[Sad Mermaid]

I am wondering if anybody on here is taking more than 160 mg of Geodon.

I currently take 160 mg plus 600 mg of Lithium plus 1.25 mg of Zyprexa for sleep. Lithium is giving me a whole list of problems and apparently my kidneys have started to suffer. My neurologist wants me to stop Lithium. My Lithium level is below the therapeutic range by a bit. I want to propose to the pdoc that we lower the Lithium and increase the Geodon (to which I have no side effects whatsoever, which is remarkable), but that would mean taking more than the maximum dosage. I did see mentions of such use off-label...

[still_crazy]

hi. from what I've read, dosing of neuroleptics varies wildly from person to person. You might want to Google up the chlorpromazine equivalents for your dosage of Geodon. Even the newer, "atypical" antipsychotics can be (roughly) converted into CPZ, or Thorazine, equivalents. So, 2mgs of good ole Haldol=100mgs CPZ=7.5mgs/Abilify, etc. etc. etc.

The big deal, from what I understand, is that you want to keep your overall exposure to the neuroleptic as low as possible, while still maintaing control over your problems. The FDA approved range isn't as big a deal, especially with the "atypicals," as your cumulative exposure. Higher overall exposure=higher risk of tardive syndromes.

Its interesting, too, how dosing has changed. I'm stuck at 30mgs/Abilify, which roughly=400mgs/Thorazine. Back in the day, 600mgs/Thorazine was fairly standard for outpatients, and some people were on well over 1,000mgs/day ("high dose phenothiazine therapy"). This is one reason why antipsychotics have such a terrible reputation and why the "atypicals" seemed so superior to the older drugs at first glance.

[Sad Mermaid]

Very interesting.

This is from Yale university:

Table 3. Antipsychotics and Equivalent Doses (sorted by generic name)
Proposed Code Trade Name Generic Name Equivalent dose
19 Abilify aripiprazole 7.5 mg per day
02 Thorazine chlorpromazine 100 mg per day
15 Clozaril clozapine 50 mg per day
18 Prolixin dec fluphenazine (depot) 2.5 mg per 21 days
07 Prolixin fluphenazine (oral) 2 mg per day
01 Haldol haloperidol 2 mg per day
17 Haldol dec haloperidol (depot) 30 mg per 28 days
11 Loxitane loxapine 10 mg per day
13 Serentil mesoridazine 50 mg per day
10 Moban molindone 10 mg per day
06 Zyprexa olanzapine 5 mg per day
09 Trilafon perphenazine 8 mg per day
12 Compazine prochlorperazine 15 mg per day
13 Seroquel quetiapine 75 mg per day
20 Risperdal Consta risperidone (depot) 25 mg per 14 days
05 Risperdal risperidone (oral) 2 mg per day
03 Mellaril thioridazine 100 mg per day
04 Navane thiothixene 4 mg per day
08 Stelazine trifluoperazine 2 mg per day
17 Geodon ziprasidone 60 mg per day

So all your numbers are listed here, plus 60 mg for my Geodon. So, if you are taking 30 mgs of Abilify, can I take 240 mg of Geodon? I would be very happy to try it...

[still_crazy]

hi. I would think so. With most tranquilizers, EPS and other adverse effects become more common as the dose increases, but not always. I seem to recall reading about people on very high doses of zyprexa in state hospitals, and seroquel doses, of course, can get crazy high. But...Geodon is unique, so you should probably ask your doctor. Drugs can be weird. Like Risperidone, which my current doctor says is great until you pass about 6 mgs/day, and then its overpriced Haldol.

Good luck.

[Sad Mermaid]

I am on 180 mg (the FDA approved max is 160 mg) and doing fine, but am not sure I want to go even higher. thanks for answering my question - you had unique information... so interesting.

[Sometimes psychotic]

Just a note but if you smoke like smoke but not ecigs then your effective dose is roughly cut in half....that's one way to increase the effect if you do smoke and can switch to ecigs or gum...it's the literal smoke that hurts not the nicotine.....

[Sad Mermaid]

I do not. Thanks for letting me know - what a huge difference!