[bluemountains]

For a variety of physical reasons, I need an atypical antipsychotic to be able to survive a normal day to day routine. When I look at the list, I am pretty sure I have been through them all, some twice. The one side effect that I can't take anymore with most of them is weight gain. I am up 80 pounds from the beginning, and I have told my pdoc that the depression from the weight gain overtakes the positives of the ap.
The one ap that I can take without weight gain is geodon. The big problem I now face is how to overcome the morning sleepiness. No matter when I take it, twice a day, once a day, a lower dose-I cannot overcome a sleepiness that threatens my driving to work each morning.
First my pdoc put me at 40 mg twice daily, a pretty low dose. That was miserable. Then she had me take all 80 mg right after dinner, then I went down to 60 mg...then I started seeing shadow people, but still no major depression, so I cut it to 40 mg once daily. I still have the scary sleepiness.
I go to bed earlier. I eat earlier. I have cut out breakfast, thinking that food was reactivating the effects. With all of this, still this morning my husband and I got in the car, him driving!, and within 5 minutes I was out. 1.5 hours later he was shaking me awake because we had arrived at our destination. I don't remember a thing about the trip. I am fine for the rest of the day, whether at work or somewhere else.
Any suggestions? I don't want to give up on geodon and go back to weight gain or other problems. I have tried to give up an antipsychotic altogether, but two times ended in hospital visits. I looked at the list again this evening, and I truly have tried them all. Besides weight gain I have been through drooling, stumbling, speech impediments, vision problems, choking, etc., so I really want this one to stick!
Sorry this is so long, thanks for anything you can think of!
Bluemountains

Zoloft makes me very tired. I take a stimulant, vyvanse, to perk myself up. As a bonus its an appetite surpressant and I've lost weight I gained on other meds.

[still_crazy]

some doctors give provigil, nuvigil, ritalin, amphetamines, wellbutrin, etc., to help with sedation. i think there are some very new, on patent atypical tranquilizers that are supposed to cause less weight gain than the older generation...saphris, latuda, rexulti, vryalar, etc. i dont have any idea if those are an option for you or not, just thought id mention it.

oh, the other option i guess would be a carefully selected, reasonably dosed older/conventional tranquilizer. perphenazine did well in a big head to head trial comparing it to the 'atypicals'. some people report good results and OK tolerability with loxapine or navane. i think the older drugs got a bad reputation because it was standard practice to put people on 20mgs of haldol per day, and that was (and is) almost always way, way too much.

ok. hope your doctor can help you out here. good luck to you.

[bluemountains]

Originally Posted by still_crazy

some doctors give provigil, nuvigil, ritalin, amphetamines, wellbutrin, etc., to help with sedation. i think there are some very new, on patent atypical tranquilizers that are supposed to cause less weight gain than the older generation...saphris, latuda, rexulti, vryalar, etc. i

I have tried all of the ap's except for saphris, I'll look up that one-vralyar was the worst one I ever took, my experience only of course!
I am going ask again about another medication to help now that I have some names. At my last appointment the pdoc wasn't keen on another med.
Thanks!

Geodon made very sleepy in the beginning, but after some time it didn't make me that sleepy at all. In fact, I needed Seroquel XR added to help me sleep, but our experiences certainly may not turn out the same. Unlike you, I was on disability. I definitely can understand how difficult oversedation could be if you have to get up and drive early.

A poster above mentioned Perphanazine (Trilafon) and Thiothixene (Navane). I tried both. Navane was extremely weight friendly and was helpful for a while (I took it in addition to 160 mg Geodon). Unfortunately at a higher dose (my doctor wanted it to replace my Geodon) I developed a dystonia. A bit scary.

Perphanazine replaced Navane. I found Perphanazine even more effective, but panicked when I gained 9 lbs in one month. However, some people I know who also took it found it weight friendly.

After years, my only antipsychotic is a medium dose of Seroquel XR. At higher doses I gained weight from it, but not at medium doses. Seroquel regular was less friendly for me. Seroquel XR does have a rep for morning sedation "hangover", but that has eased for me.

[Trippin2.0]

I used to have an energy drink every morning until my body adjusted and the sleepiness disappeared.

[wiretwister]

I did sleep very well on geodon...some morning sleepiness ... when I went off geodon ( was on it for 3 years ) it took me over a year to get back to somewhat of a good sleep at night ... I wish you well ... hope you find a solution that works for you ... Tigger

Sorry you're dealing with this.

The only thing that's helped me is Ritalin. However, I know that Adderall made me completely manic to the point I was hearing voices telling me to kill myself. So stimulants are a hit or miss for me. I think if you're prone to mania in general, I'd err on the side of caution with stimulants and ask your pdoc about that one.

As far as I know, Wellbutrin was recently approved for weight loss. And there is metformin as well. I know those meds may not help with sedation per se, but they can really help you lose the excess weight in the mean time. That's all I can suggest.

It sounds like you've tried pretty much everything. But exercise helps me stay awake. It gives me an adrenaline boost, which is funny because you'd expect to be tired after working out. But not for me.

[bluemountains]

Originally Posted by bluebicycle

Sorry you're dealing with this.

It sounds like you've tried pretty much everything. But exercise helps me stay awake. It gives me an adrenaline boost, which is funny because you'd expect to be tired after working out. But not for me.

My husband suggested I take a walk when I get up which is at 5:45. I am not the greatest exerciser as it is, but I am going to will myself to try to at least make it around the block, only about .5 of a mile. Dark, cold, and sleepy will be tough to get me out the door. Those medications sound so much better!

[WildcatVet]

Vraylar is THE best AP I've ever taken. Very energizing and no side effects except for a slight tremor when I started it that resolved within a week or so. Love the stuff!

[Pookyl]

I used to find a not too hot shower and strong coffee followed by a no/low carb breakfast (eggs/eggs&bacon) worked. Oh, and another coffee for the drive.

[bluemountains]

I emailed the pdoc hoping to get a script for one of the suggested meds, instead she said I should cut back on klonopin at night, which I take before bed to help get to sleep. I guess in theory it sounds good, but now I have the panic of taking half the amount of a drug I have been on for a very long time-an addictive drug.
I hope it works.