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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by babs on January 15, 2003, at 17:45:52
My pdoc is considering switching me from risperdal to geodon. I'm currently on 60 mg celexa, 1.5 mg risperdal and 15-30 mg adderall (depending on the day). I LOVE risperdal- been on it for about two years because I had an "incomplete reaction" to celexa- still had some irritability, bad PMS, refractory anxiety and terrible obsessions. The risperdal pretty much wiped all those out but the problem is I gained 60 pounds. I'm hoping the geodon will work as well as the risperdal but allow me to drop to a more normal weight. I went from 140 to 200 pounds in a year. So I want to hear it all good and bad. My pdoc is meeting with the geodon rep Friday and if all goes according to plan I'll make thse switch next week. Meanwhile, I'm doing my research. Thanks.
Posted by comftnumb on January 16, 2003, at 2:49:39
In reply to tell me everything about geodon- good and bad, posted by babs on January 15, 2003, at 17:45:52
Here is my personal experience:
I was on Zyprexa 20-25mgs for 6months and gained 25lbs. I weighed 190lbs in July and I am 5'8". Largely due to the weight gain with Zyprexa, I decided I wanted to try Geodon and I switched in late July. I lost 30lbs over 3months (August 1st-November 1st), although I must say considerable effort went into losing the last 15lbs. I do think losing 30lbs would have been impossible on Zyprexa. The increased appetite was horrific; I could just eat and eat and eat without ever being full. Since November my weight has fluctuated a bit up and down, especially with the holidays I gained weight. Recently I switched to a low-carb diet and have subsequently lost 8lbs. I currently weigh 155lbs. My current Geodon dose is 60mgs twice a day.
Posted by xjs7 on January 16, 2003, at 14:11:01
In reply to tell me everything about geodon- good and bad, posted by babs on January 15, 2003, at 17:45:52
Dosing issues
Geodon must be taken twice daily--for some people this can be quite inconvenient. I sometimes wish I was on a once-a-day drug like Abilify. Also, you are supposed to take it with food so it can be absorbed better. This can also be a bit of a hassle. I usually take it without food, so I probably need to take more than I might otherwise need to take. I am also on a 60 mg BID schedule.Weight gain (or lack thereof)
One of the selling points of Geodon is that it does not cause weight gain. I have found this to be true; I have been on Geodon for more than a year and have not gained any weight at all from it. Of course, I am not sure if I would have gained much from other drugs; I have also been on an SSRI for a year and have not gained any weight from it.Price
1.5 mg of Risperdal is quite cheap (as far as I know). The equivalent dose of Geodon (perhaps 20 mg BID) is quite expensive--any strength of Geodon costs somewhere around $250 a month. For me, because I take a medium-high dose of Geodon, it is actually the cheapest atypical; equivalent doses of Zyprexa would cause more than $300. If you have insurance or some other way of attaining the medication without paying for it, you of course don't need to worry about it.Extrapyramidal symptoms
From the statistics I have read, about 10% of people on atypical AP's get extrapyramidal symptoms. Unfortunately I am in this 10%. So, I have to take Cogentin along with my Geodon, which is a small hassle and costs me a small amount of money. I think Risperdal is just as bad with EPS, and probably worse in the higher doses than Geodon. Since you take a lower dose of these medications you probably don't need to worry about this.Tardive dyskinesia
The risk of tardive dyskinesia is much higher in patients who take a high dose of medication for a long period of time. Since you take a lower dose, you probably don't need to worry about this condition. However, long term use does increase your risk. From what I have read the risk in people who take average doses for long periods of time, the rate of developing TD is 0.1% per year of exposure. So, I wouldn't worry about it. Also note that it is safer to remain on the medication all the time instead of going on and off of it intermittently.Overall
Geodon is an excellent medication. I wouldn't call it a 'miracle' drug, because of its side effect profile. There are substantial risks in taking this class of medications, especially on a long-term basis. If I wanted to switch to a new medication now, I would first consider Abilify, however. It has some advantages, such as a once-daily dosing schedule. I suspect it also better with regards to EPS, although I don't know of any studies to back this claim up. Abilify also doesn't cause weight gain. So, in summary, I think Geodon and Abilify are the best overall treatments available for psychotic illnesses at this point in time. Some refractory people need other medications, but for the average person, I think these two medications have the best side effect profiles. And since people often need this class of medications for long periods of time, side effects (or the lack thereof) are very important.I hope this helps.
This is the end of the thread.
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