Off Vraylar and New to Geodon

[Amethyst674]

Hello Everyone,

Sorry about the long post.  I have not been on here in a while and I actually missed it a lot.  After a long ride on Vraylar (almost a year and a half -and with a couple of short stints with abilify and rexulti in between.....)  I am now taking Geodon.  My PDOC finally took me off the Vraylar because I developed Tardive Dyskenesia.(uncontrollable movements of my mouth and tongue.)  I had actually been having the mouth and tongue movements for a while and people had noticed, but they started to become worse and it was actually my PCP who during a routine exam told me straight out :"You know you have Tardive Dyskenesia right?"    I was not very happy with the Vraylar for other reasons.  I developed a fear of driving and being a passenger which happened to coincide with the time I was on the Vraylar.  Also I could not manage to lose weight no matter what I did and I gained a total of 30 lbs during the time I was on it.  Also I became very lethargic and depressed on it.

 I am allergic to Lamictal, Trileptal and Tegretol and I refuse to take Depakote.  I did not do well on lithium and Topomax made me crazy. Anyway... bottom line was I needed to go with another AAP because after 3 weeks off Vraylar I went into a bad crisis.  I somehow thought that I could manage my hypomania  (the bad kind)which I developed after about 2 weeks off the Vraylar, without taking any type of AAP or mood stabilizer.  I kept thinking it was just withdrawals and they would go away. I really tried and wasted money on supplements and herbs and CBD oil.  But it all ended badly.  So my PDOC appointment finally came and we decided on Geodon, which is one of the AAP I have not tried.  So far I feel better.  My irritability has subsided as well as my crying jags and major agitation.  My boyfriend says I am doing alot better... which is a good thing because I had literally put him thru hell.

My concern with Geodon is mainly the caloric requirement.  I am on 40 mg BID. Geodon should be taken as directed with at least 500 calories with each pill.  This is due to it having a short half life.   I am already overweight.  I was trying to eat less and low calorie when i was on the vraylar to at least maintain my weight ( I was doing small frequent meals).  Now I find myself having to figure out how to eat a big (but healthy) breakfast so I can take my AM dose.  And then trying not to eat again until dinner which also should be 500 calories for my PM dose.  I am also starting to exercise now that I am feeling better, so I hope that will help.  

I was wondering if what I read about Geodon being one of the AAP that causes the least weight gain to be true?  Any input would be appreciated, as well as suggestions on how to eat 2 500 calorie meals a day without gaining weight.  So far I have not had any side effects (keeping fingers crossed)  I have felt neutral.  Not drowsy or dizzy.  I feel happier than when I was on Vraylar.  I hope this is not just a honeymoon phase or worse...(On my way to mania like the warning says?) 

Maybe I have just been depressed for so long that I forgot what normal feels like.  If anyone would like to share their experiences on Geodon that would be great.  Thank you for reading my long post.

Edited February 24, 2018 by Amethyst674
forgot one sentence

[looking for answers]

sorry, just started vraylar and no experience with geodon, i know many others have been on it

[Amethyst674]

Good Luck with the Vraylar.  I had some good times on it.  It just kind of changed on me after a while.  BUT Everyone is different and it is a very good drug.

[Wonderful.Cheese]

I unfortunately did not have a good experience with geodon. The first time I took it, it wasn't generic ($$$$) and I was already manic and it seemed to make me all the more manic until I landed myself IP. They took me off of it cold turkey and I don't recall what they put me on instead, but I was dizzy as hell with them stopping it like that. 

The next time I tried it I was in a state hospital and I got all the way up to 240 mg of it. I was on it for months and months there. It just did nothing. Then they finally switched me to Abilify and I got a little better or better enough within a month or two to get out of the state hospital and back to the crisis unit group home back in my home town. 

I hope you have much better luck with it. 

[Savannah]

I took several years on Geodon (160mg at night). My pdoc never said anything about taking it with meals.

it worked for me for many years.  Out of virtually nowhere I had the job from hell with so far out of control that I had to take more meds.

To finally get stable I had to add 500mg Seroquel and 10mg Prolixin. After some time I went off Geodon as it was expensive and I could do without it.

[mikl_pls]

On 2/24/2018 at 4:16 PM, Amethyst674 said:

I was wondering if what I read about Geodon being one of the AAP that causes the least weight gain to be true?

This article should answer a lot of your questions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656324/

Quote

Clozapine and olanzapine have been associated with the highest rates of weight gain, obesity, glucose dysregulation, diabetes and hyperlipidemia as well as life threatening diabetic ketoacidoses. Risperidone and quetiapine have been suggested to exhibit a moderate risk for these metabolic abnormalities, whereas zIprasidone and aripiprazole have been shown not only to have little or no effect on body weight, lipids, or glucose but often improve these indices when patients are switched from olanzapine and risperidone.

 

(Perhaps this would apply to Vraylar too?)

Quote

Ziprasidone oral bioavailability is about 60% in healthy volunteers when taken with food, which increases absorption by more than 50%.

So Geodon definitely needs to be taken with food.

Here's an article that talks about the caloric content that needs to be taken with Geodon: https://www.ncbi.nlm.nih.gov/pubmed/19026256

Quote

RESULTS: Maximum ziprasidone exposures in this study were observed with high-calorie meals (1000 kcal), which were nearly twice those observed under fasting conditions.  The medium-caloie meal (500 kcal) was associated with exposures similar to the high-caloie meals. [...]

 

500 calories need to be eaten when taking each Geodon dose.

On 2/24/2018 at 4:16 PM, Amethyst674 said:

Any input would be appreciated, as well as suggestions on how to eat 2 500 calorie meals a day without gaining weight.

You really probably should be eating something in the middle of the day so you don't put your body into starvation mode and slow your metabolism down, especially if you wish to lose weight.

If you want to lose weight that you gained from the Vraylar, create a calorie deficit (there are calculators online to help you do this, or you can use Myfitnesspal, to help you do this), and follow a particular diet with specific macronutrients, such as a low-carb diet, an ultra-low-carb diet like the ketogenic diet, or a low-fat diet. All of these diets are going to have raised protein from the American standard diet. Myfitnesspal can help you with maintaining the daily macronutrient goals and allows you to enter your custom daily calorie limit and macronutrient percentages.

That would be my advice and what has worked for me anyway. It's just a matter of sticking to it... lol.

[Amethyst674]

Thank you for all your help.  I have been feeling very depressed today.  I suspect that I need a stronger AD.  Since this "depression" has been going on since I started the Wellbutrin.  The agitation, irritability and hypomania were due to having no AAP on board but now I have to do something about the depression.  

[browri]

I know it's been recommended before for people who have issues. The Ensure meal replacement drinks can help you close the gap on calories. Each original Ensure has about 250 calories and might allow you to eat smaller meals so you don't have to prepare a full 500 calories twice a day.

Another option as @Savannah indicated is when you get into the higher doses (120mg+/day), you could talk to your pdoc about taking it all at night. Then you only have to worry about getting those 500 calories once in the day. Downside to that though is your large meal is in the evening, but I doubt you would be able to take 120mg+ in the morning. Lol That would be pretty sedating.

[looking for answers]

On 2/25/2018 at 10:33 PM, Amethyst674 said:

Thank you for all your help.  I have been feeling very depressed today.  I suspect that I need a stronger AD.  Since this "depression" has been going on since I started the Wellbutrin.  The agitation, irritability and hypomania were due to having no AAP on board but now I have to do something about the depression.  

for the eating it would help to know your age, weight, height, activity level

I eat 3500 calories a day to maintain, everyone is different my dinner is 1500 calories, so the food issue is dependent on who u are, and gender, and all those good things

[mmaryland]

I was on Latuda, lurasidone, which is somewhat similar to Geodon and I hated having to force myself to eat at least 250 calories before I take. Same goes for when I took Geodon. When I took Geodon, only for two weeks or so because my psychiatrist gave me free samples, I don't recall having increased appetite. Nothing like Seroquel or Zyprexa. It was kind of appetite neutral IME. I have a baseline low appetite anyway so for me this was a major pitfall. While on Latuda 60mg I also had the second worst depressive episode in my life, I mean I didn't even get out of bed to eat Thanksgiving dinner with my family. Geodon I only took once daily, 80mg, and honestly didn't gain any weight or have relentless hunger, but then again I was only on it for a little over 2 weeks.

In addition, both Geodon and Latuda it was not sedating enough to help me sleep whatsoever so I was still taking Seroquel for insomnia. Psychiatrist said it's best not to take two antipsychotics concomitantly so I switched from Latuda to just Seroquel, which zombified me at only 100mg QHS after 1-2 weeks. It did stabilize me for sure, but the emotionless feeling was not something I wanted to experience any longer. IMO Rexulti was the best AAP I was on, just didn't do the job for mania, but for depression it was AMAZING. 

And by the way @Amethyst674, do you mind disclosing what dose of Vraylar were on before you experienced the tardive dyskensia? And what other reasons caused you to stop taking it as well? I just started it so it would be helpful for me to know this and watch out for some of those side effects. 

[Amethyst674]

Hello mmaryland, 

I was on Latuda before as well back in 2016, but I developed Akathesia on 40 mg.  it also did not really stabilize me and it DID make me hungry.  When I was on Vrayar I started it in October of 2016. I finished with it last month (2/18).  I was always on 3mg.  I recall having some mild TD a few years ago on Saphris.  After that I tried Latuda.  No TD on that one that I remember. We tried Abilify then but that one made me extremely anxious but no TD that I recall....Then on to vraylar.  I don't recall exactly when it started but I think after like a year on it my boyfriend noticed it and after that it just got progressively worse. Until my Pcp noticed and then I called my PDOC and she told me to get off it.  (We had tried Rexulti a few months before because she had thought it would help the depression I was feeling and apathy on the Vraylar).  But I became even more depressed on the Rexulti so we returned to the V once again until she d/c it due to the TD.  Anyway, i will tell you at first I didn't really have any problems on the Vraylar and I actually liked it for a while.  But I would say around like April of 2017 i started to develop a fear of driving on the highway on it.  It got pretty bad.  But I still stayed on it. Then I just stopped liking it little by little but I still stuck with it because nothing else seemed to work and I have tried quite a few AAP.  I think overall it is a good AAP. I would give it a fair shot and I don't think everyone gets the darn TD on it.  I think I am just prone to it. And I have always had pretty bad treatment resistant depression.  Its good your on a stimulant because it used to make me tired.  Let me know how you do.  I hope this helped you and sorry if i was a bit all over the place.