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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 anthonyg23 on August 31, 2008, at 17:20:42
Hi guys,
I've been frustrated as of late because nothing my doc prescribes to me works anymore. I deal with Anxiety, ADD, and moderate Depression and cannot seem to find any helpful medications. About 5 years ago I was prescribed Serzone (Nefazadone) and it changed my life - incredible happiness, motivation, positive outlook, no anxiety, etc, etc. Unfortunately, I was taken off the med because of the liver warnings and have had no luck finding an equal since. My latest mix is Effexor/Lamictal/Provigil...They seem to help VERY slightly but nothing close to the positive reaction I had before. I was first on just Effexor/Lamictal but neither did anything to help with ADD. So, my doc put me on Provigil. It's supposed to help with productivity/concentration but all I do is sit around like a zombie. I'm not sure exactly why I've been prescribed Lamictal, I'm not Bi-Polar. With Effexor, I honestly can't even tell if it's working.
I'm really tired of trying to find a combination that works for me. Since it's similar to nefazadone, I've asked my doc about trazadone but she said it wouldn't have any similar effects on me as Serzone did... I was hoping to at least see if it would work similarly. I don't rely on medications either, I workout, eat healthy, read for inspiration, etc, there's just something about ADD/Anxiety/Depression that you can't overcome with a positive outlook.
Anyways, I'm all out of ideas... should I look for a new doc to get a new perspective???? This is the latest idea I've been thinking about... maybe I can see another doc and they will have different ideas. Maybe one of you have a similar story and could shed some light on meds that worked for you....
Here's all the meds I've tried with no luck: Wellbutrin, Lamictal, Cybalta, Effexor, Paxil, Zoloft, Lexapro (worked slightly), Klonopin (worked decently on anxiety but was told to use very infrequently because people get addicted), St.Johns Wart, 5-HTP........Any Ideas?
Posted by Nadezda on August 31, 2008, at 18:05:36
In reply to So tired of fighting with it...., posted by anthonyg23 on August 31, 2008, at 17:20:42
Ever tried an Maoi?
Also, if what you're taking isn't working, why not try trazadone-- even if your pdoc thinks it won't work. These things are awfully hard to predict. A trial wouldn't hurt, would it?
Nadezda
Posted by Fivefires on August 31, 2008, at 22:33:31
In reply to So tired of fighting with it...., posted by anthonyg23 on August 31, 2008, at 17:20:42
> Hi guys,
>
> I've been frustrated as of late because nothing my doc prescribes to me works anymore. I deal with Anxiety, ADD, and moderate Depression and cannot seem to find any helpful medications. About 5 years ago I was prescribed Serzone (Nefazadone) and it changed my life - incredible happiness, motivation, positive outlook, no anxiety, etc, etc. Unfortunately, I was taken off the med because of the liver warnings and have had no luck finding an equal since. My latest mix is Effexor/Lamictal/Provigil...They seem to help VERY slightly but nothing close to the positive reaction I had before. I was first on just Effexor/Lamictal but neither did anything to help with ADD. So, my doc put me on Provigil. It's supposed to help with productivity/concentration but all I do is sit around like a zombie. I'm not sure exactly why I've been prescribed Lamictal,>Hey Anthony 23, I'd like to know why you're on Lamictal as well.
I'm on the same, ... nope, just the Effexor-XR which I might change to the old regular Effexor and Provigil.
>I'm not Bi-Polar.>
I'm not bipolar either. Supposedly I'm atypical.
>With Effexor, I honestly can't even tell if it's working.>
How much are you on? I used to be scared of it and would never go higher than 250, but this time I'm going up above 300mg to 450mg, and I'm noticing some feelings of well-being, especially upon first awakening in the a.m., when I usually wake up and think OMG not another day of this hell.
> I'm really tired of trying to find a combination that works for me. Since it's similar to nefazadone, I've asked my doc about trazadone but she said it wouldn't have any similar effects on me as Serzone did... I was hoping to at least see if it would work similarly. I don't rely on medications either, I workout, eat healthy, read for inspiration, etc, there's just something about ADD/Anxiety/Depression that you can't overcome with a positive outlook.
>
> Anyways, I'm all out of ideas... should I look for a new doc to get a new perspective???? This is the latest idea I've been thinking about... maybe I can see another doc and they will have different ideas. Maybe one of you have a similar story and could shed some light on meds that worked for you....
>
>
> Here's all the meds I've tried with no luck: Wellbutrin, Lamictal, Cybalta, Effexor, Paxil, Zoloft, Lexapro (worked slightly), Klonopin (worked decently on anxiety but was told to use very infrequently because people get addicted), St.Johns Wart, 5-HTP........
>
> Any Ideas?Me too re: above, so I'll be anxious to see, as well, what responses you get here.
Hang on, 5f
Posted by Phillipa on September 1, 2008, at 0:11:43
In reply to Re: So tired of fighting with it...., posted by Fivefires on August 31, 2008, at 22:33:31
Did your liver enzymes go up? As last summer I was presciribed nefazadone and chickened out cause of horror stories but no side effects. I'd find a doc who will still prescribe the nefazadone. Trazadone if a male can cause priapiasm you probably know that. As for lamictal was on it too as an augmenter for an SSRI no side effects but spitting so bad had to go off it. But none of the things you normally hear about insomnia, anger well I did get a bit angry but was healthy for me as never get angry. Been on the other ones never anything and effexor has liver side effects also. I think most meds do. Just get a liver enzymes blood test every now and then. And btw how high was your dose? Love Phillipa
Posted by West on September 1, 2008, at 8:57:02
In reply to Re: So tired of fighting with it...., posted by Phillipa on September 1, 2008, at 0:11:43
Milnacipran (Ixel)
Cymbalta + Provigil
Tianeptine (suitable for anxiety accompanied by milder depression).................
MAOIs (parnate first, then nardil if ineffective)
Moclobemide is best avoided since it has not proved to be effective, although carries none of the dietary restrictions of MAOIs proper.
West
Posted by anthonyg23 on September 1, 2008, at 11:18:33
In reply to Re: So tired of fighting with it...., posted by Phillipa on September 1, 2008, at 0:11:43
Do docs even prescribe Nefazodone anymore? I'd think they be scared to prescribe it in-case a patient did in fact have liver failure and turn around and press charges.
I'm definitely not an expert but I cannot see how the effect of Trazodone could be COMPLETELY different than Nefazodone given the similar chemical compositions. I understand it's now prescribed as a sleep aid but I've also heard some that react well to it as an AD. That could be me considering I reacted so well to Nefazodone.
I hope it doesn't sound bad but I kind of need that euphoric feeling. Not the zombie sit in front of the tv feeling but more just a general happiness feeling. Nefazodone did that for me...
Posted by anthonyg23 on September 1, 2008, at 11:30:26
In reply to Re: So tired of fighting with it...., posted by West on September 1, 2008, at 8:57:02
West, may I ask...
Why do you think an MAOI might work?
I've never tried any MAOI's because of dietary restrictions...
Posted by West on September 1, 2008, at 11:45:59
In reply to Re: So tired of fighting with it.... West, posted by anthonyg23 on September 1, 2008, at 11:30:26
The MAOIs are effective because they are so unselective, particularly Nardil which will inhibit the action of the enzymes responsible for deanimating serotonin, norepinephrine, dopamine and pea. GABA levels are also raised. Parnate has a less great side effect burden (particularly somnolence) and has a stimulatory effect probably due to a strong dopaminergic action. It is thought to induce euphoria in the opening weeks of being taken and can cause (sometimes chronic) insomnia.
Both carry important dietary restrictions which require discipline. I have never taken either but would recommend any of the other drugs before an MAOI precisely because of the side effects restrictions they represent.
Interestingly MAOIs nearly abolish REM sleep which is thought to play a part in depression.
Posted by sunnydays on September 1, 2008, at 13:33:00
In reply to Re: So tired of fighting with it...., posted by Fivefires on August 31, 2008, at 22:33:31
I take Effexor XR and Lamictal. I have done a little research that I don't have time to go find. My pdoc suggested it to help back when I was taking Lamictal as a way to help the Lamictal's anti-anxiety and anti-depressant properties and smooth out my mood a little bit (I'm not bipolar, but I do tend to have a lot of variability in my mood). I don't think it does anything, but for me I never got to a therapeutic dose because of my own hang-ups.
sunnydays
Posted by anthonyg23 on September 1, 2008, at 16:06:22
In reply to Re: So tired of fighting with it...., posted by sunnydays on September 1, 2008, at 13:33:00
I'm taking 300mg of Effexor, 200 mg of Provigil and 100 mg of lamictal.
Could it just be that my doses aren't enough? I've heard Effexor has different effects as the dosage increases.
Posted by bleauberry on September 1, 2008, at 19:34:30
In reply to So tired of fighting with it...., posted by anthonyg23 on August 31, 2008, at 17:20:42
Why not just go back on Serzone? Talk the doc into it for a better life? Don't ask, demand it, and say you are willing to accept the risk and you will present him with a personal program to address the risk. Get another doc to do it? But most important of all, be aware of the liver risks and continually monitor that. Keep in mind that while liver damage has happened, it is rare.
Since the risks are known upfront, that is to your advantage. You know what to be on the lookout for. There are things you can do. Read up on the symptoms of early liver troubles. Yellowing eyes, skin, urine, loss of appetite, stuff like that. Give yourself a personal exam every week. Take a liver panel blood test prior to starting the med as a baseline reading. Do it again every two months, more or less, whatever your comfort level is for comparison to baseline. Take supplements that are scientifically proven to protect and heal the liver, with Milk Thistle being top on the list. Research other liver supplements too. Keep the serzone dosage as low as possible.
If your neighborhood modern medicine provider prefers you continue to suffer, you can order serzone online pretty easy without a doctor. I can't mention sources here due to policies, but heck right here in the USA you can order your own blood tests online, they send the kit that you take to any blood draw of your choice, and it's simple as that. Most people think you have to go to a doctor. Many choose not to either because they can't afford it or they are fed up with it.
If you really really really want serzone it can be done with just a little forcefulness, a little creativity, and a willingness to take charge in the responsibility department.
All that said, liver problems are not common. All drugs have risks, known and unknown, including any your doctor might prescribe.
The title of your post was "So tired of fighting with it.." I mean, really, if we have to fight the person who is supposedly there to heal us, something's wrong. It's your body and your life. You are willing to accept the risks, who is anyone else to tell you what you can and cannot do, unless it is illegal, which Serzone isn't.
Aquire the medicine from your doc, another, or online.
Baseline liver test.
Frequent followup tests.
Very frequent personal exams of signs.
Milk Thistle every day.Pretty easy.
Serzone can be a wonderful med. So can Zyprexa for millions of people. Zyprexa has serious risks. It is prescribed like candy all the time.
Posted by Phillipa on September 1, 2008, at 20:14:08
In reply to Re: So tired of fighting with it...., posted by anthonyg23 on September 1, 2008, at 11:18:33
It was prescribed for me. Phillipa
Posted by Fivefires on September 1, 2008, at 20:35:20
In reply to Re: So tired of fighting with it...., posted by anthonyg23 on September 1, 2008, at 16:06:22
It's late and I've been running around in circles hoping someone would bring me some candy. I need comfort food because broke up w/ sigother.
I took 375 for two days, and my mood better, thinking clearer, even a bit of looking forward to what might happen in a day.
Sorry so late. I wish to read all the followups above. Will do so when not so angst ridden. (Wal*reen's accidentally gave me reg. Xanax and it was mixed in with Xanax-XR, so I ran out of Xanax-XR yest' or day before. Not sure how they equivalate(made that word up).
takecareall, 5f
5f
I can't add much more right now; need to rest a bit.
Posted by West on September 2, 2008, at 9:28:39
In reply to Re: So tired of fighting with it...., posted by Fivefires on September 1, 2008, at 20:35:20
I believe serzone has been completely discontinued...
Posted by anthonyg23 on September 2, 2008, at 10:57:53
In reply to Re: So tired of fighting with it....)serzone disc., posted by West on September 2, 2008, at 9:28:39
I think the generic version is still available. The med was amazing for me - haven't found anything like it.
Posted by Jeroen on September 2, 2008, at 15:00:54
In reply to So tired of fighting with it...., posted by anthonyg23 on August 31, 2008, at 17:20:42
hi there, i didnt see Seroquel in your list
can do wonders try 100 mg twice daily for 2 weeks and you know your feeling great again
take one of 200 mg and cut it in half with a pill cutter
good luck
Posted by Fivefires on September 3, 2008, at 21:35:13
In reply to Re: So tired of fighting with it....)serzone disc., posted by anthonyg23 on September 2, 2008, at 10:57:53
That's a good thought to share Jeroen.
anthonyg23, eee subject line changed to disc. Serzone.
I saw that and thought to myself, well I'm glad it wasn't disc. of med that begins w/ E and ends w/ an R.
A discussion about this one, either still running because I opted out of it, or archived, became very confusing; no one could agree. Still, yes, I'm on it now. Still want nothing to do w/ a thread specifically about it.
To your inquisition about 'not enough of the med', I personally think it's possible.
I'm a very fast/poor metabolizer, prob' lose half of a meds' strength hours before one should; have to take all XRs, twice a day. I'm considering going to the old form of this med; no XR.
There were so many 'kinda' way out there' posts on the thread I referred to above, I promised self never go over 225mg a day of it.
But, I have, 300mg now, and I tried a two day increase and I DID FEEL BETTER.
We'll see.
Only thing think is one might want to be prepared to d.c. it slowly if it doesn't work for them, as it seems quite a few folks complained about it being very hard to d.c.
Here again, it was not hard for me to get off of it at all.
TksHopeMadeSense, 5f
This is the end of the thread.
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