Q:  Geodon & Bipolar Disorder

What do you know about the effects of Geodone used for Bipolars? My mom is convinced she is "fixed". I worry that she is mistaking this "fixed" feeling for actually being rather manic. (She has talked so much within the last few days she has actually lost her voice. This is a new one for me.) Please advise.


Dear Jackie -- 
This could be frightening to you, but I'm learning more about Geodon from your letter than you're going to learn from me.  My usual rule of thumb is to wait 2 years after a medication comes out before using it -- let somebody else's patients find out what the stuff really does.  Geodon is just beginning to cross that threshold into my practice.  I've prescribed it about twice, I think.  Once it was a dud.  The next patient is just starting.  He's got a very atypical bipolar disorder and he and I both are not sure what this is going to do, but he's had just about everything else routine.  I heard from two other (not my) patients with similar histories who really like it, even traveling 800 miles every 6 months to get it after starting it at UCLA or UCSD in a research project. 

But, can it cause manic symptoms?  I don't know.  It didn't take long after risperidone first came out to figure out that it can.  And there are a few case reports that even Zyprexa can (a whole lot less often that risperidone, in my opinion, like night and day; but I digress).  So, can Geodon?  I wouldn't say no, that's for sure.  

I can really go on when the answer is "I don't know", can't I.  The point is, I'm going to be on the lookout for this possible reaction, thanks to your letter.  So thanks. 

Dr. Phelps