Posted by psychobot5000 on July 6, 2009, at 1:02:38
In reply to Re: The Final Pathway To The Dopaminergic Pot Of G, posted by ABMIND on July 5, 2009, at 20:34:24
> Hi all,
> I've been looking for info re: Geodon -maybe someone out there can help.
>
> Here's a little background:
> I've been on a variety of antidepressants over the last 10 yrs. --60mgs of Cymbalta for the last 3 years. 6 mths ago I switched psychiatrists b/c my therapist suggested I might have ADHD (inattentive type) along with my major depression & anxiety (social & GAD).
>
> So, I found an 'expert' in adult ADHD (I'm 40) I went on Strattera for 1 month, then on adderall for a month with no change in symptoms. Then he started me on Vyvanse 40 mg then went up to 80mg. On the higher dose I felt calmer, a little less emotionally reactive & agitated but my head was stilled filled with tons of thoughts about the 1000 things I needed to get done.
>
> So, the doctor increased the Cymbalta to 90mg. I felt pretty good in regards to my anxiety & depression & my "to do" lists had stopped running through my head. My therapist noticed a big difference, but I was still having trouble with things like organization, prioritizing & actually getting started on tasks.
>
> At my next appointment the doctor took me off the Vyvanse and changed me to Concerta started at 18mg. then up to 72 mg. I took it for 3 weeks and my anxiety & depression became much worse.
>
> When I went back to the doc this past Thurs. he took me off Concerta & put me on Geodon. Told me to take 20mg for 3 days, then 40 for 3 days, then up to 60mg. (keeping the Cymbalta at 90mg)
>
> OK, finally my question(s)...
>
> Is Geodon a typical drug for depression & anxiety? Web sites I've found have listed it as an antipsychotic for schizophrenia or bipolar, with bad withdrawal effects. I few years back I had a horrible time getting off Effexor and I am afraid to 'try out' Geodon and then have problems weening off it, if it doesn't work.
>
> I wanted to get back on the Vyvanse, but he said that it didn't help with the ADHD, so is Geodon going to help me with the ADHD?
> Does anyone take 90mg of Cymbalta & 60 mg of Geodon? Will I expect to see improvement in my executive function skills? Or will the doc put me on another stimulant? My doctor did not explain any of this to me when he gave me the Geodon samples.
> Is 60 mg too high? Someone wrote that it will start acting like an antipsychotic!!?? What does that mean??!! Is this the doctor's way of giving me a new diagnosis??
>
> I would really appreciate any advice. ThanksDear sir,
First, not to take over this thread, but, briefly, no Geodon is not really a 'typical' drug for depression and anxiety. However, it is a -legitimate- drug for those things, even if its use for them is 'off-label.' So I don't think you need to worry about that too much. I'm taking it myself, for symptoms very similar to yours.
From what I've read, I do think 60mg twice per day (is it once or twice a day that you'd be taking the 20/40/60mg dose) is too high a dose for depression or innattentive ADD symptoms. However, I very much doubt your doctor's use of Geodon at an 'antipsychotic dose' (i.e. a relatively high one) is a way to give you a new diagnosis. I just think he may be misled on what's the best dose for your problem. What happens at the higher doses is, you get high enough levels of the drug in your system to start blocking certain dopamine receptors (D2) to a significant degree, which is very useful for people who have schizophrenia or other diseases, but probably counter-productive for people with depression or people who have difficulty concentrating and organizing. At the lower doses, theoretically at least, you can get the positive effects on mood and on 'cognitive function' from the drug's action on another target, the serotonin receptor 2a ( 5HT-2a), while only getting a tiny amount of the unwanted action on D2.
For what it's worth, I also have difficulty concentrating, organizing, and thinking, and my low dose (10mg, twice per day) of Geodon has been helpful with that--mostly in the few hours after each dose. So maybe it'll be helpful with your cognitive symptoms also.
Best of luck,
PsychbotP.S. Ultimately, you probably want to take a relatively low dose of this drug, if you can get away with it, just for general health-reasons. Geodon is part of a class of drugs that are not to be used lightly. So don't panic or anything, but that's another reason for being a little wary about the higher doses, especially if the lower might work better.
poster:psychobot5000
thread:904542
URL: http://www.dr-bob.org/babble/neuro/20090701/msgs/905195.html