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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by sheilac on August 14, 2011, at 12:23:51
I honestly feel more unstable and crazy on Geodon than ever. I hate the odd fact that at low doses this med makes me manic and so I'm supposed to go higher and higher on the dose. I take 80mg at night and it knocks me out. But when it wears off - watch out! I am hell to be around. This is terrible.
The answer is to take more of this weird drug that is making me crazy! 20mg during the day only lasts so long and then it wears off. Maybe that means I need 40mg during the day.
Now the doc says take Abilify during the day! That will probably be the same way.
Is just going back to low dose Lithium (450 - 600mg) worth the hair loss and weight gain?
At least when I used to pop 300mg of Lithium I felt a calm wash over me that was wonderful. And it kicked in pretty quick. So, isn't that the way out meds SHOULD work? Make us feel nice, calm, relaxed and reasonable instead of the psychosis that these antipsychotics are bringing on?
With the recent steroid injection these episodes are magnified on Geodon and I feel like I need more Geodon more often. At my current dose Geodon is making me manic again.
I'd rather dump the Geodon altogether - not be manic and deal with the slight depression and irritability! I hate myself right now.
Do I have to counter the mania Geodon gives me with the nice, warm feeling that Lithium gives me? Geodon has been a GREAT antidepressant.
This whole situation is crazy. I can't stand being in my own skin! I hate it.
I hate taking a drug that makes me manic and the answer is to "just take more". Hate it!
Posted by Phillipa on August 14, 2011, at 13:02:36
In reply to Feel crazy on antipsychotics!, posted by sheilac on August 14, 2011, at 12:23:51
I must have missed it or forgotten as so much bad stuff going on here but what was the steroid injection for and how long does it last for as some people get psych symptoms on them. Could that be the problem? Just thinking Phillipa
Posted by bleauberry on August 14, 2011, at 13:19:47
In reply to Feel crazy on antipsychotics!, posted by sheilac on August 14, 2011, at 12:23:51
Wow, I sure hear ya. That's my biggest problem with any new med or herb or supplement I try....getting trapped and it's hard to get out or know what to do. What an aweful place. I sure feel for you.
Well, since it has been good for your depression, at least that gives some hope that your brain is still capable of doing the job. The tricky part is figuring out how to tweek it similar to what geodon is doing, or to pinpoint the particular mechanism of geodon that is doing it.
I would guess the crazy bizarreness you are feeling is from the norepinephrine stimulation part of the med. It just sounds like being over-revved on adrenaline from within. Yeah? No? Maybe? I have often pondered that is maybe what is behind the akathisia associated with antipsychotics. I mean sure they block dopamine receptors and that is calming, they block serotonin receptors and that is calming, but they open up the flood gates for noradrenalin, which is manic-like, anxiety-like, nervous-like, or akathisia-like. Put it all together and that is one bizarre mix of emotions. What I experienced was that the dopamine and serotonin blocking would wear off, leaving all the excess NE completely unopposed.
I totally understand. In the latter stage of my years on zyprexa that happened to me. It was so calming and what a nice relief....I dosed it at 4pm, it kicked in by 6pm, nice smooth evening, great sleep, but oh my about 4am all hell broke loose....as if someone had shot adrenaline in my arm....and no amount of daytime zyprexa would make that go away. I literally had to burn off the excess noradrenalin through physical work or movement. It was a horrible, absolutely horrible, feeling. So I know it isn't helpful, but I just want you to know....been there done that it sucks!
I was thinking what would I do if I were in your shoes? Hmm. That is a tough one. For sure, no doubt, I would NOT be able to stay with it. I mean, even with the great antidepressant effect it has on you, the other crap is so bad as to not be able to function despite not being depressed. So what good is that? None. To me anyway. I mean, it is fairly predictable that even if geodon is a good antidepressant for you right now, it probably won't keep being that way in 2 years, 5 years, 7 years, whatever. So the last thing I want to do is get trapped even deeper in a hole because now I am not only on this bizarre med but also a couple others to deal with its side effects, and those themselves have their own side effects to compound my problems and they all mean I will have some bad withdrawals someday down the road. Just avoiding paying the price I will have to eventually pay, no escape.
But, that's just me. Someone else may feel differently. We all have to guide our own journeys.
The suggestion of abilify, well, I guess that kind of makes some sense. No way to tell without trying though. The hard thing about it is the dosing...akathisia/nervousness is common with it...more stimulating at lower doses...more calming at higher doses....but afraid to get trapped even deeper if it goes bad. Geez, I wish there was an easier way. Dang. I don't see, however, how abilify will dampen the excess norepinephrine stimulation, maybe make it worse.
The botanical route could be helpful, cheap, and easy. Much harder to get stuck in a 'trap'. For immediate help I would look at Lemon Balm tincture (not pills). Others that go good with it are PassionFlower and Valerian Root. There is a tea pretty good at this called Calm, made by Tazo. I think I got mine at Whole Foods Market.
Those will not stop the excess release of NE, but will dampen what has been released. To stop it, I would be thinking in terms of adaptogens, especially the more calming ones, such as Ashwaghanda.
I have seen some good things happen very frequently with Rhodiola, but never have I seen it combined with an AP so that is completely new territory to me. Maybe worth a look though. It's great for depression, more often than not, and at higher doses calming, primarily toning down excess NE.
And it might sound weird, but a NE reuptake inhibitor could help by bringing the feedback loops into play to act as governors preventing excess release. The only one I have personally experienced that can do that is milnacipran, but it comes with it about a week or so of worsened symptoms until the feedback loops kick in.
Until you can decide what to do, I would not hesitate to immediately seek some assistance from the plant medicines I mentioned. imo They all helped me through some really torturous times when I was on zyprexa. And actually, today, the botanical medicines I have pinpointed through trial and error that help me the most are outperforming any of the dozens of psych meds I ever took.
There is plenty of hope.
Posted by floatingbridge on August 14, 2011, at 16:16:40
In reply to Feel crazy on antipsychotics!, posted by sheilac on August 14, 2011, at 12:23:51
Sheila, I really don't know what to say or even have the knowledge base to work any coherent answer through.
Personally, I have been concerned since the geodon has been on board. I know it lifts you up, and goodness, that is worth quite a bit!, but the stability issue....
Your doc is o.k. with this, working out the dose and timing?
Hang in there, Sheila.
fb
Posted by sheilac on August 14, 2011, at 16:50:58
In reply to Re: Feel crazy on antipsychotics! » sheilac, posted by floatingbridge on August 14, 2011, at 16:16:40
Yea, my doc is ok with going higher and higher on the Geodon dosing. I just have a HUGE problem with the whole concept that Geodon will MAKE me manic until I reach 80mg at a time, and then it's awful when it wears off (daytime rage). And I worry about more NE (since that seems to be the problem) by adding Abilify during the day.
So far, Seroquel, Geodon and Abilify (and Effexor) have all caused mood instability unless I go really high on the dose (but then I gain weight). Too complicated. Maybe that is why this class of meds is good for schizophrenics more than bipolars.
So, really, what good is this med?
Maybe the doc made a mistake by dosing me low to begin with. Doc still thinks that most people get sleepy on Geodon and I do on 80mg, but at 40mg I was manic.
I can't imagine having to wean off this med in years to come. How do you go lower on a med when you know for a fact that a lower dose will make you manic?
Maybe going back to a tiny dose of Prozac with low dose Lithium and Klonopin is the way to go. At least I feel the relief with Lithium - even on lower doses. And Klonopin is only a quick fix, not a permanent stabilizer.
I guess it all boils down to the fact that I have a problem with NE? I just don't do well with the NE mania these antipsychotics give me.
Posted by floatingbridge on August 14, 2011, at 18:07:42
In reply to FB - Re: Feel crazy on antipsychotics!, posted by sheilac on August 14, 2011, at 16:50:58
Have you tried lamictal? I haven't.
I didn't know those meds have big NE properties. But I seem to have big problems with NE agonist things.
Jeez, Sheila. This has been some time you've been having.
:-/
I'm sorry.
Posted by sheilac on August 15, 2011, at 8:04:36
In reply to Re: FB - Re: Feel crazy on antipsychotics! » sheilac, posted by floatingbridge on August 14, 2011, at 18:07:42
I have a bad reaction to Lamictal so I can't take it. I can take Lithium or Depakote in low doses.
I may have to talk to my doc about going low dose on Lithium or Depakote and some Ablify or Geodon.
I don't like the weird/unstable feeling that Geodon has given me. I do, however, like the awesome antidepressant feel it has give me. Sometimes you get so happy you have a crazy break and fly into a rage though.
I just feel like I need something to keep the Geodon or Abilify in check so it doesn't get out of hand. Geodon or Ablify for me, on their own are just not good. Neither was Effexor - worst med ever for me.
Posted by Christ_empowered on August 15, 2011, at 9:26:54
In reply to FB - Re: Feel crazy on antipsychotics!, posted by sheilac on August 15, 2011, at 8:04:36
Mixing lithium and antipsychotics raises risks of EPS, NMS, and possibly TD.
Personally, I'd just take Abilify and up the adderall once you get in the 10-15mgs of Abilify range. That will help you focus and mitigate potential weight gain.
Given the cardio effects, the 2x daily dosing, the sedation, and the drug induced mood problems, I think personally you might want to ditch the Geodon for Abilify. I personally think that if you can avoid adding in lithium, you should. That would probably mean taking at least 10mgs/day Abilify.
Posted by floatingbridge on August 15, 2011, at 9:37:32
In reply to FB - Re: Feel crazy on antipsychotics!, posted by sheilac on August 15, 2011, at 8:04:36
I am trying to remember you abilify experience. I remember some weight gain, but not hyper manic. Is my recollection somewhat correct?
And it seems you have tried so many agents. So the draw of geoden is weight neutrality plus not feeling flattened (two great effects right there.)
I wonder if you could get away with less lithium. Like 200mg. Before you have hair loss and those other sides. Depakote works too?
I am concerned about the fragility of mood you seem to experience on geodon. Other than that, feeling good is very good. I keep thinking there is something I want to tell you, but can't recall. I'll post again if I remember.
Posted by floatingbridge on August 15, 2011, at 9:48:17
In reply to Re: FB - Re: Feel crazy on antipsychotics!, posted by Christ_empowered on August 15, 2011, at 9:26:54
CE , you post came in while I was writing. I did not know this about adding lithium. I would defer my advice to yours.
Sheila, did you get the rash on lamictal?
Posted by floatingbridge on August 15, 2011, at 9:56:51
In reply to Re: Feel crazy on antipsychotics!, posted by bleauberry on August 14, 2011, at 13:19:47
BB, are you saying that when zyprexa wears off there is a release of NE? Is this a factor with risperidone, too?
I don't understand you and Sheila discussing this NE effect. But I'd like to hear more about it.
I swear my biggest problem with risperidone is there is an interdose effect going on, but can't find any reseach on this.
I take a small dose at night and believe something happens by the afternoon.
> Wow, I sure hear ya. That's my biggest problem with any new med or herb or supplement I try....getting trapped and it's hard to get out or know what to do. What an aweful place. I sure feel for you.
>
> Well, since it has been good for your depression, at least that gives some hope that your brain is still capable of doing the job. The tricky part is figuring out how to tweek it similar to what geodon is doing, or to pinpoint the particular mechanism of geodon that is doing it.
>
> I would guess the crazy bizarreness you are feeling is from the norepinephrine stimulation part of the med. It just sounds like being over-revved on adrenaline from within. Yeah? No? Maybe? I have often pondered that is maybe what is behind the akathisia associated with antipsychotics. I mean sure they block dopamine receptors and that is calming, they block serotonin receptors and that is calming, but they open up the flood gates for noradrenalin, which is manic-like, anxiety-like, nervous-like, or akathisia-like. Put it all together and that is one bizarre mix of emotions. What I experienced was that the dopamine and serotonin blocking would wear off, leaving all the excess NE completely unopposed.
>
> I totally understand. In the latter stage of my years on zyprexa that happened to me. It was so calming and what a nice relief....I dosed it at 4pm, it kicked in by 6pm, nice smooth evening, great sleep, but oh my about 4am all hell broke loose....as if someone had shot adrenaline in my arm....and no amount of daytime zyprexa would make that go away. I literally had to burn off the excess noradrenalin through physical work or movement. It was a horrible, absolutely horrible, feeling. So I know it isn't helpful, but I just want you to know....been there done that it sucks!
>
> I was thinking what would I do if I were in your shoes? Hmm. That is a tough one. For sure, no doubt, I would NOT be able to stay with it. I mean, even with the great antidepressant effect it has on you, the other crap is so bad as to not be able to function despite not being depressed. So what good is that? None. To me anyway. I mean, it is fairly predictable that even if geodon is a good antidepressant for you right now, it probably won't keep being that way in 2 years, 5 years, 7 years, whatever. So the last thing I want to do is get trapped even deeper in a hole because now I am not only on this bizarre med but also a couple others to deal with its side effects, and those themselves have their own side effects to compound my problems and they all mean I will have some bad withdrawals someday down the road. Just avoiding paying the price I will have to eventually pay, no escape.
>
> But, that's just me. Someone else may feel differently. We all have to guide our own journeys.
>
> The suggestion of abilify, well, I guess that kind of makes some sense. No way to tell without trying though. The hard thing about it is the dosing...akathisia/nervousness is common with it...more stimulating at lower doses...more calming at higher doses....but afraid to get trapped even deeper if it goes bad. Geez, I wish there was an easier way. Dang. I don't see, however, how abilify will dampen the excess norepinephrine stimulation, maybe make it worse.
>
> The botanical route could be helpful, cheap, and easy. Much harder to get stuck in a 'trap'. For immediate help I would look at Lemon Balm tincture (not pills). Others that go good with it are PassionFlower and Valerian Root. There is a tea pretty good at this called Calm, made by Tazo. I think I got mine at Whole Foods Market.
>
> Those will not stop the excess release of NE, but will dampen what has been released. To stop it, I would be thinking in terms of adaptogens, especially the more calming ones, such as Ashwaghanda.
>
> I have seen some good things happen very frequently with Rhodiola, but never have I seen it combined with an AP so that is completely new territory to me. Maybe worth a look though. It's great for depression, more often than not, and at higher doses calming, primarily toning down excess NE.
>
> And it might sound weird, but a NE reuptake inhibitor could help by bringing the feedback loops into play to act as governors preventing excess release. The only one I have personally experienced that can do that is milnacipran, but it comes with it about a week or so of worsened symptoms until the feedback loops kick in.
>
> Until you can decide what to do, I would not hesitate to immediately seek some assistance from the plant medicines I mentioned. imo They all helped me through some really torturous times when I was on zyprexa. And actually, today, the botanical medicines I have pinpointed through trial and error that help me the most are outperforming any of the dozens of psych meds I ever took.
>
> There is plenty of hope.
Posted by sheilac on August 15, 2011, at 10:39:27
In reply to Re: FB - Re: Feel crazy on antipsychotics!, posted by Christ_empowered on August 15, 2011, at 9:26:54
Thanks, CE for the info on the Lithium Geodon combo. I didn't know this.
Maybe the Abilify is worth a shot. For now I have 2mg samples. I think I remember that Ablify stays in your body longer so maybe that won't cause the irritability like Geodon does when it wears off.
Hopefully, I can get the same antidepressant feel from Abilify.
Also - hopefully Abilify doesn't cause mania like Geodon does.
I think Abilify might be worth a shot.
For now, given my recent mania, I am skipping the Adderall and phasing out Geodon.
Maybe for now Abilify and Klonopin will work. Can't take the Geodon mania any longer!
Posted by floatingbridge on August 15, 2011, at 10:44:51
In reply to CE- Re: Feel crazy on antipsychotics!, posted by sheilac on August 15, 2011, at 10:39:27
Very best, Sheila. Good luck!
This is the end of the thread.
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