Posted by Sunnely on August 2, 2000, at 23:18:12
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
> sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure).
Serzone, Desyrel, and Ativan can interact among each other in one form or another. Since all these drugs have sedating or calming effect, the collective effect of these drugs in combination on the site of action (brain receptors) is more intense than if used alone. Therefore, you feel more sleepy. This is called the "pharmacodynamic" drug-drug interaction.
Another form of drug-drug interactions can occur among these drugs used in combination. This form of interaction pertains mainly to each drug's effect on the metabolism (liver) of the others. For example, Serzone is a marked inhibitor of the liver enzyme called CYP3A4. Because of this effect, Serzone will slow down the metabolism of a drug that mainly depends on this liver enzyme (e.g., Desyrel). (Desyrel partly depends on CYP2D6 or CYP1A2 for metabolism.) This in turn leads to an increase in its (Desyrel) blood level, leading to increased in side effects (i.e., you feel more sleepy). Serzone does not interfere with the metabolism of Ativan. In fact, Ativan bypasses the active phase of liver metabolism (cytochrome enzymes) and does not produce active metabolite (daughter compound) of its own.
In sum, there are 2 possible ways increased sleepiness can occur with combination of Serzone, Desyrel, and Ativan. Altogether, they act at the site of action (brain receptors) increasing sleepiness (pharmacodynamic interaction). In addition, Serzone slows down the metabolism of Desyrel, increasing its blood level, leading to increased sleepiness (pharmacokinetic interaction).
Replacing Ativan with Xanax will most probably even worsen the problem. FYI, Serzone, similar to its effect on Desyrel, markedly slows down the liver metabolism of Xanax (via same process), leading to increase in Xanax blood level, leading to increased sleepiness.
If you continue to experience sleepiness with this combination, how about consider reducing the dose of Desyrel to alleviate this problem? FYI, Serzone and Desyrel are related in chemical structure. May be you don't need both meds.
= = = = = = = = = = = = = = = = = = = = = = = = => Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry?
Ativan (and Xanax) are both benzodiazepines and therefore, have the capability to produce psychological/physiological withdrawal and abuse. Since they are both short-acting or have shorter half-lives, withdrawal symptoms tend to occur more rapidly and intense (including withdrawal seizures) than the longer-acting benzos. They are also more prone to cause "rebound symptoms" (e.g., anxiety, insomnia). "Rebound" phenomenon is the occurrence of an immediate worsening of symptoms shortly after the patient stops the benzodiazepine.
poster:Sunnely
thread:41982
URL: http://www.dr-bob.org/babble/20000729/msgs/42063.html