Geodon's efficacy decreases after a few years? Anyone stable on Geodon for long term?

Recently found an article saying that Geodon’s efficacy on treating sz and prevention of relapse decrease as time goes on, because it binds dopamine tightly. As time goes on, this binding will decrease and lost its effect. (see the part of the papers below)

It coincide with my own experience. I’ve been on Geodon 40mg for 1.5 years, it used to make me sleepy at night, now gradually it doesn’t do me anything at all.

I was wondering is there anyone has been stable (no any symptoms at all, and missing a few dose won’t affect you) on Geodon for more than 4-5 years? How’s your long term experience with Geodon?


part of the paper:

Comprehensive understanding of schizophrenia and its treatment


Pharmacologically, relapse may be related to dopamine-binding affinity. “Tighter-bound” agents like the first- and second-generation antipsychotics may work well initially, but upregulation of dopamine receptors in the long term may lead to greater potential for relapse. More moderately or loosely bound agents, such as olanzapine and clozapine, maintain response well. Patients on first-generation agents show a steady rate of decline in response, compared with placebo; after one year, these agents do not offer much benefit.

Ziprasidone (Geodon), which is tightly bound, has a rate of decline that is better than placebo but is still fairly rapid. Compared with placebo, haloperidol, and risperidone, olanzapine did much better in maintaining response.

I’ve been stable on Geodon, Seroquel, and Bupropion for over ten years. They still work fine for me. How these med’s work on different people can vary. In my case they last over the long haul. I’ve tried other med’s, and they don’t work as well as these med’s on me. I’ve pretty well given up trying to find a designer drug that will leave me in nirvana.

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This gives me a lot of hope.

I’m afraid of my latuda petering out. But I’ll be happy with 10 years or more. In 10 years if my Latuda doesn’t work any more… who knows what might be on the market by then.

I have been on Geodon since 2009 but I certainly wouldn’t say that I didn’t have any symptoms but it keeps me from being psychotic unless I am under significant stress.

Been on Geodon for a year and the effects have diminished. I hear voices particularly when I stress out or get angry. I’m not changing meds however, Geodon has minimal akathisia and I appreciate that A LOT.

I take 80 mg and from what I know a person can take up to 200 mg. Dosage is certainly a factor.

I’m the same with Seroquel for over 10 years. It used to knock me out like a light.
I had a relapse in December after staying hospital free for several years.
Does your body just get used to it?

Well my dose was increased from 200 to 400 mg and I read the 200 is not really much.

I was under a lot of stress as my husband has been recovering from a hip operation and hospital infection for over a year now and its getting to me after 3rd operation and another on the way. So maybe I just needed more meds at this time of stress.

I take 120mg per day. This is not quite the maximum dose. If it seriously craps out, I can take a lot more. It has me functioning like you would never guess that I have anything wrong with me, just a rather unusual appearance, I only wear black and red for the most part and am very muscular. One might infer that I have some sort of personality disorder, perhaps due to my very unusual and rather rebellious appearance. I met a neurobiologist at a party the other weekend and talking with him about psychology and schizophrenia for a good while, then asked him what he would diagnose me with. He laughed and said “Nothing, you’re normal.” I told him about my diagnosis and he was reluctant to believe me until my lady friend started protesting and confirming that I do have schizophrenia. That said, I hope Geodon does not crap out on me completely.

Most antipsychotics can crap out on you - I think that Risperdal is not working as well for me - it seems to be pooping out on me a bit. I am going to ask her if I can increase the dose a bit to possibly 3 mg - I am getting breakthrough mood symptoms, especially when under some stress. I’ll give it some more time at my 2.5 mg dose and see how it goes for the next couple of weeks, until I see her next

I’ve been taking the same amount of Zyprexa for 30 years. I know it still knocks me out like I was bludgeoned every night… Symptoms that I get haven’t happened while on it.


**Hi @pob!
My son was on zyprexa when first diagnosed about 20 years ago. It was great. At that time, they didnt have the injectable form, and of course, he stopped. The only thing he didnt like was the weight gain, which he actually needed–too thin.
You say you have been on it for 30 years? Do you have weight gain? Sorry, this is off topic… **

I gained over 100 lbs. Now I’m taking .5 to 1 mg of risperdal which stops the need to eat all the time. The same amount of abilify also controlled the overeating, though with it - late night binge eating remained.

Since making the changes I’ve lost 60 lbs over 10 or 12 years while still taking zyprexa. I suspect that the risperdal is causing some of my unwanted side effects + I’m getting antsy to try something else.

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I had ever been on the combination of Geodon and seroquel for 1 year. This medication ended with a relapse so my pdoc switched the meds to the combination of Risperidone and seroquel. He said seroquel was only for good sleep, the main antipsychotics was Risperidone. Not like Geodon, risperidone did a good job on me.

It seems the important thing is the binding between Geodon and dopamine receptor in the brain. Geodon is a tight binding, thus gradually lose functionality, according to the paper I quoted (please see the first post of this thread).

It seems some moderate binding meds work long term.

I wasn’t quite sure I understand the paper correctly. The website doesn’t allow me to upload and share with you people.

I have been on geodon for 9 years and it worked better and better. i was on 240 mg. and today i stopped taking it because i no longer am psychotic at all.

You are probably not psychotic because of the geodon. But I had to learn that the hard way for myself also. My new doc is worried about the long term effects on my heart, she has me getting an ekg every six months and blood work too.

I deciderede not to compllitly Quit geodon but to take 160 mg. Geodon. Let me tell you that beside of geodon i take another strong antipsychotic

ive been on geodon for a couple years and everything is fine, other than the late night waves in my head and the slight twitching.

My doc prescribed me benedryl for the twitching and it works.

I feel like my Geodon is losing effect after 3 years. I’m now on 160 mg. I thought this is the same for every drug.

I also wonder how Geodon work because it does not hit the D receptor strong like other drugs???