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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Sheilac on October 4, 2013, at 18:27:11
The higher dose of Trileptal has put out the steroid fire, thank goodness!
Here's the problem, a higher dose of Geodon 80-120mg is great for stability & depression, but it keeps me awake and keeps me from falling asleep - even with melatonin (6mg).
A lower dose of Geodon 40-60mg makes me sleep like a log, which is awesome, but causes hypomania.
In the past, an old pdoc gave me Seroquel to sleep! Don't like taking 2 AAPs.
The first thing a pdoc said to me 15 years ago was how very, very important sleep is to mood disorders.
So what do I do?
Posted by sigismund on October 4, 2013, at 19:02:42
In reply to Can't sleep on Geodon..., posted by Sheilac on October 4, 2013, at 18:27:11
What happens at 70?
Posted by Sheilac on October 4, 2013, at 20:17:39
In reply to Re: Can't sleep on Geodon... » Sheilac, posted by sigismund on October 4, 2013, at 19:02:42
Don't know. My pills are only 20, 40,60 & 80 mg.
Posted by Christ_empowered on October 4, 2013, at 20:39:05
In reply to Re: Can't sleep on Geodon..., posted by Sheilac on October 4, 2013, at 20:17:39
Ummm...maybe a big PM dose of Neurontin or a benzo, like Restoril? I would say Ambien, but in my experience, once you've been on a daytime benzo long enough, night time Ambien won't work as well. Might just be me, though.
Posted by Phillipa on October 4, 2013, at 21:26:08
In reply to Re: Can't sleep on Geodon..., posted by Christ_empowered on October 4, 2013, at 20:39:05
No you are right lunesta didn't work had to combine with benzos. Phillipa
Posted by SLS on October 5, 2013, at 0:08:26
In reply to Can't sleep on Geodon..., posted by Sheilac on October 4, 2013, at 18:27:11
> A lower dose of Geodon 40-60mg makes me sleep like a log, which is awesome, but causes hypomania.
Does this occur even with 1200 mg/day of Trileptal? You haven't tried this yet, have you?
Maybe you should give it a few days to see if your sleep returns to normal on its own. What is the longest period of time that you have taken higher dosages of Geodon?
Give your doctor a chance at working things out. There are lots of things you can try as a sleep aid. Some doctors gravitate towards trazodone rather than add a benzodiazepine.
I actually like the idea of taking Seroquel 50 - 100 mg/day at night along with your Geodon. Why are you scared of taking two APs? A friend of mine takes three. Her life changed tremendously once she added Saphris (asenapine).
You might consider choosing a different AAP. You could try swapping out the Geodon for Latuda. Latuda is less apt to produce insomnia, but is still capable of producing improvements in depression in bipolar disorder.
- Scott
Posted by Sheilac on October 5, 2013, at 8:31:59
In reply to Re: Can't sleep on Geodon... » Sheilac, posted by SLS on October 5, 2013, at 0:08:26
I tried spreading out the dose of Trileptal yesterday into 4 300mg doses. I took my last 300mg at bed.
I also took 3mg melatonin an hour before bed (it relaxed me but no sleep), then I took an additional 3mg at bed with the last 300mg Trileptal and slept like a baby.
When I go over meds with the neurologist who treated my husband for stroke & tremor, (he's also a psychiatrist), he may not like Geodon as an antidepressant and I would bet he changes it low dose Lamictal. Maybe not, who knows. I can only guess.
So far, the higher dose of a Trileptal is awesome. So nice not to be raging on steroids.
Posted by Christ_empowered on October 5, 2013, at 12:21:51
In reply to Re: Last night, posted by Sheilac on October 5, 2013, at 8:31:59
I take 1200/Trileptal (2 doses of 600mgs) plus 20/Abilify (AM) and up to 300 Neurontin (100 x3), and that works pretty well...I also Orthomolecular, of course.
I think you might need to do blood sodium. They do a baseline then check you again to make sure everything's OK. After the baseline and the 2nd test, I'm not really sure how often they check the blood sodium levels...Trileptal is a pretty low-maintenance medication.
Have you considered 1200/Trileptal plus maybe a low dose of Abilify every 2nd or 3rd day? Abilify has a long half life and lower doses are stimulating. I was reading about this on some Bipolar website. The idea is you take the Abilify every couple of days so you get more stimulation, less tranquilization, but still enough tranquilization to stay calm. Make any sense? I hear it works for some people.
The other thing I thought of was a switch from Klonopin to Xanax XR, plus a night time dose of some benzo. Xanax has mild antidepressant properties, so maybe that would help (?). Some docs don't like to Rx it, though, even in XR form.
Just some random thoughts...
Good luck!
Posted by Sheilac on October 6, 2013, at 12:22:13
In reply to trileptal, posted by Christ_empowered on October 5, 2013, at 12:21:51
I consult with a neuro/psych and I'm sure he'll have some opinions on Geodon. It wouldn't shock me if he changed me to Abilify or low dose Lamictal. We'll see.
So far 900mg of Trileptal knocks me out hard. It's going to take a whole to get used to.
But I not manic from the steroids anymore. And I'm sleeping great.
Posted by Sheilac on October 8, 2013, at 17:22:54
In reply to Re: trileptal, posted by Sheilac on October 6, 2013, at 12:22:13
Sorry, meant to say 1200mg Trileptal. It's awesome.
This is the end of the thread.
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