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Is Zyprexa A Good Replacement Of Geodon?

Posted on Fri, 22 Aug 2014

Question: I take Lamictal 400mg Kolonopin 4mg. I took Geodon for 12yrs 80mg but started getting Eps. My doctor switched me to 20mgs zyprexa 2 days ago and I woke up shaking this morning I called her today to tell her that but she said it will go away once the 20mgs of zyprexa kicks in. Is that true. She refused to go down on the zyprexa 20mgs and told me to stay on it till my next appt. august 25th cause she said the shaking will go away when it kicks in. I need to know if this is true. She refuses to drop the dose now. I only been on zyprexa 20mgs for the last two days.

Answered by Dr. Vishal Garala (53 minutes later)

Brief Answer:
Both drugs are atypical antipsychotic.

Detailed Answer:
Hii
I admire you for positive outlook.

Very glad to see you.

Both the drugs are atypical antipsychotics.

Geodon cantains ziprasidone. I would prefer dose ranges from 20 to 60 mg.

There are case reported of development of EPS on high doses like 60 to 80 mg.

I would prefer two ways

1st if you have good improvement with 80 mg than no need to change drug
EPS can control with anticholinergic medications

Add anticholinergic along with geodon will control EPS.

2nd if you dont have such improvement than shift to another drug which has minimal EPS.

Zyprexa contains olanzapine which is also atypical antipsychotic.

It has very minimal EPS.

Only few cases reported with zyprexa.

I would prefer innlow doses. Start low and go slow.
Start from 5 mg and increase up to 20 mg gradually.

So watch for side effect during dose escalation.

So as per my opinion 20 mg of zyprexa has minimal side effect like EPS.

So wait and watch for improvement and if EPS persist than add anticholinergic is the best option.

Always here to help you.
Please feel free to ask.
Thank you.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Vishal Garala (12 minutes later)

So you think it's just the Geodon getting out of my system. because I was at 120 Geodon then dropped to 80 cause of eps but 80 was not enough for me. she said I have to stay at 20mg of zyprexa she refused to change it. she said the eps was neuroleptic changes from the Geodon and will go away once the zyprexa works. shes the best of the best. so what you think about this.will the tremors go away when my body gets use to zypexa since she took away the Geodon all at once

Answered by Dr. Vishal Garala (5 hours later)

Brief Answer:
It is due to dopamine antagonism.

Detailed Answer:
Hiii

Good to see you.

Geodon causes dopamine antagonism so it produces EPS.

Once geodon stopped this anagonism is removed and gradually EPS will disappear.

Improvement in tremor will occur after stopping of geodon

It takes around 1 wk.

Zyprexa has different Machanism of action than geodon.

It cause less dopamine antagonism so chances of development of EPS will very less as compare to geodon.

So by time EPS will disappear and zyprexa comes in action so improvement in symptoms profile will occur.

So no need to worry.
Just stay on it.

As you said she is the best so she makes best changes which is helpful to you.

Still if you have query than feel free to ask.

Thank you
Get well soon.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Vishal Garala (1 hour later)

thank you for the answers she got angry at me when I questioned her about it and was thinking about dropping me..thank you for helping me to understand and giving me hope. I really like the zyprexa but thought I was doomed for the tremors and the medince you have too stop the tremors cause I took it for a short period and it was offal

Answered by Dr. Vishal Garala (1 hour later)

Brief Answer:
thanx I appreciate your response.

Detailed Answer:
Hiii

Thank you

Get well soon

Just countinue to take medicine and you will get better soon.

Take care

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju