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Psychiatry Malpractice? Geodon-induced Dystonia. Help

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dgarnold

Junior Member
What is the name of your state? CA

After discontinuation of my Lithium treatment, my doctor prescribed me 60 milligrams of a drug called Geodon, made by Pfizer Pharmaceuticals. At this session, he gave me about a week's worth of 60 and 80 mg samples to take home. I also take an SSRI drug called Luvox. My psychiatrist told me to increase my 200 mg to 300 mg.

Before taking my first dose of Geodon, I looked it up in The Pill Book, where it said Luvox interacts with Geodon. It said something about affecting the way it breaks down in the liver, resulting in an increase in Geodon in the blood. So I took my night's 60 mg dose with no problem. The next morning, I took my next 60 mg Geodon dose and increased the Luvox to 300 mg as instructed by my psychiatrist. Later on in the day, I noticed I was walking funny. My neck kept bending back on its own. My brother and I flagged down a police officer on the street. He called for an ambulance. At this point, I was vomiting and couldn't breathe well on my own. My eyes were rolling in the back of my head and my jaw was locking up. Little did I know I was suffering from a dystonic reaction to the Geodon.

I was put on a gurney and into an ambulance. My anxiety increased exponentially from there, thus exacerbating my suffering. I was hooked to an IV tube. One of the paramedics told me to stop sounding like a duck and to breathe normally. I was hooked up to an oxygen mask. When I was transferred to the hospital bed, I was screeching in excrutiating agony for a few hours until a nurse finally pumped me with Ativan, Cogentin and Benadryl. After a short nap, I went home.

Following the incident, I fell into a psychotic stupor and anxiety consumed me. I checked myself into the mental ward on Monday night. They put me on Seroquel and I was on my way home. I stayed there for three days.

I confronted my psychiatrist about this in person. He said it was an acute dystonic reaction that is actually quite rare. He said it usually happens with the old antipsychotics. I confronted him with the possibility of an overdose. He shrugged it off and mentioned something I couldn't understand and said it was unlikely.

I feel OK now. I'm scared that I might have arrhythmias from this. I will get checked out soon.

What can I do? Do I have a case? My mother was a witness to the prescription of the Geodon. Perhaps the hospital I stayed at could reveal helpful information.

Any feedback will be appreciated.

-Daniel
 


rmet4nzkx

Senior Member
Danial,
Below is you post from March before you were treated for Bipolar. How long were you on Lithium? How long on Luvox used to treat OCD? Is your Dx of Bipolar firm or is there a possibility that you have Asperger's Disorder, please ask your psychiatrist if that is a possibility because of the combination of Bi-polar and OCD traits. If you were a poor metabolizer of CYP4503A you would have had a reaction before the switch to GEODON. Geodon has a short half life and you were not on it long enough to have a adverse reaction if you were taking the Rx as instructed, in fact you were more likely to have the reaction with Luvox combined with Lithium.

It appears that reading information in the Pill book was not understood and may have lead to you having a reaction out of anxiety.

It is very important that you are compliant with your medication and work with your doctor to find the medication that allows you to function in society, even if you feel you don't like or need your medication.

There is no cause of action if you indeed had an adverse reaction to this medication.

dgarnold said:
What is the name of your state? California.
I'm an often naive 19 year old with Bipolar disorder. I was caught hacking into a classmate's server exactly one week ago.

Technical details:

I was sitting through a computer lab at school one Friday while I was eavesdropping on the LAN with a switched packet sniffer called Ettercap. Two classmates, one being the owner of the machine being logged into, logged into the server via FTP, which required them to enter their passwords in plaintext. Ettercap immediately parsed the passwords and I took them home and had fun.

Over the weekend, as manic as I was (before I began Lithium treatment), I began to login to his machine. I wanted to have some fun so I executed a local DoS attack called a fork bomb. It downed the server for about a day. When it came back up, I filled his message of the day with data from /dev/urandom, which is just randomness. This evoked concern on the owner's side. I believe I executed a local DoS attack once more after that until I was caught. I'd kept the server down for almost three days. I soon realized he'd caught me when I perused our Computer Science forum. At that point, I had no other choice but to come clean and beg for forgiveness. I fessed up. He sent logs to various concerned parties, claiming he himself wouldn't press charges, but others would be glad to.

I'd also like to add that no data was harmed on this system. I had no intention of sabotaging this guy's website, despite the capability to do so.

This server was supposedly his "business" and "only source of income." It is a MUD game server of some sort with some ties to sdf.lonestar.org, which is a Public Access UNIX system.

My apologies have been basically criticized and perhaps even ignored. I think this guy may start pressing charges. I just want to know where I stand legally and what kind of penalty I may be facing.

A friend and I looked at the Computer Fraud and Abuse Act and the Wiretap Act, and nothing in those seem to match what I did. I'm not sure where to look now.

Any advice will be appreciated.

Regards,
Daniel
 

dgarnold

Junior Member
I'm not too sure how firm my Dx is. I just know last time I checked it was Bipolar NOS.

I've been taking Luvox everyday since last July. I was on Lithium for about a month or so. I had to quit when I reached 1200 mg because it elevated my TSH levels. I went for about 6 weeks without anything except Luvox and Klonopin and this prompted the prescription for Geodon.

I took my pills as instructed by my doctor. I think it is unlikely for it to be a combination of Lithium and Luvox because I hadn't had any Lithium 6 weeks prior to the incident. Do you think the increase in Luvox was the main factor here?

Do you think blood test results from the hospital may be more revealing? I am thinking about contacting them.

Thank you for your reply! :)

-Daniel
 

dgarnold

Junior Member
I also wanted to add that I was on Risperdal for approximately 6 months and this drug is in the same class of atypical antipsychotics as Geodon and, according to my doctor, is more potent. I took this with a lower Luvox dose. I find it odd that Geodon would strike me out of nowhere. The 100 mg increase in Luvox definitely looks suspect.

Also I wanted to quote The Pill Book
..., fluvoxamine, ..., and ... may increase the amount of ziprasidone in the blood by interfering with its breakdown in the liver.
This part definitely got me anxious before taking it. That is also what makes me believe that I overdosed. However, I can't really verify the accuracy of that information.

-Daniel
 

rmet4nzkx

Senior Member
If you were taking lithium and luvox at the same time and didn't have a reaction after 1 month of taking it, similar to what you describe, it is unlikely that you would have had a reaction to Geodon. This is due to it's short half life and that you were no where near the therapeutic range, if you were a poor metabolizer which would be the reason for the reaction. There was a reason to increase the Luvox dosage and shouldn't have caused a reaction even if you didn't split the dosage. Something else is going on here.

As I said, you don't understand the pharmakenitics off all these medications and it is very important to work with your doctor until you get the correct dosgae of the correct medications. If your Dx is Bipolar NOS, then that means that you don't fit the typical profile for any of the bipolar types, so I would suggest again you ask your psychiatrist about the possibility of Asperger's Syndrome, because it includes bipolar, ADHD and OCD traits and in is frequently found in persons with certain interests or talents, such as computers. Persons with Asperger's may react differently to medications than expected, however Lithium, Risperdal, Synthroid, atypical antipsychotics often are helpful. SSRI's may cause unexpected reactions having nothing to do with the dosage or the metabolism of the drugs, so if you had a reaction, it may have been to the Luvox not the Geodeon. You might be more likely to have a psychosomatic reaction. Did you and your doctor discuss taking Geodon alone without anyother medicaiton?

Are you taking the Luvox on a split dosage? How were you doing with Risperdal? Lithium? Was there any discussion of adding Synthroid? How high was your TSH? Are you still taking the Luvox? Have you taken Lithium alone? Do you take any other suppliments? Are you male or female?

Even so, you must work with your psychiatrist, both to firm up the diagnosis and to find medications that work for you. Having an adverse drug reaction is not malpractice nor was there any neglect.
 

dgarnold

Junior Member
I'm not sure what a split dosage is. I am currently taking 2.5 100 mg Luvox tablets. Before I was taking 2 100 mg tablets of Luvox.

As for Risperdal, I didn't notice much. I opted to stop taking it because I didn't think I was psychotic and I didn't like the side-effects.

I did great on the Lithium. My doctor didn't mention Synthroid but I'd already considered it. He said it would be more wise to explore other treatments (Lamictal) before having to go back to Lithium.

I'm not sure exactly how high my TSH was. It was just above normal. The levels were at the normal maximum level at 900 mg which prompted him to do the TSH blood test for the 1200 mg, which I guess spilled over the top. I assume not by much.

I never took Geodon or anything else alone. I've been taking both Klonopin (2 mg) and Luvox (200+ mg) consistently since last July.

I still take the Luvox daily in the morning.

I don't take any supplements.

I am male.

On the point of diagnosis, my doctor's philosophy is that he doesn't treat diagnoses but symptoms, so he hasn't really hastened to anything particular. I think he thought I was schizophrenic or schizoaffective before. I will have to talk to him more. He said I could see a psychologist for a thorough psych. evaluation.

Thank you for your insight. :cool:

-Daniel
 

rmet4nzkx

Senior Member
A split dosage means taking it twice a day, so you would take 100 mg in the morning and 100 mg in the evening or before you go to bed or 125 mg am/pm.

Basing your meds on your belief as to whether or not you are psychotic or not doesn't work because you may not be able to preceive the actual effect and atypical-antipsychotics are also successful in treating a number of other psychiatric problems, not just psychosis. What were the side effects that you didn't like?

When the psychiatrist stated that you were possibly psychotic or schizoaffective once again makes it's sound like Asperger's, which doesn't have a specific medication that is effective and many act in unexpected ways, so it would be an excellent idea to get the referal to the psychologist for the testing/psych eval, again, the fact that you did well on lithium, but you should have a thorough set of labs, there are other things besdes lithiium that affect TSH such as foods and some minerals and treatment with synthroid may indeed help you. But knowing the TSH levels would help.

Treatment with Lamactal is a possibility. It looks as if it will take a while to find the medications that work best for you. The psychologist's evaluation would aid the psychiatrist have a better of your actual functioning levels and ability to accommodate change in your environment and social interactions.

Again, there appears to be no malpractice, only the possibility of a rare side effect, if it was a side effect and that you have not yet found the best Rx for your unique needs. You need to work with your psychiatrist.
 

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