Posted by medlib on July 22, 2001, at 16:56:12
In reply to Re: Help! GEODON, hypomania? » medlib, posted by Chloe on July 22, 2001, at 8:12:35
Hi Chloe--
I had to stop taking Geodon because of extrapyramidal symptoms--extremely high tension in certain skeletal muscles, most pronounced in the jaw. My jaw felt like it was locked shut--it could only be opened manually. I also had resting tremors in my hands and quads (large muscles of the upper thighs). What is so baffling is that these effects began abruptly, after more than 2 weeks on the drug. All antipsychotic meds can cause EPS, but Geodon was supposed to be the least likely to do so; and these symptoms, if they appear at all, normally do so within 48 hrs. of beginning an antipsychotic.
I can relate somewhat to the feelings you expressed about Geodon; my impression while taking the drug was that it was much more powerful than the SSRIs and stimulants I have taken, and I had a subjective sense of heightened vulnerability. These were feelings that I was more than willing to cope with had I been able to continue the drug.
Re Geodon metabolism: Geodon probably is not being absorbed through your tongue, merely being dissolved in your saliva. I think that the reason it must be taken with food is that it is 99% bound to plasma protein, primarily albumin and glycoprotein. The reason I suggested taking the second dose at dinner rather than at bedtime was to help alleviate the "wearing off" effects you mentioned. Geodon has a moderate affinity for the H1 (histaminic) neurotransmitters; thus, it can make most takers drowsy, at least initially. Naturally, I felt more alert, not at all sleepy, so taking it at bedtime was not an option. If you take it with a snack rather than a meal, you might want to include some protein source.
Re: Celexa. It appears that there is very little overlap in the actions of Celexa and Geodon. Celexa acts *only* on seratonin receptors, but the specific receptor types that Celexa has a high affinity for are not the ones that Geodon affects. (Details available, if desired.) There is a very small potential for liver enzyme metabolism conflict, but, as the enzyme in question is not primary to the metabolism of either med, there is little likelihood of difficulties. If you feel that both drugs have some beneficial effects, I see no problem with the combo. *But*, what I mention comes from the drug literature--I'm not a psychopharm expert like Cam or Sunnely on this board; so, I'm sure that you'll want to be guided by your pdoc on this. If Celexa made you feel less anxious, and, if you do decide to d/c this drug, it may be wise to taper off, in order to minimize possible anxiety rebound; you might check with him on this, too.
Wouldn't it be nice if Pfizer offered 5 and 10mg. doses of Geodon? I don't think that they were considering the potential market as an adjunctive med for depression. (They should--there are far more depressives than schizophrenics.)
Hope your trial goes well.---medlib
poster:medlib
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