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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by sheilac on August 20, 2011, at 19:54:08
I'm now taking 100mg of Geodon at night and 20mg of Geodon during the day. The nighttime dose was fine at 80mg.
Problem is the 20mg of Geodon during the day. I can't figure out if it is just not enough during the day or if it is wearing off. I have a tendency to fly into rages towards the end of the afternoon. Not good.
These rages just never happened to me before Geodon.
Is Geodon just too short acting of a med? Do I dump it all together and go back to Seroquel for sleep and Lithium during the day and just get fat and bald?!
This is getting ridiculous. Not having any weight gain, but what do I have to do? Take 80mg at night and 40 - 80 during the day?
I just keep taking more and more. You'll have to lock me in a padded cell to withdrawl off this stuff!
I don't know what to do anymore. I don't dig the idea of 2 antipsycotics (like Abilify daytime and Geodon nighttime).
In order to stay sane and not fly into rages I'm back to 3mg of Klonopin throughout the day. This tells me something isn't right.
Maybe I was better on low dose Lithium, Seroquel, Klonopin ad low dose Prozac. Maybe then I could be a nice person?
Posted by Phillipa on August 20, 2011, at 22:10:30
In reply to How high a dose?, posted by sheilac on August 20, 2011, at 19:54:08
Did you just answer your own question? Sounds like something not right with what you are on now. Phillipa
Posted by SLS on August 20, 2011, at 23:13:31
In reply to How high a dose?, posted by sheilac on August 20, 2011, at 19:54:08
> I'm now taking 100mg of Geodon at night and 20mg of Geodon during the day.
For unipolar depression, 40-80mg of Geodon is the dosage range I see used most. If there are manic or mixed-states involved, higher dosages are called for. However, Geodon is not much of tranquilizer for some people who actually react to it by becoming manic, anxious, or agitated. You are going to have to design (with your doctor's management) an experiment to discover how best to use Geodon, ie. dosage and timing. However, you should first screen Geodon for negative reactions.
You really are going to have to work together with your doctor to devise a scheme for determining if Geodon is the right drug for you. I get the impression that Abilify is less apt to produce mania or a mixed-state. In the beginning of Abilify treatment, there is often anxiety and insomnia. This usually dissipates without producing full-blown akathisia.
Geodon should be taken in divided doses with food.
If you go up in dosage now and feel worse, I think an argument can be made to discontinue the drug immediately.
How would you describe your illness? What symptoms are the most prominent or dysfunctional?
Maybe you can think of other important aspects of your illness and treatment that other people here can comment on.
- Scott
Posted by Christ_empowered on August 20, 2011, at 23:26:50
In reply to Re: How high a dose? » sheilac, posted by SLS on August 20, 2011, at 23:13:31
I'd drop it and switch to Abilify, personally. 10-15mgs from day one. You're already on Klonopin, so the akathisia shouldn't pop up. You might want 1-2 weeks worth of Ambien. Just my suggestion.
Posted by sheilac on August 21, 2011, at 8:12:49
In reply to Re: How high a dose? » sheilac, posted by SLS on August 20, 2011, at 23:13:31
40 - 60mg of Geodon makes me manic.
My main issue BEFORE I started Geodon was irritability, anxiety and bouts of depression which my doc said is BPII.
My issue with Geodon is that I wasn't manic UNTIL I started taking it. I understand that it is a med that at lower doses can induce mania and at higher doses it helps BP. But I just hate that whole concept. Hard for me to understand.
Doc likes Geodon due to no weight gain (he would like for me to lose more weight and not gain).
In the past, before I was diagnosed with BPII, I took antidepressants which would eventually make me manic.
So, now I'm trying to manage my main issue of irritability. It's hard.
Posted by sheilac on August 21, 2011, at 8:22:31
In reply to Re: How high a dose? » sheilac, posted by Phillipa on August 20, 2011, at 22:10:30
Phillipa, I may have answered my own question. I just don't know.
I like the no weight gain (Geodon even suppresses my appetite). Just can't deal with the quick wear off and the rages. I never acted this bad before I took Geodon.
Some say it is because I'm not taking a high enough dose. But last night with 100mg I kinda hallucinated when I got up in the middle of the night!
I wonder if an anti-psychotic can MAKE you crazy?
That is why I wonder about just going back to Seroquel (which gives me daytime irritability like Geodon) at night for sleep and low dose lithium and low dose prozac during the day. Maybe the prozac and lithium would keep me from getting irritable from the antipsychotic (Seroquel) and Lithium would keep me from getting to high from the prozac and Seroquel.
If I go over 100mg of Seroquel I start getting super hungry and gaining weight.
Last time I tried Abilify I felt like I was retaining water and gaining weight. But maybe it would be a better one med drug for me since it stays in your system for 3 days. I guess I have learned that I need longer acting meds. Not short acting meds.
I don't know. Maybe Abilify by itself is worth a shot. Right now I only have 2mg samples. Don't know if that is a good starting point.
I do like the great antidepressant feel I get from Geodon - just not the crazy rages.
Posted by Solstice on August 21, 2011, at 16:18:16
In reply to How high a dose?, posted by sheilac on August 20, 2011, at 19:54:08
My daughter was diagnosed with Bipolar as a young teenager. Before treatment, she vascillated between hypomania (most of the time) and bouts of irritability and rage.
She took Abilify for a very short trial, and had lots of side-effects.
Then took Geodon - has been on it for almost three years now. She now takes 60 mg in the morning, and 60 at night. Initially, Geodon was Very sedating, but with each increase in dosage, that only lasts a couple of weeks. Splitting the dose was the best thing we ever did. There's a big difference between your morning and evening doses - maybe try a more even split?
Her doctor also added Intuniv - close to a year ago I think. Intuniv has really evened out her moods. Increasing irritability is always our signal that her meds may need to be adjusted.
I wish for you a smooth journey in finding the right meds and dosages.
Solstice
Posted by Phillipa on August 21, 2011, at 19:35:11
In reply to Phillipa - Re: How high a dose?, posted by sheilac on August 21, 2011, at 8:22:31
Too high of a dose of an antipsychotic can make some sleep for days and others fight. Maybe dose too high? I truly don't know. You are upset it seems and not able to clearly think out a plan. Can someone who knows you well give their opinion of how you react on different meds and doses? And doc definitely needs to be contacted. Phillipa
Posted by SLS on August 21, 2011, at 20:42:39
In reply to SLS - How high a dose?, posted by sheilac on August 21, 2011, at 8:12:49
> 40 - 60mg of Geodon makes me manic.
I am not surprised by this. However, I don't know enough people taking Geodon to exclude the possibility that higher dosages are a viable alternative when lower dosages trigger mania. My initial reaction was to say that you might look for another strategy to deal with your symptoms. Trileptal might be the best anticonvulsant to use, although I wouldn't exclude Topamax or Depakote.
What other antipsychotics have you tried and what were the results?
> My main issue BEFORE I started Geodon was irritability, anxiety and bouts of depression which my doc said is BPII.
>
> My issue with Geodon is that I wasn't manic UNTIL I started taking it. I understand that it is a med that at lower doses can induce mania and at higher doses it helps BP. But I just hate that whole concept. Hard for me to understand.
>
> Doc likes Geodon due to no weight gain (he would like for me to lose more weight and not gain).
>
> In the past, before I was diagnosed with BPII, I took antidepressants which would eventually make me manic.
>
> So, now I'm trying to manage my main issue of irritability. It's hard.What drugs are you currently taking?
- Scott
Posted by Zyprexa on August 22, 2011, at 3:19:19
In reply to How high a dose?, posted by sheilac on August 20, 2011, at 19:54:08
If it were me I would take two 20mg pills durring the day, about 4 hours appart. Thats what I did to keep it from wearing off. It has a half life of what seemed like 4 hours, but they say its 7 h. When I was taking it I took 4 doses a day, high doses too. It just didnt seem that strong, and it wasn't so I had to stop it. One of the problems with geodon was it didn't calm me enough and I was always paranoid and hearing voices. It made me diabetic and gave me blurry vision, dose dependant. I tried abilify too. that was worse than geodon. Mentaly. The only thing I realy know works is zyprexa. But I say if the geodon is working and the side effects are not bad, you should stick with it. Don't be afraid of a high dose. Or should I say many doses. I was taking 60mg 4 times a day. I didn't find it sedationg enough. I was getting angry all the time with people. Not sleeping. Doc wanted to just keep raising dose, but I wasn't getting there. and my vision was getting so bad I could not drive and read signs.
Posted by sheilac on August 22, 2011, at 19:05:09
In reply to Re: How high a dose? » sheilac, posted by Zyprexa on August 22, 2011, at 3:19:19
I have vision problems too with Geodon. Since taking it I have had to wear glasses when reading.
It definitely effects my vision, I just don't know why. I hope it doesn't mean I am getting diabetes or something.
Posted by sheilac on August 22, 2011, at 19:09:53
In reply to Re: How high a dose? » sheilac, posted by Solstice on August 21, 2011, at 16:18:16
Taking Geodon during the day initially made me sleepy - like for a few months I was sleepy. But recently, I have really needed something during the day.
So, I thought about your daughter and I split my dose - 40mg last night and 40mg today. It seemed ok. I still had to take 3mg of Klonopin throughout the day, but maybe that just means I need a higher dose of Geodon.
I see doc next week and will discuss. But until then, I may see if either 40 and 40 or 60 and 60 work.
Thanks!
Posted by sheilac on August 22, 2011, at 19:15:54
In reply to Re: SLS - How high a dose? » sheilac, posted by SLS on August 21, 2011, at 20:42:39
The only problem I had with both Trileptal and Tegretol were terrible night sweats. Didn't really get a good feel for those meds.
Depakote in small doses (like 125mg sprinkles) worked pretty good.
I may need to talk to my doc about adding SOMETHING to this Geodon regime. In the meantime I tried splitting my dose yesterday. I took 40mg last night and 40mg this morning. I may need to go up to 60 and 60. I was surprised that the day dose didn't make me sleepy.
Abilify did make me hungry and gain weight in the past. Same thing with Risperdal along with some swelling. I love and miss Seroquel, but can't take the daytime irritability.
So, I'm still just taking Geodon and Klonopin.
Posted by Solstice on August 22, 2011, at 19:35:23
In reply to Solstice - Re: How high a dose?, posted by sheilac on August 22, 2011, at 19:09:53
My daughter has had sleepiness that lasts for a couple of weeks every time her dose has been increased. But.. it goes away. We're just careful about how we time any changes - like during the summer, or Christmas holidays - because for a couple of weeks she can hardly stay awake :-) I think it's great if Geodon works for someone, because it's about the only one that doesn't cause awful weight gain.Let us know how it goes for you!
Solstice
> Taking Geodon during the day initially made me sleepy - like for a few months I was sleepy. But recently, I have really needed something during the day.
>
> So, I thought about your daughter and I split my dose - 40mg last night and 40mg today. It seemed ok. I still had to take 3mg of Klonopin throughout the day, but maybe that just means I need a higher dose of Geodon.
>
> I see doc next week and will discuss. But until then, I may see if either 40 and 40 or 60 and 60 work.
>
> Thanks!
>
Posted by Solstice on August 22, 2011, at 19:39:52
In reply to Scott - Re: SLS - How high a dose?, posted by sheilac on August 22, 2011, at 19:15:54
I'd ask about lamictal or intuniv.
My daughter takes Intuniv and Adderall with her Geodon. Geodon seems to really address the hypomania. If she misses her Adderall or Intuniv, her irritability escalates dramatically. So if you have ADHD, may check on stimulants.
Soltice
> The only problem I had with both Trileptal and Tegretol were terrible night sweats. Didn't really get a good feel for those meds.
>
> Depakote in small doses (like 125mg sprinkles) worked pretty good.
>
> I may need to talk to my doc about adding SOMETHING to this Geodon regime. In the meantime I tried splitting my dose yesterday. I took 40mg last night and 40mg this morning. I may need to go up to 60 and 60. I was surprised that the day dose didn't make me sleepy.
>
> Abilify did make me hungry and gain weight in the past. Same thing with Risperdal along with some swelling. I love and miss Seroquel, but can't take the daytime irritability.
>
> So, I'm still just taking Geodon and Klonopin.
>
>
This is the end of the thread.
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