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Default Aug 16, 2020 at 07:05 AM
  #1
I take 20mg of Geodon once a day. I've been on it for roughly 4 weeks. Several days ago the area under one of my eyes started twitching. It pulses rapidly and at least a few times a second. It was going on for several hours at a time.

Yesterday, I noticed it early in the afternoon and it went on all day. I thought maybe sleep would help, but it was twitching when I woke up this morning.

I am starting to suspect it is a side effect. I looked it up and read the following:
'This drug may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, mouth, tongue, arms, or legs).'

Does facial twitching qualify? Another site said twitching or muscle spasms is a common side effect, but it did not label it as serious. I plan to call my doctor tomorrow, but wanted to know if anyone has experience with this. I am very med sensitive and this appears to be the latest in a long list of drug issues for me.
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Default Aug 16, 2020 at 07:58 AM
  #2
It could potentially be. TD doesn't usually involve eye twitching per se, but it is worth asking your doctor about. If it is TD it runs the risk of becoming permanent.

I get eye twitching sometime which seems to be related to stress or blood pressure. It's intermittent and inconsistent. I don't worry too much about it myself. It's entirely up to you though, and I'd say there's no harm in asking your doctor to be safe.
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Default Aug 16, 2020 at 08:36 AM
  #3
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Originally Posted by quietlylost View Post
It could potentially be. TD doesn't usually involve eye twitching per se, but it is worth asking your doctor about. If it is TD it runs the risk of becoming permanent.

I get eye twitching sometime which seems to be related to stress or blood pressure. It's intermittent and inconsistent. I don't worry too much about it myself. It's entirely up to you though, and I'd say there's no harm in asking your doctor to be safe.
Thanks! Yeah, I get it from time to time as well and think nothing of it. I've never had it for 4 days in a row and constantly. Usually I just get a twitch or two that repeats every so often. This is a constant twitch that probably moves at a rate of 200 or so times a minute for days. Just seemed off...
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Default Aug 16, 2020 at 08:37 AM
  #4
Hi Fern. I would definitely tell your doctor asap, but please don't panic about the twitching.

I don't know if the twitching you describe is related to Geodon. Or if it is in any way related to TD. My guess on the latter is no, but again I am not qualified to say. From what I have read and seen in videos on TD, the twitching is different from the one I'm imagining you have. Again, my interpretation of what you describe may not be accurate.

Throughout some of my life, especially in my youth, I had an occasional twitch under my eye that could last for a few minutes at a time, though I don't recall it lasting all day. It felt very weird. Almost ticklish. I, and others, could literally see the pulsing-like twitch. Mine was mostly just below or at my lower eye lid, though less frequently on the upper. To this day, I have no idea what caused that, but it wasn't meds. I didn't take any back then.

If at worst what you describe is TD, it need not be permanent. Permanent is a worst case scenario. Changing or stopping antipsychotics can stop TD. You must know that 2nd generation antipsychotics, like Geodon, have a much lower risk of TD than 1st generation APs. Plus, I know that 20 mg Geodon is the smallest possible dose of Geodon, outside of a compounded lower dose. I took 160 mg for a good seven years. I don't recall the twitch I describe during that period. If I had it, I likely ignored it as I did in my youth, but again, I don't recall the twitch lasting hours.

Again, do contact your doctor.

The following relatively innocent, and not uncommon, twitching is likely what I used to experience. I've read it could potentially last up to days or even "a few weeks" . See Myokymia Wikimedia page.
Eyelid Twitching | Causes | Treatment and here's a video, though I used to think mine was even more visible Orbicularis Myokymia - YouTube Also see "fasciculation", which seems to be almost the same.

This is what I have always learned is TD (last video on page is related to eyes, though more blinking than twitching):
What Is Tardive Dyskinesia (TD)? | INGREZZA(R) (valbenazine) capsules

Only once did I have a concerning involuntary movement attributed to a medication. I had involuntary lip puckering. I told my psychiatrist quickly and he believed it to be a dystonia (a type of dyskinesia). He immediately lowered my dose of Navane (Thiothixene), a 1st generation antipsychotic, and the lip puckering stopped. I was eventually taken off that medication.

Last edited by Soupe du jour; Aug 16, 2020 at 10:04 AM..
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Default Aug 16, 2020 at 10:04 AM
  #5
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Originally Posted by Soupe du jour View Post
Hi Fern. I would definitely tell your doctor asap, but please don't panic about the twitching.

I don't know if the twitching you describe is related to Geodon. Or if it is in any way related to TD. My guess on the latter is no, but again I am not qualified to say. From what I have read and seen in videos on TD, the twitching is different from the one I'm imagining you have. Again, my interpretation of what you describe may not be accurate.

Throughout some of my life, especially in my youth, I had an occasional twitch under my eye that could last for a few minutes at a time, though I don't recall it lasting all day. It felt very weird. Almost ticklish. I, and others, could literally see the pulsing-like twitch. Mine was mostly just below or at my lower eye lid, though less frequently on the upper. To this day, I have no idea what caused that, but it wasn't meds. I didn't take any back then.

If at worst what you describe is TD, it need not be permanent. Permanent is a worst case scenario. Changing or stopping antipsychotics can stop TD. You must know that 2nd generation antipsychotics, like Geodon, have a much lower risk of TD than 1st generation APs. Plus, I know that 20 mg Geodon is the smallest possible dose of Geodon, outside of a compounded lower dose. I took 160 mg for a good seven years. I don't recall the twitch I describe during that period. If I had it, I likely ignored it as I did in my youth, but again, I don't recall the twitch lasting hours.

Again, do contact your doctor.

The following relatively innocent, and not uncommon, twitching is likely what I used to experience. I've read it could potentially last up to days or even a few weeks.
Eyelid Twitching | Causes | Treatment and here's a video, though I used to think mine was even more visible Orbicularis Myokymia - YouTube Also see "fasciculation".

This is what I have always learned is TD (last video on page is related to eyes, though more blinking than twitching):
What Is Tardive Dyskinesia (TD)? | INGREZZA(R) (valbenazine) capsules

Only once did I have a concerning involuntary movement attributed to a medication. I had involuntary lip puckering. I told my psychiatrist quickly and he believed it to be a dystonia (a type of dyskinesia). He immediately lowered my dose of Navane (Thiothixene), a 1st generation antipsychotic, and the lip puckering stopped. I was eventually taken off that medication.
Thanks so much for this. It is very helpful. It is essentially where one would have a bag under their eye. And yeah, it is like a pulsating more than an up and down movement. The side that keeps twitching is puffy today actually. It must be worn out at this point.

And I also read about dystonia. I have been tongue thrusting for about two weeks as well. At any rate, it seems like a call is the right thing to do, but it doesn't seem lile any sort of emergency.

I took a video of it in case he needs to see it in action. My worry is mostly he will want to stop my med and I'm going on vacation next week. I have freak reactions to most meds I take and I don't want to be trying something new while away. Maybe he will just take me off altogether as I haven't had any symptoms since the first few doses over a month ago.

Thanks again Soupe! I appreciate the thoughtful response.
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Default Aug 16, 2020 at 10:07 AM
  #6
I understand where you are coming from in regards to your vacation.

Please forgive me for not remembering, but exactly what symptoms motivated your return to taking a medication? If you are willing to share.
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Default Aug 16, 2020 at 11:04 AM
  #7
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Originally Posted by Soupe du jour View Post
I understand where you are coming from in regards to your vacation.

Please forgive me for not remembering, but exactly what symptoms motivated your return to taking a medication? If you are willing to share.
I had headaches for several days and horrible nausea. All the while I was pushing myself to develop a model I needed for the last chapter of the book I'm writing. I got a little obsessed with it and my mind just wouldn't stop trying to find the perfect solution. A day or two later I couldn't sleep for two days and started having very dream-like experiences while waking. It felt kind like my world was turning inside out. So I'd hear a song or watch a show and it would have some sort of deeper meaning to me. Someone would say something and it would synchronistically match my thoughts. I started feeling like I was special and on some sort of important mission. That got scary. I hallucinated visually a few times.

I knew the thoughts were delusional and wrong and I was able to fight them for a bit, but after two days of me knowing the thoughts were wrong and after watching the frequency steadily increase, I told my husband that I was losing my mind again and we needed to stop it asap. My doctor put me on the 20mg of Geodon and it stopped mostly after the first dose and completely after another two days.

If I had to guess, I think I pushed my brain too far and seized. That caused the nausea and headaches and then the insomnia. The insomnia paired with the increased brain activity caused the rest of it.

Interestingly enough, people with TLE who have these kinds of episodes are directed to take a small dose of an AP at the onset of insomnia and then they avoid the psychosis. I wonder if I could have avoided it if I would have had prn Geodon on hand.

There was no mania this time. I felt like crap physically. Just manic like racing thoughts the night I told my husband. It was a weird ride and I am very glad it is over. I leaned on what I learned from very wise people here and finally had insight into what was happening before it was too late. It scared is, but we caught it and kids were not impacted this time. I am very grateful for that.

After that I started digging into neurological causes for psychosis and landed on TLE. My symptoms are a nice fit, so that's why I'm consulting with a neurologist on Tuesday.
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Default Aug 16, 2020 at 02:27 PM
  #8
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Originally Posted by fern46 View Post
I had headaches for several days and horrible nausea. All the while I was pushing myself to develop a model I needed for the last chapter of the book I'm writing. I got a little obsessed with it and my mind just wouldn't stop trying to find the perfect solution. A day or two later I couldn't sleep for two days and started having very dream-like experiences while waking. It felt kind like my world was turning inside out. So I'd hear a song or watch a show and it would have some sort of deeper meaning to me. Someone would say something and it would synchronistically match my thoughts. I started feeling like I was special and on some sort of important mission. That got scary. I hallucinated visually a few times.

I knew the thoughts were delusional and wrong and I was able to fight them for a bit, but after two days of me knowing the thoughts were wrong and after watching the frequency steadily increase, I told my husband that I was losing my mind again and we needed to stop it asap. My doctor put me on the 20mg of Geodon and it stopped mostly after the first dose and completely after another two days.

If I had to guess, I think I pushed my brain too far and seized. That caused the nausea and headaches and then the insomnia. The insomnia paired with the increased brain activity caused the rest of it.

Interestingly enough, people with TLE who have these kinds of episodes are directed to take a small dose of an AP at the onset of insomnia and then they avoid the psychosis. I wonder if I could have avoided it if I would have had prn Geodon on hand.

There was no mania this time. I felt like crap physically. Just manic like racing thoughts the night I told my husband. It was a weird ride and I am very glad it is over. I leaned on what I learned from very wise people here and finally had insight into what was happening before it was too late. It scared is, but we caught it and kids were not impacted this time. I am very grateful for that.

After that I started digging into neurological causes for psychosis and landed on TLE. My symptoms are a nice fit, so that's why I'm consulting with a neurologist on Tuesday.
It sounds like Geodon worked in a valuable way like a PRN. Do you think?

Have you tried other antipsychotics in the past? Somehow I recall, perhaps incorrectly, you mentioning Risperidone.

I certainly wouldn't want concerning side effects to worsen for you over your vacation. At the same time, I wouldn't want a recurrence of the symptoms that led back to the 20 mg Geodon. The use of a PRN antipsychotic has been useful for me, countless times in the past. In my case, I have low dose regular Seroquel (quetiapine). I take the extended release at a much higher dose as part of my regular cocktail. You'd better believe that I will take a small supply of my PRN regular Seroquel when I go on vacation. Nowadays, low dose Seroquel added on to my extended release doesn't make me that tired at all. If I'm hypomanic and certainly manic, it doesn't make me tired at all. It just curbs the flames.

Last edited by Soupe du jour; Aug 16, 2020 at 02:48 PM..
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Default Aug 16, 2020 at 03:26 PM
  #9
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Originally Posted by Soupe du jour View Post
It sounds like Geodon worked in a valuable way like a PRN. Do you think?

Have you tried other antipsychotics in the past? Somehow I recall, perhaps incorrectly, you mentioning Risperidone.

I certainly wouldn't want concerning side effects to worsen for you over your vacation. At the same time, I wouldn't want a recurrence of the symptoms that led back to the 20 mg Geodon. The use of a PRN antipsychotic has been useful for me, countless times in the past. In my case, I have low dose regular Seroquel (quetiapine). I take the extended release at a much higher dose as part of my regular cocktail. You'd better believe that I will take a small supply of my PRN regular Seroquel when I go on vacation. Nowadays, low dose Seroquel added on to my extended release doesn't make me that tired at all. If I'm hypomanic and certainly manic, it doesn't make me tired at all. It just curbs the flames.
Yes, exactly. It worked perfectly. I think we know now that it is a magic bullet for my psychosis.

Yes, I took a low dose of Risperdal the first time I got sick. It screwed with my cycle a lot and it gave me anxiety.

Depakote was a hot mess for me. It gave me tacychardia.

That's all that I have tried. I thought maybe if he wants me to stop the Geodon maybe I could take the Risperdal prn if needed. If I only take it for a few days I shouldn't get the cycle issues or the anxiety as it took a few months for that to set in last time. In theory maybe the same would be true for Geodon if I only used it prn.

I've never tried Seroquel. That might be an option to explore.

Luckily my vacation should be relaxing and I'm not working on any projects at the moment.
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Default Aug 16, 2020 at 04:03 PM
  #10
I've experienced eye twitching from a number of psych meds. At least, I assume it's the meds; the twitching could be just a thing the body does sometimes. Also, it could definitely be related to anxiety. I've never thought of it as a TD symptom; I don't think it is.

I've found that gently resting my finger on the spot when it twitches can help. For me that twitching (which is really annoying) can go on for days at a time, then it all of a sudden stops.

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Default Aug 19, 2020 at 03:03 PM
  #11
I am more concerned regarding your mention of the tongue. Do let us know what pdoc says. Bottom line, APs can and will do anything motor almost, even 2G ones. I got dystonia from Abilify after 13 yrs, so...

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Default Aug 20, 2020 at 05:20 AM
  #12
The tongue thrusting is not good! Did you speak with your pdoc?

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Default Aug 20, 2020 at 06:55 AM
  #13
The eye twitching stopped finally. Yay. I go on vacation next week and it is important to stay stable, so I am keeping my dose the same for another week unless something gets worse. I see him again the Monday after I get back and we are planning to reassess then.
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Default Aug 20, 2020 at 05:12 PM
  #14
That's good (about the twitching). Just be aware that TD can take hold rapidly. i.e., it doesn't necessarily take a long time to develop. I'm glad you'll be communicating with your pdoc fairly soon.

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