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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by kotsunega on November 18, 2004, at 19:48:03
I am Bipolar 1 with extreme manic tendancies. I took Zyprexa for more than 4 years and it solved my psychotic mania completely, but weight gain was a big problem.
So, about a month ago, my pdoc started me on Geodon. While it didn't give me the same restful sleep as Zyprexa, I thought I could tolerate it pretty well.
I started having vivid and disturbing dreams about 2 weeks ago, though. Then, this last weekend, I found myself laughing hysterically or crying mournfully without much provocation. Things people would say had me laughing so hard I would not be able to catch my breath. Scenes in movies that were not that depressing had the tears rolling down my face.
Then, on this past Monday, I began to feel like I just wanted to jump out of my skin. I was revisited by feelings of tiny electrical jolts surging from one area of my body to another.
When I got home from work and nobody was home Monday evening, I had to have every light in the house on in order to keep the boogeyman away. My 7 cats would look at me from time to time, and while I didn't think I was acting that strangely, the way they were looking at me was somehow frightening; like they would attack me.
I finally called my husband to come home from work early as I was just plain flipping out. Instead of the Geodon, I went back to taking 20 mgs of Zyprexa that night and slowly, slowly over the next few days, all of the psychotic mania aspects of my behavior began to subside.
I called my pdoc's office the next morning after my total flip out and talked with my pdoc's nurse as my pdoc was making hospital rounds. She asked if I felt like I needed to be hospitalized, but I told her no.
Now, several days after restaring Zyprexa,I still find myself reacting a little over-emotionally, but the hysterical laughing is gone. I still feel the need to have lots of lights on in the house, but am not as afraid as I was that terrible Monday night. The vivid dreams are not so strong. Things are getting better again.
Anybody else ever have a psychotic break with reality like this that seems to have been meds related? It was quite the nasty experience. Thanks in advance for sharing your experiences or comments about my mini-ordeal. :)
k.
Posted by sdjeff on November 18, 2004, at 23:30:32
In reply to Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 18, 2004, at 19:48:03
Well, I have Major depression with psychotic features. My dx is different but my experience with Geodon is similar.
After 2 weeks at a small dose I was very emotional. It took nothing to wind up in a crying fit. I couldn't be alone. I would call people I knew like crazy, if they couldn't hang out, that's when the paranoia kicked in. I felt like I was crawling out of my skin. Anxiety was so bad that I couldn't hold food down. The list goes on.
After the Geodon I started Zyprexa. It's been about four months since that fiasco and I'm still not 100% over it.
Just to let you know you are not alone. I hope this helps. Hang in there.
Posted by DanielJ on November 19, 2004, at 7:19:33
In reply to Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 18, 2004, at 19:48:03
This helps me make up my mind about Geodon. My son who is now 17 has Schiz. He has been on Zyprexa/Zoloft for almost 2 years but has gained a lot of weight. Psychologically he is doing fine on the current combo, but his blood sugar has gone up so the Pdoc suggested he try switching to Geodon which has less of a problem with weight gain. After reading all the posts about geodon, I think not, instead more excercise and less sweets and a good long term diet and ex program seems better than the Geodon alternative. Thanks and so far Zyprexa rules!
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.
Posted by kotsunega on November 19, 2004, at 9:13:44
In reply to Re: Freaked out on Geodon; went back to Zyprexa-Long, posted by DanielJ on November 19, 2004, at 7:19:33
Dear DanielJ:
Thanks for responding to my post. I don't have any blood sugar problems with Zyprexa; some do and some don't. I would keep a watch on this with your son, as elevated blood sugar problems on Zyprexa can lead to type 2 diabetes. You don't want that.
As for the weight gain: I topped out at 282 pounds by last Christmas, then in Febuary of 2004, I had gastric bypass surgery. I have ever-so-slowly lost to the point where, nine months following this surgery I am down to 208. Normally with this surgery I would have lost 30 to 40 more pounds by this point, but the Zyprexa slows the weight loss. That is why my pdoc wanted me to try Geodon; to try and get the remaining weight off quicker. My point is, weight loss is still possible on Zyprexa if food intake is reduced -- by whatever means; surgery or any other reduction in food intake method.
While I don't advocate an Atkin's like no carb diet, my sister, who does not have mental health problems, had type 2 diabetes until she switched to a meat, fruit, and vegetables diet only. The diabetes symptoms were eliminated in time, and she has lost a significant amount of weight on this regimen in the last two years (60 pounds).
I am an advocate of Zyprexa as, even with the weight gain, it has done me so much good mentally.
While there are other neuraleptic drugs you could try that might not raise your son's blood sugar (Risperdal or Abilify), I think if it were me I would first try a restrictive diet that is low in carbs, as simple carbohydrates are immediately converted to blood sugar (bread, pasta, sweets), while complex carbs (vegetables, fruits) take more time being converted to blood sugar.
Going low carb may assist in lowering your son's blood sugar so that a medication switch is not necessary. A body that is constantly assaulted with elevated blood sugar will eventually lead to poop out of the pancreas that produces insulin. Insulin counteracts elevated blood sugar but if the pancreas has to work overtime, this organ simply cannot compete with trying to balance out all of the blood sugar it is meant to normalize and it poops out -- hence, type 2 diabetes sets in. Thus, the lack of insulin no longer being produced by the body must be managed through diabetes diet and/or administered through diabetes drugs. I would talk to the doctor about all this, for sure.
Best of luck to you,
k.
Posted by DanielJ on November 19, 2004, at 9:53:46
In reply to Re: Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 19, 2004, at 9:13:44
We are happy that you are recovering well from your Geodon ordeal. My son's (and our) experience with Abilify (before he started Zyprexa)were equally scary.
Over a few months he went from 140 to 200lbs and now is 215lbs. We are working on getting him a trainer and also a consultation with a nutrition person to get him on a healthier track. He prefers sitting in front of the computer playing half-life to most other activities. Here in Florida the heat and humidity outdoors is a strong deterrent to outdoor excercises like jogging etc. but now that the weather is cooler we can shoot hoops go for walks and other fun things. Thanks loads for you concern and input see you on the forumRegards Dan J.
Posted by sdjeff on November 20, 2004, at 0:32:18
In reply to Re: Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 19, 2004, at 8:34:21
Thanks for your reply. I'm glad things are going well for you. At least for me, I think that it was the Geodon that caused a psychotic break. Fortunately, I have calmed down considerably since stopping it. Oh well, at least I'm a lot more social than I used to be.
very interesting info on how these drugs work. Thanks for the information.
Best,
Jeff
Posted by CraigD on November 20, 2004, at 1:27:53
In reply to Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 18, 2004, at 19:48:03
I had terrible freak-outs on Risperdal. I added it to my Serzone (what a sucky drug that was) for the psychotic aspects of my depression and thought I was going to kill my entire family and then myself.
years later, I'm about to try Abilify at 5 mgs on an as-needed basis for anxiety and ruminations. I'm wary however.
Best of luck. This can be scary stuff.
Posted by Sebastian on November 21, 2004, at 11:20:29
In reply to Freaked out on Geodon; went back to Zyprexa-Long, posted by kotsunega on November 18, 2004, at 19:48:03
I had the same thing when I stoped my zyprexa all together. It takes a few months to get back to normal.
This is the end of the thread.
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