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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Miss A on December 9, 2000, at 14:37:44
Hi there! I just stumbled on this site as I was looking for helpful serzone info. There is a wealth of information here! Thank you! I am 27 years old and I have had moderate depression/anxiety for fourteen years now, and FINALLY accepted I could not fix it on my own. Funny how long we can stay in denial, huh? (I am sure I feel yucky today because I had that cookie yesterday! Or I am sure I feel irrationally pissed off because I did not sleep well last night! Or, I am sure i feel weepy because of "whatever reason you use to fill in the blank that day". Then it hits you! You have not felt good in fourteen years.) Funny. Anyway, I started taking St. John's wort in April because I was a wimp and did not want to do the so called "hard stuff," i had basically been medicating myself with alchohol for years--slowing down each time it got out of hand, but using it nonetheless. The Wort seemed to help at first, I worked up to 900mg every night and it seemed to help me sleep and deal with every day quirks. After a few months though, i realized that it really was not doing enough. (Still dark, inexplainable moods/wanting to stay in bed all day/loss of enthusiasm for anything and 10 pound weight gain) Yesterday I bucked up and went to the student health center and explained my situation to the doctor, including how my mother, aunts, and grandmother were all on various antidepressants and all said they had wished they had stared taking them YEARS ago. Anyway (I am babbling here--I guess that is what i am SUPPOSED to do! : ) She wants to start me on 100mg twice a day, but after reading a lot of these threads, I think that is a bit excessive and i have decided to start at a much lower dose on my own. maybe 50mg at night and 25mg in the morning. I have to be careful, because nasty side effects can worsen my panic (I have not had a full blown attack in almost two years-thanks to behavioral cognitive therapy- and I would hate to accidentally bring it all back! ) She wants me to totally quit the Wort and start the serzone in five days. i have heard that can cause some nasty side effects since Wort is in the same family as prozac. Shouldn't i taper off the Wort and taper onto the serzone at the same time? I cut my dose of wort last night to 600mg. and figure I will do the same tonight, and then go down to 300mg the following day. Does anyone have any suggestions? am i overreacting here? As I am sure you all can understand, i want to be careful with my body. this is a very big step for me, and I want to do it right. i don't want to get onto a crazy roller coaster. How stupid does THAT sound?? I have already been on one for YEARS!
Miss A
Posted by Cam W. on December 9, 2000, at 23:00:24
In reply to St. John's Wort to Serzone, posted by Miss A on December 9, 2000, at 14:37:44
Miss A - I have seen many people just stop St.John's Wort and start an antidepressant with no problems (I wouldn't try it with an MAOI, though; although I am not sure if that would be a problem unless, perhaps, one was taking excessive SJW doses). A couple of people who have stopped SJW and started SSRIs may have had some slight serotonin syndrome (sweating, tremors, racing heart), but these effects are hard to tell from the start-up side effects of the serotonergic antidepressants. There should not be any problems, especially if you are willing to start low and go slow with the Serzone. Just keep your doctor informed of any changes you may think are out of the ordinary.
Hope this helps - Cam
Posted by JohnL on December 10, 2000, at 5:14:14
In reply to St. John's Wort to Serzone, posted by Miss A on December 9, 2000, at 14:37:44
Hello,
The safest route is to probably stop the SJW and give it a week to washout.But there are other possible ways to handle this:
1) You could stay on SJW and slowly add in the Serzone, starting with 25mg per evening, and increasing by another 25mg about every four days.
2) Reduce SJW and start Serzone in the same small increments mentioned above. Continue to ween off SJW while titrating onto Serzone.
3) Put Serzone on the back burner. Instead, raise the SJW dose. In clinical trials, doses up to 9 tabs a day were used to treat severe depression. I think the commonly accepted dose of 3 tabs per day is way too low. One study indicated that 300mg SJW is roughly comparable to 10mg of a tricyclic antidepressant. Considering that therapeutic doses of tricyclics start at about 75mg, then 3 X 300mg SJW is nowhere near being adequate.
4) Consider adding the inexpensive mailorder Adrafinil instead. Serzone will sedate you. Adrafinil will increase alertness, motivation, mood and interest. Serzone will seldom do all that. Some people do OK with Serzone, but for the most part it's hard to find many people that do really really well with it. In the hands of my pdoc, Serzone has had spotty results at best.I have tried all of these. (SJW, Serzone, Adrafinil). My experience with SJW was similar to what you described. I hated Serzone. It turned me into a vegetable. I really liked the way SJW and Adrafinil worked together. Very good combination. My optimum SJW dose was 5 X 300mg per day.
John
This is the end of the thread.
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