[raspberrytorte]

After waiting months, I finally had my appointment with my new pdoc today.

She was very nice. I like her. But the appointment didn't go the way I imagined it would go.

We talked. Blah blah blah. We talked about my last episode, we talked about the other times I've been hospitalized or IOP (all were for mania related issues, except for when I had PPD, and I had intensive outpatient AODA). She told me that my bipolar is very severe. Then we argued for awhile about that because I don't know how I can have severe bipolar if I never have euphoric shopping sprees or do reckless things. So we talked about my paranoia and the psychosis I had during my last manic/mixed episode, and my continuing paranoia and hallucinations and delusions I guess and stuff.

After arguing for awhile about all of this, she finally said, "Okay, I can either say you have schizophrenia or bipolar? Which would you prefer?"

Anyway, then I got freaked out even more because apparently 4mg of clonazepam is a really high dose, and apparently everyone in the office was shocked that I was on that high of a dose (which is why I got three separate phone calls from three different nurses asking me if I was okay with going off of it). She put me on a two month taper plan. Prescribed me vistaril. It's okay.

I told her I wanted off of seroquel. She said I needed to be on either a different antipsychotic then or a different mood stabilizer, since lamictal obviously isn't working anymore. She wanted to put me on depakote. How about no. I asked her why seroquel wasn't working for my paranoia, and she said it was too low of a dose, and she'd have to raise it to 800mg. HELL no. She suggested latuda, geodon, or risperdal.

Since I don't want to get fatter, I agreed to go on geodon (even if it's seventy five dollars a month because our insurance sucks!).

I might be a little shell shocked still. I don't know.

She changed my diagnosis to schizoaffective disorder, bipolar type.

Okay.

I have a headache.

Does anyone else feel a little ill after pdoc appointments?

If you were ever on risperdal, did it make you get fat?

Geodon experiences? (I know I've asked this before, but I don't remember responses. My memory and cognition is **** because of clonazepam)

[wiretwister]

Originally Posted by raspberrytorte

Geodon experiences? (I know I've asked this before, but I don't remember responses. My memory and cognition is **** because of clonazepam)

sorry things took a turn you did not expect, hope it all gets better, ... I had no problems with geodon at all, if anything it helped with sleeping, when you first start it will hit you pretty hard but your body will adjust quickly, at least I did, ...

[raspberrytorte]

Thanks wire.

I hope it works out.

After seroquel, I can't imagine any medication being more sedating. Jeez louise.

[~Christina]

I think you at least got to speak your mind and voice your concerns, so that is a good thing.. As for her saying saying BP or SA... meh.. whatever, Its more likely once you level off that is when your going to show where exactly you fit diagnosis wise.

I think its good that she has you on a reasonable taper schedule.

Geodon? I have never taken it but I know many people do and its been a miracle. BipolarRN has been on it for a long time now and im sure you can PM here with any questions, shes wonderful!

I'm glad she had a few options and wasn't being a Nazi doctor that ordered you to take medication X !

[raspberrytorte]

I'm just excited I don't have to take seroquel anymore. Yea!!

Geodon/ ziprasedone is great. It has been wonderful for me for almost 5 years now! It knocked me out for 3 days when I started it but I started on a strong dose to knock me out of a mixed episode. I thought it was sedating me at times but usually I can find other reasons for it so I can't blame it on this med. I started it after going from a 900mg dose of seroquel and it works tons better. I did monotherapy with this med for a while but the depressions caused us to add a couple more.

Rispiridone did make me gain weight but geodon did not.

A 2 month taper sounds great, good luck! I was on 4mg to none and had very few side effects. I feel better off it.

Geodon worked beautifully for my symptoms. The problem I had with it was that the sedation effect didn't wear off fast enough no matter how early I took it the evening before, so I was literally falling asleep while driving (not good) and having trouble with sedation for the first few hours of my work day (not good when you are a teacher and need to be on your toes). I had to stop taking it because of the sedation, but again, it worked beautifully on my symptoms. Some people get beyond the sedation; I just never did.

[raspberrytorte]

Thanks!

I feel pretty positive about these new med changes. I just want to get back to my old self (energetic, active, no attacks of paranoia, no inability to get up before 9 in the morning!). I really hope everything works out.

[Nammu]

I'm glad you liked her even if it didn't go quite like you wanted it to, like your Pdoc is really important.

I'm not sure what dose you are starting on but for me personally I find I needed to take it 12 hours apart or I start to get withdrawal. But in saying that I take a small dose in the morning and 3 times the morning dose in the night. This works for me. It may be helpful to play around with when to take it that works best for you. Most people only take it once a day.

[cashart10]

That's awesome about the seroquel! I know how uncomfortable you are about the weight. I tried Geodon right after I had my daughter and when I woke up in the middle of the night I was so tired I almost dropped her and I would fall asleep in a chair with her in my arms. Because of this, I wasn't able to give it a long enough trial. I hope it works out okay for you.

I know how you feel about hearing that your bipolar is severe. I have gotten that lecture from my last 2 pdocs. My current pdoc is the reason my tubes are tied and my last pdoc wanted me to come back to my current pdoc because she said "there are people who are bipolar, an THERE ARE PEOPLE WHO ARE BIPOLAR." According to her, I am the latter and she wanted me to go to someone who is familiar with this and would treat me as such. It is also ridiculous to me that I must take such high doses of so many meds but my severity is the explanation. And, it also for me isn't because of the reckless behavior and spending sprees, it is because of the severe delusions. I have argued with my pdoc over the specifics such meds and I try to convince him (and my hubs) all the time that I don't have Bipolar Disorder and should stop my meds (and I think I plead a pretty good case). He almost jokingly warns of what will happen if I stop my medications (although they don't even seem to work). It just doesn't seem like reality and it seems so unfair! I hope you are able to come to terms with your new diagnosis. Nothing has changed but, given that, try to put as many deterrents as you can into place.

[raspberrytorte]

I just wasn't expecting her to be so intense about the whole bipolar thing. I thought she was going to tell me I didn't have it. I was just going to ask if I could go on wellbutrin for my depression (and to help me stop smoking), since whenever I try going off seroquel I get depressed. I wasn't expecting, "Your bipolar is very severe!" And having her tell me I need to, eventually, go on a different mood stabilizer (she said she didn't want to wean me off of three meds at the same time, so we're going to talk about the lamictal situation later). I asked if we could just up my lamictal, and she said that I was maxed out on that at 300mg. She said I need to be on a stronger mood stabilizer. She likened lamictal to tylenol.

And she grilled me hard core about the paranoia I've been having lately (and I guess delusions, though to me they seem real). Jeez. She was really good at extracting information. She should be a frickin interrogator or something.

[BipolaRNurse]

Like Christina said, I've been on Geodon for quite a while and found it to be quite useful, as well as helpful in losing weight (I dropped 30 lbs. in the first six months on it, which I gained back when I went on Zyprexa). You have to remember to take it with a fatty food though---I just put my capsule in a big spoonful of creamy peanut butter and chow down. It's not effective if you don't eat something with it. Hope it works well for you!

[raspberrytorte]

I'm not sure what dose she's putting me on. I think she told me to take it at night though, and she told me to take it with food. And eventually I think she said she was going to have me take it in the morning, and then at night too?

Geodon acts as my mood stabiliser. It is not at a high dose at the moment but works for me in this time of my life (80mg and permission to up it when needed but any lower than 80 I get unwell). It works a million times better than lamictal ever did for me - especially the highs. They have been extremely mild to the point of not even noticing at times where my pdoc does. The depression is a bit more stubborn - I had a similar conversation as cashat in that my pdocs said there is "depression and then there is DEPRESSION" I fall into the latter.

Also YES bpnurse. Eating with it is SO important or it will not work correctly and give you stomach problems. I also find I need to eat something fatty or carbs to not get bad reflux. I usually have it with breakfast and dinner but some days it is a pain to eat enough to not get reflux.

[BipolaRNurse]

I confess I sometimes eat it with ice cream.

Speaking of, I am late with mine now but not hungry at all. Any recommendations hehe

[Capriciousness]

It is nice that she tries to get information. That seems important. I feel like sometimes they don't really ask enough and it is hard to know what to say and how to say it. As for the dx of it feels right to you that is what matters. You know I think we could go to three different docs and get three different opinions. I've had it happen. So yeah. She is one doc. The important thing is that you click and that you feel heard and respected and comfortable.

I am so glad you finally got to your appointment and are getting your meds changed. Phew what a wait! Yay you did it!

[Crazy Hitch]

I'm sorry that it didn't quite go like you thought it would go!

And you're getting your head around all the med changes.

Yikes

[PS: I'd never go on 800mg of seroquel either - hell no!]

[raspberrytorte]

I'd be a frickin walking zombie on 800mg. Lol! I'd really never get anything done.

[Moogieotter]

I was on Risperidal for about a year. Good for psychosis. I put on a lil weight. I could have used a lil weight then. I don't think its crazy w weight like Zyprexa or to some degree Seroquel.

How is the GeoDon? For me Abilify was the most weight neutral of the AAPs, but I have never been on GeoDon.

Thanks,

moogs

[wildflowerchild25]

Geodon was good for me, no weight gain. It made my memory terrible though, like worse than usual. I would forget **** thirty seconds after I heard it. I called it goldfish brain. That wore off after a couple of weeks. It did sedate me so I had to take it at night. And though it worked on psychosis, it did nothing for my severe depression, so went off of it in favor of Invega. Also no weight gain.

Supanova,

I also find that I need to take a small dose sometime during the day or I start having withdrawal symptoms. I only took it at bedtime for years, but during the last 3-4 years I've started noticing the withdrawal effects during the day, so I added a 0.5 mg dose, usually late morning.

Raspberry,

I asked the psych nurse I used to see for meds management once whether 4 mg of klonopin was a high dose. (She wanted to increase me from 3 to 4 mg/day.)

She said that it's somewhat high for people who take klonopin for psych reasons, but that people who take it for seizures may take up to 20 mg/day. (link to prescribing info at drugs.com)

So don't feel like you were taking a super high, "almost dangerous" dose. I think it's more to do with what's considered an appropriate, effective dose for a particular condition.

I was at 4 mg/day for a couple of years. I'm back at 3 mg/day now. I plan to taper down more when I feel "settled" at this dose. I dropped my dose from 3 mg/day to 2.5 mg/day about 3 weeks ago and immediately started feeling very depressed. It scared me, so I decided to slow down the taper. (My pdoc does know I'm doing the taper. He approves and is letting me manage it myself with Vistaril as needed.)

I have been taking klonopin for over 12 years, so I imagine my brain is going to have a tough time with lower doses. I have PLMD (periodic limb movement disorder - severe twitches & spasms in my large joints) so I probably won't be able to drop below 2 mg or that will get going.

I can take either clonazepam or an anti-Parkinson's drug for the PLMD. Neither seems like a good choice, so I'll probably just stick with the 2 mg clonazepam.

After all the negative press benzos have been getting lately, I wanted to drop my dose as low as possible.

I do have problems with memory and motivation and planning tasks sometimes, but it seems to be more related to depression and sleep problems and whether my meds for those are working than to my clonazepam usage, at least as far as I can tell.

When my sleep and mood are good, my brain and memory seem to work just fine. I'm more concerned about the future in regards to the klonopin than the present. I don't want to be 70 and dependent on it and fall down and break my hip. The dose I take now doesn't make me dizzy or unbalanced, but I understand that the way we metabolize drugs changes with age.

I'm glad that you like your new pdoc.