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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by CaffeinePoet on November 20, 2011, at 13:35:22
Also, is there anything like Serzone out there? I mean, besides Serzone? (I'm in the U.S. so I can get Nefazodone if I want to.)
I have GAD with some traits of OCD and depression. Nothing really took care of this like Serzone. It made me feel a little tired, that's it.
I've tried Effexor, Zoloft, Lexapro, and Clonazepam. These have all provided symptom relief while giving me life-impairing side effects. Nothing has made me feel just normal with minimum side effects the way Serzone did. Effexor and SSRI's give me short-term concentration and motivation problems, while Clonazepam has its own set of problems.
Posted by ed_uk2010 on November 20, 2011, at 13:42:35
In reply to Anything like Serzone?, posted by CaffeinePoet on November 20, 2011, at 13:35:22
Have you tried trazodone? It's related to nefazodone. It causes more drowsiness but you take it at night.
Posted by jono_in_adelaide on November 20, 2011, at 16:34:13
In reply to Anything like Serzone?, posted by CaffeinePoet on November 20, 2011, at 13:35:22
Why not go back to nefazodone if it worked and didnt produce any bad side effects?
Posted by CaffeinePoet on November 20, 2011, at 16:38:46
In reply to Re: Anything like Serzone?, posted by jono_in_adelaide on November 20, 2011, at 16:34:13
> Why not go back to nefazodone if it worked and didnt produce any bad side effects?
The liver failure/liver damage that it caused for many people. I personally had gall bladder pain on it that I have never otherwise had in life.
The risk for actual death is low, but I suspect that liver damage may have been more common among users.
Posted by jono_in_adelaide on November 20, 2011, at 17:15:36
In reply to Re: Anything like Serzone?, posted by CaffeinePoet on November 20, 2011, at 16:38:46
If the risk was significant, the FDA would have pulled it........ its about balancing risk and benifit, there is a risk driving a car or going on the bus, but we accept that risk because of the benifits they bring...... if Nefazodone worked, it might be worth accepting the very small risk of liver damage
Posted by Phillipa on November 20, 2011, at 17:37:07
In reply to Re: Anything like Serzone?, posted by jono_in_adelaide on November 20, 2011, at 17:15:36
I think serzone was pulled in some countries due to the liver failure risks. I myself in US was once prescribed it and didn't take it for same reason. Phillipa
Posted by creepy on November 20, 2011, at 19:16:00
In reply to Anything like Serzone?, posted by CaffeinePoet on November 20, 2011, at 13:35:22
vilazodone might be somewhat similar. It doesnt do many of the same things but I wonder how much the basic chemical structure might play into your response?
Another option might be to add wellbutrin to it for some NE and DA effects.
This drug is a serotonin receptor antagonist much like the atypical antipsychotics. You could try one of those and see if the response is similar.
Any reason you dont want to be on nefazodone? I did some research on it and tried to get a script from my doc, no luck. straight SSRI's seem to make me mixed.. I figured an antagonist might be a little different. Im not too keen on AAP's.
trazodone's AD effects are pretty weak. Its primarily used as a sleep aid these days.
Posted by CaffeinePoet on November 20, 2011, at 20:36:01
In reply to Re: Anything like Serzone?, posted by creepy on November 20, 2011, at 19:16:00
thanks for the advice.
re: reasons not to be on Serzone:
* Serzone has an unfavorable profile re: pregnancy and is also difficult to withdraw from. I would like to get pregnant in the next year or two.
* I had a couple of panic attacks right after taking it when I was on it, apparently due to a buildup of m-cPP, a sign of being a bad metabolizer. However when that happened I was cross-tapering with an SSRI, and that may have been related.
> vilazodone might be somewhat similar. It doesnt do many of the same things but I wonder how much the basic chemical structure might play into your response?
> Another option might be to add wellbutrin to it for some NE and DA effects.
> This drug is a serotonin receptor antagonist much like the atypical antipsychotics. You could try one of those and see if the response is similar.
> Any reason you dont want to be on nefazodone? I did some research on it and tried to get a script from my doc, no luck. straight SSRI's seem to make me mixed.. I figured an antagonist might be a little different. Im not too keen on AAP's.
> trazodone's AD effects are pretty weak. Its primarily used as a sleep aid these days.
Posted by Phillipa on November 20, 2011, at 20:47:41
In reply to Re: Anything like Serzone? » creepy, posted by CaffeinePoet on November 20, 2011, at 20:36:01
How do you know if you have m-c pp? Phillipa
Posted by Christ_empowered on November 20, 2011, at 20:56:48
In reply to Re: Anything like Serzone? » CaffeinePoet, posted by Phillipa on November 20, 2011, at 20:47:41
Is there an xr trazodone now? Maybe that's an option.
Posted by creepy on November 21, 2011, at 0:37:34
In reply to Re: Anything like Serzone? » CaffeinePoet, posted by Phillipa on November 20, 2011, at 20:47:41
mcpp is a metabolite thats common to trazodone and nefazodone. Its pretty good at causing anxiety.
Posted by SLS on November 21, 2011, at 5:50:24
In reply to Re: Anything like Serzone?, posted by jono_in_adelaide on November 20, 2011, at 17:15:36
> If the risk was significant, the FDA would have pulled it........ its about balancing risk and benifit, there is a risk driving a car or going on the bus, but we accept that risk because of the benifits they bring...... if Nefazodone worked, it might be worth accepting the very small risk of liver damage
Wouldn't regular blood tests prevent such an incident? I don't know if this is done regularly with nefazodone, but it probably should be.
- Scott
Posted by SLS on November 21, 2011, at 5:52:36
In reply to Re: Anything like Serzone?, posted by Christ_empowered on November 20, 2011, at 20:56:48
> Is there an xr trazodone now? Maybe that's an option.
Again, mCPP can precipitate anxiety states.
- Scott
Posted by SLS on November 21, 2011, at 5:53:27
In reply to Re: Anything like Serzone?, posted by creepy on November 21, 2011, at 0:37:34
> mcpp is a metabolite thats common to trazodone and nefazodone. Its pretty good at causing anxiety.
Oops. Sorry about the redundant post.
- Scott
Posted by Bob on November 21, 2011, at 15:31:16
In reply to Re: Anything like Serzone?, posted by CaffeinePoet on November 20, 2011, at 16:38:46
> > Why not go back to nefazodone if it worked and didnt produce any bad side effects?
>
> The liver failure/liver damage that it caused for many people. I personally had gall bladder pain on it that I have never otherwise had in life.
>
> The risk for actual death is low, but I suspect that liver damage may have been more common among users.
This is from Wiki..."Nefazodone (Serzone, Nefadar) is an antidepressant marketed by Bristol-Myers Squibb. Its sale was discontinued in 2003 in some countries due to the rare incidence of hepatotoxicity (liver damage), which could lead to the need for a liver transplant, or even death. The incidence of severe liver damage is approximately 1 in every 250,000 to 300,000 patient-years.[2] On June 14, 2004, Bristol-Myers Squibb discontinued the sale of Serzone in the United States and Canada. Several generic formulations of nefazodone are still available."
Bob
Posted by Phillipa on November 21, 2011, at 18:10:41
In reply to Re: Anything like Serzone? » CaffeinePoet, posted by Bob on November 21, 2011, at 15:31:16
If namebrand was discontinued even here due to liver problems how can a generic still be available? Same med different name? Makes no sense to me. Phillipa
Posted by jono_in_adelaide on November 22, 2011, at 22:52:43
In reply to Re: Anything like Serzone? » Bob, posted by Phillipa on November 21, 2011, at 18:10:41
Nefazodone wasnt banned by the FDA - the manufacturer of Serzone took a comercial decision not to market it any more, but as nefazodone was still an approved drug, the generics were quite free to stay on the market.
Same in England, you cant get brand name Valium any more, because Roche decided they werent making any money out of it, but you can of course still get generic Diazepam Tablets
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