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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by gp on June 3, 2001, at 16:45:54
Has anyone used this mix to temper the anxiety from Prozac?
Posted by PuraVida on June 4, 2001, at 17:02:37
In reply to prozac/serzone combo, posted by gp on June 3, 2001, at 16:45:54
I just started a few weeks ago. Below is the post I made after I got back from the doctors that tells more of the story (it's a bit long! :)
Anyhow, I've been ok, I guess, since the switch. I went down to 400 Serzone, and just 10 mgs of Prozac, and have been there for about 10 days. So far no really bad reactions. I am still finding I'm sleeping a lot, but the Prozac has, as I remember it did before, kinda lifted the fogginess out of my head. The Prozac seems to be lifting soem of the cognitive anxiety - making me feel a bit more confident, hopeful. I haven't touched the Neurontin yet - I'm afraid of weight gain, and just generally sick of so many pills. I'm going to try just the Serzone/Prozac combo for a month or so to see how I am.
Good luck - here is my super long post (had to get my frustrations out!)
PS Didn't get any feedback on the meds from anyone else, yet.
_________
> Whew! I feel like I'll be spending all day taking pills at this point! Any advice or comments on what transpired and what he prescribed are appreciated!
>
> Went to the doc this am - told him the 500 mgs of Serzone was making me tired, and not working - I'm uptight, can't seem to get any sense of well-being, and I can't control my impulses - eating binges/drinking/not exercising/sleeping too much. Also having nightmares (new)
>
> He told me that he saw a cycle - and that was that the medication, whatever I had tried in the past 5 years, was being negated by the alcohol I drink. I am quite sure that I'm not an alcoholic, as I've given a lot of thought and study to it, but I do know that I have a tendency to self medicate, be that through food, sleep or alcohol. It's just that alcohol is the least socially accepted - I feel that is why he is harping on it, or maybe he doesn't know what else to do/say. I can't imagine that loading myself up with carbs and fat helps my mood much, either, or staying in bed all day! Over 5 years I've been studying any links between my mood, types of food, alcohol, exercise, etc, and none of them seeem to have a drastic effect on my brain. Its not a problem to have just one or two drinks, just like its not a problem to have a simple meal, and stop there. The problem is when I'm down, or anxious, and alone, I use food or alcohol to sedate me - only when I'm alone. Its like if I'm a bit stressed, and if I have a bit of either, or both, and realize that it calmed me down, I keep going back for more to get the numb feeling.
>
> Anyhow, I told him (I'm a bit peeved about our conversation still) that I wouldn't be there talking to him if it was just a matter of motivation or self-discipline - that was the point! Then, I asked him if he'd consider giving me a very, very low dose of Topomax, and showed him an article that talked about the findings of Topomax helping binge eating disorders and helping anxiety. The guy wouldn't even look at it - said "oh - its an anti-convulsant, hasn't been proven to work for anything esle, and, its a stage four mood stabilizer, Lithium or Depakote being stage one." I begged, and it killed me that he wouldn't even SCAN the research I put in front of him.
>
> Anyhow, I felt like he just didn't think I had any problems - that I was expecting too much from the meds, looking to them to solve all of my problems. This, coming from the guy who a year ago said I'd need meds all my life, then in Feb 01 told me he wanted to wean me off meds entirely (after 5 years on)within the next year, and drasticaly dropped my Serzone dosage from 600 mgs to 400 mgs within a 2 week period (of course, I crashed, had to quit school and several projects -its been 3 months and I still haven't stabilized again, and I'm terrified of starting anyting new -just sitting here unemployed watching my brain and bank account drain away...)
>
> This I felt he was saying:"if you'd just..." (stop drinking, start exercising,be more disciplined..) NOT what I need to hear, and it isn't true. I did this to myself for years until I realized I was making things worse by beating myself up. Its like telling someone to exerise or diet away diabetes, or cancer - its preposturous (sp!.) It helps, but it isn't a cause, or a cure. I've read and tried almost everything known to man (it seems!) in the past five years - my conclusion is that there are no "if justs" - there are plenty of people out there who don't exercise ever, who drink everyday, who have a lot more stress than I do, who are not nearly as lucky as I am, yet their balanced brains keep them trucking along. Can you tell I'm steamed? :)
>
> So, now I'm on 500 mgs Serzone (300 at bedtime, 200 in am.) I also have a scrip for Serax, as needed, up to 20 mgs a day. When I had my first and only panic attack a few months ago I took 20 mgs every day for a few days, but now I'm scared of getting addicted to the Serax, and only take it when I feel really keyed up - and though it does help me with the binging (a lot!) I haven't taken it it ever to prevent or stop a binge. Maybe I should, but it seems to me I'm just substituting relaxants around...
>
> Now I'm adding 10 mgs of Prozac the first week, upping to 20 mgs. The neurontin I'm supposed to take 300mgs at night for 3 days, then increase to 600 mgs at night.
>
> My plan is (tell me what you think) to wait a few weeks before I try the neurontin - I want to try just the Prozac first, and maybe (if I'm still feeling tired in a few weeks) cut down the Serzone, so I end up a month from now at 400 mgs or Serzone and 20 of Prozac. I don't know, I just don't trust the doc anymore, and really feel I know my body (and mind) best. I'm scared of taking so much medication.
>
> But, I'm actually looking forward to the prozac - the two times I've taken it alone I really had a nice "I can handle it feeling" for the most part. The first time I went off it I was feeling a little too keyed up - the second time I was at 50 mgs and I think maybe it pooped on me. I am hoping the prozac will stimulate me enough to set off any tiredness I get from the Serzone, as well as the gain in weight/appetite I've heard the neurontin might give.
>
> Thanks for letting me blow off some steam... :)
>
> Trying to be optomistic - but its hard!> Has anyone used this mix to temper the anxiety from Prozac?
Posted by gp on June 4, 2001, at 18:33:11
In reply to prozac/serzone combo, posted by gp on June 3, 2001, at 16:45:54
geeze thats alot of drugs pura, i guess i should have mentioned when i said "temper" i meant taking
a really small dose of serzone,100~150mg per day.
nowhere near "theraputic" doses. i suspect i would feel like a zombie at those doses. maybe i'm one of the lucky ones, prozac did miracles for me but made me a bit antsy. all i wanted to do is moderate the anxiety and this seems to be working quite well. i had to drop down to 50mg serzone in the morning as i was feeling a little too tired, i take 75mg at night and sleep like a baby. i was wondering if anyone else had some success like mine. ps. if what you say about your doc is really true, change docs, he's a prick
Posted by PuraVida on June 4, 2001, at 19:11:52
In reply to Re: prozac/serzone combo, posted by gp on June 4, 2001, at 18:33:11
Thanks for your feedback - I think I probably should change docs, despite my therapist advising me that he is probably the best (this is Kaiser we are talkng about, though!)
I found the anxiety too with Prozac, and think the Serzone in addition may be the answer this time----
Good luck -
> geeze thats alot of drugs pura, i guess i should have mentioned when i said "temper" i meant taking
> a really small dose of serzone,100~150mg per day.
> nowhere near "theraputic" doses. i suspect i would feel like a zombie at those doses. maybe i'm one of the lucky ones, prozac did miracles for me but made me a bit antsy. all i wanted to do is moderate the anxiety and this seems to be working quite well. i had to drop down to 50mg serzone in the morning as i was feeling a little too tired, i take 75mg at night and sleep like a baby. i was wondering if anyone else had some success like mine. ps. if what you say about your doc is really true, change docs, he's a prick
Posted by Sunnely on June 4, 2001, at 23:58:14
In reply to prozac/serzone combo, posted by gp on June 3, 2001, at 16:45:54
Hi gp,
Believe it or not, the combination of Prozac + Serzone may provoke or worsen anxiety.
Serzone is metabolized into 3 main compounds. One of these metabolites is called meta-chlorophenylpiperazine or mCPP, which is supposedly an "anxiogenic" (induces anxiety) compound. This metabolite appears to be broken down by an enzyme called CYP2D6. Prozac is known to markedly inhibit the action of this enzyme, which could to decreased clearance of mCPP, in turn leading to increased anxiety.
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> Has anyone used this mix to temper the anxiety from Prozac?
This is the end of the thread.
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