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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by ravenstorm on December 21, 2004, at 12:17:45
Trying to decide on the next med for the med merry go round and I have a question about generic serzone (since the brand has been pulled just about every where due to that little liver failure debacle).
Here is the deal. I did try serzone once, during one of my unsuccessful attempts to switch off of paxil. I took the starter pack as suggested and had absolutely no anxiety, agitation, irritability. . .and could virtually not function (seriously) due to extreme sedation. As everyone here has heard ad nauseaum, I am extremely medication sensitive. Do you think that the starter pack titration just may have been too fast for me. Has anyone ever gone on serzone more slowly than the starter pack and gotten over the extreme sedation? Even WB sedated me for the first two to three weeks I was on it!
Yes, I am indeed grasping at straws. It was just yet another medication "maybe" that popped into my swirling brain recently. Unfortunately, the fact that I'm still on the damn mirtazapine means that I'd probably just be extra damn sedated on nefazadone.
As always, any input appreciated. . .but I don't even know if anyone is taking this stuff anymore!
Posted by upsndowns on December 21, 2004, at 13:17:45
In reply to Nefazadone question. Yes, I am desperate., posted by ravenstorm on December 21, 2004, at 12:17:45
Yes, I still take nefazadone and am extremely sensitive to meds, thus only take 25mg, cutting the pills into quarters. I have found it to be the one and only AD that I can take; I am totally weirded out by SSRI's and any others. I am BPII, so take a bunch of other things as well, but take my nefazadone at night and do not notice any sedative effects from it and have been taking it for years, never being able to go off it without getting very depressed. I am sure that you may well be another one who just needs a very small smidge if you are that sensitive to drugs and may want to talk to your doctor about that. It's worth a try. As far as the liver thing goes, my doctor told me that it is something that shows up early on or not at all and that it is less of a worry than the liver damage people are opening themselves up to by taking Tylenol PM. Hope I could give you some hope.
Posted by King Vultan on December 22, 2004, at 0:42:08
In reply to Nefazadone question. Yes, I am desperate., posted by ravenstorm on December 21, 2004, at 12:17:45
> Trying to decide on the next med for the med merry go round and I have a question about generic serzone (since the brand has been pulled just about every where due to that little liver failure debacle).
>
> Here is the deal. I did try serzone once, during one of my unsuccessful attempts to switch off of paxil. I took the starter pack as suggested and had absolutely no anxiety, agitation, irritability. . .and could virtually not function (seriously) due to extreme sedation. As everyone here has heard ad nauseaum, I am extremely medication sensitive. Do you think that the starter pack titration just may have been too fast for me. Has anyone ever gone on serzone more slowly than the starter pack and gotten over the extreme sedation? Even WB sedated me for the first two to three weeks I was on it!
>
> Yes, I am indeed grasping at straws. It was just yet another medication "maybe" that popped into my swirling brain recently. Unfortunately, the fact that I'm still on the damn mirtazapine means that I'd probably just be extra damn sedated on nefazadone.
>
> As always, any input appreciated. . .but I don't even know if anyone is taking this stuff anymore!
I just saw my pdoc and have added very low dose Risperdal to augment my Parnate. Both he and I independently came to the same conclusion that it would be best to start at 1/2 of the smallest pill available. He said that I seem to be relatively sensitive to medications, which I was a little surprised to hear, but I suppose that is basically true. My own specific reasoning in this case is that the only other drug I've tried with significant 5-HT2A blocking ability was nortriptyline, which I found to be ridiculously sedating and barely tolerable. I am fortunate that my depression is already well under control with the Parnate, and I can afford to start out at such a pitiful dose of the Risperdal and very slowly titrate upward to find a level that will hopefully have some therapeutic benefit without excessive side effects.Todd
Posted by rainy on December 22, 2004, at 8:11:50
In reply to Re: Nefazadone question. Yes, I am desperate., posted by King Vultan on December 22, 2004, at 0:42:08
Nefazadone is the only AD that I can remember working for me (I can't recall being sedated.) Problem is pdoc won't prescribe because of liver uproar and says it's illegal to get it from Canada. Two issues. Phamacist says it wasn't liver damage but poor sales that got it pulled from market. Does anybody know about legality about drugs from Canada and anybody have any ideas about how to persuade pdoc to relent? Is her license at risk if she precribes?
I'm sorry to change the subject in this direction.
rainy
Posted by upsndowns on December 22, 2004, at 9:32:02
In reply to Re: Nefazadone question. Yes, I am desperate., posted by rainy on December 22, 2004, at 8:11:50
I live in the US and have not had a problem getting this refilled or prescribed....I wouldn't think your doctor is in any danger if she prescribes the med, she is just nervous and being more concerned for herself than for you...maybe she would be happier if you got your liver functions done every month?
Posted by rainy on December 22, 2004, at 9:51:35
In reply to Re: Nefazadone question. Yes, I am desperate., posted by upsndowns on December 22, 2004, at 9:32:02
I don't know. If they pulled it off the market, how are the pharmacies getting their supplies?
rainy
Posted by jujube on December 22, 2004, at 10:27:24
In reply to Re: Nefazadone question. Yes, I am desperate. » upsndowns, posted by rainy on December 22, 2004, at 9:51:35
What I had heard (and it may be wrong), is that Serzone got pulled from the market. However, negazadone, which is the generic form of Serzone, was never pulled from the market, and is still available for prescription and sale. Someone correct me if I am wrong.
Tamara
> I don't know. If they pulled it off the market, how are the pharmacies getting their supplies?
>
> rainy
Posted by ravenstorm on December 22, 2004, at 12:06:45
In reply to Re: Nefazadone question. Yes, I am desperate. » rainy, posted by jujube on December 22, 2004, at 10:27:24
Posted by ed_uk on December 22, 2004, at 12:21:22
In reply to Re:Tamara, you are right. (nm), posted by ravenstorm on December 22, 2004, at 12:06:45
Dutonin tablets (Dutonin is our brand name for nefazodone).........
From the The Pharmaceutical Journal
Vol 271 No 7256 p11
5 July 2003........Bristol-Myers Squibb has discontinued Dutonin (nefazodone) tablets. The company estimates that stocks will be available from wholesalers for a number of weeks, but once exhausted, nefazodone can be obtained through *IDIS World Medicines* (020 8410 0710). For further information contact Bristol-Myers Squibb (0800 731 1736).
From the IDIS website.....
'IDIS is the world's leading buyer and seller of unlicensed medicines for the Pharmaceutical and medical industries.'So, I guess the generic nefazodone comes from IDIS.
Ed.
Posted by ed_uk on December 22, 2004, at 12:37:16
In reply to Re: Nefazadone question. Yes, I am desperate. » rainy, posted by jujube on December 22, 2004, at 10:27:24
It looks like Pfizer sells a brand of nefazodone called Deprefax in Argentina. Not sure if they still do though because the Pfizer Argentina website isn't working.
Ed.
Posted by upsndowns on December 22, 2004, at 12:51:00
In reply to Deprefax in Argentina!, posted by ed_uk on December 22, 2004, at 12:37:16
My nefazadone here in the US is made by Teva, USA. It is my understanding that Teva is one of the largest generic pharmaceutical companies in the world, so I am not concerned about this drug disappearing.
Posted by rainy on December 22, 2004, at 13:57:05
In reply to U.S. nefazadone manufacturer, posted by upsndowns on December 22, 2004, at 12:51:00
Thanks, you guys. I just talked with another pharmacist who confirmed the original statement that the decision to withdraw Serzone was based on marketing as well as the danger of liver damage. The latter, according to something I read earlier occurred in people at high risk already. You pay your money and you take your choice. If only I can convince pdoc of this. I was on the durn stuff until it went off the market this summer.
rainy.
Posted by rainy on December 22, 2004, at 14:00:18
In reply to Re: Nefazadone question. Yes, I am desperate., posted by rainy on December 22, 2004, at 8:11:50
Best of luck, ravenstorm.
Posted by jujube on December 22, 2004, at 14:05:41
In reply to Re: U.S. nefazadone manufacturer, posted by rainy on December 22, 2004, at 13:57:05
Perhaps you can explain to the pdoc that you have done your research, are aware of the potential risks, and would be willing to sign a waiver or something like that confirming this and that the pdoc has explained the potential risks to you, and releasing the pdoc from any liability if you develop liver damage. I agree with another poster that you will probably want to make a point of having your liver enzymes tested regularly or at least once a year when you have your annual physical. My family doctor routinely does a liver function test when I have my annual physical, so I always assumed it was one of those standard tests that were carried out annually during a physical.
I hope for your sake that you can convince your pdoc to prescribe nefazadone for you. Good luck.
Tamara
> Thanks, you guys. I just talked with another pharmacist who confirmed the original statement that the decision to withdraw Serzone was based on marketing as well as the danger of liver damage. The latter, according to something I read earlier occurred in people at high risk already. You pay your money and you take your choice. If only I can convince pdoc of this. I was on the durn stuff until it went off the market this summer.
>
> rainy.
>
Posted by rainy on December 22, 2004, at 14:17:52
In reply to Re: U.S. nefazadone manufacturer » rainy, posted by jujube on December 22, 2004, at 14:05:41
You're right, of course. Maybe my arm for blood work will do, instead of a waiver. And Ravenstorm, best of luck staying awake and alert. I hope those little suckers work as well for you as I remember them working for me.
rainy
Posted by sabre on December 23, 2004, at 0:45:50
In reply to Re: U.S. nefazadone manufacturer » jujube, posted by rainy on December 22, 2004, at 14:17:52
Hello Ravenstorm
I took Nefazadone for 6months. I started at 75mg and incresed the dose up to about 200mg per day.
It was more useful than Lexapro and Mobeclomide for me.
I found the sedation wasn't too strong which surprised the GP and I didn't notice it at all after a while. I felt numb and dumb however. No motivation. Couldn't cry. Started forgetting words and names.
Initially the numbness was great and a definite improvement on depression and crying over the TV news etc I ended up cutting the dosage back - chopping the pills into little flakes until Serzone was banned in Australia.
Didn't kill the social anxiety but mine's teflon coated.
I hope you manage to get a hold of some!
sabre
Posted by ravenstorm on December 24, 2004, at 13:38:28
In reply to Re: U.S. nefazadone manufacturer, posted by sabre on December 23, 2004, at 0:45:50
Hey everybody. Well, I'm still deciding whether it would be worth a second attempt. On the titration up on the starter pack I seriously could not keep my eyes open, the sedation was sooo great. I was just wondering if I titrated more slowly if that would make a difference? From the posts it doesn't seem likely. Seems like people either got over the sedation in the initial titration or they didn't. Since I didn't there is probably no point in trying a slower titration and hoping for different results.
Oh, well. At least this thread cleared up some confusion about the availability for some of you, so it wasn't a total waste of space.
My 28 day hormone trial is almost up, so next I'm going to try moclobemide (since I already bought it), but am not feeling very hopeful about getting any results. I'll try it as a rule out before going back to the pdoc. . .because quite frankly I don't know what else the pdoc could give me this point except either an MAOI or an atypical psychotic (neither of which i'm all that excited about).
All I want for Christmas is my prepaxil brain!!
This is the end of the thread.
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