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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Sheilac on July 17, 2016, at 14:06:47
For 6 months I took 160mg of Geodon. It worked great for my serious depression and mania. Then I started developing sides effects: insomnia, severe shakiness, etc. so my doc dropped me down to 120mg. This cured the shakiness and insomnia, but brought about bouts of manic outbursts (severe anxiety resulting in screaming episodes making me look like a total lunatic).
I also take 2500mg a day of Keppra, but I don't find it strong enough to control my mania.
I really miss the feeling of 160mg of Geodon. But my doc added 300mg of lithium (which has created uncontrollable hunger), but has helped somewhat with the mania.
She also said I could take either Xanax or klonopin for anxiety.
Since I'm experiencing episodes of angry outbursts, resulting from uncontrolled anxiety, I'm wondering if klonopin wouldn't be a better choice. I like Xanax, but it doesn't seem very strong. Perhaps klonopin throughout the day is the way to go?
I just wish I could go higher on Keppra or find a mood stabilizer that doesn't cause extreme hunger like lithium.
My doc will only go up to 2500mg on Keppra.
Maybe if I give 300mg of lithium and klonopin time I will feel better?
In order for me to lead any kind of quality life I must control the mania. My life feels out of control lately. Plus I'm having depersonalization feelings. I feel like I'm living outside my body, yet I'm not in control of my mania, if this makes sense.
Posted by SLS on July 17, 2016, at 14:39:07
In reply to Geodon reduction / mania anxiety, posted by Sheilac on July 17, 2016, at 14:06:47
My first reaction is to suggest that you see another doctor for a consultation.
What happened to Trileptal?
Do you take Lamictal?
You might do very well with a combination of Lamictal, Trileptal, and lithium. No Geodon. Just a thought...
- Scott
Posted by Sheilac on July 17, 2016, at 15:19:37
In reply to Re: Geodon reduction / mania anxiety » Sheilac, posted by SLS on July 17, 2016, at 14:39:07
Lamictal caused a serious reaction: mouth sores & blisters and I had to stop. Trileptal caused severe joint pain so I had to stop. I can't take ssris so Geodon takes care of my depression.
I've been hard to treat due to all the side effects.
Posted by SLS on July 17, 2016, at 15:29:44
In reply to Re: Geodon reduction / mania anxiety » SLS, posted by Sheilac on July 17, 2016, at 15:19:37
> Lamictal caused a serious reaction: mouth sores & blisters and I had to stop. Trileptal caused severe joint pain so I had to stop. I can't take ssris so Geodon takes care of my depression.
>
> I've been hard to treat due to all the side effects.Okay. Now I have a better understanding of your dilemma.
What is the minimum dosage of Geodon that you respond to?
- Scott
Posted by Sheilac on July 17, 2016, at 15:32:40
In reply to Re: Geodon reduction / mania anxiety » Sheilac, posted by SLS on July 17, 2016, at 15:29:44
Probably 40-80mg for depression, but even 120mg doesn't help mood stabilization & mania.
Posted by SLS on July 17, 2016, at 16:40:00
In reply to Re: Geodon reduction / mania anxiety » SLS, posted by Sheilac on July 17, 2016, at 15:32:40
> Probably 40-80mg for depression, but even 120mg doesn't help mood stabilization & mania.
Crap.
Have you tried Depakote?
Have you tried Topamax?
Have you tried lithium at higher dosages: 900-1500 mg/day?Keppra is not a bad choice for you, but there are no guarantees. You know how that goes. I know of at least one case of it being effective for a young woman who was rapid-cycling and experienced a mixed-state hypomania. Nothing else had worked for her.
Everyone wants to help you find an effective treatment. I will probably repeat myself because my memory still isn't that good. Please be patient with me.
You might very well have to take two antipsychotics. This is not a novel or radical idea. It is done often enough to consider it as an alternative. You have already won half the battle with Geodon and depression. The goal, then, is to find a drug from any class to attack your mania and help to stabilize your mood. So, I think it would be a great help to make a list of the antipsychotics you have tried and what your reactions were.
1.
2.
3.
4.
etc.
- Scott
Posted by Horse on July 17, 2016, at 17:01:10
In reply to Re: Geodon reduction / mania anxiety » Sheilac, posted by SLS on July 17, 2016, at 16:40:00
My doctor told me once that Geodon can provoke activation. Personally, I experienced a delayed breakthrough eight months after adding a medication. My experience and knowledge in these matters is pretty limited.
I think klonipin would be better than xanax, and it's more of an anticonvulsant, too. Xanax is best for anxiety attacks.
A little lithium could help, although I recall you reacted poorly to it at one point, but 300 mg might do the trick.
Can you stomp on this outburst with a couple of doses of AP (zyprexa?).
I used to post under a different name, so I've been here for 7-8 years, so I do recall you are treating ADD with a stimulant. Is that correct? Has anyone brought up guanfacine for long term supplementation? It can be calming. There is an extended release called Intuiv.
Posted by Sheilac on July 17, 2016, at 17:06:53
In reply to Re: Geodon reduction / mania anxiety » Sheilac, posted by SLS on July 17, 2016, at 16:40:00
I don't know if my doc would Rx me 2 APs. But I have tried Abilify & Risperdal, both made me swell up & hungry, but risperdal as better than Abilify.
Maybe switching from Xanax to klonopin would help.
Right now my doc has me trying 300mg of lithium, which makes me hungry & gives me acne. Oh well. I feel like I don't have a lot of choices.
Posted by Sheilac on July 17, 2016, at 17:08:57
In reply to Re: Geodon reduction / mania anxiety, posted by Horse on July 17, 2016, at 17:01:10
I loved Zyprexa when I tried it. But my doc at the time wouldn't Rx it due to serious weight gain. I wasn't on it long enough for weight gain.
Right now, I've dropped the Adderall due to it effecting mania. So I'm not treating my ADD.
Posted by SLS on July 17, 2016, at 18:33:01
In reply to Re: Geodon reduction / mania anxiety, posted by Horse on July 17, 2016, at 17:01:10
> My doctor told me once that Geodon can provoke activation. Personally, I experienced a delayed breakthrough eight months after adding a medication. My experience and knowledge in these matters is pretty limited.
>
> I think klonipin would be better than xanax, and it's more of an anticonvulsant, too. Xanax is best for anxiety attacks.
>
> A little lithium could help, although I recall you reacted poorly to it at one point, but 300 mg might do the trick.
>
> Can you stomp on this outburst with a couple of doses of AP (zyprexa?).According to Sheila's previous descriptions, the mania, once it evolves, is persistent. I don't think that PRN or short courses of an antimanic or mood stabilizer will be sufficient.
Sheila: If I were you, I would look into the use of multiple antipsychotic drugs. It is not contraindicated. For some reason, people have a strong aversion to taking multiple agents for treating a mental illness. I don't see the logic in that. Personally, I like the idea of doing whatever works, regardless of how many drugs it takes to get there safely and tolerably. The brain operates using innumerable structures and functions. It is not beyond reason that one would need to address multiple sites of dysfunction. If one drug were able to manipulate all of them at once, you would not need a second drug.
A friend of mine could not build a life for herself until she added Saphris to Navane. She has schizoaffective disorder - bipolar type with paranoia. She is working and going to school to become an registered nurse. She has not had a single breakthrough symptom, despite the stress she is under.
Again, it would be helpful to have a list of APs you have taken and how they affected you.
- Scott
Posted by Lou PIlder on July 17, 2016, at 20:54:37
In reply to Re: Geodon reduction / mania anxiety, posted by SLS on July 17, 2016, at 18:33:01
> > My doctor told me once that Geodon can provoke activation. Personally, I experienced a delayed breakthrough eight months after adding a medication. My experience and knowledge in these matters is pretty limited.
> >
> > I think klonipin would be better than xanax, and it's more of an anticonvulsant, too. Xanax is best for anxiety attacks.
> >
> > A little lithium could help, although I recall you reacted poorly to it at one point, but 300 mg might do the trick.
> >
> > Can you stomp on this outburst with a couple of doses of AP (zyprexa?).
>
> According to Sheila's previous descriptions, the mania, once it evolves, is persistent. I don't think that PRN or short courses of an antimanic or mood stabilizer will be sufficient.
>
> Sheila: If I were you, I would look into the use of multiple antipsychotic drugs. It is not contraindicated. For some reason, people have a strong aversion to taking multiple agents for treating a mental illness. I don't see the logic in that. Personally, I like the idea of doing whatever works, regardless of how many drugs it takes to get there safely and tolerably. The brain operates using innumerable structures and functions. It is not beyond reason that one would need to address multiple sites of dysfunction. If one drug were able to manipulate all of them at once, you would not need a second drug.
>
> A friend of mine could not build a life for herself until she added Saphris to Navane. She has schizoaffective disorder - bipolar type with paranoia. She is working and going to school to become an registered nurse. She has not had a single breakthrough symptom, despite the stress she is under.
>
> Again, it would be helpful to have a list of APs you have taken and how they affected you.
>
>
> - ScottFriends,
Be not deceived. Scott is leading you to think that it could be safe to take multiple mind-altering drugs. He does not state the horrific consequences that could befall those that follow him. This is allowed by Mr. Hsiung and could be deemed to be supportive bhy those that trust Mr. Hsiung. And in his TOS, he asks for your trust.
This sad situation could lead to deaths from readers thinking that it is safe to take multiple drugs. You see, the nervous system can shut down the heart from multiple drugs. Many of the thousands of deaths from these drugs each month are sudden death by the drugs stopping the heart. You see, combining these drugs increases the effects exponentially. And those deceived to trust Scott and Mr. Hsiung here in thinking that you will not be killed by these drugs that they advocate, will have no recourse.
Lou
Posted by herpills on July 17, 2016, at 22:24:36
In reply to Lou's warning-no recourse » SLS, posted by Lou PIlder on July 17, 2016, at 20:54:37
Posted by Christ_empowered on July 17, 2016, at 22:55:13
In reply to Geodon reduction / mania anxiety, posted by Sheilac on July 17, 2016, at 14:06:47
Hi. I think SLS has some good ideas. I read some case studies where doctors added various doses of Abilify to an ongoing AP/AAP treatment, with good results.
Maybe that could work for you? Just a thought. I do think Klonopin might be a better idea than Xanax, although there is a Xanax xr. Also...valium is easier to taper than klonopin, but a lot of doctors don't Rx sufficient doses of valium, if they even Rx valium at all. Weird, huh?
I hope you can find something that keeps you on an even keel without too many side effects.
Posted by SLS on July 18, 2016, at 3:58:03
In reply to Re: Geodon reduction / mania anxiety (nm), posted by herpills on July 17, 2016, at 22:24:36
This is the end of the thread.
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