Posted by Stan on August 2, 2002, at 2:27:41
In reply to Serzone » Stan, posted by Anyuser on August 1, 2002, at 10:39:18
> I am considering trying Serzone and I would like to ask you a couple of questions.
>
> Do you have any problems with dizziness or somnolence on Serzone?
>
> When do you take Serzone? There is one Bristol-Meyer study that says Serzone can be taken in one dose at night. Ever tried that? I wonder if taking a therapeutic dose at night would minimize daytime side effects.
>
> What other drugs do you take with Serzone? I am considering Serzone with Wellbutrin.
>
> Thanks.________________________
hey anyuser -- i wasn't aware that B-M had conducted a study which suggested that serzone might work just as well with a once-daily dosing regimen. for my part, i take a 200 mg pill at noon and another at midnight. after an initial "break-in" period of about a week while your body adjusts to the medication, you probably won't experience any bothersome side effects to speak of during the day. if there's some mild drowsiness, dizziness, or postural hypotension at first, it should fade fairly soon. it's not like trazodone which delivers a "knock-out punch" of sleepiness with each dose. but if B-M says it's ok to take the whole daily dose before bed, then you could always try it if your doc gives you the green light. i think it has a relatively short half-life (about 4 hrs) but some of its metabolites have much longer half-lives.....
.....which brings me to your questions about combining serzone with other meds. unfortunately, serzone interacts with a lot of other psych-meds because it is processed by a liver enzyme which i believe is known as P450 CYP3A4. i found out the hard way that when you take serzone concurrently with certain other drugs, the metabolism of serzone and these other drugs can be altered and often slowed down, and you end up with higher blood levels of some in your system.....and the half-lives are extended. i took xanax with serzone for awhile but the combo causes xanax blood levels to double what they normally would be and the half-life is doubled as well. so now i combo w/ativan.
but that's not all on the interaction front....i combine it with buspar as well....for years i took 15 mg a day -- it made me lightheaded and dizzy at first but after awhile i got used to it.....but a few months ago i found that coadministration of these two causes plasma buspirone levels to rise up to 20 to 50-fold times normal! (this info is in the package insert, but i'd never gotten one from the pharmacy until last winter) i've probably fried every serotonin receptor in my brain by now! it's the liver enzyme issue again....if you're going to try a combo, you should investigate the interaction issue carefully -- serzone's metabolites are processed by various *other* liver enzymes and taking multiple meds that inhibit these enzymes can create a contraindication or at the least necessitate dosage adjustments. oh yeah, and you can't drink grapefruit juice!
i can't comment on the combo with wellbutrin you're considering because i've never combined serzone with another drug classified strictly as an AD nor have i taken wellbutrin -- i might try it someday, but i've always felt it would be too "activating" for my overly-anxious self. who knows, i might have a "paradoxical reaction" to it and calm down. if i try another AD soon, it might be remeron, though i wish they hadn't made it with such potent antihistamine effects -- i fear it will leave me exhausted all of the time due to this factor.....so i'm waiting to see if i can get some samples without springing for a whole month's supply.
aside from the meds i mentioned, i occassionally take 25 mg of trazodone before bed (my tolerance for it is low these days) and i also take low-dose mirapex (D2/D3 dopamine agonist) for restless legs syndrome -- it also reduces anxiety a bit. i have tried to taper some of these down with the ultimate goal of discontinuing some, but i seem to have great difficulty with that -- i don't feel like my program is working very well and i'm still acutely anxious and depressed......but if i try to phase a med out, i feel MUCH worse, so i'm currently stuck in a rut.
thanks for listening,
Stan
poster:Stan
thread:114609
URL: http://www.dr-bob.org/babble/20020731/msgs/114897.html