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Add Geodon and up the Lithium!


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Having been medicated for 12ish years now I just recently started Lithium a few months ago. I explained to my current pdoc that Lithium had always been my "scary drug" and I had turned down all my previous doctors when they suggested it. He sat down with me and let me ask a billion questions and even drew out a diagram of what it would do in my body chemically.

So anyways, on my last visit he upped my dose to 1200mg. I also expressed my concern about having gained about 10lbs and we attributed this to the Seroquel. He told me about a few other meds similar to Seroquel and we decided on Geodon.

I took Geodon about seven years ago and I was taking it in the morning and it made me SO tired that I would sleep through my whole day. Now, I take all my meds at night anyways (except for the Vyvance) so he told me to stop the Seroquel (100mg) and substitute the Geodon (starting at 60mg). I did as he said and when I woke up in the morning I COULD NOT keep my eyes open. I don't know how to explain it...almost like there were anvils on my eyelids...I could not PHYSICALLY keep them open. I took my Vyvance and drank some coffee and went back to bed for an hour and then I was fine to get up.

So here's my questions:

Is 1200mg of Lithium on the high end or low end? Or in the middle?

Can anyone shed some light on my Geodon hangover? Even at such a low dose?

I'm scared to take it again when I have to be up to work in the morning and think I should stick to the Seroquel till I have a day off to test it out...?

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The amount of lithium doesn't matter so much as the blood level. I'm taking 750mg in twice a day (1500mg total), which gives me a stableish level of 1.0mmol/l. So depending on clearance, Yours may be lower or higher for the same amount of lithium. I would hazard a guess, but you really can't tell without a blood test.

I can't help with Geodon much, having never taken it myself, However you might be better off taking it at night. (Unsure if you are now, heh)

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The amount of lithium doesn't matter so much as the blood level. I'm taking 750mg in twice a day (1500mg total), which gives me a stableish level of 1.0mmol/l. So depending on clearance, Yours may be lower or higher for the same amount of lithium. I would hazard a guess, but you really can't tell without a blood test.

I can't help with Geodon much, having never taken it myself, However you might be better off taking it at night. (Unsure if you are now, heh)

I am taking the Geodon at night since I remember having so much trouble with it when I took it before. Still, the hangover was horrible and left me unable to function. Not functioning is not an option with my busy schedule.

As for the Lithium, I do get my blood checked once a month and pdoc said that my levels were on the low side. I had read in another post that caffeine effects the levels. Do you know if this is true? I for sure drink a LOT of caffeine which I know is bad in general but with my cocktail of meds combined with my crazy schedule, it's the only safe option (I'm a few years clean otherwise I could probably think of a few other options haha).

Do you notice any serious changes in your energy that you can blame Lithium for?

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I just thought of something else....

I noticed you were on Seroquel and Xanax. Do either of those make you tired? The first time I took Xanax a few years ago I was prescribed the 2mg bars and after I picked up the script at the pharmacy I popped one. The next thing I remember is waking up in the stairwell of my second floor apartment. Apparently I couldn't even make it up the stairs!

The Seroquel makes me crazy tired (and we all know I can't afford much more crazy in my life) but I take it at night so it's okay. The hangover isn't too bad and I take a Vyvance in the morning to help get me going. I call it my legal crack pill. That plus lots of coffee and I'm good to go. I usually feel like I am drunk or something when I take it, especially if I haven't eaten much that day (stumbling around, goofy, giggly, spin-y, etc.). The whole reason I switched to Geodon was simply for the fact that it was weight neutral. I've gained a bit of weight on the Seroquel which I am attributing to the "sleep eating". First time I took it I woke up with halloween candy wrappers all over my bed/floor with no memory of eating them.

Have you experienced anything like that?

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geodon's effects are pretty different, depending on the dose. You could tinker with that a little and see. Also its absorption is better with food. Not sure how this corresponds to your sedation in the morning. Maybe taking more, or taking it with food will help?

Im in a similar position with what I take, I have a terrible time waking up in the morning. I think its because I take something stimulating in the daytime and by the time I wake up its gone from my system. I used to be on a NRI with a long half-life and Id take that just before bed. I had no problem waking up on that stuff.. too bad my doc took me off of it =(

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So here's my questions:

Is 1200mg of Lithium on the high end or low end? Or in the middle?

Can anyone shed some light on my Geodon hangover? Even at such a low dose?

I'm scared to take it again when I have to be up to work in the morning and think I should stick to the Seroquel till I have a day off to test it out...?

Your Li dose is the same as mine, and I'd say it's a medium dose. As others said, that means very little in terms of what your level ends up being. I've taken a higher dose and ended up with a high level; I've taken this dose and ended up with both a high level and a low level. You never know. You should know, in case no one told you this, that NSAIDs may increase your level to an unsafe point, so it's better to take aspirin or acetaminophen for pain than ibuprofen or naproxen. Best to avoid COX-2 inhibitors as well.

As far as the Geodon hangover goes, how long have you been taking it? All of the AAP's I've taken made me sleepy at first, and that went away in a few weeks.

I just thought of something else....

I noticed you were on Seroquel and Xanax. Do either of those make you tired? The first time I took Xanax a few years ago I was prescribed the 2mg bars and after I picked up the script at the pharmacy I popped one. The next thing I remember is waking up in the stairwell of my second floor apartment. Apparently I couldn't even make it up the stairs!

The Seroquel makes me crazy tired (and we all know I can't afford much more crazy in my life) but I take it at night so it's okay. The hangover isn't too bad and I take a Vyvance in the morning to help get me going. I call it my legal crack pill. That plus lots of coffee and I'm good to go. I usually feel like I am drunk or something when I take it, especially if I haven't eaten much that day (stumbling around, goofy, giggly, spin-y, etc.). The whole reason I switched to Geodon was simply for the fact that it was weight neutral. I've gained a bit of weight on the Seroquel which I am attributing to the "sleep eating". First time I took it I woke up with halloween candy wrappers all over my bed/floor with no memory of eating them.

Have you experienced anything like that?

2mg of Xanax is a huge dose. The vast majority of people who take it take well less than 1mg at a time. At such a dosage (e.g. .25mg), I don't think most people are sleepy, at least not after they have taken it for a short time. If I took 2mg at once I'd sleep for a week.

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This is my experience with Geodon:

Reaction - Slight improvement after two weeks with the depression, but made anxiety much worse.

Side Effects - At first: Didn't put me to sleep, but kept me asleep for 12 hours. Felt groggy in a sickly way upon waking, then I was fine. Then, After two weeks: Sickly feeling upon waking went away, but I became more drowsy for a longer period of time (to the point of not being able to function). I was always tired, but had anxious insomnia & trouble sleeping. My anxiety got really bad, to the point where I had a 6 hour panic attack & couldn't work for 2 days. When I quit, I saw and heard things..followed by horrible shakes and zaps. Nasty Med.

Basically, it's both sedating and activating with a sweet spot in the middle. If my memory serves me correctly the lower doses are the sedating ones, and the higher are the activating. I never came to a spot where everything cleared.. just got both sides. However, when it does work for people here, they tend to like it.

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Try taking the Geodon earlier. Give it a week or two for the sedation to diminish. LIke MJ said, the morning hangover from AAPs often wears off. If it's still a problem then, talk to you doc about a dose change.

Lithium may be adding to the sedation problem. This most likely is secondary. I'm dealing with it right now. It should pass. It always has.

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I just thought of something else....

I noticed you were on Seroquel and Xanax. Do either of those make you tired? The first time I took Xanax a few years ago I was prescribed the 2mg bars and after I picked up the script at the pharmacy I popped one. The next thing I remember is waking up in the stairwell of my second floor apartment. Apparently I couldn't even make it up the stairs!

The Seroquel makes me crazy tired (and we all know I can't afford much more crazy in my life) but I take it at night so it's okay. The hangover isn't too bad and I take a Vyvance in the morning to help get me going. I call it my legal crack pill. That plus lots of coffee and I'm good to go. I usually feel like I am drunk or something when I take it, especially if I haven't eaten much that day (stumbling around, goofy, giggly, spin-y, etc.). The whole reason I switched to Geodon was simply for the fact that it was weight neutral. I've gained a bit of weight on the Seroquel which I am attributing to the "sleep eating". First time I took it I woke up with halloween candy wrappers all over my bed/floor with no memory of eating them.

Have you experienced anything like that?

As said earlier, 2mg is a pretty hefty dose. I take .5mg for anxiety, and 1-2mg if I get a panic attack. It doesn't usually make me tired however.

Caffeine can increase clearance due to its effects as a diuretic, But other than that it doesn't do much afaik. The thing about lithium is if you drink coffee every day for example, it won't matter because your dose will go up to compensate. The key is consistancy in what you do.

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