Tapering off geodon
 

I am going to ask my pdoc to start tapering off geodon.
I have lost too many memory cells over the years.
My life is pretty stable right now. and I think that with extra support from increased tdoc and pdoc visits and the help of my family and friends being on board I think that I could get off geodon and maybe even lamictal. I would stay on klonipin for sleep always. I would go VERY slowly!
bizi

Hi Bizi I'm concerned that you are doing to many things at once. The alcohol free phase is a great accomplishment,but going beyond that,and tapering off some medications concerns me. If I where you I wouldn't think about that yet.

At one point in my life after I became alcohol free,I tried to taper off my medications. I started to taper off. When I was almost off of my medications for months,and they where out of my mind,I started having anxiety problems,pain,and then panic attacks. It threw me into a 6 month tailspin.

It's a noble idea,but please be careful. Please learn by my mistake. The medications help to provide some stability over a long period of time. BF:hug::hug::hug:

thank you for your concern steve. But you and I are different people and have different issues.
I hear what you are saying...and I am going to be very careful.
bizi

Hi Bizi
 

Dear Bizi

About the memory, can I be blunt?

Because my first "pick" as to the cause would not be Geodon :o ... sorry.

I'm going to wait for a "go ahead" before I say anything else.

waves

Dear waves, do you think it is the lamicital?
I am all ears.
bizi

ok, here goes...
 

I'd rate likely causes in this order:

1. Alcohol
2. Lamictal
3. Klonopin
4. Geodon* (I know little of this but explanations follow)

1. Alcohol -- you've been a chronic abuser and have consumed in large quantities, "over the years". The effects of this won't go away overnight.

First, it does cause memory impairment. The concomitant use of a benzo (Klonopin) would have made this worse. Short-term memory impairment will have caused difficulty in long-term memory formation, and you'd only notice the difficulty in recollecting some things now... as opposed to immediately when you stopped drinking.

Also, have your B12 status checked with your next blood test. Do not supplement for at least 24 hours before testing (I'd recommend longer but...whatever). Heavy alcohol consumption can cause damage to the stomach lining and thereby impair B12 absorption. Poor B12 status can cause cognitive impairments. As a meat eater, you should easily fall within healthy levels, unless there is a problem with absorption.

http://www.webmd.com/vitamins-and-su...de-vitamin-b12
Different people show different symptoms.


2. Lamictal -- this can cause cognitive impairment of all kinds. I don't know of an AED that doesn't have this as a potential side effect.


3. Klonopin -- Long-term, chronic benzo use is known to produce cognitive deficits an memory deficits can occur even with occasional use. The fact that you've used alcohol on top of your Klonopin will amplify amnestic effects. The benzo might be more of a player than the lamictal... but I'd put a long distance between coming off alcohol and any thoughts of tapering Klonopin. Plus, with the social anxiety, I don't know that it is a good idea to try to remove this unless you acquire skills to manage that. I know you take it for sleep but it isn't strongly hypnotic -- most likely it helps you through its anxiolytic and/or myorelaxant effects.


4. Geodon -- I am not saying Geodon isn't contributing to your memory difficulties. It probably can. I'd bet that most strongly sedating drugs can do that. Mostly, I think it is your #1 most important medication... perhaps on par with Klonopin as they have different roles.

==============

Geodon vs. Lamictal

You've said before that you take Lamictal as a "stabilizer" (indication) and Geodon as an "antipsychotic" (class, indication). I can appreciate that maybe your doc told you that (or so you understood?), but to express things in parallel terms --

Lamictal is an AED (class, indication),
Geodon is an antipsychotic (class, indication).

BOTH drugs serve as stabilizers (indication).

You, personally, have been given extra Geodon for breakthrough hypomania but you also take it when you are stable (maintenance drug). This suggests to me that Geodon is being given you as a mood stabilizer, not just as an antipsychotic.

Finally, while Lamictal is near useless at preventing mania, Geodon is very effective for that purpose. Given your tendency towards mania rather than depression, the Geodon will be more valuable to you as a stabilizer than the Lamictal. So if I had to pick one to throw out in your case, I'd pick the Lamictal.

==============

CONCLUSION: I'd recommend a longer AF period before changing things -- at least 6 months -- but after 3 months you can probably start to assess whether your memory has improved.

Pay special attention as to whether you have more trouble with short/long term memory, or both. Bear in mind you'll never be able to recollect events that were not stored... you'll have to take into consideration only memories of events that occurred after you stopped drinking. Also note any other cognitive difficulties (concentration, verbal difficulties, spatial orientation, arithmetic). It might help your doctor decide if one drug or another is a more likely cause. If the doc thinks the Geodon is the more likely cause then by all means...

Finally, if/when you decide a drug change is in order, I suggest you fess up to your doctor 100% regarding the alcohol history. Right now, any ideas she has or decisions she makes will not be based on an accurate clinical picture. :o

love

waves who feels like writing a huge disclaimer or an apology or something but can't think of what to say after all that! :o

First of all I want to thank you waves for your very thoughtful remarks.
I want to reassure everyone that I will only do this with my pdocs assistance.
The excessive drinking had gotten to be a problem not that long ago. I was an occasional binge drinker before. I believe that I had been a problem drinker for the past year or so.
My memory issues have been on-going and have gotten worse over the years. This is not something new.
I am just sick of it and jeff says it has gotten worse.
I would never give up my klonipin.....I can't sleep with out it.
bizi
A year ago my pdoc wanted to test me to see if I had ADD. I told her I did not want to test for that. Maybe I do have ADD and can't focus and therefore don't get points of information input there fore can't recall.

Bizi,

Sorry, I really thought the alcohol thing had really gone on longer. It seems like this past year is when you've tried to quit.

I do not see going off the Klonopin either, for reasons that go well beyond sleeping.

I hear that you are sick of it and that you need a change. I see that you have just made a huge change that is still impacting you (I would not call that life being stable but YMMV). I do see that you are chomping at the bit to make more changes, and I am afraid for you.

If you talk to the doc, you will talk about the alcohol too, and no downplaying, right? Including when you really stopped and how much you were using before you stopped?

If you must charge ahead with this, please, seriously consider the Lamictal rather than the Geodon. For all you know, the Geodon is doing all the work. That is what the statistics on Geodon and Lamictal suggest, that is what their respective indications suggest. You told me before you started those two at the same time, so in regard to your personal use, there is no reason to think you are an "exception" to the statistics.

waves

Ok, one day of missed meds... no, just one dose of missed meds, and you were running high? That picture does NOT say "stable" to me -- anything but. :( My point of view.

I honestly can't help wondering if you are getting a little hypo *NOW* and that is getting these ideas into you about coming off meds... not even changing meds... coming off them! :eek:

Totally, totally scary.

I do not want to be mean, or a wet blanket etc, and I will now cease and desist. I am done. I have said what I had to say, all of it. But I would not have felt honest if I didn't say what I have said -- ALL OF IT.

I hope that you will be sensible, Bizi, and that, whatever you do, you will end up being ok. :hug::hug::hug:

love you

waves

yes about the ADD screening
 

The ADD thing is worth investigating IMO. Not sure if this would a the right time but I agree with your observation that lack of focus or concentration would cause trouble recalling.

I am really proud of you for how well you have done with the alcohol, Bizi. I just want to remind you of that.

love

waves