cymbalta and geodon
in [Anxiety]
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From: Mister Goldfinger on 15 Sep 2008 18:54 My shrink said that the prozac pooped out on me, and that I should try cymbalta, and a bi-polar drug called geodon (I dont have bipolar disorder, just chronic moderate depression, GAD, and PAD. I read reviews on both drugs , and I am scared to take them. Although prozac doesn't do much anymore, I don't have crying spells. I take xanax 2mg Bid, prozac 20mg once a day, and an occasional ativan. Have anyone of you taken Cymbalta or geodon. Last time he gave me the lowest dose of Abilify, but I told him I'm too scared to take this type of medicine. He told me to ignore the internet and just TRY the meds and see what happens. I am medicine resistant, meaning that SSRI"s make me quite ill, but prozac doesns't. I have been seing this shrink since 1993. He is definitely not benzophobic. He told me that he is trying to help me but if I don't take these meds, I will never feel better. I think the prozac and xanax and ativan is good enough. But I do get chest discomfort when I am upset. And I rarely leave the house. I am a male , 56 years old. Cymbalta, geodon? Any advice? Goldfinger
From: ideamania21 on 16 Sep 2008 02:50 On Sep 15, 4:54 pm, MisterGoldfin...(a)webtv.net (Mister Goldfinger) wrote: > My shrink said that the prozac pooped out on me, and that I should try > cymbalta, and a bi-polar drug called geodon (I dont have bipolar > disorder, just chronic moderate depression, GAD, and PAD. I read > reviews on both drugs , and I am scared to take them. Although prozac > doesn't do much anymore, I don't have crying spells. I take xanax 2mg > Bid, prozac 20mg once a day, and an occasional ativan. Have anyone of > you taken Cymbalta or geodon. Last time he gave me the lowest dose of > Abilify, but I told him I'm too scared to take this type of medicine. > He told me to ignore the internet and just TRY the meds and see what > happens. I am medicine resistant, meaning that SSRI"s make me quite > ill, but prozac doesns't. I have been seing this shrink since 1993. He > is definitely not benzophobic. He told me that he is trying to help me > but if I don't take these meds, I will never feel better. I think the > prozac and xanax and ativan is good enough. But I do get chest > discomfort when I am upset. And I rarely leave the house. I am a male > , 56 years old. Cymbalta, geodon? Any advice? > > Goldfinger Hi, I tried cymbalta last year after being on Paxil for 7 years. I thought that I had begun to be immune to paxil so we tried cymbalta. One thing I can say for myself is that it made me very peaceful. I mean very peaceful. I would turn on the television and just listen to it, not really watch it. Or I would sometimes play Freecell for 4 to 5 hours in a row and I didn't really know why. My doctor said this isn't the most common reaction but that it had been recorded in the journals as one of them. It didn't make me feel better, but also it didn't make me feel any worse either. After 2 months I went back to paxil and have done very well. Maybe I just needed a break from the paxil and the cymbalta gave me or took away a couple of months of my life. It was interesting to say the least. I'm usually quite busy reading and learning but it put me into a lazy I don't care state.
From: Philip Peters on 16 Sep 2008 19:26 Mister Goldfinger schreef: > > My shrink said that the prozac pooped out on me, and that I should try > cymbalta, and a bi-polar drug called geodon (I dont have bipolar > disorder, just chronic moderate depression, GAD, and PAD. I read > reviews on both drugs , and I am scared to take them. Geodon is an antipsychotic. Is is only used for bipolar disorder as an adjuvant drug to lithium or another mood stabilizer and only if necessary. It is becoming en vogue among a certain kind of pdoc to use all kinds of off label prescriptions where anxiety/panic is concerned. They prescribe antipsychotics, mood stabilizers, anticonvulsants, you name it. For a garden variety anxiety disorder this makes no sense as there are oodles of other meds to try first. Only if the disorder is treatment resistant (and it takes *years* to assess that) or if there is a double dagnosis (in DSM IV-terms: a combo of an Axis I and an Axis II disorder, for instance) an antipychotic can be tried. You say SSRI's make you quite ill. What exactly does that mean? Sometimes people get prescribed an SSRI at too high a starting dose, get a worsening of anxiety symptoms plus other symptoms of various kinds and then stop the med after a few weeks while it could have turned ut to be a helpful one if they only had been prescribed it the right way: *start low, go slow*. I don't know if this hasanything to do with your problem but just in case... But there areother ADs out there, mainly the older TCA's, which may not have such bad effects (although there is no gurantee). You might want to try imipramine or one of its brothers or sisters. Cymbalta, like Effexor is an SNRI and consequently in a way related to the TCA's but they work in a different way and are not more effecdtive or better tolerated. You could try Cymbalta, however, and see what it gets you. Would a benzo alone be enough for you? In that case the right dsose of Xanax XR plus some Xanax IR to take *as needed* would be recommendable. Instead of taking 4 mg of Xanax IR twice a day you would be better off by taking it in the XR version. Xanax IR works for about five hours so twice a day is really undermedicating and may cause that *rollercoatser* effect, maybe you have no problem with that but if you do Xanax XR is recommended bwecause it will keep you on an even keel for 24 hours (for some people with fast metabolism it may be 12 hours, the proof is in the pudding, so to speak). There is little sense in combining Xanax IR with Ativan as they are both short acting benzos although it won't harm you. OTOH you say you have comorbid depression so an AD might be necessary. I would be inclined to go with a tried ad true TCA before trying SNRI's but that may be because I myself have good results with TCA's (better than with SSRI's, there is no rule for that except YMMV). You could also first try to up the Prozac to 30 and then 40 mg, that's not unheard of and may give the stuff the boost you need. You can learn to leave the house again by doing CBT (http://panicdisorder.about.com/od/therapycbt/) etc. CBT and medication can well be combined. Philip Although prozac > doesn't do much anymore, I don't have crying spells. I take xanax 2mg > Bid, prozac 20mg once a day, and an occasional ativan. Have anyone of > you taken Cymbalta or geodon. Last time he gave me the lowest dose of > Abilify, but I told him I'm too scared to take this type of medicine. > He told me to ignore the internet and just TRY the meds and see what > happens. I am medicine resistant, meaning that SSRI"s make me quite > ill, but prozac doesns't. I have been seing this shrink since 1993. He > is definitely not benzophobic. He told me that he is trying to help me > but if I don't take these meds, I will never feel better. I think the > prozac and xanax and ativan is good enough. But I do get chest > discomfort when I am upset. And I rarely leave the house. I am a male > , 56 years old. Cymbalta, geodon? Any advice? > > Goldfinger >
From: Gary on 17 Sep 2008 04:07 On Sep 15, 6:54 pm, MisterGoldfin...(a)webtv.net (Mister Goldfinger) wrote: > My shrink said that the prozac pooped out on me, and that I should try > cymbalta, and a bi-polar drug called geodon Your doctor is changing two medicines at once, which makes my antenna go up immediately. If you improve, you won't know why, and more importantly, if you don't do well on the new plan, you won't know if it's the Cymbalta, or the Geodon giving you problems. I disagree right away with the strategy, solely based on that, but we'll continue.... (I dont have bipolar > disorder, just chronic moderate depression, GAD, and PAD. I read > reviews on both drugs , and I am scared to take them. Although prozac > doesn't do much anymore, I don't have crying spells. I take xanax 2mg > Bid, prozac 20mg once a day, and an occasional ativan. I would dispense with the ativan; it has the propensity to exacerbate depression, and as Philip correctly pointed out, there isn't any really good reason to combine two short half-life benzodiazepines (BZD's). Stick with the Xanax, and use it a little more (with your dr's blessing) if you need to. Also, mixing benzodiazepines without a goal, such as cross-tapering is additionally senseless because it tends to mess with your sleep architecture even more than taking one BZD. Have anyone of > you taken Cymbalta or geodon. I try most of the psych drugs, and have taken both of those, albeit a long time ago. Cymbalta was pleasing to me, and I took it for well over a year, possibly two years. Geodon, I took exactly one 20 mg capsule, and never took another one. It is too strong, it is meant for bipolar manics and psychotic people. Of note, Geodon and Cymbalta are both still under patent, which means your doctor may be making money from prescribing them. Incidentally, I suffer from generalized anxiety d/o, panic d/o, and major depression without psychotic features. Last time he gave me the lowest dose of > Abilify, but I told him I'm too scared to take this type of medicine. > He told me to ignore the internet and just TRY the meds and see what > happens. Sometimes that actually IS good advice, because people tend to read WAY too much into drug monographs. In your case though, I'm not sure you'd benefit from abilify - it's a partial agonist for dopamine. Abilify made me think I was going to die, i took exactly 5 mg of that drug, once. I am medicine resistant, meaning that SSRI"s make me quite > ill, but prozac doesns't. I have been seing this shrink since 1993. I hate to ask, but you have referred to "never getting better" as stated by your doctor of 15 years. Have you improved at all over 15 years of seeing this guy ?? Do you see him primarily because he isn't benzophobic? If so, that's fine, but you can always get another consult and discuss the various drugs out there. He > is definitely not benzophobic. Good. He told me that he is trying to help me > but if I don't take these meds, I will never feel better. That seems like an awfully non-prescient statement, considering he's never seen you while you were taking these new suggested meds... I think the > prozac and xanax and ativan is good enough. But I do get chest > discomfort when I am upset. Does "good enough" mean that your psych symptoms are under control to an extent that you are satisfied with? Does "upset" mean 'having panic anxiety with subsequent chest pain', or does upset mean just upset, as in the newspaper got wet in the rain, and you become aggravated, as any normal person would ? >And I rarely leave the house. I don't like to make assumptions, so I will simply ask, "why not?" I am a male > , 56 years old. Cymbalta, geodon? Any advice? Please know that my commentary is Never to be construed as medical advice or instruction, however, it is based on a reasonable amount of empiric observation and experience as a psych nurse who works in a psych hospital. It is NEVER meant to substitute for a physician's instructions. That having been said, there are good, mediocre, and downright bad physicians - so take all of that as you will. If i were you, I would not take Geodon. If I were you and really WANTED to try Geodon, I would definitely get a cardiology work-up first, one of the most important components of which would be a 12 lead EKG. This is particularly important in your case because you speak of chest pains. Without your entire medical chart/history in front of me, I like to err on the side of caution. As to Cymbalta, you have said you are "sensitive" to meds, so you might find it to be initially a bit unpleasant. It almost always causes some nausea, and can cause chest palpitations in some people. That having been said, it's often very well tolerated, and a lot of people really like it. It would not be a difficult transition to make from Prozac in all likelihood. It sounds as though you are reasonably satisfied with the results of your current med profile, although if you are agoraphobic, your doctor probably would like to see better results; you do occasionally leave the house, so you could work on doing that more, if there is a psychologic reason for your homebound nature. I still recommend ditching the ativan, it's just creating un-needed complication. I very much dislike his statement of "if you don't take these meds you will never get better". I would definitely seek crystal clear clarification as to exactly why he told you that. Definitely. If you get symptoms when you get 'upset', it's probably time to really start looking at WHY you get upset. This goes back to therapy, which is rarely dispensed much by psychiatrists these days. Cognitive- behavioral therapy and REBT are two of the most studied, and both can provide excellent results. Pills alone rarely solve an entire anxiety/ depressive scenario. Nutrition, exercise, recreation, healthy relationships/friendships and a general balance in life go a long way to help your meds work for you. Examine these things unflinchingly as to what you're doing well with, and what you have an opportunity to improve. Props to Philip for mentioning therapy - it's a critical element of much change and insight. I hope you start feeling better soon. Gary
From: Mister Goldfinger on 18 Sep 2008 17:53 Thanks to those who responded to my question about Cymbalta and Geodon. I think I will NOT take these drugs and stick to what I have been taking all along , such as Prozac, Xanax, and only an occasional ativan if I need it for sleep. I don't think any pill is going to make me feel happy. If the light in my soul has gone out, nothing will light it again unless I find the reason for my sadness. I know the reason but there is no way to get back the happiness I felt when I was young. Some people are lucky in life, some are not. I have been dealt a deck of cards that did not work in this lifetime of mine. Taking anti-psychotic drugs seems ridiculous to me, and changing to another anti-depressant won't work. At least I am not having crying spells and feeling suicidal. Prozac must be doing something, even if its just a little bit. I know why people like to take the painkiller 'oxycontin (sp), or percocet, or vicodin. When I had a gallbladder inflammation, I took percocet and felt relaxed and more social. Maybe oxycontin should be prescribed for depressed people? Yes, its addicting, but if it makes you feel better, why not take it? Of course , this will not be given to me. And I do not drink alcohol, or do drugs. So...what is, is, and I just have to deal with it. The pain and suffering all over the world goes on and on, so I always remember that some people have it good, some don't. It all depends on genetic factors, your environment, your family relationships, and your love for your job, and good physical health. This is the recipe for a good, happy life. Thanks for reading this and I sincerely wish every one a happy day and evening. Richard, New York City Goldfinger
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