Geodon

[miles2go]

Read other Geodon threads, got some conflicting info, thought it's time for another one.
difficult child busted through 120lb weight limit (psychiatrist and I agreed on this number as "try Geodon here" a few months ago) and last night we started on a tiny (20 mg) dose of Geodon (with a full meal of course) last night. psychiatrist gave a lecture about scary side effects (stiff neck or tongue, eyes rolling up) so I'll have benadryl on hand and have a prescription for some other thing (forgot name, some "..dryl") to fill if he gets these effects.
I see that other threads had conflicting info about which medications do what to weight. From what I saw and read Abilify definitely makes kids very hungry. As far as I hear from the psychiatrist and read in Pavuluri's "What works for bipolar kids" Geodon is an appetite suppressant -- we are hoping a small dose will counteract Abilify appetite and will further reduce difficult child's mania (reduced by Abilify but still far from 0).
Else we'll be increasing Geodon to the effective doses -- 120mg and up -- and reducing Abilify.
Today difficult child's been very sleepy but there's also spring pollen allergy going around, so who knows what's doing it.
Anyone has any experience with Geodon, especially with side effects?

Also, does anyone have a link to overeating threads (I know there've been some good ones)?

Me: single dad, 50 y.o. or so.
difficult child, 10 y.o., Bipolar, 15mg Abilify, 2mg Intuniv
2 more easy child's, animals etc.

 

[crazymama30]

I am pretty sure geodon causes weight gain too, but it is a more weight neutral drug. As is abilify. I have never heard of it as an appetite suppressant. Here is a link http://www.drugs.com/geodon.html it says on side effects that it can cause extreme hunger and then further down did say it could cause weight loss.

 

[miles2go]

I see what you mean. The "hunger" part has to do with high blood sugar -- a serious side effect which abilify can also produce -- my insurance company required psychiatrist to order annual lab workup just for that.
But among side effects I see both "reduced appetite" and "weight gain" , so who knows...
That's why I am trying to collect experiences from the good folks here...

 

[crazymama30]

I think with this medication, as with all of them, responses vary with the person taking them. My difficult child son has never been on geodon, but my husband was. For him it was not a good medication, but that does not mean it would not be good for your difficult child. For husband abilify caused tardive dyskinesia, but for my difficult child it is a godsend. I have a friend who is BiPolar (BP) and was on geodon, and it was a good medication for her but due to her other health problems she had to quit taking it.

 

[rlsnights]

Geodon has been weight neutral for my son where he gained a lot of weight on Abilify. He had also developed slightly elevated liver enzymes and was consistently having some mild red blood cell abnormalities (odd shapes, sizes) that have disappeared since he stopped Abilify. Geodon has been more effective for him but he still has some symptoms.

The biggest hidden danger of Geodon that we are aware of is that it can cause something called Long or Prolonged Q-t syndrome. This is a change in heart rhythm that can result in sudden death.

Before starting Geodon your psychiatrist should have ordered an EKG to check for any heart problems.

If he did not, I suggest you call and ask for one to be done and refuse to start the Geodon until his EKG has been cleared by the peds or psychiatrist.

Once he's on Geodon the EKG should be repeated to check for any change.

My son has developed mild orthostatic hypertension on Geodon. That's when you have a drop in blood pressure when you change position like going from sitting to standing. This has to be assessed by the peds and if it's severe then it may require further evaluation and change of medications.

Long q-t syndrome is actually a risk with any of the atypical anti-psychotics but Geodon carries the most significant risk.

Since my son developed problems with his blood pressure his EKG has been repeated a couple times. So far those have been normal.

Patricia

 

[miles2go]

Thanks, rlsnights -- I'll look into the long Q-t and EKG issue. I assume as we keep him on 20mg for a month or so until the next psychiatrist appointment it's not a rush to see psychiatrist/do EKG before that? Or do you think these dangers can exist even at such a small dose? psychiatrist definitely did not mention anything about this...

 

[rlsnights]

I don't know if it's dose dependent. I am the cautious type, having a kid with major medical issues. I would contact either your peds or the psychiatrist to ask about this. Either way, I believe he should have had an EKG before starting. That's what our psychiatrist wanted to know - had he had one before starting it in the hospital.

difficult child 2 was inpatient when he was switched to it at 60 mg and had an EKG done before he started and again the next day. We have done EKG twice more. Once about 4 months after he started - at his psychiatrist's order. And once again about 3 months ago when he developed persistent orthostatic hypotension.

Some people have an inborn error that either gives them long Q-t syndrome or makes them especially susceptible. Since it has no symptoms in most people that makes it extra dangerous. You don't know you have it.

If you do have symptoms it would include fainting, seizures and sudden death. Apparently significant orthostatic hypotension can be an indicator based on the way our peds has handled that but it's not listed anywhere as a symptom. Since the first symptom can be sudden death - well it's not something I'm inclined to guess about. Especially since a simple EKG that takes about 1 minute will rule it out.

And there's a lengthy list of drugs with potential serious interactions with Geodon. If you want to see that list go to

http://www.drugs.com/drug-interactions/ziprasidone,geodon-index.html?filter=3&generic_only=#I

 

[miles2go]

Allright you talked me into it, I have a call in to psychiatrist and talked to his pediatrician doctor, will get him that EKG. meanwhile his appetite and mania is lower, kinda nice. on the other hand, his allergy got him wheezing and crackling in lings and he's on antibiotics and albutirol; sigh.....

 

[rlsnights]

My son is on Topomax plus Geodon and he lost weight when the Topomax was added. If you are still seeing big mood swings maybe adding a mood stabilizer like Lamictal or Topomax might be worth considering.

 

[timer lady]

Just want to offer that each of our children react differently to medications (i.e. weight gain, sleep issues, etc). My kt didn't do well on geodon. She's on seroquel with topamax to lessen the weight gain that comes with the seroquel.

kt's twin wm, on the other hand, doesn't gain a pound on any of these medications. It's all based on an individuals neuro chemistry.

 

[susiestar]

It was my info (back when Wiz was on geodon) that it was weight neutral, not that it caused weight loss. In fact, other than stims and illegal drugs and things like that ally medication for weight loss, the only medication I know to cause weight loss is topomax. It can be a very useful drug - for me it helped when I got into a depression that didn't lift with other medications and it prevented migraines very well. It was actually rx'd for migraine prevention not the depression, but the psychiatrist I saw was glad the reg doctor put me on it. It helped my prozac back then. Sadly it was very expensive and stopped working for the migraiens after about 6 mos.

Geodon was not very effective for Wiz but it didn't give any bad side effects.

I would be insistent about having the EKG done, and done by people who are trained in how to do EKGs on children. When Jess was 12 she had an EKG done because she was having chest pains and periods of super rapid heartbeat. It was done in our ER after the pediatrician freaked out when it happened in her office. It was just sheer luck that it happened in her office, we were there for a well check but her heart rate was so fast the machine couldn't count it and by hand the doctor couldn't keep up with it. This runs in my family on my mom's side and is NOT much fun to go through.

We were told that Jess had long QT syndrome and could not WALK anywhere alone, would need a wheelchair to go ANYWHERE, was to not do or watch anything exciting like a fast paced or scary movie, and we needed to look into getting a home defibrillator and learn how to use it ASAP. The pediatrician actually got the home defib approved through our state kids' insurance in less than 2 days. We never got it. I freaked when the only pediatrician cardio practice in the state watned us to wait three MONTHS to see her. We went in to a diff pediatrician at our doctor's practice and she got us worked in the next day with the pediatrician cardio. turns out that the fright was all for NOTHING because they did the EKG wrong. they placed the EKG leads where they would with an adult and that is NOT correct iwth a child, even one with the development that Jess had (already required a bra, etc...).

That long QT problem is SCARY. If you are proactive and keep getting him checked regularly it shouldn't be a problem but you just have to make sure the docs do the tests. We had one doctor who tried to tell us that the people who mandate those kinds of tests for kids are nervous nellies and just want to scare parents. I refused to accept that and made the tests be done anyway.

For those that geodon works well for, it seems to be an awesome drug. It is easy to get frightened by the side effects, and you always have to weigh risk and reward. I hope it works well and causes no problems and stips a bunch of other problems! We were advised by several docs that atypical antipsychotics were all together bad medications for kids, but for us the risk was well worth it. Otherwise Wiz would have killed or seriously harmed someone and it would have ruined a lot of lives. risperdal was the medication that worked for him, and it was a miracle and worth the risk.

Hope this helps.

 

[miles2go]

so far after a few weeks it does seem to work nicely; his appetite and mania are reduced -- both are still there but down a notch or two.
I am taking him to the psychiatrist next tuesday (and have call into him). psychiatrist'll be more concerned I think about this weird neck-shoulder big, voluntary (he can stop for a while, etc) movement, like a slow twitch. He says it just feels "funny" or "tickly" and he needs to pull his shirt collar and do this thing. It started before Geodon, and come to think of it, he doesnt do it when walking around shirtless, so may be it is a skin thing.
re: geodon and appetite -- Pavuluri in her book ("what works with bipolar kids"?) does say that she likes how it controls weight gain for these kids.
Not that it stopped him from having a dinner after the dinner tonight but it is down overall I think.

 

[crazymama30]

Miles, that can be a very serious side affect, I cannot remember the name of it. Maybe dystonia? there are others too. I would really want to hear from psychiatrist sooner than next Tuesday.

 

[LookingForAnswers]

My son was Geodon for a while and I didn't like it at all. It did help with his moods but it knocked him out at night and made him do some really weird stuff on some mornings. Some morning he would look "high". His speech would be slurred and his eyes wouldn't be "bright". Sometimes he would say his arm hurt and he would hold it straight out (but there was nothing wrong with his arm). He would also say his leg hurt and he would walk around like his leg was buckling out from under him and he would even fall to the ground. It was very weird! It didn't happen on a regular basis but once was to much! He was taken 80mgs and he weighed only 80lbs (My son is VERY underweight!). I was glad when we took him off of it and it has not happened again since he stopped taking it!

 

[miles2go]

Dang, crazymama, I don't like it myself, but psychiatrist hasn't returned calls. It's not dystonia as far as I know since that would be involuntary muscle movements. His muscle movements are volntary and are dealing with "tickling" sensation on his skin around neck and shoulders so he pulls his collar so it doesn't rub, bends to the side to alleviate the sensation etc.
Started before Geodon. I've been looking for such a side effect of Abilify but got nothing
. His Geodon is a small dose, 20mg for his 120lb weight. He got a benztropin prescription with geodon and started on that; seems to make no diff.