Posted by kotsunega on November 19, 2004, at 8:34:21
In reply to Re: Freaked out on Geodon; went back to Zyprexa-Long, posted by sdjeff on November 18, 2004, at 23:30:32
Dear sdjeff:
Thanks for sharing your Geodon experience. It's comforting to know someone else had this happen (misery loves company?); I'm just sorry that it has taken so long for you to get over it.
Last night I went to bed without the lights on -- first time in days. I was apprehensive but I am trying to ignore continuing irrational thought patterns. I did manage to fall asleep, so that's an improvement.
I wonder if it is a question of whether the Geodon causes this psychotic break we experience or if its lack of efficacy is to blame? I guess it could be either.
I started Geodon at a maximum dose because my pdoc said that some things had been learned about administering Geodon since they started prescribing it years ago. For one, it is my understanding that Geodon effects the 5HT2A receptor; acting as an antagonist. The result of this receptor inhibition is an increase in Dopamine and NE availability that the 5HT2A receptor, if left to do its work, would normally inhibit Dopamine and NE availability.
The second thing Geodon is supposed to do is to block the D2 and D3 receptors. The net result of this is supposed to block certain dopamine receptors that are active in psychosis while raising the levels of dopamine to the underserved pathways of the brain. Another action of Geodon is to increase levels of NE in the brain. So, what happens (if I've got this right) if you take a small dose, is that the only drug action occurring is 5HT2A antagonism; the low dose does not block the D2 and D3 receptors. When this happens, you've got excess Dopamine and NE floating around in your brain without any Dopamine receptor inhibition. Thus, you only increase your chances for a return to psychosis.
Zyprexa, on the other hand, supposedly blocks Dopamine action at the D1 and D2 receptors, while, unlike Geodon, is NOT an NE reuptake inhibitor (I think I have this right) as well.
I think for you, this explains why your low dose caused a return to psychosis. For me at the maximum dose, I'm thinking the drug is just not my cup of tea, and evidently is not blocking the correct Dopamine receptors or is not blocking the Dopamine receptors in the correct way. I guess nobody really knows how these neuroleptics work, but that's my understanding anyway.
I flushed my remaining script for this stuff down the toilet!
Best wishes for your continued recovery!
k.
poster:kotsunega
thread:417668
URL: http://www.dr-bob.org/babble/20041118/msgs/417832.html