Psycho-Babble Medication Thread 10206

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Re: serzone/nefazodone

Posted by yardena on August 17, 1999, at 0:27:16

In reply to Re: serzone/nefazodone, posted by Adam on August 16, 1999, at 21:41:04

Thanks, Adam.

> I was taking Serzone for about four months before winding up in the hospital.
> In other words, Serzone did not work for me in a big way. A rather traumatic
> event just prior to hospitalization drove that point home, so to speak. The
> psychiatrist I saw most in the hospital regarded Serzone as, and I quote,
> "not a very robust antidepressant." I initially thought I was responding to
> Serzone, too. But that effect just seems to evaporate.
>
> Of course, it does help some people, and MGH or no, maybe the doc didn't know
> all the facts on Serzone. At any rate, I hope you find something that works,
> be it a new drug or a dosage change.
>
> If you are feeling suicidal, get help. By that, I mean, if you feel like you
> might actually do something to hurt yourself, call someone right away.
>
> Take good care.
>
>
> > I have been on a cocktail of various meds for a few years, and recently added serzone for two reasons: 1)to replace the trazodone that was becoming less and less effectine as a sleep aid to counteract the sleeplessness caused by the effexor (and possibly, ritalin) and 2) to boost the antidepressant effects, as my depression was escalating. When I got to about 100 mg (taken once a day, in the evening), I definitely noticed a pronounced antidepressant effect, and was pleased and feeling hopefull. The sleep-aid effect took a bit longer to work, but after being on 150 mg for a while, my sleep has definitely improved. But, a recent family conflict really set off a bad downward spiral, and it is hard for me to discern if it is just the interpersonal/intrapsychic issues that are making me this depressed (on top of a particularly stressful few months during which I was fired for being a so-called whistleblower, and started a new job, etc. along with legal procedings), or is it possible that the serzone is also not agreeing with me. I know that people often feel worse before feeling better, and I am following the pattern of going from totally passive and numb to more agitated and emotional, with suicidal feelings, etc., ie, the pattern in which one is in more danger after some of the depression lifts but before it is fully remitted. I guess I want to hear if anyone else has experienced a worsening of their depression on serzone or any other antidepressant, for that matter. My psychiatrist is away on vacation, and I would like to know if I need to increase the dose, add a morning dose, or change something altogether.

 

Re: serzone/nefazodone

Posted by JohnL on August 17, 1999, at 2:27:14

In reply to Re: serzone/nefazodone, posted by yardena on August 17, 1999, at 0:27:16

Yardena, it sounded like you were describing MY experience on Serzone. I too felt better at first, doc pushed the dose higher pretty fast, and I then got worse and worse. I was a suicidal vegetable when I finally decided it was the drug, not me. Some people do so well on Serzone, others real bad. Anyway, what you describe sounds like a familiar behavior of this drug. I don't think it's your imagination or your depression. What I did, without my doc's permission (was also out on vacation!) was start lowering the dosage as fast as possible without going cold turkey. I started feeling better in just a few days, so I knew it was the drug. Sorry you're feeling bad! JohnL.

 

Re: serzone/nefazodone

Posted by Roo on August 17, 1999, at 11:02:21

In reply to Re: serzone/nefazodone, posted by JohnL on August 17, 1999, at 2:27:14

Yardena,

Same here....I didn't do well on Serzone, and I
swear it made my depression worse than before. I
too, felt suicidal on it. It made me scared to
to try any other ad's I wasn't familiar with b/c
my experience on serzone was pretty traumatic.
It was hard to figure out too, b/c one day I'd be
feeling fine, and then the next, I'd be really agitated
and easily angered...I was very unstable on it...

 

Re: serzone/nefazodone

Posted by Malia on August 17, 1999, at 12:13:23

In reply to Re: serzone/nefazodone, posted by Roo on August 17, 1999, at 11:02:21

Same here too...I've been on it for only 5 days, but can tell you I know there's a big difference. I was taking Effexor, but had to switch due to my high blood pressure. It had increased by 20 points on a low dose (75-150) of Effexor! So I felt like I'm in withdrawal from Effexor, and I hate it! It is making me agitated, moody, tired and my crying spells have resumed. Last night, I couldn't even sleep. I just got to bed at 4:00am this morning, and got up again at 7:00am, and now I'm at work. I'm not feeling "hungover," but I'm having headaches and dizzy spells. I'm calling my psychiatrist today to ask him if I should continue on Serzone, or quit now and switch to something else. Maybe he should've tapered me off the Effexor first.

 

Re: serzone/nefazodone

Posted by Cindy on August 18, 1999, at 21:32:39

In reply to Re: serzone/nefazodone, posted by Malia on August 17, 1999, at 12:13:23

> Same here too...I've been on it for only 5 days, but can tell you I know there's a big difference. I was taking Effexor, but had to switch due to my high blood pressure. It had increased by 20 points on a low dose (75-150) of Effexor! So I felt like I'm in withdrawal from Effexor, and I hate it! It is making me agitated, moody, tired and my crying spells have resumed. Last night, I couldn't even sleep. I just got to bed at 4:00am this morning, and got up again at 7:00am, and now I'm at work. I'm not feeling "hungover," but I'm having headaches and dizzy spells. I'm calling my psychiatrist today to ask him if I should continue on Serzone, or quit now and switch to something else. Maybe he should've tapered me off the Effexor first.
I've been taking Serzone for about two weeks, and can relate to what you have said about dizziness, fatigue, and easy anger and irritability. Does anybody know if it is effective at all with OCD and not just depression?Thanks!

 

Re: serzone/nefazodone - Do I need to switch AD's?

Posted by Carolyn on August 18, 1999, at 21:33:46

In reply to serzone/nefazodone, posted by yardena on August 16, 1999, at 20:51:23

Thanks to all who gave input regarding the experience on Serzone. I have been on Serzone just over 2 months now. I am at 400mg a day. I cannot articulate if the drug is working or not working - somedays I am absolutely fine and other days I am completely slung deeply into my depression. I Called my Dr's office and they suggested I wait til my next appt which is Sept 7 to see how I am doing (so that they can rule out if this drug is or is not working for me).
Anyway I too experience this agitation with rage and anger which I know in my head is unreasonable and inappropiate. Also when I feel down it feels as though my symptoms of depression are enhanced ten fold.
At times I have done great on the drug but seem to plateau after a while and then the Dr just up's the dose. How do I know when enough is enough - expecially when I don't feel that my Dr understands??

 

Re: serzone/nefazodone

Posted by CAM on August 19, 1999, at 10:32:46

In reply to Re: serzone/nefazodone - Do I need to switch AD's?, posted by Carolyn on August 18, 1999, at 21:33:46

I have been watching this board for a few months now, but I've never posted and I really don't
know if I'm doing this right. If I'm not, just let me know what I need to do.
I know how frustrating it is to find the right AD and the right dosages. I have been trying to
do that myself for a couple of years. I've been on several: amitriptyline, effexor, paxil, celexa,
and I'm now on serzone. Serzone takes a long time to begin working in your system. I started out a few
months ago on a low dose of 50 mgs twice a day for 1 week, then 100mg 2x per day for 1 week, 150 2x per
day 3 weeks. At this point I didn't like it and it wasn't working and I was getting worse again. I was
needed to take xanax with it almost everyday. I wasn't able to focus, I didn't feel right, I was very
monotone. Since then every 3 or 4 weeks my dosage was upped. Now I take 600 mgs a day. 200 in the am and
400 at bedtime. It is working much better now and I haven't taken any xanax in 2 weeks. Serzone has a
minimum effective theraputic dose at 300 mgs a day, so I've been told. So, possibly if you're not feeling
alright your dosage may be to low. It also has side effects that have went away with time, for me.
CAM

 

Re: sleeping while I'm working right now...

Posted by Malia on August 20, 1999, at 13:19:22

In reply to Re: serzone/nefazodone , posted by CAM on August 19, 1999, at 10:32:46

I'm not quite in the so-called "SErenityZONE." I'm nodding off right now while I'm working at my desk. I hate this stuff...I already put in a call to my doctor, because I'm not feeling the happy "high" I felt on Effexor, which was great, except that my blood pressure soared 20 pts, and I kept sweating alot. Oh well, I'll have to keep trying!

 

Re: serzone/nefazodone

Posted by MA on August 20, 1999, at 13:46:03

In reply to Re: serzone/nefazodone , posted by CAM on August 19, 1999, at 10:32:46

I am supposed to start Serzone today and after reading your post I am surprised to hear you say it took so long to work. I don't know how much longer I can take this depression. It did take almost a year once to find the right medication, although in retrospect, I'm not so sure I was feeling that great.

Serzone is one of the few AD's I haven't tried, along with Luvox, Celexa, and Remeron (took 2 doses and felt reallly bad).

I just came off Wellbutrin and Prozac since it mas made me very anxious, but Wellbutrin alone didn't keep the depression away.

I'm really hoping that Serzone will work and work quicker than your experience with it. I'm speaking from a very dark place right now, so time is running out.

Wish me luck and I hope we all find something to make the pain go away.

 

Re: serzone/nefazodone

Posted by yardena on August 20, 1999, at 16:39:13

In reply to Re: serzone/nefazodone , posted by MA on August 20, 1999, at 13:46:03

That they often take so long to be effective is one of the frustrating things about these meds. It is so hard to wait when you are in that "dark place". Hang in there. Also, ask your doctor if there is anything short term you can take to jump start some relief in the meantime.

Update on me and serzone: It is not sufficient for my depression, so my doctor now has me on a higher dose of the Effexor. I just increased it yesterday, and he says it could take 2 weeks to determine if it will make a difference. If it doesn't it's on to another augmentation strategy.

Malia, your serenity zone reference made me laugh. Is this your invention, or is it really the basis of the naming/marketing of the drug?

 

Re: serzone/nefazodone

Posted by Cam on August 21, 1999, at 8:59:15

In reply to Re: serzone/nefazodone , posted by MA on August 20, 1999, at 13:46:03

I am very sorry about that it takes so long to feel and I don't know
why it takes so long to work. I've been told that it is a good AD for
anxiety and for me that was the very last thing that it has helped me
with. I am curious to know the dosages that all of you are on now and
at what time of day you take your dosages. The reason I am curious is
because I tried dosing in several different ways. Another thing I have
found is if I don't go directly to bed after my nightly dose, I risk
not being able to sleep. So, I wait until I'm ready to go to bed, then
I take it.
It sounds like most of you are just starting out on Serzone. So you
are probably on small amounts. Also, you may not have been doing very
well on the drugs just prior to this. If that would heve been the case
for me I'm not sure how I would have came out. As it was, I had been on
Celexa and using Doxepin to help me sleep. Celexa can be a weight gainer
for some people and Doxepin made me crave sweets which is a side effect
of that drug. I gained 20lb. while taking that combination. My doctor
said that is too much too fast. So, that is how I was put on Serzone.
I had all the side effects and kept falling deeper and deeper down.
I was so afraid that I was going to hit bottom. So, my doctor sent me
to a psychiatrist so that he could ajust the dosage. They both kept
telling me to just hold on alittle longer, it does best 6-8 weeks out.
I thought there was no way I could wait that long. But they raised my
dose just as fast as they felt was safe. For me that was longer than
eight weeks. But, as I said before I'm up to 600mg now. Even though I
thought I was sinking deeper into depression I was getting enough
Serzone to keep me from that, but I would cry, remained sad, didn't
want to do anything. I sat on that wire for several weeks.
I wish you all the best and if I can share anything else with you, I
would be happy to.
Cam

 

Re: serzone/nefazodone

Posted by Cindy on August 21, 1999, at 11:36:09

In reply to Re: serzone/nefazodone , posted by Cam on August 21, 1999, at 8:59:15

> I am very sorry about that it takes so long to feel and I don't know
> why it takes so long to work. I've been told that it is a good AD for
> anxiety and for me that was the very last thing that it has helped me
> with. I am curious to know the dosages that all of you are on now and
> at what time of day you take your dosages. The reason I am curious is
> because I tried dosing in several different ways. Another thing I have
> found is if I don't go directly to bed after my nightly dose, I risk
> not being able to sleep. So, I wait until I'm ready to go to bed, then
> I take it.
> It sounds like most of you are just starting out on Serzone. So you
> are probably on small amounts. Also, you may not have been doing very
> well on the drugs just prior to this. If that would heve been the case
> for me I'm not sure how I would have came out. As it was, I had been on
> Celexa and using Doxepin to help me sleep. Celexa can be a weight gainer
> for some people and Doxepin made me crave sweets which is a side effect
> of that drug. I gained 20lb. while taking that combination. My doctor
> said that is too much too fast. So, that is how I was put on Serzone.
> I had all the side effects and kept falling deeper and deeper down.
> I was so afraid that I was going to hit bottom. So, my doctor sent me
> to a psychiatrist so that he could ajust the dosage. They both kept
> telling me to just hold on alittle longer, it does best 6-8 weeks out.
> I thought there was no way I could wait that long. But they raised my
> dose just as fast as they felt was safe. For me that was longer than
> eight weeks. But, as I said before I'm up to 600mg now. Even though I
> thought I was sinking deeper into depression I was getting enough
> Serzone to keep me from that, but I would cry, remained sad, didn't
> want to do anything. I sat on that wire for several weeks.
> I wish you all the best and if I can share anything else with you, I
> would be happy to.
> Cam
Cam, Currently I have been taking Serzone for just over two weeks. I started on 150 mg/day at night, then in week two went up to 75 mg/day in the daytime and 225 mg at night. For the past three days, I have been taking l50 mg/day in the morning and 300 mg/day at night. I started taking Serzone because Prozac had too many bad sexual side effects. I quit taking Prozac because I figured, hey, if it's going to take me 4 hours to climax, I might as well do the four hours of rituals instead, which for me involves taking care of living things (frogs). I take it for OCD, not primarily for depression which is just secondary to the OCD. The side effects I noticed at first (which are diminishing Thank God!) were extreme fatigue, dry mouth, irritability, and intense anger for no particular reason, as well as dizziness. These have gradually decreased. Last night, after barfing up the Serzone that I took on an empty stomach, I decided to always take it with food and I'll probably be fine. I'm worried though that it will not have sufficient impact on the OCD. Best wishes!

 

Re: serzone/nefazodone

Posted by yardena on August 21, 1999, at 14:55:52

In reply to Re: serzone/nefazodone , posted by Cam on August 21, 1999, at 8:59:15

At the moment, using it to augment effexor. Taking 150 mg/day in the early evening. I found it doesn't kick in fast enough to help me sleep if I take it at night.

 

Re: serzone/nefazodone

Posted by yardena on August 21, 1999, at 14:59:57

In reply to Re: serzone/nefazodone , posted by yardena on August 21, 1999, at 14:55:52

oops, I had more to say....

The "side" effects I experience/d include: feeling sleepy (although it isn't that great at helping me sleep), and in the first few days, I felt poor balance and a bit of dizziness. I also felt extremely tearful, emotional, but who knows if that is a symptom of the depression or caused by the nefazodone. One day, I had tinnitus, but that stopped. It seems that it takes a period of adjustment to this med.

 

Re: serzone/nefazodone

Posted by Malia on August 23, 1999, at 13:17:29

In reply to Re: serzone/nefazodone , posted by yardena on August 21, 1999, at 14:59:57

To answer your question, Yardena, yes...that SERenityZONE comment was taken from a quote on the Serzone pamphet I was given. It read something like, "find serenity in your life..." or something to that effect. I'll go look for the pamphlet. Funny, huh?

Yes, I'm still taking 2 doses of Serzone 2x a day. I still find it making me sleepy at first + my high bp medication really makes me tired too, so morning doses are accompanied soon after by a cup of coffee. Great, huh? I wonder what caffeine does with these drugs. .

I'm seeing my doc on Wednesday, so well see what cocktail I get next. I really miss my Effexor, but not the high blood pressure that went with it. I think I'm fading from Effexor withdrawal. That first week was a B*#@%! Rather, I was!

I'm not anxious or nervous on Serzone, which is a good thing, but it's not doing anything much for the depression. I'm just kinda "there" and okay, but I miss the "lift" that the Effexor gave me. I was happy about everything! It's so odd...

 

Re: serzone/nefazodone

Posted by Cindy on August 23, 1999, at 20:23:07

In reply to Re: serzone/nefazodone , posted by Malia on August 23, 1999, at 13:17:29

Malia said:
I was happy about everything! It's so odd...
Malia, I have been taking Serzone for nearly four weeks, and at first, I just couldn't stand it. But now, I feel good, and I'm not sure why! I have more energy and an absence of the disabling anxiety so I have been able to eliminate a couple of my OCD rituals and have regained an hour per day (of 4 or 5 hours per day in rituals) and not go to pieces (although I still feel anxious and guilty). Maybe this stuff does do something? Or else it is a total placebo effect. At least I have been able to make some small changes in my totally F****** up life! But I guess it took me 48 years to mess it up and it will take some time to untangle things. Now at least I can deal with real life problems instead of just the anxiety, obsessions, and rituals that I was using to keep from dealing with all the negative affect (hurt, anger, fear, anxiety about relationships, feelings about what to do with the rest of my life, etc.).I'm taking 450 mg/day right now.--Cindy

 

Re: serzone/nefazodone

Posted by Kaj on August 26, 1999, at 14:51:40

In reply to Re: serzone/nefazodone , posted by Cindy on August 23, 1999, at 20:23:07

Hi, I'm new to this board and have found the information quite helpful--thank you. I have some information that might also be useful to all of you...

My Dr. put me on an alternative dosage plan as researched by Markovitz in 1997. The study was designed to gauge what improvement this dosing plan had in patients with major depression...I don't see OCD or anxiety accounted for, nor drug interactions, but I only have one page of the study before me.

Basically, I take Serzone once a day, not twice, before bed, and up my dosage every four to six days (up to 600 mg.--I'm at 300 now.)

My hunch is that this cuts down a bit on the daytime drowsiness and fatigue. I've noticed that, if I take the drug at 11pm, I feel no side effects by 4pm the next day, which gives me some hours of "feeling normal". According to the research, this dosage plan also cuts the therapy time down by 2 months and achieves the same improvement.

I can't detect what effect the drug has had on my depression, but I can tell you the two-week vacation I'm on now has been excellent therapy. I highly recommend it.

A final note on Markovitz: I have searched the web for this research but can't find it online. My Dr. is on vacation (seems like they all go in August!) but if you'd be interested, e-mail me or post a note and I'll ask him.

Best to all--Kaj

 

Re: serzone/nefazodone

Posted by starla willett on August 26, 1999, at 17:17:37

In reply to Re: serzone/nefazodone , posted by Kaj on August 26, 1999, at 14:51:40

Hi all,

I am also new to the board and new to Serzone. I am interested in all comments regarding this drug. I wa son Celexa for one day and it gave a real bad case of diarrhea and nausea. I then switched to Remeron. One week later The dose was raised to 30mgs. The problem is that after two weeks I was still in the flat zone. Completely void of energy and ambition. Remeron is a calcium blocker and since I have a serious case of osteoporosis I requested something else. So now I am on the Serzone trip. Your posts have made me a little anxious about it but I will give it a chance. I started feeling much better within an hour (this is usually normal for me). I feel a little giddy right now and maybe a little hypomanic after four hours. My pdoc gave me the starter kit 50mgs twice a day for the first week, 100mgs a day for the second week, graduating to 150 starting the third week. I have been bipolar most of my life being diagnosed in '93 and started on lithium. After six years (actually four) it stopped working. Went to Depakote but had to give that up after 2 1/2 months because it was screwing up my liver function (have to save the liver if the cancer comes back)and am now taking Neurontin. Been on that for about 3 1/2 months and it seems to help the moods but doesn't help the depression much. So now I am I on the search for the right AD.

Star

 

Re: serzone/nefazodone

Posted by Carolyn on August 27, 1999, at 7:35:52

In reply to Re: serzone/nefazodone , posted by starla willett on August 26, 1999, at 17:17:37

>I have been on Serzone for over 2 months and I must say it has been a roller coaster ride. This ride up is fantastic and that is where I am right now. I have felt so sooo good these past 3 days which has happened to me before, however unless I am now fully responding to the Serzone in a postive way (I truly hope this is the case) the ride down is long and I find myself feeling sunk down deeper in despair then i was before. Does this make sense?
I am willing to stick with this Serzone because I have good days which my doc said is an excellent sign.
I have also noticed that the side effects that bothered me earlier or disapating such as the uncontrollable and unreasonable anger over the most stupid things, light headedness and tingles in my arms.
Well just wanted to share my experience - even though it is wishy washy!!!!!!!!! Take Care To You All!!!

 

Re: serzone/nefazodone

Posted by Cindy on August 28, 1999, at 11:46:05

In reply to Re: serzone/nefazodone , posted by Carolyn on August 27, 1999, at 7:35:52

Hi everyone! After taking Serzone for about four weeks, I really feel pretty good! No more fatigue, dizziness, "unreasonable anger," or hopelessness! Have been back to the doctor and started a small dose of Luvox (since my depression is secondary to OCD) and hope that helps. Am now taking Serzone 300 mg/day (down from 450) along with Luvox 50 mg/day. Despite some bad initial side effects from Serzone, these have diminished/disappeared, and I really think the Serzone helps! My mood seems "normal" again!--Cindy


 

Re: serzone/nefazodone

Posted by yardena on August 28, 1999, at 14:14:26

In reply to Re: serzone/nefazodone , posted by Cindy on August 28, 1999, at 11:46:05

It's great to hear some good news!

update on me re: serzone--taking 150 in the evening.
The side effects have calmed down a lot. It does make me a bit drowsy, but not bad. On the other hand, I am sleeping fairly well. Also increased my effexor dosage from 225 SR to 300 SR, about one week ago. Definiely noticing the difference. Still not "euthymic" (it has been a while so I don't even know if I would recognize it) but the severe depression has dissipated.

 

Re: serzone/nefazodone

Posted by Log on November 1, 2000, at 20:52:09

In reply to Re: serzone/nefazodone , posted by Cam on August 21, 1999, at 8:59:15

I was on Zoloft(100 mg a day) first of all, and loved its anti-depressant effects and did quite well on it but of course it had many side effects, but i guess all SSRI ad's do.I was then switched to Remeron(30 mg) after a suicide attempt and it worked for a while with few side effects and better sleep routines, but then tapered off. I am now on my second day of Serzone(100 mg first week 200 next and continual)and dont really know what to expect, from all that I have found its quite similar to Deserel, which I've taken a few times, anyway nausia,dry mouth and feeling warmer than usual have been the only things I have noticed. So if anyone can tell me more please do, thanx.

 

Re: serzone/nefazodone

Posted by noa on November 2, 2000, at 8:42:32

In reply to Re: serzone/nefazodone , posted by Log on November 1, 2000, at 20:52:09

Hi, you might want to check out the Serzone folder at psycho-babble-tip/links (link above on this page).

I used to take desyrel (aka trazodone) for sleep (to counter the sleep problems from ssris and effexor) and I now take serzone. I don't find serzone to be as intensely sedating as trazodone. It has a slower, longer acting and less intense sedation effect. With trazodone, I would be drooping within an hour. With serzone, I have about 30 minutes of feeling somewhat drowsy, about 30 minutes after dosing, but then it lightens up. Then, a few hours later, I am ready for bed, but not as drowsy as with trazodone.

I don't find the dry mouth that I did on trazodone.

You started higher than I did, but I like to start low and titrate up slowly.

The first few weeks on serzone were rough--emotionality, coordination problems, spaciness. But that wore off.

I take serzone and effexor, so I can't speak to serzone's AD effect on its own.

 

Re: serzone/nefazodone

Posted by Log on November 2, 2000, at 9:51:05

In reply to Re: serzone/nefazodone , posted by noa on November 2, 2000, at 8:42:32

Thank you noa.

 

Re: serzone/nefazodone

Posted by rouillard on November 10, 2000, at 20:09:17

In reply to Re: serzone/nefazodone , posted by Log on November 2, 2000, at 9:51:05

> I have just received samples of serzone from my regular doctor for my fibromyalgia/panic attacks/sleep disorder/depression. I am almost off of clonazapam although I am scared to go off it because it works so well for my sleep and anxiety, but not for my body pain and depression. I have to admit I'm also scared after reading all of your logs. But it sounds like it just takes some time so I'm going to give it a shot. My Dr. thinks it should work for everything. I really hope so as I also have been on an emotional and physical rollercoaster of trying different drugs...such as prozac (awful for me) trazadone (constantly sleeping) paxil (constantly sleeping) celexa (gained weight and didn't make a difference at all). I will keep you posted, and am very interested in more info from you who have taken serzone for a long time. Thanx for all your input. Wish you all the best.



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