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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 SheilaC on July 22, 2010, at 15:31:50
I complained to my doc today AGAIN about being sleepy during the day and having to take naps. He was not happy with me.
He has me taking 1mg Klonopin and 50mg Seroquel at night and then 40mg Geodon and 10mg Adderall in the morning.
He also wanted me to take Klonopin .5mg 2x during the day.
I told him I wasn't taking the .5mg Klonopin due to being very sleepy from the Geodon. I also told him I upped my Adderall to 20mg to see if that would help with energy, motivation, etc.
He was mad at me! He told me to go back to 10mg Adderall and to cut down to 20mg of Geodon in the morning. He said it was ok to cut out the .5mg Klonopin 2x during the day, but to stick with the 1mg Klonopin and 50mg Seroquel at night.
He said he doubted very seriously that the Geodon was making me tired.
I'm not sure what to think about today's visit. I will try it his way for the next couple of weeks. But I thought a higher dose of Geodon would help with energy. I thought the lower doses of Geodon make you sleepy.
He would also dump me if he knew I still drank my 1 cup of coffee in the morning.
I'm just not sure that 20mg of Geodon will do anything.
Posted by Phillipa on July 22, 2010, at 17:07:14
In reply to Geodon dose ???, posted by SheilaC on July 22, 2010, at 15:31:50
Why two atypicals? Can you do without the seroquel? Phillipa
Posted by emmanuel98 on July 22, 2010, at 21:02:44
In reply to Re: Geodon dose ??? » SheilaC, posted by Phillipa on July 22, 2010, at 17:07:14
I tried geodon for about two weeks. Went up to 160mg. The first few days (I was taking 40mg), it made me sleepy, but after that, I got used to it and wasn't sleepy at all. On the other hand, it didn't work at all for me.
Posted by Zyprexa on July 23, 2010, at 2:31:30
In reply to Geodon dose ???, posted by SheilaC on July 22, 2010, at 15:31:50
Why would he dump you over coffee use?
I took doses of geodon from 20mg up to 300mg a day. It never made me tired, but I was switching from 10mg zyprexa, which made me a little tired waking up and yawn a bit during the day. You could try abilify. I don't know if that would work for you. It had the tendency to wake me up. Even though I was lacking in sleep and couldn't function.
Why do you take geodon.
Posted by SheilaC on July 23, 2010, at 16:35:34
In reply to Re: Geodon dose ???, posted by Zyprexa on July 23, 2010, at 2:31:30
I think he is having me take Seroquel because it helps me sleep. I only use a low dose of Seroquel (50mg).
The Geodon really helps me with irritability. It has taken away the mean, irritable witch I was for so long.
I think what has been making me tired is the Metformin. My hormone doc has me taking it to cut my risk of getting diabetes (I don't have diabetes), especially since I am taking Geodon and Seroquel.
This doc doesn't believe you should have any sort of caffeine or alcohol. He considers those just as powerful drugs as the meds I am taking. But honestly, can 1 cup of coffee really hurt?!
Maybe I should see another doc for a 2nd opinion. I don't know.
I thought Lithium was really helping me, but I was gaining weight, so I'm not sure what to do.
Posted by Christ_empowered on July 23, 2010, at 16:54:45
In reply to Re: Geodon dose ???, posted by SheilaC on July 23, 2010, at 16:35:34
Hey. Maybe we just angry about the adderall thing. Even though 20mgs/day of Adderall is a pretty small dose (severe cases of ADD and narcoleptics sometimes take several times that), it is still a schedule II substance--its probably not something he wants you to experiment with in terms of dosing, even if your experiment makes perfect sense (which it did, by the way).
Geodon can make people tired, so I think it is kind of strange that your doc is saying that it couldn't be or probably isn't the Geodon. Even non-sedating or minimally sedating antipsychotics can make people more tired and lethargic.
I don't know what to tell you about Geodon dosing for your problem. From a safety standpoint, you're better off with the lowest dose you can get away with, because every single dose increases your odds of tardive dyskinesia and other tardive syndromes. I'm not saying this to scare you--if Geodon works for you, take it--I'm just saying that the "LED" (Lowest Effective Dose) is what doctors are supposed to aim for when they're prescribing antipsychotics. Higher dose antipsychotics are sometimes called for in severe cases, but sometimes high-dose antipsychotics create a whole new set of problems (social withdrawal, apathy, lethargy, depression, etc.). So....I personally agree with his decision on lowering the Geodon, unless you have active psychosis or something.
Could you maybe try something else for sleep? The thing about seroquel is that it doesn't even become active as a mood-stabilizer/antipsychotic until you hit higher doses (I want to say a couple 100mgs/day, but I'm not sure...). Until you hit that point, its a very expensive antihistamine with lots of potential side effects. Have you tried hydroxyzine? It comes in two forms, Vistaril and Atarax. If I remember correctly, hydroxyzine can have anti-anxiety effects and boost antidepressants, although there is a small tardive dyskinesia risk when using higher doses for a prolonged period of time. There's also a risk of seizures, mostly for people prone to seizures or people temporarily at risk of seizures (people undergoing benzo or alcohol withdrawal, for instance). Hydroxyzine is old, so its pretty cheap, and I don't think it has the same potential metabolic side effects as seroquel. Then again, if you like the seroquel and you're aware of and OK with the potential risks, then by all means, take it.
I hope this was somewhat helpful.
Posted by SheilaC on July 24, 2010, at 7:04:11
In reply to Re: Geodon dose ???, posted by Christ_empowered on July 23, 2010, at 16:54:45
I like how Seroquel knocks me out, but I hate how it effects me the next morning. It makes me very irritable the next day. So then I pop the Geodon and wait and that takes away the irritability.
I'm not saying that Seroquel is responsible for ALL my irritability, but it does make me really irritable.
So, yes, I think there must be something else that would help with sleep.
This doc's big thing is getting on a schedule with sleep and getting good sleep. I don't disagree, but I hate the side effect of bitchiness.
Posted by Zyprexa on July 25, 2010, at 22:01:55
In reply to Re: Geodon dose ???, posted by SheilaC on July 23, 2010, at 16:35:34
My experiance with geodon did not include weight gain. Seroquel is known for weight gain. I never had tirdness from metformin. I doubt that one cup of coffee would hurt. If you have cut out coffee, that could be why you are tired..
Posted by Zyprexa on July 25, 2010, at 22:07:16
In reply to Re: Geodon dose ???, posted by SheilaC on July 24, 2010, at 7:04:11
If seroquel is making you irritable. Anouther option is perphenazine. I find that one not irritable and it has no weight gain. Its also generic. I find the sandoz version the best.
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