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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by lapdog on July 12, 2002, at 0:45:43
Hi, my son has had the following history of medications over the last 7 years.
1. Haldol
2. Resperidol
3. Zyprexa
4. Zyprexa and Seroquel
5. Seroquel
6. Zyprexa and Seroquel
7. Geodon
8. Geodon and Seroquel - the current.His switch (7) to Geodon was marked by manic like activity, tension, insominia etc at 160mg a day (after ramping up). Reduced to 120mg a day.
Initial reaction to Geodon (7) (or possibly the discontinuance of Zyprexa (6)) was positive for several months. Better communication and cognition, more normal conversations, no thought lag, etc.
However, gradually, his blockage (short for ask him a question and wait 5 to 15 seconds for him to process it) became more pronounced. Added Seroquel (8) and gradually increased it to 800 mg a day - his former maximum (6).
Now, he has trouble hearing people - can't seem to catch what people are saying very well even while trying to.
My question (finally): Does anyone know or suspect that Geodon and Seroquel do not work well together?
Also, does anyone know or suspect that Geodon may not be as effective as its suspose to be.
Last, supposing that Resperidol, Zyprexa, and Geodon (all related drugs) are no longer effective, what might be the next best drug to try?
We are working closly with his doctor, but would like to hear from others on known problems with Geodon (or the Geodon/Seroquel combination).
Thank-you.
Posted by wcfrench on July 12, 2002, at 21:08:01
In reply to Geodon and Seroquel - Interactions?, posted by lapdog on July 12, 2002, at 0:45:43
HI... You might be in luck. I've taken Geodon, Zyprexa, and Seroquel and can give you my bid on how they work. But keep in mind, reactions are different for everyone.
First of all, Seroquel is the weaker of the 3 medications and has a stronger factor of sedation. 800mg a day is quite a high dosage, but if he could handle it, then so be it. I first started Seroquel and things seemed to be on the upswing. I had depression and some psychotic depressive symptoms and it made me feel pretty normal for a time, but didn't quite get rid of all my symptoms. It was at this time that we decided to go to Geodon, a stronger medicine. I had and still have had, the most success with the Geodon. However, unfortunately, after gradually going up to 80mg twice a day, I got a pain all over my body that I went to the emergency room for from a side effect of the med, and quickly had to decrease, and had HORRIBLE withdrawal symptoms-- major depression and psychotic feelings. After this trouble, I asked my doc if there was something similar to Geodon that was a once-a-day med, since when taking the Geodon during the day it sedated me, and he mentioned Zyprexa. Well, I had limited success with the Zyprexa, but it never seemed to give me all the positive benefits that the Geodon did, leading me to believe that the ratios were different, (Mostly, I felt a more positive dopeminergic "high, calm" feeling with the Geodon that I didn't get with the Zyprexa) Also, a few weeks after taking the Zyprexa, it seemed to start giving out on me, the so-called Poop-out, and I stopped taking it. Recently, I have restarted the Geodon and are working in the 40-60mg nightly range, and the effects are good, but not as great as the first time I took it, but still _very_ good.
About your question: The only thing I can think of about the combination of Seroquel and Geodon is that they are both fairly strong anti-psychotic medicines and the trouble might be that it's a little too much medicine when combined. I'm no doc, but I would say that his thought lag (is there any oversleeping too?) would be caused from slight oversedation from the medicine. If he is unresponsive to Geodon, the next route, depending on his diagnosis, would be Lithium as a mood stabilizer. If you said he had manic episodes, Lithium is usually the path that is taken, and has a high success rate. For other depression/anxieties, if one has already tried an SSRI, there are several other options. Many choose a different type of anti-depressant (assuming they already have taken an SSRI, such as Prozac, Paxil, Celexa, Effexor). There are other A.D.s that sometimes work when SSRIs give out, such as Wellbutrin (works on different chemicals - dopamine and norapinephrine), MAOIs, tricyclics, and tetracyclics. You'll see them posted all over this board, and you can run some of them in a search on google.com and easily find out about the meds. For your son, if you say he's manic, I would most likely say that Lithium would be the next trick in the bag for controlling his episodes. From my personal experience, Geodon has been a very effective medicine for me, but I'd err on the side of caution when combining it with another anti-psychotic. You might want to ask his doc about possible oversedation, or if he's no longer responding, inquire about Lithium. The road only gets easier from here!
Sorry about the long post. Good luck to you and your son!!
-Charlie
Posted by lapdog on July 13, 2002, at 19:15:15
In reply to Re: Geodon and Seroquel - Interactions?, posted by wcfrench on July 12, 2002, at 21:08:01
Thank-you for your kind reply. My son has been on lithium for years and a variety of anti-depressants. I omitted these to keep the list of medications readable. Interestingly, he stoped taking an anti-depressant when he started Geodon. He was really wired the first month as we realized that the combination of Geodon and Celexa was causing an overload of dopamine. We cut out Celexa and he calmed down somewhat at 160 mg of Geodon a day but still couldn't sleep, and was very tense. At 120 mg he could sleep, albiet with a sleep aid, and a little less tense.
I read you reply carefully, and have thought about you suggestion to reduce the meds. Certianly, he is not getting better at higher doses any more. Which one to reduce though, Seroquel or Geodon?
BTW, my son agrees with you in that he prefers Geodon to Zyprexa as Zyprexa seems heavy handed. However, I myself am disappointed with Geodon, and so begin the search for an alternatives.
I'm surprized that such a light dose of Geodon is working for you. Are you taking any other anti-psychotics?
Again thanks for your time and help.
> HI... You might be in luck. I've taken Geodon, Zyprexa, and Seroquel and can give you my bid on how they work. But keep in mind, reactions are different for everyone.
>
> First of all, Seroquel is the weaker of the 3 medications and has a stronger factor of sedation. 800mg a day is quite a high dosage, but if he could handle it, then so be it. I first started Seroquel and things seemed to be on the upswing. I had depression and some psychotic depressive symptoms and it made me feel pretty normal for a time, but didn't quite get rid of all my symptoms. It was at this time that we decided to go to Geodon, a stronger medicine. I had and still have had, the most success with the Geodon. However, unfortunately, after gradually going up to 80mg twice a day, I got a pain all over my body that I went to the emergency room for from a side effect of the med, and quickly had to decrease, and had HORRIBLE withdrawal symptoms-- major depression and psychotic feelings. After this trouble, I asked my doc if there was something similar to Geodon that was a once-a-day med, since when taking the Geodon during the day it sedated me, and he mentioned Zyprexa. Well, I had limited success with the Zyprexa, but it never seemed to give me all the positive benefits that the Geodon did, leading me to believe that the ratios were different, (Mostly, I felt a more positive dopeminergic "high, calm" feeling with the Geodon that I didn't get with the Zyprexa) Also, a few weeks after taking the Zyprexa, it seemed to start giving out on me, the so-called Poop-out, and I stopped taking it. Recently, I have restarted the Geodon and are working in the 40-60mg nightly range, and the effects are good, but not as great as the first time I took it, but still _very_ good.
>
> About your question: The only thing I can think of about the combination of Seroquel and Geodon is that they are both fairly strong anti-psychotic medicines and the trouble might be that it's a little too much medicine when combined. I'm no doc, but I would say that his thought lag (is there any oversleeping too?) would be caused from slight oversedation from the medicine. If he is unresponsive to Geodon, the next route, depending on his diagnosis, would be Lithium as a mood stabilizer. If you said he had manic episodes, Lithium is usually the path that is taken, and has a high success rate. For other depression/anxieties, if one has already tried an SSRI, there are several other options. Many choose a different type of anti-depressant (assuming they already have taken an SSRI, such as Prozac, Paxil, Celexa, Effexor). There are other A.D.s that sometimes work when SSRIs give out, such as Wellbutrin (works on different chemicals - dopamine and norapinephrine), MAOIs, tricyclics, and tetracyclics. You'll see them posted all over this board, and you can run some of them in a search on google.com and easily find out about the meds. For your son, if you say he's manic, I would most likely say that Lithium would be the next trick in the bag for controlling his episodes. From my personal experience, Geodon has been a very effective medicine for me, but I'd err on the side of caution when combining it with another anti-psychotic. You might want to ask his doc about possible oversedation, or if he's no longer responding, inquire about Lithium. The road only gets easier from here!
>
> Sorry about the long post. Good luck to you and your son!!
>
> -Charlie
Posted by wcfrench on July 15, 2002, at 22:47:15
In reply to Re: Geodon and Seroquel - Interactions?, posted by lapdog on July 13, 2002, at 19:15:15
Hi
I thought I posted another reply but apparently it didn't go through.
I'm not on any other anti-psychotics, but am on Lithium, getting off of Effexor, on Wellbutrin, and Geodon. For reducing the meds.. for me the Seroquel caused the most amount of sedation. The Geodon is a stronger med... this all depends on if you're talking about taking during the day or at night. I couldn't take either during the day. The seroquel made me not able to stand up, and the Geodon was less sedating, but still made me feel a very wierd tired. I would try decreasing the Seroquel first.. it seems to have the mosts sedating effects.
I'm glad I'm not taking any other anti-psychotics. The low dose Geodon seems to be working, and I hope it doesn't give out on me. Lithium I think is helping a lot too.
Good luck.
-Charlie
This is the end of the thread.
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