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Re: RE: Using Serzone to Raise Levels of Other Meds

Posted by dove on January 2, 2002, at 15:02:24

In reply to Re: RE: Using Serzone to Raise Levels of Other Meds dove, posted by Rick on January 1, 2002, at 12:44:58

>
>So I'm guessing that your "and/or" is actually an "and." (I seem to recall the chemically-related trazodone was involved in one case.)
>

Yes! It is indeed an "AND", and thank you!

>
>Incidentally, while it depends on dosages, I get the impression serotonin syndrome has occurred with Serzone + SSRI, but is rare. I think it's more likely to occur with SSRI+SSRI, and certainly more likely to occur with SSRI + MAOI.
>

I also agree with the above statements. The SSRI + SSRI interactions and potential for serotonin syndrome are significantly higher than any Serzone + SSRI combo. And the MAOI + SSRI is a high risk given.

>
>I think they were poor metabolizers of liver enzyme CYP3A4, which Serzone uses for its own elimination in addition to inhibiting (restricting/delaying its availability to) other drugs that need it for elimination (a la the examples you mentioned).
>
>If you take Serzone, you should have liver function tests once a year (twice even better), and *definitely* have them if you're simultaneously taking other drugs that use or affect CYP3A4 enzymes, as I had been (Klonopin/clonazepam and Provigil/modafinil).
>

Multiple meds that utilize and inhibit the CYP3A4 enzyme can lead to the highly talked about and infamous "serotonin syndrome". It seems almost bizarre to me--as a prescribed consumer--that Serzone inhibits the very enzymes it needs for processing and elimination. The whole spectrum of the Cytochrome P450 and its enzymes and their inhibitors, antagonizers, and inducers is so cross-wired and enmeshed (at least for me) that it is difficult to locate where, exactly, the benefits and the drawbacks of intermixing meds are or aren't.

However, they do seem to work together in a beneficial manner that suits my needs, and I'm willing to play short-term guinea pig for those results.

dove


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