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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 bigcat on June 25, 2006, at 9:02:17
My doctor recently told me the dose for Serzone/Nefazadone can go all the way up to 1200mg. I called her out on that figure immediately, as I thought 600mg was the upper end of the dose range. (She's generally a conservative prescriber- won't take effxor over 225mgs), so I was just wondering if it really went that high? I've been on it for two weeks and just reached 500mgs- so far it seems to be sapping my energy and making me even more noticeably mute and withdrawn than usual, though it could just be that the depression has gotten worse now that I've lost hope in ad's. I'm treatment resistant and able to tolerate very high doses. Anyone have any luck or experience with the buspar, pindolol, and nefazadone combo? If so, at what doses? It would be nice to know if the nefazadone really does go that high, because a while back I did have one great day on it (at 500mgs), a feeling that didn't last or come back when I upped the dose to 600mgs. Hope you all are well...
-matt-
Posted by willyee on June 25, 2006, at 14:23:45
In reply to 1200mgs of Serzone?!?, posted by bigcat on June 25, 2006, at 9:02:17
> My doctor recently told me the dose for Serzone/Nefazadone can go all the way up to 1200mg. I called her out on that figure immediately, as I thought 600mg was the upper end of the dose range. (She's generally a conservative prescriber- won't take effxor over 225mgs), so I was just wondering if it really went that high? I've been on it for two weeks and just reached 500mgs- so far it seems to be sapping my energy and making me even more noticeably mute and withdrawn than usual, though it could just be that the depression has gotten worse now that I've lost hope in ad's. I'm treatment resistant and able to tolerate very high doses. Anyone have any luck or experience with the buspar, pindolol, and nefazadone combo? If so, at what doses? It would be nice to know if the nefazadone really does go that high, because a while back I did have one great day on it (at 500mgs), a feeling that didn't last or come back when I upped the dose to 600mgs. Hope you all are well...
>
> -matt-
Not to add a a scare factor or anything,but wasnt serzone notorious for possably damaging the liver,in fact banned in certain places or something,im not sure if there was a tweak to the med or some type of change,i dont know the follow up just remeber reading a story on a girl who made me so sad on it and the liver problems she had.If it were still true in any way,a med that needs to be watched in vivo ur liver would be one id think ud want to make slow changes too,not one you wanna make such a drastic dose chance,you might want to research serzones status as of now unless u know more about it than i do as far as that goes.
Like i said i hope im just outdated on this and something changed,but i do remeber it was quite serious at the time.
Posted by bassman on June 25, 2006, at 15:09:27
In reply to Re: 1200mgs of Serzone?!?, posted by willyee on June 25, 2006, at 14:23:45
That's right-Serzone was taken off the US market in 2004 for cases of liver failure and prior to that it was taken off the market in Canada. So it really doesn't seem like a good idea to go to a very high dosage, it would seem...maybe worth double checking for your own health/piece of mind.
Posted by Tom Twilight on June 25, 2006, at 17:03:23
In reply to 1200mgs of Serzone?!?, posted by bigcat on June 25, 2006, at 9:02:17
Hey Matt
I'm in agreement with others
You should get your Liver checked, especially for such a high dose
I know this isn't a good time to ask but I was wondering if you could recommend any Pdocs?
I've been thinking of traveling for treatment for a while, but so far haven't had much luck finding docs.
Take care of yourself anyway
Posted by bigcat on June 25, 2006, at 19:53:41
In reply to Re: 1200mgs of Serzone?!?, posted by Tom Twilight on June 25, 2006, at 17:03:23
thanks ya'll. i can't think past the pain I feel today, so dangers of liver damage wouldn't really deter me at this point. i've tried everything else essentially, serzone was just one question mark I've had lingering. hey Tom- umm I have the contact info of a doc that will prescribe you 90mgs of nardil or parnate or an adequate benzo dose if that's what you're looking for (since the UK seems to hate effective medications). but as far as a doc worth crossing the seas for, I haven't come across one (I live in Connecticut, in the Northeast about 2 hours from NYC). if I remember correctly, you had a pdoc who wouldn't take you above 30mgs of Marplan, which is absolutely ridiculous. let me know if there is anything I can do on this end.
Posted by Tom Twilight on June 26, 2006, at 6:29:29
In reply to Re: 1200mgs of Serzone?!?, posted by bigcat on June 25, 2006, at 19:53:41
Thanks Matt
If you could babblemail me the detailes of any decent docs you know of it would be good.
Its great that you live in on the East Coast, at least its somewhere I can get to (theoreticly)
For the record the Pdoc I saw said I could go up to 50mgs of Maplan (!) my GP let me go up to 60mg
(thats the maxiumun dose allowed in the UK).Seriously I don't know whats wrong with the medical culture here, my GPs got this idea that you have to be on an AD for at least 6 months to know if it will work.
Now he's angry with me because I discontinued the Marplan.
Regarding the Liver concerns there are supplements that supposed help with Liver issues.
Milk thistle is the one I keep hearing about, sorry thats all I can think of off the top of my head!
Take care anyway
Posted by willyee on June 26, 2006, at 12:22:12
In reply to Re: 1200mgs of Serzone?!?, posted by Tom Twilight on June 26, 2006, at 6:29:29
> Thanks Matt
>
> If you could babblemail me the detailes of any decent docs you know of it would be good.
>
> Its great that you live in on the East Coast, at least its somewhere I can get to (theoreticly)
>
> For the record the Pdoc I saw said I could go up to 50mgs of Maplan (!) my GP let me go up to 60mg
> (thats the maxiumun dose allowed in the UK).
>
> Seriously I don't know whats wrong with the medical culture here, my GPs got this idea that you have to be on an AD for at least 6 months to know if it will work.
>
> Now he's angry with me because I discontinued the Marplan.
>
> Regarding the Liver concerns there are supplements that supposed help with Liver issues.
>
> Milk thistle is the one I keep hearing about, sorry thats all I can think of off the top of my head!
>
> Take care anywayAgain i hate to be a bummer,i know there is long term liver damage,i.e kava over long use,alcholol etc.
Like u guys id risk this in respect to a working drug,HOWEVER i seen the msn and other legitie sites coverage,and were not talking mild damage to the liver,the girl that passed on was in her teens,suffering from bad depression,otherwise totaly healthy,it came on in a snap.
She spent christmas in the hopsital where a new liver was rejected twice,were not talking long term liver damage,were talking in the case scenerios the drug shreded the liver and destroyed it instantly.Milk thistle is a weak herb recomended to be overall healthy for ur liver,in the long run,but milk thistle is not gonna protect the liver from toxic damage or immediate damage.
I am not one to be afraid of walking thin lines of wanring,the warnings of liver damage progressivly being done i would not mind,but i seen this,in fact i saved it,it was some serious looking stuff,im only re stating it cause u may feel right now like u dont worry but the last thing u want on top of fighting the depression is having severe liver problems,at that point id imagine any med would be a problem.
Remeron if im not mistaken is the cousin to serzone,newer and improved,if u r on serzone anyway,have u ever tried remeeron,they both,serzoe and remeron are sedating type of meds,so remeron should offer any thing in a more negative light id assume.
Posted by Tom Twilight on June 26, 2006, at 13:22:30
In reply to Re: 1200mgs of Serzone?!?, posted by willyee on June 26, 2006, at 12:22:12
Sorry didn't mean to suggest that Supplements
were a substitute for Liver tests!Neither did I mean to say that supplements could make drugs that can cause heptic damage safe.
The other supplement which is supposed to help proctect the Liver is N-Acetyl-Cysteine.
Posted by willyee on June 26, 2006, at 16:07:37
In reply to Re: 1200mgs of Serzone?!? Liver, posted by Tom Twilight on June 26, 2006, at 13:22:30
> Sorry didn't mean to suggest that Supplements
> were a substitute for Liver tests!
>
> Neither did I mean to say that supplements could make drugs that can cause heptic damage safe.
>
> The other supplement which is supposed to help proctect the Liver is N-Acetyl-Cysteine.No personaly i think ur right,if u indulge in liver contaminating stuff,meds,drinking etc,it is definatly smart to do the most to protect ur liver as best u could.
Milk thistle is a great herb for that,but u have protecting it from something that eats at it,and u have at times a drug or substance that literaly attacks the liver dead on,and for those i doubt anything even short of a new liver is help.
I remeber the sick feeling i had,looking at the pic.It was a young girl,a oprhan.She was being treated for depression,.....she was taking the drug in hopes of it helping her,and instead the poor girl ended up in the hospital on christmas,fighting for her life,the pic shows her in her last days and its such a sad sad sight,all i could think of was how someone failed this girl,she did the right thing and took the drugs,sought the help,and someone failed her.
Anyway im all for otc products that over long term benifits,i.e FISH OIL,GARLIC,B-VITAMINS,MILK THISTLE and prob a ton more.
Its just some things are just violently toxic,its a shame these slide through the loops sometimes and get us.
Posted by idolamine on June 30, 2006, at 20:24:33
In reply to 1200mgs of Serzone?!?, posted by bigcat on June 25, 2006, at 9:02:17
Serzone should be titrated upwards. The max suggested dose is 600mg, but it was common when it was mainstream to go above 600, but not to 1200!! Serzone is a drug that is subtle and slow when it comes to working. If you're too knocked out, go upwards more slowly. The incidence of liver problems is about one in every 15,000 patient years, very approximately. Incidence of liver trouble began at one week and extended 6 months into therapy. Liver damage was both dose and time related. Your chances are low overall, but maybe bimonthly (?) liver enzyme tests would be good. I think the upper limit is 300 for alananine transaminase and aspartate transaminase. If it works for you, it works. Pinodol is a beta blocker, which may not be good to use with nefazadone since both will lower blood pressure. Buspar would, in my opinion, probably make you feel more depressed unless you added a more powerful ssri like prozac. Good luck!
> My doctor recently told me the dose for Serzone/Nefazadone can go all the way up to 1200mg. I called her out on that figure immediately, as I thought 600mg was the upper end of the dose range. (She's generally a conservative prescriber- won't take effxor over 225mgs), so I was just wondering if it really went that high? I've been on it for two weeks and just reached 500mgs- so far it seems to be sapping my energy and making me even more noticeably mute and withdrawn than usual, though it could just be that the depression has gotten worse now that I've lost hope in ad's. I'm treatment resistant and able to tolerate very high doses. Anyone have any luck or experience with the buspar, pindolol, and nefazadone combo? If so, at what doses? It would be nice to know if the nefazadone really does go that high, because a while back I did have one great day on it (at 500mgs), a feeling that didn't last or come back when I upped the dose to 600mgs. Hope you all are well...
>
> -matt-
This is the end of the thread.
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