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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Sheilac on March 23, 2014, at 11:13:22
Tegretol still rocking! Shocking, but true.
Doc had me go back to Geodon for my depression and mood since I've taken it in the past.
I've been taking 60mg at night. It instantly got rid of my depression. But after a few days I noticed that I get irritated a little more easily and am afraid I will fly into a rage and scream at someone.
I've had this same feeling on Adderall and full blown rage mania on Wellbutrin. So I'm thinking this must have something to do with dopamine.
I need a boost in dopamine for my depression & motivation, but I don't need to fly off the handle.
I like Geodon - no weight gain.
Is there a way to get the benefits without the irritation?
Right now I take it at night with dinner. Do I go up to 80mg? Won't I lose the dopamine AD effects at that dose? I don't want to lose my drive & motivation.
So far I feel like I've gotten my life back with Geodon I don't want to drop it.
There must be a way to keep the good and curb the bad. I can't go back to feeling depressed & unmotivated. Taking more Tegretol would just make me depressed.
Suggestions? Abilify is out due to severe weight gain.
Posted by phidippus on March 23, 2014, at 15:34:31
In reply to Geodon doseage? Dopamine?, posted by Sheilac on March 23, 2014, at 11:13:22
>Is there a way to get the benefits without the irritation?
The higher up you go on Geodon, the more dopamine is suppressed, which should help with your irritabity.
>Do I go up to 80mg?
Why not try 120 or even 160 mg?
>Won't I lose the dopamine AD effects at that dose?
There are no dopamine AD effects at any dose of Geodon. Geodon exerts its antidepressant qualities in two ways: 1. It agonizes key serotonin receptors 2. blocks the reuptake of serotonin and norepenephrine.
Eric
Posted by Sheilac on March 23, 2014, at 16:38:51
In reply to Re: Geodon doseage? Dopamine? » Sheilac, posted by phidippus on March 23, 2014, at 15:34:31
Then why do I feel similar on Adderall, Wellbutrin and Geodon? I was assuming the motivation and AD effect I was feeling on Geodon was because of dopamine.
My doc did say there is lots of room to go up on Geodon and not to worry. I think I do need to try a higher dose. I'm also wondering if I could get away with a higher dose of Geodon as my only med? Maybe? Maybe not?
Posted by phidippus on March 23, 2014, at 17:16:50
In reply to Re: Geodon doseage? Dopamine? » phidippus, posted by Sheilac on March 23, 2014, at 16:38:51
>Then why do I feel similar on Adderall, Wellbutrin and Geodon?
Each is helping you with depression, which I imagine feels the same no matter which drug does it.
>I'm also wondering if I could get away with a higher dose of Geodon as my only med? Maybe? Maybe not?
Eeegads, no! Antipsychotics do not make good mood stabilizers-stabilizing mood is so much more than antagonizing dopamine and agonizing serotonin. All neurotransmitters are affected and your Tegretol helps keep them in balance.
Eric
Posted by Sheilac on March 23, 2014, at 17:28:40
In reply to Re: Geodon doseage? Dopamine? » Sheilac, posted by phidippus on March 23, 2014, at 17:16:50
Thanks, Eric! I appreciate your input.
I guess going up to a higher dose of Geodon will ward off the irritability and hopefully I will still get the motivation & AD effect.
You're right. I would love to be on just 1 or 2 meds, but I understand that a mood stabilizer is the base.
Posted by rjlockhart37 on March 23, 2014, at 18:54:00
In reply to Geodon doseage? Dopamine?, posted by Sheilac on March 23, 2014, at 11:13:22
for some weird reason....geodon was activating for me....i took it above the max dose in 2009, it was on 160mg at night....it did block some annoying background thoughts....but it does somehow increase dopamine a little, but not alot, from my personal feeling it did have a activating feeling....
i think you'll be fine at 80mg's ... it not heavy antpsyotic like clozapine and haliparidol...you can function fine on it, well in my case i did....
Posted by Sheilac on March 23, 2014, at 19:12:23
In reply to Re: Geodon doseage? Dopamine?, posted by rjlockhart37 on March 23, 2014, at 18:54:00
I take it for mixed or bp2 depression (mixed or bp2, depending on what doc you ask).
Posted by SLS on March 23, 2014, at 19:22:33
In reply to Geodon doseage? Dopamine?, posted by Sheilac on March 23, 2014, at 11:13:22
I'm sure Phiddipus understands this better than I do, but the newer atypical antipsychotics all block serotonin 5-HT2a receptors. This mechanism effectively increases dopamine activity downstream. Sometimes, you need to think of the brain as a network of circuitry, not simply a a pool filled with neurotransmitters.
One step at a time. I would encourage you to stay on Tegretol. If you can't get Geodon to work well for you, speak to your doctor about Latuda. Latuda is a weight-neutral antipsychotic, and has well-documented antidepressant effects in bipolar depression. It is now approved by the FDA for that indication.
Try not to screw around with your medication. Let your doctor do that.
- Scott
Posted by porkpiehat on April 5, 2014, at 13:50:35
In reply to Re: Geodon doseage? Dopamine? » Sheilac, posted by SLS on March 23, 2014, at 19:22:33
No one seems to be honing in on this:
Drugs that stimulate the alpha2 andrenoreceptors (wellbutrin, buspar metabolite pp-1, serzone?) can cause rage and irritability, ESPECIALLY in BP/BPII people. These drugs send me off the rails angry and the only thing that clued me into this was a post on psychobabble:
http://www.dr-bob.org/cgi-bin/pb/mget.pl?post=/babble/20030604/msgs/232446.html
Perhaps this is the culprit? I'd be interesting in knowing myself
Posted by miko84 on April 13, 2014, at 2:12:23
In reply to Re: howabout alpha2 andrenoreceptor?, posted by porkpiehat on April 5, 2014, at 13:50:35
Buspar metabolite, ziprasidon are alpha-2 antagonist, not agonist.
This is the end of the thread.
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