepressants...Saphris might be worth trying as well. herpills
Posted by psychobot5000 on September 7, 2015, at 1:15:20
In reply to Re: Low-dose (but how low?) Geodon for depression » psychobot5000, posted by herpills on September 6, 2015, at 17:57:13
I have but without success--and given the drugs' toxicity, I'm not inclined to try again. ECT first, I suppose. Others may have better luck.
Posted by SLS on September 7, 2015, at 7:29:47
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by psychobot5000 on September 7, 2015, at 1:15:20
> I have but without success--and given the drugs' toxicity, I'm not inclined to try again. ECT first, I suppose. Others may have better luck.
You have tried Saphris already? What was your reaction to it? It produces significant antidepressant effects for some people, although perhaps not as monotherapy.
- Scott
Posted by psychobot5000 on September 7, 2015, at 14:03:36
In reply to Re: Low-dose (but how low?) Geodon for depression » psychobot5000, posted by herpills on September 6, 2015, at 17:57:13
> I tried Geodon at 40-60mg for a couple months...did nothing for my depression symptoms. It was helpful in stopping a "mixed state" that I was in, worked very quickly for that...but I think as an antidepressant Geodon isn't that great.
Yup. Agreed!
>
> Have you tried any other antipsychotics for your depression? Seroquel and Latuda both can act as antidepressants.Allegedly they can. I have--tried probably tried all of the remotely psych meds on the American market, including AAP adjuncts. Whatever their efficacy in trial may not be measuring properly, and can relieve a lot of something...or create it. AAPs are not as safe as we were left to believe (I never really believed it but, with an element of randomnness in how severe and when, it destroys your brain. Nothing that could be reinstructed. Might affect you one day, might not.
Other more reliable combos: two antidepressant, using a modern atypical antidepressant, or a tricyclic, should both be used. After you've failed twice with established tryciclics. Plus, amphetamine (adderally)--which is a much-better established treater of depression than any AAP. Trial that, first.
That said, Latuda seems to have some unique properties. But it's an antipsychotic, so...not a dose more of it for me.
Posted by psychobot5000 on September 7, 2015, at 14:14:37
In reply to Re: Low-dose (but how low?) Geodon for depression » psychobot5000, posted by SLS on September 7, 2015, at 7:29:47
first, I suppose. Others may have better luck.
>
> You have tried Saphris already? What was your reaction to it? It produces significant antidepressant effects for some people, although perhaps not as monotherapy.
>
>
> - ScottThanks for the tip--I haven't tried saphris, yet. No. I've stopped following medications--they all seem to be uncreative copy-cats in the same family as X. But, no, I haven't tried that, not yet. Sorry.
Posted by Lamdage22 on September 9, 2015, at 6:34:03
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by psychobot5000 on September 7, 2015, at 1:15:20
Do you know the risks and side effects of ECT and how frequent they are?
Posted by Jeroen on September 13, 2015, at 16:39:46
In reply to Re: Low-dose (but how low?) Geodon for depression » psychobot5000, posted by porkpiehat on September 3, 2015, at 15:07:02
not approved in belgium for TD and dystonia risk and cardiac issues
Posted by porkpiehat on September 13, 2015, at 19:20:36
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by Jeroen on September 13, 2015, at 16:39:46
Does this have a higher rate of TD/side effects than other AAP's?
How does it perform for borderline and social anxiety and concentration issues?
Posted by psychobot5000 on September 13, 2015, at 19:26:59
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by Lamdage22 on September 9, 2015, at 6:34:03
A few opinions, unfortunately. What's your opinion on the subject of ECT risk? The current medical opinion seems to be mostly unchanged--nonspecialists who are uneasy with it--vs the specialist, who claims that since a single old woman's brain was examined after having undergone hundreds of treatments, and no post-mortem STRUCTURAL damage could be found, then everything is fine. So the only recent change I've noticed is that practitioners have continued along the road to claiming that their new settings make it magic fairy dust and any cognitive or even memory damage just doesn't exist.
Of course, then there's your average patient who's been treated with ECT--definitely unscientific data, but there are a few too many people shouting to stay the hell away from it, it shredded ten years of my life, don't let them put you in that chair, man...for me to ignore. I suppose they could just want attention--but if that's the case, why don't other people with treatment failures behave this way?
Posted by Lamdage22 on September 15, 2015, at 7:06:24
In reply to Re: Low-dose (but how low?) Geodon for depression » Lamdage22, posted by psychobot5000 on September 13, 2015, at 19:26:59
Its your call.
I cant do more than warn you. I do so because i have seen many patients.
Maybe they did the ECT for attention in the first place??
Posted by Lamdage22 on September 15, 2015, at 7:20:07
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by Lamdage22 on September 15, 2015, at 7:06:24
The question is: Should you trust what you call "the science behind it"?
Posted by Lamdage22 on September 15, 2015, at 10:44:34
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by Lamdage22 on September 15, 2015, at 7:20:07
Should you trust what "experts" say.
I certainly dont and thats my opinion about it. I have never met anyone who said "thank god i did ECT".
Which is an outcome you would want i suppose.I only believe what i see. And i saw 10 out of 10 people who had rather not done it.
The results ranged from "i forget where i put my keys all the time" to "i am disoriented in my own hometown". Some temporarily, some permanent. None of them where "healed" by any stretch.
Placebo effect is pretty big i think. I have caught myself being well on a med that i thought was doing anything. But it didnt. It could have been a sugar pill.
Trust in the mental health industry rarely pays off. I can only think of Ace here on this board and he is an exotic.
Posted by Lamdage22 on September 15, 2015, at 11:11:45
In reply to Re: Low-dose (but how low?) Geodon for depression, posted by Lamdage22 on September 15, 2015, at 10:44:34
It is like gambling.. usually the bank wins and you are better off looking somewhere else for your money. Id say odds 1 to 10 that you are going to be better off with ECT. Only you wouldnt gamble with possessions here, youd gamble with your mental wellbeing.
What is going on other than meds? Any room for improvement there? There always is.
This is the end of the thread.
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