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I have been on on Zoloft for 2 years now with Klonopin 1 mg as needed for OCD and has been working somewhat. Recently not working too well. I am also on Topomax 100 mg a day for migraines

I went to my PDOC last week and told him things not going to well, that my depression has come back real bad, I also suffer from PTSD from something that happened as a child, and suffer from obsession impulsive addiction

He put me Gedeon 80mg a day, (40 mg twice a day) I tried it just once, the thing knocked me out like I never been knocked out before in my life, I slept for like 14 hours, I don't even remember sleeping, it was really scary even when I woke up I was dizzy could not function luckily I tried it on the weekend, but I said I cannot tried this again if I did this during the week I be screwed i took that the night before.

I am going back to see him on Monday. Any advice what I should recommend to him I should take? I hear things about amplify? I want something that will not cause me to gain weight? I just assumed he would switch me to another SSRI, not sure why he put me on this psychotic drug kind of scared me when he did. I also do not like all these serious warnings on these psychotic drugs about heart and serious neurological disease, not sure if it worth it, i dont know.

Any ideas? Thanks in advance?

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like with any med, if the Geodon starting dosage is excessive, then decrease it. Try half a dose taken after dinner, in order to allow time to recover. if that doesn't work cut the tab in half, if possible, and take 1/4 a dose.

Geodon is probably a lot stronger med than you have been used to. But as with most meds, with a little time your body adjusts to it and the side effects arent' so strong.

Do your best to give a fair trial to each med. See how it goes and be sure to discuss this with your doc at your next visit.

Good luck!

a.m.

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Thanks but i was taking lowest dosage i think only one capsule which is 40mg, he wanted me to take 80, 40 twice a day i only took 40

i was just curious is there anything else besides this? Why did he prescribe geodon? I see nothing that geodon is good for OCD and depression? or am i missing something? There must be other meds that are much better for it?

like with any med, if the Geodon starting dosage is excessive, then decrease it. Try half a dose taken after dinner, in order to allow time to recover. if that doesn't work cut the tab in half, if possible, and take 1/4 a dose.

Geodon is probably a lot stronger med than you have been used to. But as with most meds, with a little time your body adjusts to it and the side effects arent' so strong.

Do your best to give a fair trial to each med. See how it goes and be sure to discuss this with your doc at your next visit.

Good luck!

a.m.

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Thanks but i was taking lowest dosage i think only one capsule which is 40mg, he wanted me to take 80, 40 twice a day i only took 40

You might request 20 mg capsules if this trial doesn't work out.

i was just curious is there anything else besides this? Why did he prescribe geodon? I see nothing that geodon is good for OCD and depression? or am i missing something? There must be other meds that are much better for it?

It can be prescribed for obsessive thinking as an off-label indication. If you find that you're prone to magical thinking (i.e., "I can influence the outcome of events or the safety of certain persons through rationally unconnected means"), it may help you. Yes, there are other medications. Perhaps he observed that your thoughts have been disordered due to severe depression. Has your OCD crossed into psychosis (which might simply involve thought-blocking)? Don't be afraid to ask your doc what he expects the drug to do. And don't worry about bothering him, say, by calling tomorrow. You should be in close contact with him when starting a new med. EDIT: I just reread, and see you're going in on Mon. Perhaps somebody can opine if pouring some of the powder out of a capsule is a prudent move. I did this to try a smaller dose, but it may not be advisable (most frown on it).

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In fact, you might call a pharmacist or your doc's line today to double check. He has probably run an interaction check... unless you haven't told him of the Topamax. You should mention it. The following is an interaction between the drugs. I think it's standard for Topamax and AAPs. It might be fine, but it might be sedating you / affecting you more than your doctor would like. I would to double check. But that's the story of my life.

"topiramate and ziprasidone (Major Drug-Drug)

MONITOR CLOSELY: Certain drugs such as carbonic anhydrase inhibitors and drugs with anticholinergic activity (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, class IA antiarrhythmics especially disopyramide) may potentiate the risk of oligohidrosis and hyperthermia associated occasionally with the use of topiramate, particularly in pediatric patients. These agents may alter electrolyte and fluid balance (carbonic anhydrase inhibition), inhibit peripheral sweating mechanisms (anticholinergic effect), and/or interfere with core body temperature regulation in the hypothalamus (neuroleptics and phenothiazines), resulting in the inability to adjust to temperature changes, especially in hot weather. Also, agents with anticholinergic activity frequently cause drowsiness and other central nervous system-depressant effects, which may be additively or synergistically increased in patients also treated with topiramate.

MANAGEMENT: Caution is advised when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, including carbonic anhydrase inhibitors and drugs with anticholinergic activity. Patients, particularly pediatric patients, should be monitored closely for evidence of decreased sweating and increased body temperature, especially in warm or hot weather. Proper hydration before and during vigorous activities or exposure to warm temperatures is recommended. Patients (or their guardians or caregivers) should contact their physician immediately if they are not sweating as usual, with or without a fever. Ambulatory patients treated with topiramate and agents with anticholinergic activity should also be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them."

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Thanks I have to be honest I have no clue what all that below means at all LOL

pharmacist knows all the drugs I am taking, though she was very nervous giving me the geodon ketp saying are you sure you had an EKG something to do with my heart if anything she did scare the geebus out of me, I said I just had an EKG just a few months ago and everything was fine.

The topomax does not sedate me at all, I also know fro what I read the topamax is good for mood stabilizing and maybe for some OCD though i think I am too low dosage for that not sure.

To be honest I was just very suprised m pdoc did not just give me another SSRI to try before going to this real powerful med but will see tomorrow

thanks

In fact, you might call a pharmacist or your doc's line today to double check. He has probably run an interaction check... unless you haven't told him of the Topamax. You should mention it. The following is an interaction between the drugs. I think it's standard for Topamax and AAPs. It might be fine, but it might be sedating you / affecting you more than your doctor would like. I would to double check. But that's the story of my life.

"topiramate and ziprasidone (Major Drug-Drug)

MONITOR CLOSELY: Certain drugs such as carbonic anhydrase inhibitors and drugs with anticholinergic activity (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, class IA antiarrhythmics especially disopyramide) may potentiate the risk of oligohidrosis and hyperthermia associated occasionally with the use of topiramate, particularly in pediatric patients. These agents may alter electrolyte and fluid balance (carbonic anhydrase inhibition), inhibit peripheral sweating mechanisms (anticholinergic effect), and/or interfere with core body temperature regulation in the hypothalamus (neuroleptics and phenothiazines), resulting in the inability to adjust to temperature changes, especially in hot weather. Also, agents with anticholinergic activity frequently cause drowsiness and other central nervous system-depressant effects, which may be additively or synergistically increased in patients also treated with topiramate.

MANAGEMENT: Caution is advised when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, including carbonic anhydrase inhibitors and drugs with anticholinergic activity. Patients, particularly pediatric patients, should be monitored closely for evidence of decreased sweating and increased body temperature, especially in warm or hot weather. Proper hydration before and during vigorous activities or exposure to warm temperatures is recommended. Patients (or their guardians or caregivers) should contact their physician immediately if they are not sweating as usual, with or without a fever. Ambulatory patients treated with topiramate and agents with anticholinergic activity should also be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them."

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erhaps somebody can opine if pouring some of the powder out of a capsule is a prudent move. I did this to try a smaller dose, but it may not be advisable (most frown on it).

Asked my psyNP about this with Cymbalta. She said it's generally not a good idea because the capsule either is protecting the drug from your stomach acids or protecting your stomach from the drug.

*tosses in 2 cents*

Peace,

Woo

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