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Abilify/Geodon


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Went to Dr today. Not surprised she said I was bipolar, she classified it as bipolar II probably because of how horribly non-functional and depressed I was 16-20 (and again in my early 20s, but not as severe as the first time).

She was the sort not even willing to consider what I thought I might need. She basically told me "you are having symptoms and I want you on an antipsychotic". I was so pissed off, fortunately did not make a scene. I did leave the office, without prescriptions.

Now, at home, a few hours later, I am starting to wonder maybe I should just listen to her. I felt like she wasn't listening to me though, I felt like she was making everything more extreme than it was... I mean antipsychotic come on now? That's more for mania or a last resort when other stuff doesn't work.

I fully expected to walk out with a prescription for an antidepressant, lamictal, and a sleep aid/PRN for activation instead what I got was this choice, my way or the highway: Abilify or Geodon

I was so mad! WTF.

She wouldn't even meet me half way... she wouldn't give me lamictal, and she wouldn't give me a sleeping pill.

I am feeling kinda crap now, I am in one of those "cant STFU" overstimulated and generally feeling like horse crap places in time where I worry about how bad I may feel the next minute and... damn maybe I really should have just taken whatever she was willing to give me.

I'm so frustrated. I just wanted to try the lamictal because everyone said it helped them, or this is more usual than not... you don't hear that same glowing review for abilify or geodon. She must really think I'm crazy given that she wouldn't even consider an antidepressant and told me to get off st johns wort.

Well in her favor she did listen a little. I emphasized over and over and over that I am terrified of my depression, it is not a joke, and the two drugs she was willing to prescribe also help depression. I did tell her about my weight/blood sugar problems and these two meds are the least damaging antipsychotics in that regard.

What do you think, should I take it?

Is this doctor's attitude typical? Is it common for a doctor to refuse to be reasonable and meet a patient half way with scripts? I just don't understand why she wouldn't give me lamictal alone...

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I am feeling kinda crap now, I am in one of those "cant STFU" overstimulated and generally feeling like horse crap places

Prescriptions are not a negotiation.

-It's the doctors decision what to give you or not give you.

-It's your decision if you want to continue to pay this doctor or not.

Some doctors will give you many options, and some will not. Depends on the pdoc.

I'll leave the question of if she is being unreasonable to someone more knowledgeable in AP's then I am.

I will say however, that any pdoc will probably be more willing to discuss med options with you when you AREN'T in the middle of an episode. (IMO) Taking something to level you out is a good idea.

I do hope you find some relief with whatever you decide to do.

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Look that all makes sense if we are talking about a hospitalized patient, a psychotic patient... but it was agreed I was not psychotic, it was agreed I was functional, this is all new to me, I'm used to assuming doctors will work with you. It's not like I'm looking for drugs I neither need or are bad for my health. Lamictal is a mood stabilizer.

I mean, I agree I am having "symptoms" but I wouldn't classify them as an "episode". I'm functioning. I didn't leave the house without pants.

She said to me "it sounds like you don't wanna take medicine". That pissed me off. I want to take medicine, just not metabolic poison. It is invariably discovered all antipsychotics cause metabolic side effects. Considering my history (obesity, blood sugar disorders, PCOS) I do not feel like blowing up to 300 pounds, and getting severe PCOS again. Thanks. Look I would be willing to try it if I were in one of those "not leaving the house with pants" type places (or at least my family would I imagine) but not for what I have.

She was also giving me the smiling and nodding "I'm dealing with a crazy motherf'ing patient" look. The sort I use on demented residents. The overly enthused smile and nod that is placating, pretending to agree with everything I said because she thought my feelings were extreme, and I was incapable of not responding to disagreement without anger. That pissed me off. Ironically, her attempting to keep me placid with her insincere placating communication produced a logical anger.

WHen I left the office she goes "maybe come back in a week when you are feeling better?" Which I think was code for "come back when you aren't crazy and I won't make you take an antipsychotic".

If this is what it's like to go to a doctor - being treated like a child, being placated, not being listened to, being forced to take medicine without any remote hope of compromise.... I mean, count me out.

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Not having been there, I have no idea whether or not you were appropriate in your communications with the pdoc. Given your own previous statements about eliciting surprising reactions, when you thought you'd been perfectly appropriate, I'm inclined to think not, but I wasn't there.

Lack of insight is so common to people with bipolar it might as well be a DSM criteria. You've been unmedicated for a long time. You're probably worse than you think. Possibly much worse. It sounds like the pdoc thought you were unstable enough that you needed to stablize somewhat before being able to participaye much in your treatment. Considering that you emphasized blood sugar/weight gain & depression issues with her, she probably did take those into account in making her reccomendations.

You're complaining about a child, but kind of, you're acting like one.

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Abilify and Geodon are both weight neutral from what I've seen and experienced. I've been on Geodon for almost 3 years and it has worked very well for me. It stopped the racing thoughts and agitation and even helps a little with the depression. I'm also on Lamictal and Welbutrin.

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I know how it feels to not be heard. To be rightfully angry and then have that anger pathologized. When one pdoc I had left and put me in the hands of a new pdoc who had her own ideas of what meds I should be on EVEN THOUGH I WAS PERFECTLY FINE, she changed my meds. I went into a mixed episode and I begged and pleaded to be put back on my old meds and she just kept saying NO. Then I got angry and I distinctly recall how that anger was chalked up to just another symptom. I know exactly the kind of placating look you're talking about. I finally had to switch pdocs and pay out of pocket for the new one. My advice to you is to find a different pdoc. It's worth it in the end.

--lluvia

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I know how it feels to not be heard. To be rightfully angry and then have that anger pathologized. When one pdoc I had left and put me in the hands of a new pdoc who had her own ideas of what meds I should be on EVEN THOUGH I WAS PERFECTLY FINE, she changed my meds. I went into a mixed episode and I begged and pleaded to be put back on my old meds and she just kept saying NO. Then I got angry and I distinctly recall how that anger was chalked up to just another symptom. I know exactly the kind of placating look you're talking about. I finally had to switch pdocs and pay out of pocket for the new one. My advice to you is to find a different pdoc. It's worth it in the end.

--lluvia

That is not the case here. The OP is symptomatic and has never been treated before. It seems very much to me that the pdoc is seeking to immediately stabilize so that the OP can better participate in her treatment plan.

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Like Mayteana said, the only opinion that matters, in the end, is the doctors. They are the one with the medical knowledge that *you* pay and selected them for.

You can google psych meds all day long, but you never went to organic chemistry in college. We, as patients, can only offer feedback and suggest meds we want to take. Other than that, we are just along for the ride.

You also appear to be unmedicated for your condition. This likely means, and stacia said, that you are not in the most impartial and clear-thinking place. You need to give control to the one person who can help you now. Accept your doctor's treatment advice, it sounds as though you really need it now.

I'm overweight, a prime candidate for diabetes. Yet I've been on vaious APs for years and two months ago, added the worst AP for diabetes, zyprexa, to my cocktail. Am I worried about side effects? No. I get my blood sugar tested at every visit to be safe, and I have a good diet and I exercise. I even dropped 33 pounds in two months recently and my triglycerides dropped 41 points. The side effects you are speaking of are like 1:1000. You will want to be aware of them, but you don't have to be convinced they are going to happen to you unless you don't follow a good diet or don't exercise. And even then, its still rare to have happen.

I've taken both abilify and currently take geodon. I've taken lamictal twice, and I'll tell you, it really did nothing for me. Lithium was much better for me than lamictal. I like geodon. I unfortunately had some severe agitation and restlessness on abilify (called akathesia) that caused me to stop the drug.

I hope that after you calm down and consider the situation, you will follow your doctor's suggestion and fill that prescription. Everyone, icluding your doctor, wants you to feel better.

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BTW, I changed my name. I <3 Smiths. Slightly less corny than my old name I think.

Thanks for the replies everyone. I just want to mention I have decided to trust the doctor, after reading more about abilify, I'm a little less scared now. I guess all I can do is trust that this may help.

This may be a little faulty logic but I am rationalizing it as such: I have never experimented with illegal drugs, I don't drink, don't smoke, I'm pretty much completely clean and sober, so I figure I am no worse off for attempting a psychiatric medicine considering the entire population has at least SOME vice now or past. Even if we assume it doesn't work for me and causes real bad side effects, it can't be worse than what your average person does by smoking drinking or using drugs for pleasure.

Also, so much of my mood/well being is related to my weight. Not so much the bipolar stuff but I mean just my self esteem and how I feel... I used to have an eating disorder... I was pretty depressed in december & janurary and I gained a lot of weight (I gain weight when depressed, the only time I didn't is when acutely eating disordered at around 22-23, in which my depression got pretty bad again but I was losing weight becuase of how screwed up I was with food/weight).

My mood has been more trending upward lately (more frequently up), and I am finally starting to lose weight. In these past few days I've been eating very little on the "up days" because I'm not hungry because of symptoms, and I am happy that I'm finally losing all the crap I piled on december/jan... I mean, I really don't want to gain ANY weight. I gained 8 POUNDS in those 2 months. I was just unsatifiable. My mood does that to me.

And, even the bipolar stuff is affected by my weight but I don't know if it is just a learned association (it usually follows that getting fat leads to depression / lethargy /lack of motivation and losing weight leads to being energized and hypomanic symptoms). Like, I don't know if my mood crashing leads to getting fat (and vice versa) but the bottom line Is I am super super super scared of weight gain because it usually implies being depressed, makes me depressed, and generally makes me feel horrible about myself. I am trained to view getting fat with feeling like complete garbage, no energy, no motivation, so any drug that causes weight gain is, in my mind, a drug that will cause depression.

I suppose I'm trying to say that weight is a real big deal for me, I really don't want to gain another pound. It's just too scary both in terms of what it means for mood and self image.

I am so stupid sensitive to anything that messes with dopamine/serotonin and blood sugar and weight... if it causes hunger, odds are I'll become ravenous. If it messes with insulin/sugar, I'll be broken up with sugar, hypoglycemic and frantic from that alone... not to mention the more chronic burried underground and oblivious type depression that I get from teh process of becoming a fatty.

Right, I'm rambling. Well, I'll try it, that's all I can say, gotta at least try. She'll see me in a week, how bad could it be. It's just 5 mgs.

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