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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 hawaiistaci on May 17, 2004, at 2:29:48
After the birth of my baby over a year ago, Zoloft stopped working to control my depression. My psychiatrist switched me to Serzone and eventually I was taking 600mg. Although it controlled my depression, anxiety, and mild OCD, it made me so confused I just couldn't continue taking it. Not only was I forgetful about conversations I'd had and things I'd done, I became worried I'd forget something major like my daughter at the grocery store. I was that confused. I'm now on 450mg of Wellbutrin, and while it's controlling my depression my anxiety is back in a BIG way. My dr suggested keeping the dosage the same and adding back 200mg - 300mg of Serzone to help with the anxiety. Anyone else on Wellbutrin and Serzone? Does this sound like a reasonable plan for anxiety and depression? I'm considering lowering the dosage of Wellbutrin to 300mg for a few weeks and see if that helps. Any suggestions would be helpful.
PS I accidentally posted this to the substance forum and apologize if any of you are reading it twice.
Posted by RobertPalsing on May 17, 2004, at 6:02:06
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
Wellbutrin is known to sometimes cause anxiety increase and sleep deprivation. Have you tried any other SSRIs? (Lexapro, Prozac, etc)
Posted by Dr. Bob on May 17, 2004, at 7:58:06
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
Posted by bride2be on May 17, 2004, at 6:21:51
In reply to zoloft, then serzone, then wellbutrin, help!, posted by hawaiistaci on May 17, 2004, at 2:20:31
have you asked your doctor about lexapro for the anxiety. you shouls go to the med board and read all the posts by people that are on lexapro. i know there are a few that take lex and wellbutrin and it works great for them. i have never heard of serzone. but if it makes you feel better there a many many people who have to take 2 or more meds to feel normal and happy. but you really should ask your doc about lexapro since it is more for anxiety. anymore questions, let me know.
Posted by King Vultan on May 17, 2004, at 8:01:10
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
Be careful here because one of the metabolites of Serzone, mCPP, is cleared by the CYP-450 2D6 enzyme, and Wellbutrin is a powerful inhibitor of this enzyme. What this means is that at the dosages of Wellbutrin you are talking about, the 2D6 enzyme is going to get tied up to such an extent that the levels of mCPP in your bloodstream may rise to much higher levels than they would otherwise--this may be on the order of of two to five times normal. Because mCPP is pharmacologically active, it is important to at least be aware of this, and it may be more prudent to start at a lower level of Serzone than you would otherwise.
You might want to consider adding back an SSRI to see if it might help with your anxiety if the Wellbutrin seems to be controlling the depression. I would suggest Paxil, but there are horrendous CYP-450 interactions between Wellbutrin and Paxil, and IMO these two drugs should not be combined. I'm not aware of any interactions between Lexapro/Celexa and Wellbutrin, though.
Todd
Posted by Waterlily on May 17, 2004, at 15:41:32
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
Wellbutrin + Serzone is worth a shot. I have been experimenting with adding things to Wellbutrin to control anxiety and Serzone is one of the ones that seemed to work. It was a little difficult to tell at the time, but in retrospect, I do think that it worked. I went off of it only because I wanted to see if my eye dryness would improve (it didn't). I've also tried imipramine (worked okay, but made my mouth really dry), Paxil (didn't work, libido problems), Prozac (didn't work), Effexor (worked, but gave me terrible insomnia), and now Luvox. I'm mentally stable and relatively happy with Luvox, except for the libido problems. After three years of psychotherapy, I just graduated last month so I guess that Luvox is the best so far. Just hope that things stay this way.
Posted by visionmachine on May 19, 2004, at 13:56:54
In reply to Re: Zoloft, then Serzone, then Wellbutrin, need help., posted by Waterlily on May 17, 2004, at 15:41:32
You might be interested to know that Serzone (nefazodone) was recently banned in Canada due to reports of liver failure: http://www.hc-sc.gc.ca/english/protection/warnings/2003/2003_83.htm
I believe that several countries in Europe have also banned the drug. The FDA has also required the drug carry a black box warning: http://www.consumerjusticegroup.com/serzone.htm
Posted by Waterlily on May 19, 2004, at 16:15:47
In reply to Re: Zoloft, then Serzone, then Wellbutrin, need help., posted by visionmachine on May 19, 2004, at 13:56:54
> You might be interested to know that Serzone (nefazodone) was recently banned in Canada due to reports of liver failure: http://www.hc-sc.gc.ca/english/protection/warnings/2003/2003_83.htm
>
> I believe that several countries in Europe have also banned the drug. The FDA has also required the drug carry a black box warning: http://www.consumerjusticegroup.com/serzone.htmYes, I'm aware of this and my pdoc told me about it. He had a baseline liver enzyme blood test done on me before I started taking it and periodically thereafter. He said that if anything started to go out of whack we'd catch it before it did any damage.
Posted by francesco on May 19, 2004, at 16:31:50
In reply to Re: Zoloft, then Serzone, then Wellbutrin, need help., posted by Waterlily on May 17, 2004, at 15:41:32
Sorry to jump in this conversation but I'm going to start Luvox tomorrow and I'm a bit concerned about sexual side-effects becuase my libido is already compromised by prostatitis problems.
Is it really that bad ? How do you compare it with other SSRIs under this respect(if you have tried some of the other) ? Which areas of sexual fuctioning affects for you ? (just libido or delayed ejacution, erection problems or what else ?)
Anyway, glad to see it's working for you, hope it will work for me too. By the way, which dosage are you on ? Other side-effects ? Oh, my god, sorry for all these questions, but I'm a bit anxious about it : )
Thanks !!!
Posted by allisonm on May 20, 2004, at 19:06:13
In reply to Zoloft, then Serzone, then Wellbutrin, need help., posted by hawaiistaci on May 17, 2004, at 2:29:48
I took Wellbutrin and augmented with Serzone for awhile. It seemed to be the best combination in about 5 years of trying to find something to quell anxiety/major depression. I was switched to Zoloft, though, about 18 months ago. It with the WB works better for me.
Posted by Waterlily on May 21, 2004, at 20:21:45
In reply to Luvox sexual side-effects » Waterlily, posted by francesco on May 19, 2004, at 16:31:50
> Sorry to jump in this conversation but I'm going to start Luvox tomorrow and I'm a bit concerned about sexual side-effects becuase my libido is already compromised by prostatitis problems.
>
> Is it really that bad ? How do you compare it with other SSRIs under this respect(if you have tried some of the other) ? Which areas of sexual fuctioning affects for you ? (just libido or delayed ejacution, erection problems or what else ?)
>
> Anyway, glad to see it's working for you, hope it will work for me too. By the way, which dosage are you on ? Other side-effects ? Oh, my god, sorry for all these questions, but I'm a bit anxious about it : )
>
> Thanks !!!Sorry I didn't see this post until today. How's the Luvox working for you? I imagine you're not experiencing anything positive yet, but hopefully you're not having too many side effects.
I have terrible problems with erections and ejaculation....wait a minute...I don't have the right anatomy for that. *sigh* Guys have all the fun. Sorry, Just couldn't help myself ;0)
Seriously, I've been on Wellbutrin for 9+ years almost continuously. I've tried Zoloft, Paxil, Prozac, imipramine, Effexor, Serzone, and now Luvox, all in combination with Wellbutrin. There's probably a few others that I forgot. Doc doesn't think it's wise to do away with the Wellbutrin. I have problems with climax and desire with the Luvox. If I was guy I'd be impotent. It's not as bad as Paxil, but not as good as Serzone or a few of the others. However, after having tried almost everything out there and after being exhausted from depression and anxiety, I am grateful for any length of time being mentally healthy. I started it in November and was desparate to get better before our Caribbean cruise in December. Thankfully, it worked. I did need ativan to offset the initial increased anxiety, but it really wasn't too bad and that went away within a few weeks anyway. I was even able to finish up with psychotherapy last month after 3 years. As long as Luvox works, I'll keep taking it unless something better comes along.
I have sleep problems, not sure if they're directly related to Luvox. Ativan or 1/2 an Ambien works nicely to get me to sleep.
I take 150 mg of Luvox daily, split into 100 mg in the morning and 50 in the evening. I also take 150 mg of generic Wellbutrin SR twice a day.
>
This is the end of the thread.
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