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Re: Rick ---- CELEXA to SERZONE... ???? » Milena

Posted by Rick on January 5, 2002, at 18:15:28

In reply to Re: Rick ---- CELEXA to SERZONE... ????, posted by Milena on January 5, 2002, at 17:00:43

> And, yes, it's great for anxiety, but I also need a long term thing, ya know?

Me, too. And until something better and with a longer-term safety record comes along, I'm sticking with Klonopin as my mainstay. However, the fact that I've needed less over time, even pre-Serzone, (I'm now at 1 mg/day, morning only) suggests that Klonopin's created a partial remission of my SP symptoms...or at least allowed me to face enough anxiety-provoking situations so that I've learned to deal with them better. (See reference below.)


>So serzone is an SSRI, correct?

Partially. It's more of a hybrid. Serzone produces weak serotonin reuptake inhibition (the "SRI" of "SSRI"), but it also preserves serotonin -- and to a lesser extent adrenaline -- in the brain through a different kind of mechanism that the SSRI's don't use.

>An antidepressant as well?

Oficially (i.e., FDA indication) it's ONLY an antidepressant, but as I said it's known as being good for anxiety. (BTW, Klonopin's only "official" indications are as an anti-convulsant and panic disorder, but it's used for a slew of other disorders from social phobia to bipolar to chronic pain to movement disorders.)

>Thanx again Rick!

You're welcome! Let us know how it works out.

> PS What is Provigil?

Povigil (modafinil) is a fairly new, more-gentle kind of stimulant that doesn't have the side effects that traditional amphetamine-related stims like Ritalin can sometimes cause (nervousness, crashing, cardiac effects, abuse potential). I believe it's the first non-amphetamine based stimulant introduced in many, many years (along with its kin adrafinil, which is used as an AD in parts of Europe but isn't sold in the U.S.). So far Prvigil's only official indication is for excessive daytime sleepiness due to narcolepsy, but it's actually being prescribed more by pdocs for purposes such as countering AD-induced fatigue or increasing the effectiveness and/or speed of response to AD's. It's not generally thought of as an anti-anxiety med, but a low dose adds SO much to my SP treatment in terms of assertiveness and alertness. (A number of people on this board have said adrafinil -- purchased from overseas -- has been great as the primary treatment for their social phobia.)

Everyone's different, but for me the "cocktail" of Klonopin, Serzone and Provigil -- all taken first thing in the morning -- is extremely, consistently effective for SP. For me, Serzone + Klonopin is a little sedating without Provigil, but if Serzone works well for you perhaps Klonopin will be out of the picture soon.

One thing I forgot to mention about Serzone and SP: The study I read using Serzone for SP showed the greatest leap in treatment response between weeks eight and twelve. My own response seemed consistent with this. So be sure to give it time.

One more thing: If you take Serzone be sure to get a standard blood test for liver function at six and twelve months, and then yearly thereafter.
This is especially true if you take it with any other meds, since it interacts metabolically with many. For me, Serzone's probable metabolic interaction (a "stretch-it-out" effect) with both Klonopin and Provigil could be what allows me to take them in low doses, and all in the morning. But everyone's metabolic system is different, so both the theraputic reaction and liver function should be monitored carefully.

Rick

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9790154&dopt=Abstract

(Last sentence sums it up nicely.)


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