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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 42. This is the beginning of the thread.
Posted by Racer on August 25, 1998, at 23:07:12
I've had bad experiences with a couple of anti depressants, and now find myself too depressed to function again. I know that the drugs do alleviate the depression, but the side effects i've had in the past make it a pain in the butt to deal with them. I have a congenital connective tissue abnormality which affects the way my body uses drugs. The other anti depressants I've taken have always required huge doses and several months of "gee, is it not gonna work at all or haven't we gotten to the appropriate dose yet?" Funny, that exacerbates the depression. Once we get to the therapeutic dosage, I get side effects. On Paxil, the drug I used most recently, I gained 50 or 60 pounds, lost the ability to have orgasms (Ok, that doesn't seem so relevant right now, but if the drug works, I hope it will matter again in the next couple of months...), and couldn't experience any emotions normally. On top of that, I also couldn't stay awake all day. I needed to nap so much, it would have been a joke had it not been for the way that affected my life. Shall we say that it had a negative impact and leave it at that?
So, now I've got these pills, Serzone, and a doctor who says, "They're anti-depressants. Take em and you'll feel better. Nothing wrong with you, your perceptions are just off." Gotta love county doctors, especially when you are smart enough to know that gee, if I had health insurance, I could get myself to a decent doctor. So, can anyone out there who has taken Serzone tell me anything about your experiences? Was the "average" dose effective, or did you have to take more or less? Did you gain weight? Lose weight? Sexual dysfunction? Sleepy all the time? Able to respond normally to stimuli like weddings, funerals, etc?
My depression says that it's too much to ask to have an effective drug that doesn't make you more miserable than the depression does already, but my intellect says that there must be something that works on the depression without making the rest of my life impossible. So, anecdotal evidence greatly appreciated. Thanks
Posted by Racer on August 26, 1998, at 1:08:49
In reply to Scared to try Serzone. Any exp. to share?, posted by Racer on August 25, 1998, at 23:07:12
OK, the side effects list includes things like dizziness, lightheadedness, and lowered blood pressure. My normal blood pressure is ranges from 90/60 to 98/65, so the blood pressure thing is a big deal to me. Anything to mention?
Thanks for anything you can say to help. My depression is so far out of hand suicide doesseem the most reasonable response, but if there is a chance of a fix, I'm willing to try.
So tell me, folks, how much of a jerk is this Dr? Did she read my chart at all?
One last thing, anything on the interaction of serzone and ketoconazole (sp?)?
Posted by Toby on August 26, 1998, at 16:00:53
In reply to PS: A look at the side effects scares me more, posted by Racer on August 26, 1998, at 1:08:49
Oddly enough, ketoconazole has been used to treat major depression at doses of 400 mg per day (need blood tests to monitor liver function, though). I can't find any interactions between it and Serzone.
Pros of Serzone: Almost no anxiety, nervousness or insomnia side effects, no sexual side effects, low risk of inducing mania, OK in kidney or liver diseases. Cons: Some drowsiness initially, some folks get dry mouth and nausea at first which tends to go away in about 2 weeks. The risk of lowered heart rate and hypotension is clinically about 5% greater than placebo (so basically most people don't get it).
Sounds like you've been on multiple drugs without much effect and the doses were pretty high. If your metabolism is the culprit, you may do better with a combination of medications rather than trying to max out just one. Here are some suggestions: Pindolol 2.5-5 mg three times a day added to any antidepressant you are taking; Remeron 15-60 mg added to any antidepressant you are taking; switch to a different class of medication than before like a tricyclic antidepressant (imipramine or nortriptyline) or a MAOI (Nardil); add Buspar 15-60 mg per day to the antidepressant you are taking; add Wellbutrin to any antidepressant you are taking (other than an MAOI); check your thyroid to make sure you aren't borderline hypothyroid and get that treated; adding Revia 25 mg per day to an antidepressant (Revia is a medication to take away cravings for alcohol and opiates, but it is reported to be quite miraculous in relieving resistant depression); an unusual report of Pavabid (Papaverine) 600 mg added to an antidepressant worked; adding a stimulant such as Ritalin or Dexadrine to an antidepressant.
I wrote those in the order that I would try them. In my personal experience I have seen Pindolol work absolutely great and especially with Serzone I have seen hugely great results. Buspar is also quite effective. People don't like to hear about it, but ECT is also an option that doesn't involve ongoing medication side effects, is safe and QUICKLY effective (if I understand you correctly about the suicidal thinking, you don't want to wait much longer on medications to work). I don't know if your particular medical condition makes that feasible. Other "heroic combos" include: Effexor + SSRI, Effexor + Wellbutrin, Serzone + Wellbutrin, or Remeron 45 mg + Effexor 300 mg (which Stephen Stahl, MD depresion guru endorses).
I don't know about your doctor. Is she new to you or have you been with her for awhile? From your previous statement about her reading your chart, it sounds like you are new to the county system or she is new to you. I hope she IS paying attention to you (and I hope you are asserting yourself as best you can about your concerns and questions -- she can't tell you what you don't ask) but that's hard to tell because, honestly, if a person doesn't respond quickly to the first few antidepressants that are tried, it's a matter of just picking some combinations out of a hat to see if your chemistry will respond and to rely on what we hear has worked well for other people. There is no test yet that we can do to determine what specific chemical need a person has so that we can pick a medicine that fits that need. That's coming, but not soon enough for those who are suffering through multiple medication trials now. Nonetheless, don't give up and if you aren't being heard by your doctor, don't dawdle with her -- ask for another doctor. Good ones are out there, even in the county system. I'm a county doc and a good one from what my patients say. That's why I AM a county doc -- because there are alot of bad ones and uninsured folks need just as effective treatment as insured ones. So DON'T give up and DON'T kill yourself. Find a local mental health support group and go to it; there's a lot of good info you can pick up from other patients there in regard to medications, doctors, and other strategies to get rid of the depression. Take your medicine, MAKE yourself exercise and eat right (yes it's hard; yes you have to MAKE yourself do it), and keep all your doctor's and therapy appointments. Good luck.
Posted by Racer on August 26, 1998, at 17:26:17
In reply to Re: PS: A look at the side effects scares me more, posted by Toby on August 26, 1998, at 16:00:53
First off, the ketoconazole is used topically, but was mentioned on a FAQ sheet, so I wanted to make sure I could keep using it.
Second, this is the first trial of anti-depressant medication in several years. However, since I have had so many side effects in the past, it's really frightening to try a new drug, especially in this case.
This county doctor is the only one on this side the county. If the lightheadedness gets worse, I'll call around to see about getting someone to drive me over to the other county doctor (you may live in a bigger or richer county!), but that's not so easy to arrange.
As for the doctor, she was terrible. I went from fully ready and semi able to participate in my treatment to feeling like a "disposable" person and ready, once more, just to end it. It may have been partially colored by the depression, but let me assure you, if she had been in private practice, I would have told her why, after about 5 minutes, I was walking out, why she might want to rethink her therapeutic manner (telling me that my life was just fine, it was just the depression? Not answering my questions about the possible side effects of the drug? Blowing off my questions?), and why I didn't think she should charge me. I'm depressed, not stupid, and I can tell the difference between someone who goes to work for the county in order to help the rest of us and someone who goes to work for the county because she can't get any other job.
Here's one example: in the course of the interview, she asked about a note on my chart regarding an eating disorder. I responded by telling her that it was still a problem, and that it got worse with the depression. She said, "well, you look fine, so there's no reason to worry about your weight." Gee, thanks for telling me. I never realized that before. I thought 110# really was the recommended weight for a 5'9" woman. I guess that all those doctors out there who specialize in eating disorders should go find another specialty, since all it takes is pointing out the reality like that. No, she didn't ask anything about prior treatment for it. No, nothing more. Just "you look fine."
Funny, huh, that I'm so unreasonable as not to trust this doctor? Strange that my depression seems worse today than yesterday?
Posted by Toby on August 27, 1998, at 8:28:22
In reply to Thanks, there's a bit more to the story..., posted by Racer on August 26, 1998, at 17:26:17
Your concerns about your doctor sound more than justified. I am embarrassed for her, since it sounds as though she is incapable of empathy and lacks the simple skill of observation. I hope you are able to get to the other side of the county.
Considering the eating disorder, Serzone is a good choice since it tends to cause less agitation and jittery feeling than the SSRI's and can lessen the anxious, obsessive feelings you may experience along with the depression. If it causes nausea when you start it and you can't tolerate it, cut the pill in half, or even quarter it for several days and try to eat a little before you take it, even some crackers would help. Then increase it slowly every 3-4 days.
Is emergency Medicaid an option for you? That may open some opportunities to see another doctor. Just a thought.
Posted by Racer on August 27, 1998, at 11:55:13
In reply to Re: Thanks, there's a bit more to the story..., posted by Toby on August 27, 1998, at 8:28:22
Thank you for taking me seriously. Thank you for taking the time to respond, twice even. It's nice to have someone listen, which obviously ain't happ'nin' with the doctor who can see me face to face. I'd be embarrassed for her if it weren't for the part about being stuck with her.
My county has very limited resources for mental health. Basically, they can pay to have me in the hospital, or to see one of their doctors about half a dozen times. After that, there's almost nothing. After the 4 - 6 visits to the psychiatrist, they shift over to a med clinic where they give you the meds, and send you on your way. If you don't like the doctor, your choice is to drive across county, about 40 minutes, and go to the walk in clinic where you may or may not be able to be seen. If you are seen, the doctor can change your meds, stop your meds, or write you up as a danger to yourself and lock you up. As for talk therapy, the sliding scale goes down to about $35 per session, no billing, pay as you go. Since my depression is tied up with my inability to find work, gee, that sliding scale is still way out of my reach. I can't buy food, how can I pay rates like that? Not alot of choices there.
Thanks again, though. I am trying the drug, just don't feel very good about the whole thing. I do wish that I could talk to someone I could trust about the side effects and my concerns, but unless I can find someone to give up a couple of hours to drive me up there, well, not much to do about it. (Don't know if it's the drug or if it's knowing about the potential side effect, but I am feeling kinda disoriented and lightheaded. I'm trying to tell myself it's the latter.)
Posted by Jessie on March 10, 1999, at 14:45:13
In reply to Thanks Toby., posted by Racer on August 27, 1998, at 11:55:13
> By now you've probably tried the drug; I hope you have found some relief. If you were too nervous to try it you should know that a) the side effects really suck at first; and b) if you take the correct dosage at the same time every day, the side effects honestly do go away. Don't be frightened by the initial feelings. If you increase your dosage as is often reccomended, every time you increase you will experience side effects. GIVE IT TIME!! I was so tempted to stop, too, but I stuck it out. It took a good two to three months before it truly began working, but it is so, so worth it. I have never felt so good.
One thing to consider is to listen to the medication when it is sedating, though...that extra rest can be enormously helpful at times in combatting the depression. Drink lots of liquids and suck on hard candy or chew gum to get rid of the dry mouth. Also consider taking the entire dose several hours before you go to sleep, so that the sedation hits you worst when you are already sleeping.
Hope that helps.
Posted by saintjames on March 10, 1999, at 20:45:08
In reply to Scared to try Serzone. Any exp. to share?, posted by Racer on August 25, 1998, at 23:07:12
> I've had bad experiences with a couple of anti depressants, and now find myself too depressed to function again.
James here...
If sedation is a problem take total dose in PM a few hours b4 bedtime. The sedation side effect tends to wear off with time for me.
james
Posted by Terry on March 11, 1999, at 15:46:17
In reply to Serzone Concerns, posted by Jessie on March 10, 1999, at 14:45:13
I agree 100% with Racer! I've been on a low dose of Serzone (I'm bipolar, so can't take a full dose) along with depakote and it's the best antidepressant I've tried so far. But be sure to take it at bedtime because it does make you sleepy. Terry
> > By now you've probably tried the drug; I hope you have found some relief. If you were too nervous to try it you should know that a) the side effects really suck at first; and b) if you take the correct dosage at the same time every day, the side effects honestly do go away. Don't be frightened by the initial feelings. If you increase your dosage as is often reccomended, every time you increase you will experience side effects. GIVE IT TIME!! I was so tempted to stop, too, but I stuck it out. It took a good two to three months before it truly began working, but it is so, so worth it. I have never felt so good.
>
> One thing to consider is to listen to the medication when it is sedating, though...that extra rest can be enormously helpful at times in combatting the depression. Drink lots of liquids and suck on hard candy or chew gum to get rid of the dry mouth. Also consider taking the entire dose several hours before you go to sleep, so that the sedation hits you worst when you are already sleeping.
>
> Hope that helps.
Posted by Patricia on March 15, 1999, at 9:22:55
In reply to Re: Serzone Concerns, posted by Terry on March 11, 1999, at 15:46:17
Does anyone know how long you should or can stay on Serzone? I've been using it in a low dose (150mg/day) for about three or four months, with three more renewals on my Rx.
It took a good 6-8 weeks to begin working, but I now feel pretty much like myself again, with no troublesome side-effects.
I suspect my doctor (whom I trust completely) will suggest stopping the medication in June.
What can I expect? Will the depression and anxiety return? Are there any long-term effects?
Hope to hear from someone.
Posted by BOBSNITRO@prodigy.net on March 15, 1999, at 13:41:36
In reply to PS: A look at the side effects scares me more, posted by Racer on August 26, 1998, at 1:08:49
I've been on elavil & imipramine, one or the other for the last 20 years-side effects are all true. The "gain weight" side effect is really a problem now. Before I retired, I seemed to keep it in control, but since then I've gained 50 lbs.
I've turned to Herbs instead of the drugs. St. John's Wort and Kava Kava. So far, so good. Coming down off drugs at 20mg every two weeks. Really recommend you find a good Herbalist Doctor and see that route helps you. Better than suicide. Prayer helps more than the meds sometimes. As the old Indian saying goes "Sometimes all you can do is pray."
God Bless
slewis
> OK, the side effects list includes things like dizziness, lightheadedness, and lowered blood pressure. My normal blood pressure is ranges from 90/60 to 98/65, so the blood pressure thing is a big deal to me. Anything to mention?
> Thanks for anything you can say to help. My depression is so far out of hand suicide doesseem the most reasonable response, but if there is a chance of a fix, I'm willing to try.
> So tell me, folks, how much of a jerk is this Dr? Did she read my chart at all?
> One last thing, anything on the interaction of serzone and ketoconazole (sp?)?
Posted by Karla on March 24, 1999, at 23:13:26
In reply to PS: A look at the side effects scares me more, posted by Racer on August 26, 1998, at 1:08:49
I have been taking Serzone for about six months. There are only side effects for the first four days or so, they make you feel kinda funny, but it's a lot better than being depressed.
It won't hurt you, try it.
> OK, the side effects list includes things like dizziness, lightheadedness, and lowered blood pressure. My normal blood pressure is ranges from 90/60 to 98/65, so the blood pressure thing is a big deal to me. Anything to mention?> Thanks for anything you can say to help. My depression is so far out of hand suicide doesseem the most reasonable response, but if there is a chance of a fix, I'm willing to try.
> So tell me, folks, how much of a jerk is this Dr? Did she read my chart at all?
> One last thing, anything on the interaction of serzone and ketoconazole (sp?)?
Posted by Karla on March 24, 1999, at 23:16:28
In reply to Serzone , posted by Karla on March 24, 1999, at 23:13:26
>I forgot to tell you that I've been on many meds, and Serzone is the best I've taken. I have a question though, has anyone taken Neurontin for bipolar disorder, and does it make you gain weight??????????
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Posted by Laurie on April 27, 1999, at 2:29:40
In reply to Thanks Toby., posted by Racer on August 27, 1998, at 11:55:13
> Thank you for taking me seriously. Thank you
for taking the time to respond, twice even. It's
nice to have someone listen, which obviously ain't
happ'nin' with the doctor who can see me face to
face. I'd be embarrassed for her if it weren't
for the part about being stuck with her.> My county has very limited resources for mental
health. Basically, they can pay to have me in the
hospital, or to see one of their doctors about
half a dozen times. After that, there's almost
nothing. After the 4 - 6 visits to the
psychiatrist, they shift over to a med clinic
where they give you the meds, and send you on your
way. If you don't like the doctor, your choice is
to drive across county, about 40 minutes, and go
to the walk in clinic where you may or may not be
able to be seen. If you are seen, the doctor can
change your meds, stop your meds, or write you up
as a danger to yourself and lock you up. As for
talk therapy, the sliding scale goes down to about
$35 per session, no billing, pay as you go. Since
my depression is tied up with my inability to find
work, gee, that sliding scale is still way out of
my reach. I can't buy food, how can I pay rates
like that? Not alot of choices there.> Thanks again, though. I am trying the drug,
just don't feel very good about the whole thing.
I do wish that I could talk to someone I could
trust about the side effects and my concerns, but
unless I can find someone to give up a couple of
hours to drive me up there, well, not much to do
about it. (Don't know if it's the drug or if it's
knowing about the potential side effect, but I am
feeling kinda disoriented and lightheaded. I'm
trying to tell myself it's the latter.)How timely! My doctor just prescribed Serzone to
me today. I've been taking Prozac for many years
with much success.However, the lack of sexual
interest and difficulty having orgasms has gotten
to me. I've decided that I have nothing to lose
and a lot to gain by trying this new drug. I'm
kind of excited about it. I'll report back to you,
Racer, about side effects, etc. I too have had to
deal with county docs and I know exactly how you
feel. But, try the new drug, maybe it will work
and you will feel better and can get a job with
insurance and won't have to deal with her anymore!
Good luck to you.
Posted by Jayne on April 27, 1999, at 2:34:19
In reply to Re: Serzone , posted by Karla on March 24, 1999, at 23:16:28
Am going to try it soon. Will let you know how it goes re: side effects, etc. Please keep posting on your progress. People really do care.
Posted by CeeCee on May 6, 1999, at 23:20:43
In reply to Re: Serzone , posted by Jayne on April 27, 1999, at 2:34:19
I tried Serzone 3 years ago. I got such severe headaches that I couldn't function. I had to crawl to the bathroom because I couldn't stand up.
I've been on Prozac, Zoloft, Paxil, and Effexor. I'm back on Effexor and it has helped me the most.
Posted by Gisele on May 14, 1999, at 10:39:25
In reply to Scared to try Serzone. Any exp. to share?, posted by Racer on August 25, 1998, at 23:07:12
>I know this message is late in response to yours but I'm just learning how to get on the Internet. I took Serzone for several years with pretty good affects. I've been having a hard time loosing weight and was concerned that it might be contributing to weight gain (I doubt it, but I was hoping). Anyway I just started Celexa (similar to Prozac) a couple of weeks ago and I have terrible nightsweats and the inability to reach orgasm. I think I probably will go back to Serzone. Sometimes I'd like to just not take anything. But I have two major depressive episodes in my life (currently 41 years old - first episode at 18 years old, 2nd at 34 years old).
I'd appreciate any feedback. There aren't too many people you can talk to about this. Thanks.
Posted by Sylph on May 14, 1999, at 18:49:58
In reply to Re: Scared to try Serzone. Any exp. to share?, posted by Gisele on May 14, 1999, at 10:39:25
I just got my starter kit and a scrip for Serzone. My doc was in such a hurry he never mentioned side effects or anything of that nature. Was afraid to try it, but read your posts. will watch for the side effects you mentioned, and will keep you posted.
Thanks!
Posted by John on May 25, 1999, at 2:46:15
In reply to Re: Serzone Just Prescribed for Me, posted by Sylph on May 14, 1999, at 18:49:58
> I just got my starter kit and a scrip for Serzone. My doc was in such a hurry he never mentioned side effects or anything of that nature. Was afraid to try it, but read your posts. will watch for the side effects you mentioned, and will keep you posted.
>
> Thanks!I've been on Serzone and may go back. Here's the deal...It has a sensitive window of therapy. Start low and raise dose slow. Stay at a new dose a two or three weeks. If you get too aggressive and go past the right dose, which is different for everyone, you may actually get worse. Find your window and stay there. It will cause some sedation, but also seems activating once you get moving. Great sex. Slight headache that does go away. Generally a pretty mild med compared to most. Again, to make it work, go slow. Don't believe it if someone pushes you too fast to a high dose, you may go past your window of therapy. It is sensitive and works in a small window, which you must find by trial, error, and patience. Hope this helps. John.
Posted by Delores on December 22, 1999, at 9:49:21
In reply to Re: Serzone Concerns, posted by Terry on March 11, 1999, at 15:46:17
> I am a new candidate for this drug. My confusion is beginning to deminish. I was a Paxil user until the late summer and due to side effects dropped the drug. Big time depression set in and was not relieved until a month of serzone. I am not seeing anyone professionaly-my HMO doc has not recommended this. The up side is that I am feeling more like my old self-secure,happy,etc. I am so glad that at least I have received a temporary reprieve from this illness. I only discovered I was going thru depression when I contacted my HMO in spring of 98. I was there to determine if I was going thru menopause. I had no idea that my life of mood swings was directly related to depression and that as I have gotten older my depression has surfaced and taken hold.
> > Hope that helps.
Posted by jeff on December 22, 1999, at 14:42:38
In reply to Re: Serzone Length of medication Concerns, posted by Delores on December 22, 1999, at 9:49:21
what dose are you at. Do you sleep well? Any agitation?
> > I am a new candidate for this drug. My confusion is beginning to deminish. I was a Paxil user until the late summer and due to side effects dropped the drug. Big time depression set in and was not relieved until a month of serzone. I am not seeing anyone professionaly-my HMO doc has not recommended this. The up side is that I am feeling more like my old self-secure,happy,etc. I am so glad that at least I have received a temporary reprieve from this illness. I only discovered I was going thru depression when I contacted my HMO in spring of 98. I was there to determine if I was going thru menopause. I had no idea that my life of mood swings was directly related to depression and that as I have gotten older my depression has surfaced and taken hold.
> > > Hope that helps.
Posted by Cindy on December 22, 1999, at 20:23:28
In reply to Re: Serzone Length of medication Concerns, posted by jeff on December 22, 1999, at 14:42:38
> what dose are you at. Do you sleep well? Any agitation?
>
> > > I am a new candidate for this drug. My confusion is beginning to deminish. I was a Paxil user until the late summer and due to side effects dropped the drug. Big time depression set in and was not relieved until a month of serzone. I am not seeing anyone professionaly-my HMO doc has not recommended this. The up side is that I am feeling more like my old self-secure,happy,etc. I am so glad that at least I have received a temporary reprieve from this illness. I only discovered I was going thru depression when I contacted my HMO in spring of 98. I was there to determine if I was going thru menopause. I had no idea that my life of mood swings was directly related to depression and that as I have gotten older my depression has surfaced and taken hold.
> > > > Hope that helps.I took Serzone for three months, at a max of 450 mg/day. It made me feel much better (less depressed, less social anxiety, better sleep). I'd still be taking it if it worked for OCD (now am trying Effexor). The side effects at first were weird (dizziness, some strange visual effects, dry mouth, irritability) but these went away after a couple of weeks.--Cindy W
Posted by Alice on December 23, 1999, at 19:26:48
In reply to Re: Serzone Length of medication Concerns, posted by Cindy on December 22, 1999, at 20:23:28
I've been on Serzone for nearly 3 weeks now, and though I do feel a little less depressed and anxious, it is not much of a noticable change. The side effects are getting to me...I sleep until 1 in the afternoon, and then can't sleep at night until late. My stomach is off. The other night I threw up after taking my dose of 300 mgs. I feel forgetful and drained of energy. Some people have written that these side effects will subside, and that this med takes several months to begin to work. I hope that this is true for me. I need to get out of this...depression, anxiety, mood swings. I was thinking of going off of it until I read some of the other comments. If this drug can really make me feel good, and normal eventually, I will stick with it.
Posted by bob Moses on October 18, 2000, at 10:30:10
In reply to Re: Serzone , posted by CeeCee on May 6, 1999, at 23:20:43
anyone here anymore?this board still werk?
any serzone folx around?
Posted by Cindy W on October 18, 2000, at 21:57:39
In reply to Re: Serzone , posted by bob Moses on October 18, 2000, at 10:30:10
> anyone here anymore?this board still werk?
> any serzone folx around?bob, there are a lot of Serzone folks around (I only take 75 mg/day right now). This board is very active, but the threads you want are probably archived. See below and I'm sure people will comment on Serzone. Personally, I loved it in terms of its antidepressant effect, but unfortunately it didn't help my OCD.
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