Posted by iforgotmypassword on December 16, 2008, at 12:06:14
i am wondering if low dose ziprasidone (Zeldox, Geodon) could have serious risk of deleterious effects on problems commonly seen be caused by inadequate dopaminergic transmission, like apathy, anhedonia, death of inspirational drive, executive drive and initiative, poor co-ordination, poor concentration, blunted fluency, and all types of permanent extrapyramidal symptoms.
these are serious concerns of mine as my complex of symptoms already is based on these issues including EPS that have been permanent since SSRI use several years ago. in fact my current worry is that i'm developping a parkinsonian syndrome and i am not being hyperbolic. i can't get through more of the details that i need to in this post, i never can, but technically speaking, i am primarily going after ziprasidone for high 5-ht2a and 2c antagonistic capacity of the drug with not too much h1 antagonism. i have suspicions that my problems may be dopaminergic dysregulation due to serotonergic dysregulation, unfortunately this drug also has D2,3 antagonism as well, occupancy being higher than it's relative affinity (relative to 5ht-2a) would suggest (like risperidone.) unfortunately, buspirone is the only drug that can deplete overflow of serotonin via the 5-ht1a autoreceptor mechanism, but it has caused dystonia at lower doses than one would suspect suggesting that it may be even more antidopaminergic, but lack of information on this drug may cause this to be overlooked.
MAIN FOCUS (i think this sums it up): i am wondering if ziprasidone at 20mg once at morning or bedtime, or 2x a day, would be too much, too little, or not worth risking at all.
i am guessing based on this information and two articles*, making an estimate placing 20mg ahead 4-8 hours given it's half-life (D2 occupancy seems still alarmingly high):
"Each subject received a clinically effective single oral 40 mg dose of ziprasidone. Mean 5HT2 occupancy remained higher than D2 occupancy at all time points: 98.5% vs 80%, 91% vs 68%, 80% vs 52%, and 55% vs 32% 5HT2 and D2 receptor occupancy at 4, 8, 12, and 18 hours post-dose."
*article/abstract urls:
poster:iforgotmypassword
thread:869088
URL: http://www.dr-bob.org/babble/20081214/msgs/869088.html