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Re: Reply to Erin

Posted by JohnL on July 9, 1999, at 3:14:11

In reply to To JohnL, posted by Erin on July 8, 1999, at 20:33:03

> John-
>
> I just got my prescription for Serzone. My doctor wants to start me out at 100 mgs for the first week and increase to 200 mgs the second week. I just reread your message and I'm not sure what I should do. I know that Serzone can be really sedating so I think I'm going to call my doctor and talk to him about starting off more slowly.
>
> Any other suggestions?
>
> Thanks again,
> Erin


Nice to hear from you Erin. The dosage your doctor gave you is quite normal. It is the typical run-of-the-mill standard dose most doctors would give. Not the dosage, however, recommended by a very impressive doctor I had the pleasure of meeting who happens to be having good success with Serzone. His secret to success, he claims, with any antidepressant is to start very low and increase dosage in small steps, to avoid being in a hurry getting up to a higher dose. That's hard to do when you need relief NOW. But it's like an initial investment today that pays off big in a couple months.

Like he said, start at 25mg-50mg a day at dinner or early evening. Expect a hangover feeling in the morning which will go away. At first it might linger, but with time it will be gone rapidly after waking, and with more time will not even be a concern at all. See how it affects your sleep, as you might find afternoon versus early evening a better time to dose. Whatever works for you. I liked mid-to-late afternoon best because it really helped me relax about the time I got home from work, I could sleep great, and the hangover feeling was a lot less in the morning. I noticed the closer to bedtime I dosed the worse the hangover was.

After a 5 to 7 days, go up another 25mg-50mg a day. I would stick with the 25mg steps, even if any side effects are no problem, because of that "sweet spot" I mentioned. It could be as finicky as a 25mg range. If you start feeling better, great! Stay there for a while. I felt best at about 275mg, but then I blew it by following my docs orders all the way to 550mg. The slow-and-easy strategy will take a bit longer than your doctor's generic strategy, but will greatly increase your chances of success with regards to efficacy and tolerability. This advice DOES come from a great doctor ya know. I'm just relaying it. You are your own best manager, because nobody knows your body better than you. More failures come from increasing dosage too aggressively than from too conservatively.

This post is basically a collection of my own experience with Serzone, literature I've read about it in research, a fantastic doctor's approach, and comments from dissatisfied trial-users. I want your suffering to end and hope the wisdom gained from the failures of others will be to your benefit. Right now you know more about Serzone's characteristics than your doctor does. Don't feel at all guilty about going slower than he instructed. If Serzone is going to work for you, you now know how do to it. If it ends up not working as you hoped, at least you can look back and say you gave it your best dedicated effort.(Definitely add Wellbutrin before considering a total switch) Unlike me. My failure was due to the generic doctor formula of more is always better and the quicker you get there the better. I flew right past that "sweet spot" and abondoned the drug in a hurry out of the deep frustration resulting from totally inappropriate management. Wishing you the very best. Stay in touch. In a month to 6 weeks, around 200mg, let us know how it's going. Follow up any time with questions or anything. Incredible compassion and wisdom at this site. Has helped me tremendously. So many good folks to help out. JohnL.


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URL: http://www.dr-bob.org/babble/19990726/msgs/8467.html