Posted by JohnL on March 15, 2000, at 2:51:12
In reply to serzone to JohnL or anyone else for that matter, posted by sherry on March 14, 2000, at 7:05:56
> I have just started taking 100 mg serzone, and I have to tell you the anxiety is pretty bad. If my memory serves me correctly from a previous post, JohnL told me that I may not be able to take serzone because of the NE action. I feel exactly like I felt when I took desipramine. I can not tolerate any of the ssri's. The sad part about this is that I can tell that it is helping with the depression in small tell tale ways. For instance, I don't sleep nearly as much, my appetite has decreased, and I don't find it as difficult to speak. I have been taking a small dose of Klonopin to counteract the anxiety, but I still feel really revved. My question is, is there anything I can do to smooth out the really speeded up feeling and continue taking this AD? I have been on several, so my options are getting pretty slim, and since I do see some improvements would like to be able to increase medication and see if it helps. Until JohnL brought to my attention that I may not be able to take AD's with NE action, and now looking back, he is right. None of the ones I have taken helped with anxiety. Not even the Parnate which did help my depression quite a bit. Do you think a mood stabilizer might help? Thanks to anyone and everyone that has any suggestions.
I sure wish there was an easy answer. But based on the clues provided by your reactions to other meds, can I make a couple suggestions to ponder?
First...an antipsychotic. No joke. Why? Because your symptoms could very well be a result of elevated dopamine, and have nothing at all to do with serotonin or NE. Your previous, and current, medication trials prove this. Zyprexa 5mg is wonderful for depression and anxiety. Sedation allows good sleep. After a couple days of adjustment, daytime sedation disappears. The cool thing is that if it is to work, you will know quickly. From my own experience as well as others, benefits were dramatically obvious by day 3. If your doctor is reluctant, remind him you only want to try a low dose. And to further convince him, tell him to just write a prescription for 2 weeks just to see. He can always call in a refill by phone if you report back to him you're doing much better. I've found this approach helpful in overcoming doctor resistance.
Other AP choices would be Stelazine which is more alerting. Risperdal is kind of inbetween. Zyprexa seems to be a favorite based on comments at this board. For antidepressant and antianxiety treatment, when conventional methods have been frustrating, an AP usually does the job nicely. It's just a matter of targeting the right chemistry. Your reactions so far indicate serotonin or NE might not be the right chemistry with you.
Two other good choices might be Lamictal or Neurontin. Personally I favor Lamictal for its antidepressant qualities, its smoothing qualities, and its very mild (if any) side effect profile. I just hope you have a doctor who is openminded enough to see the logic in trying either an antipsychotic or an anticonvulsant like Lamictal. You don't have to have any schizophrenic or bipolar symptoms to respond robustly to either of these approaches.
In the meantime, you can always reduce the Serzone dosage to a level that is more comfortable. I know one doctor who starts his patients at 50mg a day and then increases by 25mg every four days. Higher doses are sometimes just too much to start with. I hope some of this might be helpful to you. JohnL
poster:JohnL
thread:26959
URL: http://www.dr-bob.org/babble/20000312/msgs/27071.html