Geodon vs Risperdol vs Lithium

I can’t believe it! I just spent $589 for a one month supply of 80 mg of Geodon at  Fred Meyer Pharmacy, a nearby retail pharmacy. This same medication at Medco, an online pharmacy, is $233 for a one month supply. Still, that’s a lot of money. But we don’t yet know whether it’s going to work, so there’s no point in ordering a three month supply at this point. In the meantime,  I’m stuck paying $589 for a one month supply until we know for sure that it’s going to work. And it takes at least 3 weeks before we will know.

When I was in the mental hospital, they started me on lithium, which costs about $15 a month, to control and hopefully eliminate my delusions and hallucinations. But although Lithium is a powerful antipsychotic that almost always works, it has its own share of severe side effects, including a loss of coordination, tremors, restlessness, slowed intellectual functioning and weight gain. But the reason they use it in the mental hospital is because it almost always works for everyone in a severely psychotic stage, bringing them out of the psychosis sooner than any other drug.

In the hospital, I was on 900 mg of lithium, which is a large dose meant to snap me out of my psychosis as soon as possible.  In the controlled atmosphere of the mental hospital, the staff was able to closely monitor the drug, doing blood draws on me every few days just to make sure that I was on the proper amount. They can tell how much your body is metabolizing based on the blood draw information.  They don’t want too much of it in your bloodstream because the side effects get more severe, but not enough means you’re not getting better.

When I got out of the hospital, my first appointment with my new psychiatrist, Dr. K, was the day after my release.  When he examined my records and learned that I was on 900 mg of lithium, he continued me on the lithium, but lowered that dose to 600 mg.  I stayed on the lithium for several months, putting up with those terrible side effects. He promised me at that time that he would only have me on that high of a dose of lithium for a few months, which seemed like forever while I was in the middle of the treatment. Initially, I had to see Dr. K once a week, but that changed to every two weeks after about a month. During this time, he continued my blood draws, making sure that I was getting the proper dose.

After about 4 months, Dr. K said that I was stabilized enough to consider putting me on 80 mg of Geodon, a drug which had fewer side effects.  He explained that for most people, Geodon didn’t cause weight gain, and didn’t have the restlessness  or coordination problems that were the hallmark of Lithium.

Because the Geodon took several weeks to build up to the most effective dose, he continued me on Lithium, gradually reducing that dosage as the Geodon built up. Eventually, after several weeks, he began to taper off my lithium, finally eliminating it entirely over the course of several months.

However, while he was in the process of eliminating the Lithum, I had what I call a few “breakthrough” voices, which means that I heard voices. When this happened, he increased my lithium levels,  attributing the voices to the fact that the Geodon wasn’t yet at its effective dose. For several months, I roller-coasted through several episodes of increasing and decreasing my Lithium dose while I was taking the Geodon.

It was frightening when the voices returned, since I was afraid after every returning episode that the voices might not ever leave permanently.  After several months of this, Dr. K decided that the Geodon just wasn’t working for me.

Because of the terrible side effects of Lithium, he didn’t want to return me to that drug on a permanent basis. Since Geodon wasn’t working, he decided to try a drug with fewer side effects than Lithium, but whose success rate was greater than Geodon. That drug was Risperdol, whose generic form was Risperdone.

He started me on .5 mg of Risperdone, at a cost of about $100 per month for a 30 day supply, and that seemed to work fairly quickly.  But although the side effects of Risperdone are less severe than those of Lithium, they are still fairly severe. Those side effects included a less severe case of  slowed intellectual functioning and weight gain as well as sexual dysfunction and a sense of “flatness” of life in general.  But at least the voices were gone.

After about 2 years on Risperdone, I came to realize that I continue to have the occasional “breakthrough” voice, no matter what I do.  I have come to accept the “breakthrough” voices as part of my life, rearing their ugly head whenever my stress level gets too high. But I am much more comfortable with those voices, realizing that they do indeed to away after a little while.

Lately, though, I came to realize just how “flat” my life had become, registering neither excitement nor fear even in extreme situations.  I am fed up with this side effect, as well as the other side effects.

Coming to terms with the voices has allowed me the freedom to once again try Geodon, since the unwanted side effects of Risperdone are so much more severe than those of Geodon.  So Dr. K and I decided to try Geodon once more.

Although I am wary of hearing voices once again to the extent I heard them when I was on Geodon before, I am willing to try it again because I am in a much more stable place than when I first tried it, and because I am resigned to hearing voices occasionally, just like I hear them with the Risperdone.

So with trepidation, I went to my local pharmacy, Fred Meyer Pharmacy, to get my new prescription filled. However, I was shocked at the price: $598 for a one month supply. That is insane.

If the Geodon works, the voices will be gone for the most part, my sex drive will return, my weight will stabilize, my intellect will improve.  And most importantly, my life will lose its “flatness”.  I miss those emotions of happiness, sadness, fear, surprise. Is it worth almost $600 a month to have them?  I think so.  But it’s unfortunate that people without the means to pay for Geodon will be stuck.