Posted by SLS on April 25, 2004, at 2:34:09
In reply to two very important questions about GEODON, posted by sdjeff on April 24, 2004, at 23:47:16
> Here's the thing. I thought my Nortriptyline was causing mixed hypomanic states.
Can you describe your symptoms? How do you know you are experiencing a mixed-state?
> I quit it 2 night ago. No relief.
Well, even if the nortriptyline were responsible for triggering a mixed state, you might not see it resolve so soon. In fact, once triggered, a manic episode might last well beyond the discontinuation of nortriptyline.
> I still don't know for sure, but the only other culprit could be Geodon.
I would look at the Geodon. There have been many cases of it inducing mania.
> 1. Is this drug really tolerated better at higher doses?
I never heard that. Perhaps it is true. In what ways does raising the dosage help to make it more tolerable?
> I wonder if I should double my current 40 mg.
Why are you taking Geodon? Perhaps it is the wrong drug for you. Going up in dosage might make things worse, right? I think this is one for the doctor to deal with. He might have better insight into what's going on.
> 2. It's touted as one of the cleanest AP's, but can it cause dysphoria and mixed hypomanic states?
Yes. Definitely. It is the AP most likely to do this from what I have seen.
> I'm checking on mood stabilizers, but my next appt is quite a ways out.
It's probably a good time to pick up the phone. There are too many variables in your case that one would need to be aware of in order to troubleshoot your situation. Hopefully, your doctor is familiar enough with you to be able to decide what to do next. As was mentioned by HG, Depakote is a reasonable drug to consider. So, too, is Zyprexa. Either drug used acutely would probably help with a mixed-state. If you were to use Depakote, your doctor might start you off with a loading dose of between 1500-2000mg and follow up with a dosage between 750-1500mg a day. I once needed 1000mg to treat a drug-induced manic state. For a real emergency, Zyprexa might work faster. I guess it depends on the individual.
Good luck.
- Scott
poster:SLS
thread:339721
URL: http://www.dr-bob.org/babble/20040423/msgs/339761.html