Ziprasidone

[SEANML]

Afraid to take it. I am on olanzapine right now but they are looking to change me to a less weight gaining drug. Argh but I am required to eat before taking it. I am scared to eat before bed (it is linked to gastrict cancers) I saw the research that supports my fears.

[panic_down_under]

Argh but I am required to eat before taking it. I am scared to eat before bed

Why can't you take it at the regular meal time? And what are you taking it for?

[SEANML]

It will be for helping me sleep
I am on 30 mg mirtazapine , 20 mg olanzapine and 200mg trazadone currently to sleep. Plus 20mg melatonin.

The ziprasadone is on attempts to stop the hunger cravings. I bugged my Dr for 2 weeks with constant phone calls (my ocd/anxiety is really been on the loose. I seem to have relapsed after 15 years.)
So basically he gave me 20 mg ziprasadone and now I am refusing it and trying to get back on olanzapine until I stabilize more. I felt changing meds while I am loosing control might not be the best time. Plus the "cancer" anxiety.
Thats my health anxiety that I have been able to get more under control.

[panic_down_under]

It will be for helping me sleep
I am on 30 mg mirtazapine , 20 mg olanzapine and 200mg trazadone currently to sleep. Plus 20mg melatonin.

Plus lisdexamfetamine (Vyvanse)?

So you are taking mirtazapine, olanzapine and trazodone all for insomnia? Plus lisdexamfetamine and maybe soon methylphenidate (Ritalin) instead just to damp down the mirtazapine and olanzapine induced carbohydrate cravings?


The ziprasadone is on attempts to stop the hunger cravings. I bugged my Dr for 2 weeks with constant phone calls (my ocd/anxiety is really been on the loose. I seem to have relapsed after 15 years.)

Did you take any medication for it 15 years ago? If so, what?

Also, have you ever tried cognitive and/or behavioural, or mindfulness therapy for it? If so, did it help?


So basically he gave me 20 mg ziprasadone and now I am refusing it and trying to get back on olanzapine until I stabilize more

I'm not sure it would make much difference anyway because mirtazapine is probably driving most of the carb craving. It is notorious for doing so. Some will literally eat sugar straight from the bag in a vain attempt to satisfy it.


Thats my health anxiety that I have been able to get more under control.

None of these meds is a first line treatment for health anxiety/OCD, or for insomnia at the doses some have been prescribed at. The sooner a psychiatrist evaluates your med regime the better, imo.

[SEANML]

My meds as a kid solved nothing (paxil,effexor,olanzapine). I try to just talk myself down from any actions. Mirztazapine solved some issues in the past but at the moment I am out of control. Takes a long time for a phyc I can just hope and wait.
Also my dr is very frustrated that I am asking for olanzapine back (he is more less saying you bugged me for ziprasadone so take it) But I really dont think I should be messing with my meds during this mental break down lol. I think I should leave it all the way it is until a phyc evaluates what I need and what is wrong with me. I am no dr so I got no idea other then that I am loosing my mind.

Just walked off my job at a grocery store today due to concrete work being done (they were not offering me a proper mask for the silica dust) So now god knows what is going to happen with my career. Another breaking point.

*What solved my childhood breakdown was this:
I hit the streets as a homeless kid and did a ton of silly drugs. Boom sobered up after 2 years and my mental problems were gone. So either it was the doing drugs that solved it or the fact that I began living a stressfree life. I cannot and will not hit the streets again. I am old now and that life would most likely kill me.

[panic_down_under]

My meds as a kid solved nothing (paxil,effexor,olanzapine).

So they didn't work? Can you remember what the maximum dose was and how long you were on that dose?


Also my dr is very frustrated that I am asking for olanzapine back (he is more less saying you bugged me for ziprasadone so take it)

The olanzapine is working now when it didn't before?


But I really dont think I should be messing with my meds during this mental break down lol.

Not if they are working well, although significant weight gain is a concern.

Also, I wonder how much the trazodone is contributing. Although mostly prescribed for insomnia these days, it is a pretty good AD at doses of 200mg/day plus. I don't understand why such a high dose has been prescribed for insomnia. It is usually most sedating at low doses becoming progressively less so as the dose increases with the sweet spot for insomnia being in the 10-100mg range.


*What solved my childhood breakdown was this:
I hit the streets as a homeless kid and did a ton of silly drugs. Boom sobered up after 2 years and my mental problems were gone. So either it was the doing drugs that solved it or the fact that I began living a stressfree life.

I doubt the drugs had a positive effect on your mental state. They usually do the opposite. Some are pretty efficient at destroying neurons, or parts thereof and repair is very slow if it occurs at all.

[SEANML]

*I am not sure what my doses were as a child. But it did not work, I remember that.
*The weight gain from my meds I will have to just deal with until I get a phychiatrist (my family Dr is not good with follow upas/blood work or medication.)
*Trazadone is so high due to my previous family DR some nights I take 100 some nights I take 200. No dr has said anything about
(200mg trazadone, 30 mirtaz, 20 mg olanzapine, 70 vyvanse--daytime for vyvanse--)
I am just simply trying to fight the cravings which is very difficult. But as one dr said don't fix it if it aint broken "weight gain is the least concern from side effects" he said.

*I only wanted to go on ziprasadone thinking the weight gain would stop but then I decided it would be too dangerous to change any meds with the family dr because he was not familiar with ziprasadone and his followups would be a month apart. So dose raising would be hard to achieve and he is difficult for getting tests such as blood work and a ekg (needed on ziprasadone.)

Lastnight the cravings were rough but I was able to eat some nuts,a veggie burger and brussle sprouts lol. I see some weight that is there but I just am stuck at the moment. Changing meds could really effect me mentally as I found out on a lower dose of olanzapine. I am lost for words I do not know what to do and I have no other peoples opinions to help me come to any decisions or solutions.

[panic_down_under]

*Trazadone is so high due to my previous family DR some nights I take 100 some nights I take 200. No dr has said anything about

I think you need to discuss dosing with your GP. 200mg is too high as a sleep aid and chopping and changing doses will interrupt any positive effect it might have as an antidepressant. I also wonder whether the constant dose changes may not be making anxiety worse.


(200mg trazadone, 30 mirtaz, 20 mg olanzapine, 70 vyvanse--daytime for vyvanse--)
I am just simply trying to fight the cravings which is very difficult. But as one dr said don't fix it if it aint broken "weight gain is the least concern from side effects" he said.

In the short-term, yes, but to quote myself in my working life, there is often nothing so permanent as a short-term fix, or issue.


*I only wanted to go on ziprasadone thinking the weight gain would stop but then I decided it would be too dangerous to change any meds with the family dr because he was not familiar with ziprasadone and his followups would be a month apart. So dose raising would be hard to achieve and he is difficult for getting tests such as blood work and a ekg (needed on ziprasadone.)

Even if ziprasidone were better than olanzapine on weight, mirtazapine is likely just as much responsible for the weight gain, and very probably the main driver.


Lastnight the cravings were rough but I was able to eat some nuts,a veggie burger and brussle sprouts lol. I see some weight that is there but I just am stuck at the moment. Changing meds could really effect me mentally as I found out on a lower dose of olanzapine. I am lost for words I do not know what to do and I have no other peoples opinions to help me come to any decisions or solutions.

The sooner you can see a psychiatrist the better, imho. I'd keep pressure on your GP to get you fast tracked if possible.

[SEANML]

Thank you for the information. A part of me is trying to accept weight gain as a side effect.
Cravings are the issue. I seem to crave nuts/seeds and those hefty protein cliff bars lol.
You have been of great help my friend.
I cannot call my dr as they said "only call once a week" and I had a phyc lined up but my anxiety acted up and I asked for female instead of male. Due to my trauma I am more comfortable with a female in theory. Not even sure until I try and talk to someone anyways. Tried to take back what I had said and said I would take the male but it was too late.Argh.
I must let you know as I increase my olanzapine I have been feeling better mentally. Not 100% but better then where I was 2 days ago.

[panic_down_under]

I must let you know as I increase my olanzapine I have been feeling better mentally. Not 100% but better then where I was 2 days ago.

Dropping the dose by 50% was unwise. It would have been better to cut back in 2.5mg steps every couple of weeks, longer if withdrawal effects are severe, although the mirtazapine may mitigate some of them as it hits most of the same receptors.

[SEANML]

I reassure you I will now wait before toying with my meds. It may take a few months and some weight gain but I cannot go back to the mess I was. I am only feeling a little better. I require more help but the waiting list can and will take time. My family dr is no good. He can give meds but his follow ups are distant. I hate that I have to stay on the 2 weight ganing meds to stay stable at the moment but I do think that is my safest bet at the current time sadly :(

[panic_down_under]

My family dr is no good. He can give meds but his follow ups are distant.

Correct me if I'm wrong, but my understanding is that in Canada you're not restricted to which GPs you can see, as seems to be the case in the UK, so you can switch to another relatively easily, or at least get a second opinion. A second opinion would be a good idea, imo. I've found pharmacists are good sources of information about the local GPs and which issues they may be more interested in.

[SEANML]

Yes you can change but finding a family Dr is near impossible right now. It would be faster to just get a psychiatrist through the family dr. (Referrals) But finding a family dr was hard once my original one retired.

[panic_down_under]

Yes you can change but finding a family Dr is near impossible right now.

Because of COVID?


It would be faster to just get a psychiatrist through the family dr. (Referrals) But finding a family dr was hard once my original one retired.

Bummer! :sad:

[SEANML]

Nope. we are just in need of family DR's where I live. Alot are not taking patients. If you have a family doctor don't loose it kind of deal. Cause that could be you last for a long time.
On one waiting list i was number 100. Never got a call back so they most likely filled the available spots.

My new dr isnt the best but it's a dr

[spectrum123]

Correct me if I'm wrong, but my understanding is that in Canada you're not restricted to which GPs you can see, as seems to be the case in the UK, so you can switch to another relatively easily, or at least get a second opinion. A second opinion would be a good idea, imo. I've found pharmacists are good sources of information about the local GPs and which issues they may be more interested in.

That's slightly changed in the UK now, certainly has in my NHS authority. You can swap practice, (if that practice is taking on patients), quite easily. At my practice you are nominally assigned a Dr, they will do your repeat prescriptions, but you won't automatically see then if you book a general appointment. General appointments if you have specific times when you can attend like me (pre covid), I work 45min to an hour away from home and local practice, so usually ask for an after 6 pm, then you'll see a Dr who's available at that time. If a specific Dr has been dealing with you on a certain treatment you may have to wait longer to see them dependant on their work rota, or you can see them immediately if you're available anytime.
All the Dr's certainly at my practice have listed on the website what their speciality interest is outside General Practice work so you can ask to see that Dr if you think they would be more suited to your requirements.
The practise I go to and the Dr I used to see (since retired), was one of the heads of practice and didn't believe the one Dr one patient system was particularly healthy, and that you should from time to time see a different Dr for long term illness (like mental health), for an alternative view on things. He particularly espoused the view as he was one of the older Dr's of seeing a young GP in his case, as they would be more up to date with the latest ideas and more aware of new treatments, than as he put and 'old fossil' like himself. Also he thought the reverse worked as well if you had been seeing a newish GP 'fresh out of the packet'.

[panic_down_under]

Nope. we are just in need of family DR's where I live. Alot are not taking patients. If you have a family doctor don't loose it kind of deal. Cause that could be you last for a long time.
On one waiting list i was number 100. Never got a call back so they most likely filled the available spots.

My new dr isnt the best but it's a dr

Yikes! :ohmy:

The local docs where I live have a waiting list too, but that's because it has been only a small community until recently and an influx of outsiders is overwhelming the staff at the two practices, not helped by one GP retiring recently. However, there is no shortage of doctors in the bigger town 30 km away and I think generally it isn't difficult getting an appointment in most of Oz.

[panic_down_under]

That's slightly changed in the UK now, certainly has in my NHS authority. You can swap practice, (if that practice is taking on patients), quite easily.

Ah, thanks for the heads up.


The practise I go to and the Dr I used to see (since retired), was one of the heads of practice and didn't believe the one Dr one patient system was particularly healthy, and that you should from time to time see a different Dr for long term illness (like mental health), for an alternative view on things. He particularly espoused the view as he was one of the older Dr's of seeing a young GP in his case, as they would be more up to date with the latest ideas and more aware of new treatments, than as he put and 'old fossil' like himself. Also he thought the reverse worked as well if you had been seeing a newish GP 'fresh out of the packet'.

They each have their positives and negatives. I'm currently having issues with my newish GP as she's too eager to send me to a specialist whenever something odd shows up on routine tests and won't take no for an answer even when I know there isn't a problem because it's an old issue which has been thoroughly investigated and found to be benign.