Psycho-Babble Medication Thread 58726

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Re: serzone question

Posted by SalArmy4me on April 5, 2001, at 2:09:34

In reply to serzone question, posted by e503 on April 4, 2001, at 22:14:19

Weight gain and sedation must be less with Serzone than with all of the SSRIs, tricyclics, or MAOIs.

I have a feeling that you may benefit from the addition of Wellbutrin during the day to wake yourself up. Either that or methylphenidate, pemoline, or the new modafinil.

 

Re: serzone question

Posted by loosmrbls on April 5, 2001, at 8:01:46

In reply to serzone question, posted by e503 on April 4, 2001, at 22:14:19

e503:

I had the same experience with serzone. It is interesting, because 50mg twice a day is a very low dose, and usually only elderly patients or those with other health problems are started so low. All the trials show that the antidepressant effect doesn't start until 300+ milligrams per day.

That being said, I was started in 50mg twice a day and also felt a little drugged, foggy, and sedated. So it may indeed be a side effect of the medication.

I think weight gain is a potential of ALL of the antidepressants.

As for the sleep, this sounds like insomnia (difficuly falling asleep). Do you wake up alot during the night? Do you have a lot of anxietyt at night? The dexedrine should be way out of your system by nighttime, so I doubt that is playing a major role.

But appetite increase, weight gain, and insomnia are all symptoms of depression by themselves. Maybe it's not under control yet.

loosmrbls

 

Re: serzone question

Posted by e503 on April 5, 2001, at 9:29:00

In reply to Re: serzone question, posted by loosmrbls on April 5, 2001, at 8:01:46

I also am weaning off prozac,,,which made me soooo apathetic. I have been on it for many years. My brother takes 600 mg. serzone, so my doc thought it might help me too. We are very similar in profile --- anxiety, add, etc. I do think that the serzone is helping with some anxiety though. Is it ok (or does it really help?) to take it all in the evening? Does it build to a steady state like prozac? I know it does not have a long half life like prozac,,,but if I take it all at night, it that acceptable? I am afraid to take it in the morning,,,but guess that I will do so if need be.

 

Re: serzone question

Posted by Miss Amy on April 5, 2001, at 10:06:24

In reply to Re: serzone question, posted by e503 on April 5, 2001, at 9:29:00

I just started taking my whole dose at night---350mgs--and I was very groggy (until like 11:30!) and I was seeing tracers for about an hour after waking. Sooooo...after everyone's gracious advice, I decided to split the dose again-I am now taking 275 at night and 75 in the morning. No tracers or grogginess today. Also--maybe starting at 100mg a day is too much for you. I started at 25mg. every night and then increased the dose by 25mgs every three days until I got to the starting dose that my doctor wanted me on. She wanted to start me on 200mg. a day! Good luck to you! I hope you find some energy soon! : )
P.S. since you are just starting out on this drug, I would not recommend combining it with any other AD's (unless you have to) just so you can distinguish which one is giving you trouble.

 

Re: serzone question

Posted by loosmrbls on April 5, 2001, at 10:07:43

In reply to Re: serzone question, posted by e503 on April 5, 2001, at 9:29:00

I have read that Serzone has a very short half-life and that it should be taken twice a day, but this is something you need to run by your psychiatrist.

I also became very "flat" on Prozac, almost like a robot, and I also had very bad headaches. I had to stop it after only a few weeks.

Because you are coming off some meds, and going on others, it is hard to say what is doing what. Prozac really takes a while to flush out of your system.

 

serzone dose

Posted by allisonm on April 5, 2001, at 18:03:51

In reply to Re: serzone question, posted by loosmrbls on April 5, 2001, at 10:07:43

I just got put on Serzone today. I'm to start with 50mg at night for tonight and tomorrow night, then up to 50mg in the am and pm for the next week.

 

Re: serzone dose

Posted by mair on April 5, 2001, at 21:13:56

In reply to serzone dose, posted by allisonm on April 5, 2001, at 18:03:51

>I've been on serzone for about 6 or 7 weeks and I've really had a bad time with it. My doc wanted me to start on 100 mgs for only about a day and then up it to a divided dose of 200 mgs. I titrated it much more slowly based on some stuff I read on this board and I still had an awful time with side effects. I felt cognitively impaired; I had trouble with some motor functions; I couldn't sleep very well; and I felt incredibly sluggish during the day. I became very depressed and felt emotionally dead. Things got so bad that I became obsessively suicidal, and my therapist started raising the issue of a hospital stay. It's not at all clear to me whether I got so depressed as a side effect to the meds, or as a reaction to the side effects. I was so fatigued, and each day felt shorter because I had no energy to do anything. My pdoc switched so that I took all 200 mgs at night. This made a huge difference in how I felt during the day. I frequently take clonopin at night also. I have to be careful, because I can have alot of trouble getting up in the morning. However once I force myself out of bed and start moving around, I lose that foggy feeling.

The jury is still out on this drug - I've noticed no therapuetic effect, but at least the side effects are not as much of an issue anymore. I want to stick with it to see if I can get some anti=depressant effect, but given my recent experience, I'm trying to be diligent about the side effects too. I've recently upped my dose to 250 mgs taken at night, and I'll go up to 300 as soon as I'm sure I can handle 250. Good luck - you may have to go through a fairly lengthy adjustment period, but I'm hoping it'll prove to have been worth it.

Mair (fna ksvt)

 

Re: serzone dose

Posted by allisonm on April 5, 2001, at 21:32:45

In reply to Re: serzone dose, posted by mair on April 5, 2001, at 21:13:56

Dear Mair,

I've missed you! Sorry to hear about your Serzone experience. You and I seem to be following in each other's footsteps...

My pdoc said he's found that either his patients have no side effects and good response, no side effects and no response, or bad side effects. If the side effects are that bad, I don't know whether I would be able to last as long as you have. It took about 8 weeks or more to get to get over the Celexa side effects and to where I am now, which is better, but I still feel lethargic, hence the switch. This is my eighth antidepressant in three years. I am alternately hopeful and extremely weary of this.

Let me know how things go. Thanks for writing!

allison

 

Re: serzone dose » allisonm

Posted by Mair on April 6, 2001, at 21:55:43

In reply to Re: serzone dose, posted by allisonm on April 5, 2001, at 21:32:45

> Allison - what a treat to hear from you? Of the 3 possible reactions your doc suggested, does bad effects mean no response? I'm pretty determined to give this drug a chance, but I have to get through some rough periods to do this. Now that I've upped it to 250 mgs for the last few days, I'm starting now to feel some of the same lethargy/paralysis I felt before. It was pretty discouraging at work today. I sort of took stock at the end of the day and realized that I had been able to squeeze into a full day, about 1 hour of constructive work. The rest is pretty much living in my head - staring out the window, jumping all over the place from thought to thought.

I don't know what made me stay on it before through some really awful periods. It might be stubborness or maybe just the paralysis that hit me with the drug. Any task, no matter how easy, seemed overwelming. This included calling or emailing my doc which I didn't do until my therapist got really pretty pushy about it and I started feeling like I couldn't make it through the 5 or 6 days remaining until my next appointment. I think part of it is that this is, in combination or alone, the 7th or 8th AD I've taken. I try not to get my hopes up with any of these, but each time one doesn't work, I feel like I've lost yet another possible solution and of course worry that there will be no options. It does get wearying and it's hard after awhile to generate enthusiasm.

I think we must be on the same track. After my last drug failure and a break in between, I was supposed to start on Celexa. That was with my last doc who recently retired. I just didn't feel good about it because I've never had much success with SSRIs. When I hooked up with my new doc, I was more than willing to go in a different direction. I'm on Wellbutrin too and klonopin also.

Thanks for writing - keep me posted on how you fare with this.

Mair

 

Re: serzone question

Posted by Noa on April 9, 2001, at 10:38:13

In reply to Re: serzone question, posted by loosmrbls on April 5, 2001, at 8:01:46

I take my entire dose of 350 at night. I had started taking it near bedtime, but switched to earlier in the evening because it took a while to take effect and then also to wear off.

Lately, I am taking it closer to bedtime again because if I go to the gym in the evening, the serzone can affect my balance ever so slightly (not enough to make a difference anywhere else in my life, but enough to make the workout just a bit cumbersome), and I discovered that I don't have the same problems of being groggy in the morning anymore. This is after being on it over a year!

But during the first month of starting it I was groggy all the time, and had balance and coordiantion problems as well as emotional swings. All that wore off after a few weeks.

 

Re: serzone question » Noa

Posted by mair on April 9, 2001, at 22:00:43

In reply to Re: serzone question, posted by Noa on April 9, 2001, at 10:38:13

>
> But during the first month of starting it I was groggy all the time, and had balance and coordiantion problems as well as emotional swings. All that wore off after a few weeks.

Noa - How long did it take you to get up to 350 mgs? When you talk about the side effects wearing off after a few weeks, is that a few weeks after you landed at 350? How long before you felt therapeutic benefits and did you start to feel these before you hit the 350 level. At different times for me the side effects have been awful. I've received no benefit yet but I hold on in the hope that the benefit will come. At some point I need to consider whether the side effects pose too great a risk. Thanks K

 

Re: serzone question

Posted by Noa on April 9, 2001, at 22:57:11

In reply to Re: serzone question » Noa, posted by mair on April 9, 2001, at 22:00:43

I started to feel desired effects at around 200, I think. I took 300 for about a year, then increased to 350 after I decreased another medication.

I don't remember exactly, but I think the grogginess and coordination problems, etc. started to wear off after I had gotten up to 150 or so and had been there a few weeks.

 

Re: serzone question

Posted by e503 on April 10, 2001, at 15:31:07

In reply to Re: serzone question, posted by Noa on April 9, 2001, at 22:57:11

I went up to 150 mg. at night of serzone last night. I was taking 100 mg. /night. I am thinking about going off of it. I feel like sh/t. I am really tired/groggy during the day and just started to get nauseous. Once I fall asleep at night, I can sleep EASILY for a LONG time ----- i can't get myself out of bed! I hate this stuff. So....how do I taper myself off of it?

 

Re: serzone question

Posted by Sunny on April 10, 2001, at 16:28:46

In reply to Re: serzone question, posted by e503 on April 10, 2001, at 15:31:07

e503,
I've been on Serzone for a while now (only 150mg), and I had the same symptoms as you to start - incredible, paralyzing sedation. But, I kept with it, and now I have virtually no side effects. My sedation symptoms wore off when I made two changes - 1) spliting my total daily dose into 4 separate doses & 2) having a cup of coffee in the morning (seems simple, but I've been off caffeine for years). Also, the nausea should go away. Try keeping bland crackers around, also hard candy (helped to soothe my stomach & with dry mouth). I made these changes after being on the serzone for ~ 3 months.
For me, these symptoms were relatively easy to deal with - but I know they may not be for you.
Good luck!

> I went up to 150 mg. at night of serzone last night. I was taking 100 mg. /night. I am thinking about going off of it. I feel like sh/t. I am really tired/groggy during the day and just started to get nauseous. Once I fall asleep at night, I can sleep EASILY for a LONG time ----- i can't get myself out of bed! I hate this stuff. So....how do I taper myself off of it?

 

Re: serzone question

Posted by e503 on April 10, 2001, at 16:38:24

In reply to Re: serzone question, posted by Sunny on April 10, 2001, at 16:28:46

Sunny,

do you th ink I should just take 37.5 mg/ 4 x a day starting today??? Is it ok to do that? From taking all 150 mg. at night?

elise

 

Re: serzone question

Posted by Noa on April 10, 2001, at 16:52:54

In reply to Re: serzone question, posted by e503 on April 10, 2001, at 16:38:24

Talk to your pdoc about this. Have you tried taking the dose a bit earlier so it will wear off by morning? Or, like you said, breaking the dose up? How long have you been on it? I think I find it less sedating than in the beginning, and definitely I don't have the grogginess and zombiness I had during the first month.

 

Re: serzone question

Posted by e503 on April 10, 2001, at 21:03:13

In reply to Re: serzone question, posted by Noa on April 10, 2001, at 16:52:54

i hate this stuff. I feel horrible. I want to cut it out. How much should I take tonight? (I started at 150 mg. last night). I hate it. How do I taper down?

 

Re: serzone question » e503

Posted by Stagalee on May 11, 2001, at 17:41:30

In reply to Re: serzone question, posted by e503 on April 10, 2001, at 21:03:13

> i hate this stuff.

I started on Serzone just 3 days ago, took the first dose of 100 mg on an empty stomach, and had a horrible night with dizziness, fuzzy peripheral vision, insomnia and even anxiety keeping me up until 4:30 AM. I talked to my doc and cut back to 25 mg twice a day then back up to 50 mg at night just after dinner, and though I am a little wobbly even the next morning I am pretty much OK and have given presentations and driven with no problem.

Lots of folks seem to have the experience that the side effects went away when they went slowly and just kept with it for several weeks, even through dose escalation. Despite my awful start I am going to stick with it in the hopes that the side effects go away and the benefits kick in at 4-6 weeks as advertised. It seems like there is room for you to give it more of a chance.

 

Re: serzone question

Posted by Pharma on May 12, 2001, at 6:15:10

In reply to Re: serzone question, posted by Sunny on April 10, 2001, at 16:28:46

Geez, I take 300mg a day (at night) of Serzone. That is the maximum dose allowable here in Australia. I do have a lot of nasty side effects though. I get dizziness, confusion and excess sedation and I have taken 330mg a day for over six months. I want to stop taking it as I can feel some symptoms of SErotonin Syndrome starting to surface.

 

Re: serzone question

Posted by Sunny on May 14, 2001, at 16:51:11

In reply to Re: serzone question, posted by e503 on April 10, 2001, at 21:03:13

e503,
If you feel so strongly about the serzone, you should definitely talk to your pdoc about other alternatives. You don't need to suffer more! I'm sure there is some med out there that will help you feel better with out side-effects that you find intolerable. (I know how you feel about having an instant negative reaction to a med. I was on Wellbutrin for about 2 weeks and positively HATED it. My pdoc wanted me to give it another week - but I said NO! I wasn't willing to go through any more of the side-effects.)
Good luck!

PS: have you tried the coffee? & splitting the dose?
> i hate this stuff. I feel horrible. I want to cut it out. How much should I take tonight? (I started at 150 mg. last night). I hate it. How do I taper down?

 

Re: serzone question

Posted by pami on May 19, 2001, at 13:20:01

In reply to Re: serzone question, posted by Sunny on May 14, 2001, at 16:51:11

Hello,

I have been on Serzone for 6 weeks, the first 3 were also spent weaning off Zoloft. I wanted to loose the "sexual side affect" as my husband was becoming a bit frustrated with me. I was started on 100mg at night for 4 days, added another 100 for 4 days. Added 100mg in the morning 4 days later, and the last 100mg in the morning for a total of 400mg, 200before bed and the other 200 in the morning. My reason for taking any antidepressant is mainly so I don't honk at bad drivers! Also a mild case of depression that runs through my family.

I can barely stay awake during the day, my memory is not functioning, and I'm crankier than ever in the car. I'd like to quit, but see my doc in a week. Please help with any suggestions.

Thank you.

 

Re: serzone question

Posted by Sunny on May 22, 2001, at 10:44:11

In reply to Re: serzone question, posted by pami on May 19, 2001, at 13:20:01

Pami,
I hope you've seen your pdoc! I'm a fan of serzone, because I've found a way to manage the side effects (in the beginning it made me SOOOO sleepy; and with every dose increase, it still does). I worked with my pdoc to develop a dosing schedule that fits my life - 3x per day, with the largest dose before bedtime. And I started drinking coffee in the morning. If you haven't been scared off by your experience, you might want to talk to your doctor about dosing times.

Also, there are several posts that discuss a slow taper up for serzone. I'm not sure what opinions other pdocs have about a slow start, but mine started me on 25 mgs once per day for a week. Increases were in 25 mg doses, no more than once per week. I'm now at 225 mgs total which works well for me. Some people have said that serzone has a very narrow theraputic dowing window and rapid increases in dose can sometimes result in blowing right past your theraputic window. Hope this helps.
PS: The coffee & "mini"meals (apple with PB; hummos & pita; a few pretzels) througout the day helped me deal with the sedation.


> Hello,
>
> I have been on Serzone for 6 weeks, the first 3 were also spent weaning off Zoloft. I wanted to loose the "sexual side affect" as my husband was becoming a bit frustrated with me. I was started on 100mg at night for 4 days, added another 100 for 4 days. Added 100mg in the morning 4 days later, and the last 100mg in the morning for a total of 400mg, 200before bed and the other 200 in the morning. My reason for taking any antidepressant is mainly so I don't honk at bad drivers! Also a mild case of depression that runs through my family.
>
> I can barely stay awake during the day, my memory is not functioning, and I'm crankier than ever in the car. I'd like to quit, but see my doc in a week. Please help with any suggestions.
>
> Thank you.

 

Re: serzone question

Posted by dove on May 23, 2001, at 9:04:03

In reply to Re: serzone question, posted by Sunny on May 22, 2001, at 10:44:11

>
> I'm a fan of serzone, because I've found a way to manage the side effects (in the beginning it made me SOOOO sleepy; and with every dose increase, it still does). I worked with my pdoc to develop a dosing schedule that fits my life - 3x per day, with the largest dose before bedtime. And I started drinking coffee in the morning.
>

I take a number of meds and Serzone is one of them. I take 400mgs per day, split up into 4 - 100mg doses. I definitely feel the effect if I take them too close together, and sleepy just about describes it. However, when taken in four separate doses, Serzone is truly a wonderful med for me.

One other item about discontinuation, if I miss a dose of Serzone I feel the effects about one hour later. I get very nauseous, my stomach moans in agony, my head throbs and I feel disconnected. So, should you decide to taper, keep these thoughts in mind, slow and low.

Best of luck to you!

dove

 

Re: serzone question

Posted by Leighwit on May 24, 2001, at 15:46:24

In reply to Re: serzone question, posted by Sunny on May 22, 2001, at 10:44:11

I started Serzone a few weeks ago using a starter "package" Bristol-Myers recently started using which provides a specifically scheduled ramp-up that is different from what was recommended a few years ago. (A slower ramp-up I believe, but am not sure about that.) Are you using that one, Pami? (50 mg. the first five days; 100 for the next seven, 150 mg for another seven days, and then 200 mg for two days. It's divided into two doses per day. Tomorrow is my first day on 200 mg. I saw my Pdoc today and complained of confusion and fatigue. She said those are common side effects, and recommended taking entire dosage at bedtime. She has several patients doing that, with success.

She also said the therapeutic dosage now is 400 mg and that it's a change from the past. (Higher I think she said.)

You might want to try it at bedtime and see if there's any improvement. That's what I'm going to do. Best of luck,

Leighwit

> Pami,
> I hope you've seen your pdoc! I'm a fan of serzone, because I've found a way to manage the side effects (in the beginning it made me SOOOO sleepy; and with every dose increase, it still does). I worked with my pdoc to develop a dosing schedule that fits my life - 3x per day, with the largest dose before bedtime. And I started drinking coffee in the morning. If you haven't been scared off by your experience, you might want to talk to your doctor about dosing times.
>
> Also, there are several posts that discuss a slow taper up for serzone. I'm not sure what opinions other pdocs have about a slow start, but mine started me on 25 mgs once per day for a week. Increases were in 25 mg doses, no more than once per week. I'm now at 225 mgs total which works well for me. Some people have said that serzone has a very narrow theraputic dowing window and rapid increases in dose can sometimes result in blowing right past your theraputic window. Hope this helps.
> PS: The coffee & "mini"meals (apple with PB; hummos & pita; a few pretzels) througout the day helped me deal with the sedation.
>
>
> > Hello,
> >
> > I have been on Serzone for 6 weeks, the first 3 were also spent weaning off Zoloft. I wanted to loose the "sexual side affect" as my husband was becoming a bit frustrated with me. I was started on 100mg at night for 4 days, added another 100 for 4 days. Added 100mg in the morning 4 days later, and the last 100mg in the morning for a total of 400mg, 200before bed and the other 200 in the morning. My reason for taking any antidepressant is mainly so I don't honk at bad drivers! Also a mild case of depression that runs through my family.
> >
> > I can barely stay awake during the day, my memory is not functioning, and I'm crankier than ever in the car. I'd like to quit, but see my doc in a week. Please help with any suggestions.
> >
> > Thank you.

 

Re: serzone dose

Posted by newjersey on May 27, 2001, at 20:06:06

In reply to serzone dose, posted by allisonm on April 5, 2001, at 18:03:51

I was just put on Serzone also at 50 mg 2 x daily.
Tomorow I start 100 mg 2 x daily. So far I seem to
be crying a little less often (down from 4-5 times
a day to 1 or 2)! I am also taking Ativan for my anxiety
since it is not supposed to interact with Serzone.
I am new to this bulletin board and found
it surfing the web. Anyone interested in discussing
their depression/anxiety and how to cope and
hopefully beat these conditions please do feel
free to email me. I would love to hear from you.
Thanks, Barb (waybar1@home.com)


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