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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by anthonyg23 on October 12, 2008, at 14:27:46
I asked this question in the past but it's always nice to get more points of view and experiences.
I took Serzone(Nefazodone) in the past and it was the ONLY drug that's ever worked completely effectively for me.
I've tried a million AD's/Anti-Anx after Nefazodone with no success. Has anybody that liked Nefaz(Serzone) found any similar success with Other Meds??? I've heard Remeron could work, but other than that none have measured up.
I'm on Effexor, Lamictal, and Provigil and it barely helps. Thanks guys!!
Posted by azalea on October 12, 2008, at 16:02:30
In reply to Former and Current Nefazodone Users... help, posted by anthonyg23 on October 12, 2008, at 14:27:46
What doses of Effexor. Lamictal, and Provigil are you taking?
Remeron + Effexor is a particularly powerful combination to consider.
> I asked this question in the past but it's always nice to get more points of view and experiences.
>
> I took Serzone(Nefazodone) in the past and it was the ONLY drug that's ever worked completely effectively for me.
>
> I've tried a million AD's/Anti-Anx after Nefazodone with no success. Has anybody that liked Nefaz(Serzone) found any similar success with Other Meds??? I've heard Remeron could work, but other than that none have measured up.
>
> I'm on Effexor, Lamictal, and Provigil and it barely helps. Thanks guys!!
Posted by anthonyg23 on October 12, 2008, at 17:27:47
In reply to Re: Former and Current Nefazodone Users... help » anthonyg23, posted by azalea on October 12, 2008, at 16:02:30
I take 150mg of Effexor.
100MG of Lamictal.
200MG of Provigil.
I've tried to educate myself on what it is that I have trouble with and it really seems like a combination of anxiety and A.D.D. Any depression that I seem to have will follow certain things that I've avoided or not followed-through on due to the Anxiety. I really don't think Lamictal and Provigil are the most effective for what I see as my problem.
Posted by Phillipa on October 12, 2008, at 19:36:46
In reply to Re: Former and Current Nefazodone Users... help, posted by anthonyg23 on October 12, 2008, at 17:27:47
Anthony I'm the same way no way you can get the serzone? I do remember the other thread. Effexor would be two stimulating I would think. For all that anxiety? Phillipa
Posted by azalea on October 12, 2008, at 21:19:16
In reply to Re: Former and Current Nefazodone Users... help, posted by anthonyg23 on October 12, 2008, at 17:27:47
Effexor should be good for anxiety and possibly ADD. Provigil should help with ADD. Lamictal is generally used as a mood stabilizer and as an augmenting agent for treatment resistent depression.
Has your doctor tried increasing the dose of Effexor? Some people find 225mg much more effective than 150mg as you get some norepinephrine reuptake (as well as serotonin) at higher doses.
When you did well on nefazodone, were you taking any other medication?
> I take 150mg of Effexor.
>
> 100MG of Lamictal.
>
> 200MG of Provigil.
>
> I've tried to educate myself on what it is that I have trouble with and it really seems like a combination of anxiety and A.D.D. Any depression that I seem to have will follow certain things that I've avoided or not followed-through on due to the Anxiety. I really don't think Lamictal and Provigil are the most effective for what I see as my problem.
Posted by anthonyg23 on October 13, 2008, at 15:50:18
In reply to Re: Former and Current Nefazodone » anthonyg23, posted by azalea on October 12, 2008, at 21:19:16
Nope, it was Nefazodone straight up. Seem to hit on everything for me.
I've scheduled an appointment with a well known psychiatrist here where I live. I'm going to express my thoughts to her and see what she thinks.
Posted by Phillipa on October 13, 2008, at 18:39:10
In reply to Re: Former and Current Nefazodone, posted by anthonyg23 on October 13, 2008, at 15:50:18
Can you post back and let us know what is decided? Phillipa
Posted by bleauberry on October 13, 2008, at 19:04:38
In reply to Former and Current Nefazodone Users... help, posted by anthonyg23 on October 12, 2008, at 14:27:46
The thing that makes serzone unique is the way it blocks certain receptors. The meds that would come closest to doing similar blocking of similar receptors would include zyprexa, remeron, and risperdal. Without a receptor blocker in your mix I doubt you will find anything to replace serzone. Maybe trazodone. It is in the same family as serzone.
I remember you had to get off serzone because the doctor feared liver probs? Cases of that happening were actually quite rare. More common than other meds, but still rare. I don't understand the hesitancy to get back on it. Frequent liver tests (monthly) as well as daily supplementation with Milk Thistle should keep you well entrenched in the safety zone. Generic serzone is easily available anywhere in the world either through a doctor or directly through the internet no-prescription pharmacies.
Milk thistle is a powerhorse at liver protection and rejuvenation. What's better, to be depression-free and living a good life where the only catch is you have to protect/monitor the liver; or having your life, your job, your family, your entire being, suffer in the mud everyday but your liver doesn't need any extra care? I mean, what's better of those two choices?
Posted by azalea on October 13, 2008, at 19:36:30
In reply to Re: Former and Current Nefazodone, posted by anthonyg23 on October 13, 2008, at 15:50:18
That's great that you did so well on nefazodone monotherapy. Were you having liver problems or was it the concern about potential problems that prompted you to discontinue it?
I hope your appointment with your new pdoc goes well.
> Nope, it was Nefazodone straight up. Seem to hit on everything for me.
>
> I've scheduled an appointment with a well known psychiatrist here where I live. I'm going to express my thoughts to her and see what she thinks.
Posted by yxibow on October 14, 2008, at 11:03:43
In reply to Re: Former and Current Nefazodone Users... help, posted by bleauberry on October 13, 2008, at 19:04:38
> The thing that makes serzone unique is the way it blocks certain receptors. The meds that would come closest to doing similar blocking of similar receptors would include zyprexa, remeron, and risperdal. Without a receptor blocker in your mix I doubt you will find anything to replace serzone. Maybe trazodone. It is in the same family as serzone.
Remeron is primarily an a2 drug but yes I believe they in turn form a serotonin blockade at higher doses -- its why I believe Remeron worked for me at a high dose at one point.
Trazodone would take a considerable effort to get used to, and I'm not sure its really safe to have an adult dose of it today.
It can cause priapisms in a small percent (for males, obviously) which must be taken care of post haste -- that doesn't mean everyone will get that.
I have several times but I was on a small dose for sleep so it wasn't an issue really -- umm.. managed to figure a way to take care of it. Anyhow, no its a serious thing.
Also there's the mCPP metabolite issue -- which for a certain few will activate some psychosis.
> I remember you had to get off serzone because the doctor feared liver probs? Cases of that happening were actually quite rare. More common than other meds, but still rare. I don't understand the hesitancy to get back on it.
>Frequent liver tests (monthly) as well as daily supplementation with Milk Thistle should keep you well entrenched in the safety zone.Not sure about the milk thistle, but yes frequent liver tests are basically the protocol with serzone today. The original manufacturer fled. Monthly maybe at the beginning, probably every couple of months or so later on.
Jaundice is very easy to detect, it affects the eyes and a few other parts of the body first and is reversible by stopping the affending agent -- not that I suggest one goes there.
Generic serzone is easily available anywhere in the world either through a doctor or directly through the internet no-prescription pharmacies.
>...but your liver doesn't need any extra care? I mean, what's better of those two choices?The liver, if one is in good health is very regenerative and will return back to a good state, and cirrhosis is something that is not likely to happen. Still, not something worth heading down that path.
Basically if one is on nefazodone I would coordinate with their doctor as to what else can be added safely (and will show up on tests), e.g. ibuprofen, alcohol, etc, and other medications.-- tidings
Jay
Posted by anthonyg23 on October 14, 2008, at 15:43:11
In reply to Re: Former and Current Nefazodone Users... help » bleauberry, posted by yxibow on October 14, 2008, at 11:03:43
Serzone(Nefaz) is a serotonin antagonist - it decreases serotonin activity in the brain. There are something like 21 identified serotonin receptor types. Serzone (I think) blocks activity at the 5-HT(2A) and 5-HT(2C) receptors.
So I've researched near and far for something or a combination of things that would target similar receptors. I've never tried Zyprexa, Remeron, risperdal so maybe that's my problem. But again, I did hear that remeron may work.
I know one thing though, the typical AD's prescribed these days just don't work for me. IE Effexor, Prozac, Lexapro, Wellbutrin... these seem to put a small band-aid on a severed limb sort-to-speak. Just to be clear, I've done numerous activities to alleviate the anxiety & ADD. I exercise 3x a week, I eat healthy (Subway $5 Chicken Breast Sub!), Take vitamins, read many books regarding anxiety and ADD with cognitive therapy, I've even attempted to "think positively" and convince myself that I don't suffer from anything at all. Some obviously work a bit but still there's just something about me that I can't fix without a good medication. I just don't want anyone to think I rely solely on the drugs.
I also mentioned that I had ADD as well... been taking Provigil but my younger brother has had lots of success on Adderall. Assuming we're biologically similar this could be a good choice to use in combination with an AD like serzone, remeron, etc.
This is the end of the thread.
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