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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by mogger on June 9, 2014, at 11:09:47
Has anyone had any luck with Serzone (Nefazodone) for depression? I have tried almost everything and see that it has a different mechanism than others. Any experiences would be greatly appreciated.
mogger
Posted by Hugh on June 9, 2014, at 11:49:11
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
I've been on both. Serzone made me very irritable. When I quit, I suffered intense withdrawal symptoms. But I tapered it way too quickly. I think I would have been fine if I'd taken a month to taper it. Serzone can cause liver damage, and has been banned in Canada and Europe because of this. I slept well on trazodone, but I felt groggy for much of the day.
Posted by SLS on June 9, 2014, at 12:33:45
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
> Has anyone had any luck with Serzone (Nefazodone) for depression? I have tried almost everything and see that it has a different mechanism than others. Any experiences would be greatly appreciated.
>
> moggerFrom the few stories I've read on Psycho-Babble, nefazodone seems to have a better chance of producing an antidepressant response than trazodone.
"Systematic reviews suggested that the incidence of hepatic failure due to nefazodone is 1 per 250,000 to 300,000 patient-years of exposure."
http://livertox.nlm.nih.gov/Nefazodone.htm
- Scott
Posted by Phillipa on June 9, 2014, at 12:35:09
In reply to Re: Serzone or Trazodone for Depression? » mogger, posted by SLS on June 9, 2014, at 12:33:45
I wouldn't take it because of this. Phillipa
Posted by herpills on June 9, 2014, at 13:34:49
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
There is a medication called Oleptro which is a sustained release version of trazadone for depression. I'm not familiar with Serzone
Posted by Catling on June 9, 2014, at 18:02:06
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
> Has anyone had any luck with Serzone (Nefazodone) for depression? I have tried almost everything and see that it has a different mechanism than others. Any experiences would be greatly appreciated.
>
> moggerHi Mogger,
I have tried nefazodone (and trazodone) for depression. It didn't have any effect for me. I have wanted to try adding it in with an AD for treatment of anxiety but it is very difficult to find doctors that are willing to prescribe it because of the black box warning. The doctor who initially prescribed it for me felt that the warning was a bit exaggerated. As he put it: "I highly doubt that you are that 1 in 300,000 patient." Many people get scared away from trying it because of that though. It's certainly not a first line drug, but if you've tried other things without success and have a doctor who's willing to prescribe it, it might be worth a shot.
Best,
Cat
Posted by phidippus on June 11, 2014, at 17:55:03
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
Nefazadone has been discontinued in some countries because it can cause liver damage/death due to liver damage.
Nefazodone acts primarily as a potent antagonist at the 5-HT2A receptors (Kd 26 nM). It also has moderate affinity for the α1-adrenergic receptor (Kd 48 nM) and 5-HT1A receptor (Kd 80 nM), and very low affinity for the α2-adrenergic receptor (Kd 640 nM) and D2 receptor (Kd 910 nM). Nefazodone has low affinity for the serotonin (200 nM), norepinephrine (360 nM), and dopamine (360 nM) transporters as well, and therefore acts as a weak serotonin-norepinephrine-dopamine reuptake inhibitor (SNDRI). It has negligible affinity for the H1 receptor (24,000 nM) or muscarinic acetylcholine receptors (11,000 nM), and accordingly lacks any antihistamine or anticholinergic side effects.~wikipedia
Post-synaptic 5-HT2A overdensity is involved in the pathogenesis of depression. Therefore, antagonizing this receptor should alleviate the effects of depression-this is the thinking behind Nefazadone.
Trazodone acts predominantly as a 5-HT2A receptor antagonist to mediate its therapeutic benefits against anxiety and depression. It is similar to Nefazadone in its action, however it is a much safer drug.
Curiously, Trazadone works a lot like Abilify.
Eric
Posted by Chris O on June 12, 2014, at 3:52:51
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
Took a pretty massive dose (1600mg a day) for about 7 months and it did absolutely nothing for me. My main symptoms are chronic anxiety and depression. No problems with liver, or anything else for that matter while on it.
Chris
Posted by mogger on June 14, 2014, at 14:47:13
In reply to Re: Serzone or Trazodone for Depression? » mogger, posted by Chris O on June 12, 2014, at 3:52:51
Thanks everyone for your thoughts and experiences. I am not concerned with the liver issue as that is the least of my worries so I shall chat to my doctor about both this week. I would like to try brintellix but that would mean pulling me off zoloft and buspar of which I am on high doses and still am not feeling well so the thought of withdrawals are not pleasant.
Posted by softheprairie on June 16, 2014, at 3:36:13
In reply to Serzone or Trazodone for Depression?, posted by mogger on June 9, 2014, at 11:09:47
Sorry I am late to the game, but I saw this and can answer, since I am taking the nefazodone. It is working well for me, and my liver is okay so far. I have been on many, many antidepressants and combinations of meds from various classes (even up to MAO inhibitor), so it is justified. Just before this one, I was pleased with the high dose desipramine, and was on it for a few years I think, but I developed a horrible urinary pressure problem from it, and was not willing to live with that. I was on no main antidepressant there for a little bit after that (just the adjuncts of perphenazine and liothyronine), but depression worsened until I stressed insistently to the pdoc that I needed a new antidepressant, and this is the one he mentioned and I went with. We did a gradual increase, but at a bigger dose I started to get the same urinary pressure feeling (even after just urinating), so we brought the dose of nefazodone back down to 100 mg twice a day, and that is something I can live with, and my depression feels pretty well-treated to me.
Trazodone I can't speak to that much, since I have not tried it. I do have a general low energy/fatigue thing going on as my norm, so I don't think I'd want more tiredness during awake times that trazodone usually causes. I don't think I get much fatigue from the nefazodone, so that is good.
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