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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Sebastian on October 25, 2005, at 12:45:05
I started hearing voices on the geodon, never had on zyprexa or at all before. The zyprexa is so much more calming too. I took geodon for 11 months and now I am giving up on it. My doctor says you will just complain about the high dose of zyprexa. But it works better I say. And he gives in and puts my zyprexa up and geodon down. Is it all a big mistake, will I want the geodon back, when I start gaining wight.
Posted by SLS on October 25, 2005, at 13:31:52
In reply to Geodon not = to zyprexa, posted by Sebastian on October 25, 2005, at 12:45:05
Abilify might be worthy of consideration. It produces no weight gain. Yes, I would have to say that Zyprexa is second only to Clozaril for schizoid symptoms, but the weight gain can be a major drawback. I can't guarantee you that Abilify will be the equal of Zyprexa, but I can say that it is usually better than Geodon. If you choose to go with Abilify, just be aware that there can be a brief period of akathisia-like anxiety and insomnia as startup side effects. More often than not, these dissipate within a week or two.
- Scott
Posted by SLS on October 25, 2005, at 13:34:41
In reply to Re: Geodon not = to zyprexa, posted by SLS on October 25, 2005, at 13:31:52
Hi Sebastian.
I just read in one of your other posts that you have already tried Abilify. What happened with that?
What about with Seroquel and Risperdal?
- Scott> Abilify might be worthy of consideration. It produces no weight gain. Yes, I would have to say that Zyprexa is second only to Clozaril for schizoid symptoms, but the weight gain can be a major drawback. I can't guarantee you that Abilify will be the equal of Zyprexa, but I can say that it is usually better than Geodon. If you choose to go with Abilify, just be aware that there can be a brief period of akathisia-like anxiety and insomnia as startup side effects. More often than not, these dissipate within a week or two.
>
>
> - Scott
Posted by Sebastian on October 25, 2005, at 13:39:43
In reply to Re: Geodon not = to zyprexa, posted by SLS on October 25, 2005, at 13:31:52
I've tried abilify, it was not a good experience. Couldn't sleep, eat and the anxiety was the worst I have ever felt. I even holucinated on it once.
Think I am going to go back to 5 mg zyprexa and 4 60 mg geodons. How do I tell my doctor? I just asked him last night to let me take 7.5 mg zyprexa and 3 60 mg geodons. I ate less yeasterday than I have been and I still gained 3 pounds over night. I was starving when I went to bed, how can it be? Do you think he will be upset if I call and say I want to go back in a brief message? He was not that happy to talk to me last night.
Posted by Sebastian on October 25, 2005, at 13:46:49
In reply to Re: Geodon not = to zyprexa, posted by SLS on October 25, 2005, at 13:34:41
Risperdal I have tried. It had me holucinating that the tv was talking to me and the cartoons were very tripy. Also I was as stiff as a board. Not a good med. I've never tried seroquel but it also has weight gain, may as well just take the zyprexa in that case.
Posted by SLS on October 25, 2005, at 14:03:18
In reply to Re: Geodon not = to zyprexa, posted by Sebastian on October 25, 2005, at 13:46:49
> Risperdal I have tried. It had me holucinating that the tv was talking to me and the cartoons were very tripy. Also I was as stiff as a board. Not a good med. I've never tried seroquel but it also has weight gain, may as well just take the zyprexa in that case.
There is usually not nearly as much weight gain with Seroquel as there is with Zyprexa. It is a good drug and might work well for you at dosages above 400mg.
I don't think the stimulation of appetite and weight gain with Zyprexa is very dependent on dosage. In other words, I would look to go higher on the Zyprexa and forget about the Geodon, unless you have a compelling reason to stay on the Geodon. Other options include some of the older antipsychotics like Stelazine. Stelazine is weight-neutral.
What exactly is your diagnosis, Sebastian?
I think one of the problems that you are encountering is that anything that is even mildly stimulating or anxiogenic works against you. Now that I think about it, Stelazine might be too activating for you. I would have to look into it. In the meantime, you could try amantadine as an aid to prevent Zyprexa weight gain. It is being looked into by several investigators and there are anecdotal reports that make me believe that it works.
- Scott
Posted by Sebastian on October 25, 2005, at 14:19:42
In reply to Re: Geodon not = to zyprexa, posted by SLS on October 25, 2005, at 14:03:18
Schizoaffective. So I should stay with zyprexa at a higher dose? I just put in a paniced call to my psychiatrist, saying that I wanted to go back to 5 mg zyprexa and 3 60 mg geodons. I'm not convinced that the dose is independant of weight gain. The thing is I find zyprexa to be the most theraputic drug I have ever taken. I just can't get mydelf fully off of it. Just lower doses for a while and then I always want to go back up.
Posted by med_empowered on October 25, 2005, at 15:42:23
In reply to Re: Geodon not = to zyprexa, posted by Sebastian on October 25, 2005, at 14:19:42
hi! OK, first off-combining 2+ antipsychotics in general should probably be avoided...it hasn't really been studied all that well. If zyprexa works for you, I think you can go up to 20-30 mgs (per the manufacturer's data), possibly higher if necessary...so, you could maybe add in Metformin (glucophage) to prevent the metabolic problems, add in amantidine to take care of weight gain, and gradually discontinue the geodon and go up on zyprexa. Since you're schizoaffective...you might be able to minimize the dose of your antipsychotic(s) by using other meds...a pretty standard cocktail for schizoaffective is a benzo (anxiety), mood-stabilizer, and antipsychotic...possibly with an antidepressant thrown in. I'd personally try to focus on the mood-stabilizer and benzo combo first, then use as low an antipsychotic dose as you possibly can. If you're going to take an antipsychotic long-term, you might also want to look into supplements to help prevent tardive dyskinesia..the antioxidants (E, C, etc.) might help. Good luck!
Posted by 4wd on October 25, 2005, at 20:55:39
In reply to Re: Geodon not = to zyprexa, posted by SLS on October 25, 2005, at 13:34:41
> Hi Sebastian.
>
> I just read in one of your other posts that you have already tried Abilify. What happened with that?
>
> What about with Seroquel and Risperdal?
>
>
> - ScottIf Zyprexa worked well, but caused terrible hunger, will Risperdal have a similar positive effect? Is there any way to know? Abilify caused severe headache.
Marsha
Posted by Sebastian on October 25, 2005, at 22:01:52
In reply to Qx re risperdal, posted by 4wd on October 25, 2005, at 20:55:39
Risperdal made me hungry also. It did not have a positive effect for me as I wrote about in this thread. Geodon is the only one that did not make me hungry. Even Abilify made me a little hungry, probably was my anxiety. I never got a headack from risperdal.
Posted by DanielJ on October 26, 2005, at 8:23:45
In reply to Re: Qx re risperdal, posted by Sebastian on October 25, 2005, at 22:01:52
My son turns 18 in a few days almost 2.5 years after his first episode he has tapered down his zyprexa from 20 mg to 12.5 mg. Hopefully it will stay there. Reason being he seems to be very tired lately wanting to go to bed at 8:00 many nights. He still is taking 75 mg of Zoloft daily for the obsessive behavior that is part of Schiz.
Zyprexa is still the best from what I have read.
I think it could give you back your peace of mind.
Posted by Sebastian on October 26, 2005, at 10:38:52
In reply to Re: Tapered down from 20 mg Zyprexa, posted by DanielJ on October 26, 2005, at 8:23:45
I have increased my dose of zyprexa from 2.5 mg to 5 mg. 2.5 is when I had the voises, they seem to have gone away now that I'm on 5 mg. I'm not sure if the geodon is helping at all, but my doc wants me to take it. Maybe I was just jumping the gun going up to 7.5 and giving up on geodon all together. Its just that I would gain weight. I'm going to try sticking with this 5 mg dose for a while, see what happens.
Posted by Sebastian on October 26, 2005, at 10:40:48
In reply to Re: Tapered down from 20 mg Zyprexa, posted by DanielJ on October 26, 2005, at 8:23:45
20 mg is a high dose and I could see him being tired. I was tired just on 15 mg, my highest dose ever of zyprexa. Hope the 12.5 mg dose works out.
Posted by med_empowered on October 26, 2005, at 15:18:49
In reply to Re: Tapered down from 20 mg Zyprexa » DanielJ, posted by Sebastian on October 26, 2005, at 10:40:48
Instead of doing combos with atypicals..maybe an old-school ap (at a low-dose, of course) would be a good idea? There was a recent study that found Trilafon (perphenazine) compared very well to zyprexa...I think zyprexa had a **slight** edge, but it was pretty minor. If you keep the AP dose low, you could get necessary antipsychotic action w/ minimal side effects (the EPS seen with old drugs might be b/c they used to be given in such high doses). Plus, perphenazine is pretty good for mania and depression (that's why it was put in Triavil, for agitated depression and depression in schizophrenia). So..maybe something like perphenazine, or loxapine, at low-doses, maybe with buspirone added and maybe an anti-depressant would be good? It seems like you could avoid weight gain that way, and probably also avoid EPS.
Posted by xbunny on October 26, 2005, at 17:17:45
In reply to maybe an old-school AP?, posted by med_empowered on October 26, 2005, at 15:18:49
> Instead of doing combos with atypicals..maybe an old-school ap
I agree, I spent years experimenting with atypicals until I hit my current combo of two old antipsychotics (I take pericyazine and flupenthixol). I reckon trying an older antipsychotic after you have trialled several atypicals would be a good course of action. Theres lots to try with a wide variety of side effects.
Buns
Posted by Sebastian on October 27, 2005, at 16:24:07
In reply to maybe an old-school AP?, posted by med_empowered on October 26, 2005, at 15:18:49
I started a thread on perphenazine a little while back and the consensuse was not to take it. If I was to take perphenazine what could I expect? Side-affects. Would I get uncontrolable movements? Things like that.
Posted by Sebastian on October 27, 2005, at 16:27:03
In reply to Re: maybe an old-school AP?, posted by xbunny on October 26, 2005, at 17:17:45
What side-affects do you get? What affects do you get? Tiredness, awakeness or nither?
Posted by xbunny on October 27, 2005, at 17:35:05
In reply to Re: maybe an old-school AP? » xbunny, posted by Sebastian on October 27, 2005, at 16:27:03
> What side-affects do you get?
Tiredness from the pericyazine, a sexual side effect from the flupenthixol and a little weight gain from both. When I started pericyazine I got some hypotension (I passed out on one occasion) it passed after a few weeks. I also got some extrapyramidal side effects these were easily managed with procyclidine and I was able to discountinue it without them returning after a month.
> What affects do you get?
From the pericyazine I get a decrease in anxiety, less paranoia when I am outside and generally I feel a lot calmer. From the flupenthixol I get a decrease in hallucinations, delusions and intrusive thoughts and also a boost in my mood and concentration. If I miss a dose for whatever reason I am always amazed by the difference in me, meandering, listless, apathetic and prone to staring into space. I also take the antidepressant mirtazapine which helps me maintain a more stable mood.
Hope this is of some help, Best regards, Bunny
This is the end of the thread.
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