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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by garyengelm on December 16, 2007, at 17:32:09
I've been on Serzone 200mg bid for 4 years. I've tried to wean Serzone, but I get severe Akasthasia even just reducing 25mg. This last year, I've tried adding low doses of several SSRI's. The Serzone has pooped out and when I add say 1.25mg of Lexapro, I feel good for the first few days, but then I go into pre-Seratonin Syndrome, or so it seems. I get severe nausea with gagging, chills, body aches, diarrhea, rumbling stomach, literally on the couch all day in fron of the fireplace. Even adding 1.25mg of Lexapro to the Serzone does this and it has happened with celexa, and zoloft. All the symptoms go away after stopping the SSRI within 24hours. I feel stuck, as the Akatasia I get when I go down just a little bit on the Serzone is also unbearable. I feel like I'm gonna crawl out of my skin, my anxiety feels like I had 50 cups of cappachino and I can't sit still or think right. If I add the 25mg back to my system, I'm better within an hour.
The Serzone blocks the 5HT2A receptor, which helps anxiety, and I'm pretty sure, the decrease in dosage does something there. Not sure about the norepinephrine blockage is also part of the equation.
So, I'm thinking, if I could either make a complete switch or just go down on the Serzone and replace it with anohter SSRI, it might work. But if I'm on 400mg of Serzone, then what is the equivalent of Lexapro, or Zoloft, etc. I'm so sick of this crap, thank god for Xanax, whcih does nothing for the Akasthasia when it comes on.
Appreciate any input.
Gary
Posted by linkadge on December 16, 2007, at 20:48:48
In reply to Need Help..How do you switch from SERZONE to SSRI, posted by garyengelm on December 16, 2007, at 17:32:09
Have you ever tried trazodone? Its chemically related to serzone but without the liver stuff.
Some people do well on trazodone/SSRI combinations.
Linkadge
Posted by Justherself54 on December 16, 2007, at 21:39:34
In reply to Re: Need Help..How do you switch from SERZONE to SSRI, posted by linkadge on December 16, 2007, at 20:48:48
> Have you ever tried trazodone? Its chemically related to serzone but without the liver stuff.
>
> Some people do well on trazodone/SSRI combinations.
>
> LinkadgeIs trazodone the same as trazadone? Trazadone knocked me out for a night part of the following day, so it may be a real help for the severe akathesia the original poster experiences when trying to reduce the dosage..
Posted by Phillipa on December 16, 2007, at 23:08:47
In reply to Re: Need Help..How do you switch from SERZONE to S, posted by Justherself54 on December 16, 2007, at 21:39:34
I thought trazadone was not a good ad? Now I tried serzone and it was one of the better ones as has a lot of sedative properties which I need for my bad anxiety. Phillipa and that pdoc tried only higher doses of benzos on me and it made me worse went from sleeping to no sleeping.
Posted by linkadge on December 17, 2007, at 0:22:19
In reply to Re: Need Help..How do you switch from SERZONE to S, posted by Phillipa on December 16, 2007, at 23:08:47
Trazodone/trazadone, I'm sure I spelled it wrong, but its the same drug.
Its not really used much as a sole antidepressant like serzone is, but it does have properties that can make SSRI's more tollerable. It can reduce insomnia, and sometimes anxiety related to SSRI's.
Linkadge
Posted by Racer on December 17, 2007, at 0:39:45
In reply to Re: Need Help..How do you switch from SERZONE to S, posted by linkadge on December 17, 2007, at 0:22:19
> Trazodone/trazadone, I'm sure I spelled it wrong, but its the same drug.
>Actually, you spelled it correctly.
Posted by Racer on December 17, 2007, at 0:42:34
In reply to Need Help..How do you switch from SERZONE to SSRI, posted by garyengelm on December 16, 2007, at 17:32:09
I'd talk to your doctor about the best way for you to make a switch like that. It could be that a low dose of Zyprexa or Risperdal would help with the restlessness, and control your anxiety, while you make the transition. Or maybe a different benzo -- sometimes Ativan is more helpful, since it's a longer-acting medication.
Or, maybe Trazodone would help, or maybe something else. Since you can't prescribe any of them for yourself, you're probably best off talking to your doctor about this.
Good luck.
Posted by garyengelm on December 17, 2007, at 8:19:41
In reply to What does your doctor say? » garyengelm, posted by Racer on December 17, 2007, at 0:42:34
One psych doc told me to Start Lexapro at 5mg and stop Serzone on day 4. I did so and landed up in the ER due to the major w/d (Akastasia) symptoms that developed. I was eating benedryl for 4 days after that even as the Benedryl was the only thing that would settle me down just a little, the worst 4 days of my life.
Another psych doc weaned me down from 400mg at 50mg/week. By the time I got to 150mg from 200mg, same thing happened with the Akasthasia and I landed myself in the ER again. If you've never hear of Akasthasia, look it up, it's terrible symptoms.
Other docs, have just added SSRI's to the Serzone or some other drugs to augment it without success. I always wind up with the pre-serotonin syndrome when they do this.
I need off of Serzone. It pooped out and really seems to be the culprit in getting well. On the other hand, I could go up higher, as 600mg is the max. No one has suggested this, but I'm scared if I do this, and it doesn't work, than I'll have a longer weaning period to get off 600mg rather than 400mg. My biggest problem is anxiety. The depression I have is mostly due to losing my 39 y.o. brother. Of the 6 psych docs I've seen, some say I have PTSD, others say it GAD, or Bipolar II, or co-morbid condition. They just can't get it right. Xanax has been my savior in all of this, but who wants to take it 4 x day forever. It appears I need a med that has 5HT2a antagonist properties as well as 5HT3 antagonist properties and one that has inhibits Serotonin reuptake which is 5HT1a agonistic properties. I have the knowledge, but feel so lost in this journey to find the right med.
Gary
This is the end of the thread.
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