![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by Erin on July 8, 1999, at 20:33:03
In reply to Re: Serzone users please reply, posted by JohnL on July 7, 1999, at 19:22:07
John-
I just got my prescription for Serzone. My doctor wants to start me out at 100 mgs for the first week and increase to 200 mgs the second week. I just reread your message and I'm not sure what I should do. I know that Serzone can be really sedating so I think I'm going to call my doctor and talk to him about starting off more slowly.
Any other suggestions?
Thanks again,
Erin
Posted by JohnL on July 9, 1999, at 3:14:11
In reply to To JohnL, posted by Erin on July 8, 1999, at 20:33:03
> John-
>
> I just got my prescription for Serzone. My doctor wants to start me out at 100 mgs for the first week and increase to 200 mgs the second week. I just reread your message and I'm not sure what I should do. I know that Serzone can be really sedating so I think I'm going to call my doctor and talk to him about starting off more slowly.
>
> Any other suggestions?
>
> Thanks again,
> Erin
Nice to hear from you Erin. The dosage your doctor gave you is quite normal. It is the typical run-of-the-mill standard dose most doctors would give. Not the dosage, however, recommended by a very impressive doctor I had the pleasure of meeting who happens to be having good success with Serzone. His secret to success, he claims, with any antidepressant is to start very low and increase dosage in small steps, to avoid being in a hurry getting up to a higher dose. That's hard to do when you need relief NOW. But it's like an initial investment today that pays off big in a couple months.Like he said, start at 25mg-50mg a day at dinner or early evening. Expect a hangover feeling in the morning which will go away. At first it might linger, but with time it will be gone rapidly after waking, and with more time will not even be a concern at all. See how it affects your sleep, as you might find afternoon versus early evening a better time to dose. Whatever works for you. I liked mid-to-late afternoon best because it really helped me relax about the time I got home from work, I could sleep great, and the hangover feeling was a lot less in the morning. I noticed the closer to bedtime I dosed the worse the hangover was.
After a 5 to 7 days, go up another 25mg-50mg a day. I would stick with the 25mg steps, even if any side effects are no problem, because of that "sweet spot" I mentioned. It could be as finicky as a 25mg range. If you start feeling better, great! Stay there for a while. I felt best at about 275mg, but then I blew it by following my docs orders all the way to 550mg. The slow-and-easy strategy will take a bit longer than your doctor's generic strategy, but will greatly increase your chances of success with regards to efficacy and tolerability. This advice DOES come from a great doctor ya know. I'm just relaying it. You are your own best manager, because nobody knows your body better than you. More failures come from increasing dosage too aggressively than from too conservatively.
This post is basically a collection of my own experience with Serzone, literature I've read about it in research, a fantastic doctor's approach, and comments from dissatisfied trial-users. I want your suffering to end and hope the wisdom gained from the failures of others will be to your benefit. Right now you know more about Serzone's characteristics than your doctor does. Don't feel at all guilty about going slower than he instructed. If Serzone is going to work for you, you now know how do to it. If it ends up not working as you hoped, at least you can look back and say you gave it your best dedicated effort.(Definitely add Wellbutrin before considering a total switch) Unlike me. My failure was due to the generic doctor formula of more is always better and the quicker you get there the better. I flew right past that "sweet spot" and abondoned the drug in a hurry out of the deep frustration resulting from totally inappropriate management. Wishing you the very best. Stay in touch. In a month to 6 weeks, around 200mg, let us know how it's going. Follow up any time with questions or anything. Incredible compassion and wisdom at this site. Has helped me tremendously. So many good folks to help out. JohnL.
Posted by ruth on July 9, 1999, at 7:11:06
In reply to Re: Reply to Erin, posted by JohnL on July 9, 1999, at 3:14:11
John,
I'm curious why you didn't give Serzone another trial,
and dose more slowly the second time around? What do
you take now for you depression?
(Just curious b/c I gave it only a one month trial,
but my depression just kept getting worse and worse,
to the point where I felt suicidal)...It's tempting
to give it another chance, but I'm just now feeling
better on prozac, so I don't dare...
(I'm sure, by now, by all my posts, you're familiar
with what my issues are--trying to find a med that
dosen't effect sex--have an appt. with a pharmacologist
early Aug., going to give her some of the buspar,
pinnadol suggestions...)
Posted by JohnL on July 9, 1999, at 16:13:30
In reply to Re: Reply to Erin, posted by ruth on July 9, 1999, at 7:11:06
> John,
>
> I'm curious why you didn't give Serzone another trial,
> and dose more slowly the second time around? What do
> you take now for you depression?
> (Just curious b/c I gave it only a one month trial,
> but my depression just kept getting worse and worse,
> to the point where I felt suicidal)...It's tempting
> to give it another chance, but I'm just now feeling
> better on prozac, so I don't dare...
> (I'm sure, by now, by all my posts, you're familiar
> with what my issues are--trying to find a med that
> dosen't effect sex--have an appt. with a pharmacologist
> early Aug., going to give her some of the buspar,
> pinnadol suggestions...)Ruth, I go worse and worse too. I'm pretty sure it was due to going up too fast. I started real low and slow and felt improvement, but as soon as the doc had me move up aggressively I got real bad. You know how it is when you have a bad experience, you get gun-shy. That's why I haven't tried it again. But I might. It was great for sex and sleep. Like you, I am giving Prozac a try. So far it hasn't instantly killed my sex drive like Zoloft and Paxil did. Just 10mg every other day, which can work if given enough time (2-3months). I'm also following Wayne's lead and taking Naltrexone, though just little bits right now. I am at the stage where I just feel the side-effect stuff getting on new drugs, and I feel pretty lousy. Both my psychiatrist and my family doc are excited about me being their guinea pig, so I hope I can please them, and at the same time maybe actually get better! Hope so. I really liked the potential of Buspar and Pindolol, but Buspar causes such loud tinnitus for me that at higher doses Pindolol didn't stand a chance of countering it. That was short-lived, but I can see how it might be great for someone else. It really pisses me off that drugs I really like cause such severe tinnitus. So for now, Prozac+Naltrexone it is. I am following my own advice and going very low and slow. I've been burned and learned. Always nice to read your posts. JohnL.
Posted by Erin on July 11, 1999, at 1:24:24
In reply to Re: Reply to Erin, posted by JohnL on July 9, 1999, at 3:14:11
John-
I took my first dose of 50 mg last night- really didn't have too many problems (just a tad bit sleepy). I have a few questions about the slow initial dosage- Why did your doctor recommend the slow dosage increase (by 25 mg weekly, instead of the jump from 100 to 200 mg after a one week period) before hitting the 200 mg mark? It seems like the therapeutic dosage is at least 200 mg and if I read it correctly it looked like your was about 275 mg. Are some people's ideal dosing range lower than 200 mg? I hope that what I asked is somewhat clear- I may have to clarify later.
I'm augmenting my 50 mg dose with 1 mg of Lorazepam at night to help me sleep. My anxiety level seems to have increase more in the evening when I have time to contemplate my situation.
I think I remember reading that you might be dealing with BiPolar II. What did your doctor recommend for dealing with the hypomanic times? I'm still trying to figure out if that's what I'm dealing with. I don't remember ever having a manic episode but I may have had a hypomanic episode where I was incredibly irritated and agitated. I've never had the wilder side of a manic episode I've read about in books. I really need to get some more recent info about this condition- any recommendations?
Thanks again for your time and consideration,
Erin
Posted by JohnL on July 11, 1999, at 5:54:00
In reply to Question for JohnL, posted by Erin on July 11, 1999, at 1:24:24
> John-
>
> I took my first dose of 50 mg last night- really didn't have too many problems (just a tad bit sleepy). I have a few questions about the slow initial dosage- Why did your doctor recommend the slow dosage increase (by 25 mg weekly, instead of the jump from 100 to 200 mg after a one week period) before hitting the 200 mg mark? It seems like the therapeutic dosage is at least 200 mg and if I read it correctly it looked like your was about 275 mg. Are some people's ideal dosing range lower than 200 mg? I hope that what I asked is somewhat clear- I may have to clarify later.
>
> I'm augmenting my 50 mg dose with 1 mg of Lorazepam at night to help me sleep. My anxiety level seems to have increase more in the evening when I have time to contemplate my situation.
>
> I think I remember reading that you might be dealing with BiPolar II. What did your doctor recommend for dealing with the hypomanic times? I'm still trying to figure out if that's what I'm dealing with. I don't remember ever having a manic episode but I may have had a hypomanic episode where I was incredibly irritated and agitated. I've never had the wilder side of a manic episode I've read about in books. I really need to get some more recent info about this condition- any recommendations?
>
> Thanks again for your time and consideration,
>
> Erin
Hello Erin. I'm certainly no expert, just a troubled patient struggling to get better. But I have learned a lot in my travels and I will try my best to answer your good questions.First, I have heard of people doing fine at lower doses, but you are correct that at least 200mg is considered therapeutic. Usually 300mg-600mg. I even heard of one case at 1000mg in addition to Zoloft! Holy cow! That person must be tough as a tank. The purpose of increasing in small steps is three-fold: 1)It's easier to get the body used to side effects, 2)Serzone can give unexpected erratic results when increased too fast. By that I mean worsening depression, excessive sedation, agitation, and who knows what else. 3)That is the method used by a doctor who has discovered it works best through painful trial and error. It really seems to me to be a finicky drug. I got up to 200mg real fast because, like you, the side effects seemed so easy to handle. But looking back I still believe that was what caused the drug to act so weird with me. And perhaps others who have tried it too. It's really hard to argue against a doctor's successful approach, even if we can't pinpoint exactly why it is successful.
I may be dealing with Bipolar II, but 3 psychiatrists, a family doc, and a counselor are all in disagreement on that. I think I've had hypomania before, but without agitation, just lots of energy and creativity. I wouldn't mind getting stuck there..."the manic advantage" they call it. Never had a real mania. That would be a completely different picture, quite crippling and scary I would think.
There are no clearcut bounderies, and one form of hypomania is called a mixed state, because it has irritation and agitation mixed in with it. I've never had that, but it sounds like you maybe have. That's a maybe...3 different doctors, 3 different answers.
In any case, an anticonvulsant treats those symptoms. I take 25mg Lamictal (very low dose), and may go higher. I find it does wonders. It helps the depression, it smooths my moods, it calms by bladder and I go to the bathroom a lot less, and it quiets my tinnitus. Of all the mood stabilizers, Lamictal and Neurontin are the newer ones with a much easier side effect profile, and stronger action on depression. In addition, I'm in my 2nd week of Prozac+Naltrexone. If I need a real good night's sleep, I take a crumb (maybe 5mg) of Remeron which I have lots leftover.
For more info on Lamictal or Neurontin, click on tips at the top of the page, then go down to search and push that button. You'll have a huge page of topics to explore, with bipolar, anticonvusant, and Lamictal issues to choose from. Nice talking with you, and wishing you a smooth day. JohnL.
Posted by Erin on July 11, 1999, at 17:43:13
In reply to Re: Erin, posted by JohnL on July 11, 1999, at 5:54:00
John,
Thanks for the fast reply- as always. Does Lamictal help with anxiety? As I mentioned earlier, I'm taking Lorazepam at night but would like to find something I could take during the day to tone down the anxiety until Serzone kicks in.
Best wishes to you in your medical quest-
Erin
Posted by ruthE on July 12, 1999, at 8:06:08
In reply to Re: Reply to Ruth, posted by JohnL on July 9, 1999, at 16:13:30
John,
Good luck with the prozac and naltrexone. It's
funny to be going back on the first drug I ever
tried for depression after trying all the newer ones.
They just didn't work for me. With the exception
of the sex thing, I really like prozac. My drive
is still there, but sensitivity isn't, and orgasm
can be elusive. But that tends to improve with time,
and I'm hoping that buspar might reverse all that
stuff. Also, after I catch my breath (I figure
3 months or so), I plan to start experimenting again.
Trading in sexual sensitivity for mental health just
isn't acceptable for me. And I'm convinced I can
find something that will work eventually.
Right now, I'm just tired of the battle! I'm sure
you know what I mean--I just get tired of trying to
untangle what's reality, what's side effects, why
I'm feeling certain feelings....my brain just starts
to feel like one giant beaker full of thrashing
chemicals that I can't figure out...Anyhow...I always enjoy reading your posts too :-)
You're the best!Ruth
Posted by doug t on July 13, 1999, at 16:43:37
In reply to Serzone users please reply, posted by Erin on July 7, 1999, at 1:25:06
Erin....after 30 years of looking, I have found serzone has the least side effects, allows the best sleep and in combo with klonopin or whatever it suprerior by far (for me) to prozac, zoloft, paxil, wellbutrin, etc. No "libido" problems. No "cloudy thinking or sleepiness but no speediness either. By the way I keep thinking of ways to row our in the ocean about 100 miles, blow my brains out with a shotgun, and simulaneously pull the drain plug on the boat and sink. Funny, I only seem to feel that way ever other month or so with the serzone vs. nightly with everything else. Big problem is forgetting something too. I mean i might get hungry after rowing 100 miles or capsize and drop the shotgun. problems problems. If its sunny tomorrow I'll be fine.
Posted by carly on July 14, 1999, at 10:59:25
In reply to Re: Serzone users please reply, posted by doug t on July 13, 1999, at 16:43:37
> Erin....after 30 years of looking, I have found serzone has the least side effects, allows the best sleep and in combo with klonopin or whatever it suprerior by far (for me) to prozac, zoloft, paxil, wellbutrin, etc. No "libido" problems. No "cloudy thinking or sleepiness but no speediness either. By the way I keep thinking of ways to row our in the ocean about 100 miles, blow my brains out with a shotgun, and simulaneously pull the drain plug on the boat and sink. Funny, I only seem to feel that way ever other month or so with the serzone vs. nightly with everything else. Big problem is forgetting something too. I mean i might get hungry after rowing 100 miles or capsize and drop the shotgun. problems problems. If its sunny tomorrow I'll be fine.
I have been using Serzone for two years now. I am also pleased with my sex life and a good nights seep. I do have to drink prune juice for constapation. My depression has lifted I have many days that I just feel happy. What a difference from the days I couldn't get out of bed. I started with a low dose and increased slowly. I now take 150mg am. and 400mg pm. Serzone has been the best I have tried so far.
Posted by Carly on July 14, 1999, at 19:01:04
In reply to Re: Serzone users please reply, posted by carly on July 14, 1999, at 10:59:25
> > Erin....after 30 years of looking, I have found serzone has the least side effects, allows the best sleep and in combo with klonopin or whatever it suprerior by far (for me) to prozac, zoloft, paxil, wellbutrin, etc. No "libido" problems. No "cloudy thinking or sleepiness but no speediness either. By the way I keep thinking of ways to row our in the ocean about 100 miles, blow my brains out with a shotgun, and simulaneously pull the drain plug on the boat and sink. Funny, I only seem to feel that way ever other month or so with the serzone vs. nightly with everything else. Big problem is forgetting something too. I mean i might get hungry after rowing 100 miles or capsize and drop the shotgun. problems problems. If its sunny tomorrow I'll be fine.
>
> I have been using Serzone for two years now. I am also pleased with my sex life and a good nights seep. I do have to drink prune juice for constapation. My depression has lifted I have many days that I just feel happy. What a difference from the days I couldn't get out of bed. I started with a low dose and increased slowly. I now take 150mg am. and 400mg pm. Serzone has been the best I have tried so far.>Carly, just wanted to let you know I love to hear cases like yours. Very encouraging. Thanks much for the post. JohnL.
Posted by Debbie on July 16, 1999, at 14:31:47
In reply to Re: Serzone users please reply, posted by ruth on July 7, 1999, at 7:52:50
I'm trying to find out some information on the side effects of Serzone. I've been on Serzone for almost a year and even though it does a wonderful job on controlling my anxiety, it seems to be giving me horrible back and neck pains. I have seen my internist and he says there is nothing wrong with me physically, so it must be the Serzone. My psychiatrist claims that this is not a side affect. I feel like I'm between a rock and a hard place. All I know is that the neck and back pain is getting so severe that I live on Motrin and a heating pad. Would very much appreciate any information that I can get. Thanks, Debbie
Posted by Carolyn T on July 17, 1999, at 9:11:04
In reply to Re: Serzone users please reply, posted by Debbie on July 16, 1999, at 14:31:47
I have been on serzone for over a month. I am so up & down & have had enough. I cannot sleep on this drug. I started out taking 50mg at night for 3 nights then increased to 100mg for the next 3 nights, and kept increasing 50 mg in same manner unitl I reached 300mg. I was flying high. I would sleep for 1 hr and wake up and be up all night rearing to go. I also felt a tingleness in the back of my neck and on the back of my forearms. After a week of not sleeping my dr. cut me back to 200mg a day and suggested I take 100 mg upon awaking & then another 100mg at 6 pm. If I still didn't sleep (which I didn;t) then the 6 pm dose should be taken at noon, which I am currently doing. I do not feel tired during the day and I am sleeping a bit better but it is still very interrupted sleep and I would like some relief. Going back to dr. next week. Every where I read it says Serzone main side effect is sleepiness. Not for me - any suggestion? Also someday I feel so frustrated and unreasonably angry that I feel I just want to rage. HELP????
Posted by Judy on July 17, 1999, at 9:44:39
In reply to Re: Serzone users please reply, posted by Carolyn T on July 17, 1999, at 9:11:04
Carolyn - This is a *perfect* example of why you can never rely on anyone else's experience with benefits/failures/side effects of a drug...you have to try it yourself. You can't sleep on Serzone - I slept 15 hours a day (if undisturbed) and wanted more. I stayed on Serzone only for 6 - 8 weeks, and that was because my doctor insisted I give it a reasonable length of time to 'work.' I couldn't get off it fast enough when he gave me the go-ahead and I had no problems weaning off, in case you're wondering about that. In fact, I probably did it too fast; but, at the time, any withdrawal pains I felt weren't anywhere near as bad as being on Serzone. It was one of the worst experiences of my life!
Watch out for that unreasonable anger and rage! No matter what anyone tells you, those ARE side effects of Serzone. I 'hated' everyone I knew when I was taking Serzone and, worse, I felt the need to tell them so and why! As soon as the Serzone began to leave my system, I returned to my semi-tactful self. I wish I could remember where I finally found the information, but I did read that 'feelings of hostility' can accompany the use of Serzone. It's not one of the side effects they brag about, apparently.
Don't put up with it for too long if you can't find a comfortable dose. There are too many other drugs to try. Good luck, Judy
> I have been on serzone for over a month. I am so up & down & have had enough. I cannot sleep on this drug. I started out taking 50mg at night for 3 nights then increased to 100mg for the next 3 nights, and kept increasing 50 mg in same manner unitl I reached 300mg. I was flying high. I would sleep for 1 hr and wake up and be up all night rearing to go. I also felt a tingleness in the back of my neck and on the back of my forearms. After a week of not sleeping my dr. cut me back to 200mg a day and suggested I take 100 mg upon awaking & then another 100mg at 6 pm. If I still didn't sleep (which I didn;t) then the 6 pm dose should be taken at noon, which I am currently doing. I do not feel tired during the day and I am sleeping a bit better but it is still very interrupted sleep and I would like some relief. Going back to dr. next week. Every where I read it says Serzone main side effect is sleepiness. Not for me - any suggestion? Also someday I feel so frustrated and unreasonably angry that I feel I just want to rage. HELP????
Posted by Carolyn T on July 18, 1999, at 8:09:22
In reply to Re: Serzone users please reply - To Carolyn, posted by Judy on July 17, 1999, at 9:44:39
Judy, Thank-you for sharing your experience with me. I was on Paxil for about 18 months and felt it was time to be done with treatment for my depression. With my Phyiscian's approval I tapered off Paxil and had been off it for a year when depression reared it's ugly head at me again. It reared up at me in the form of extreme anxiety with feelings of unreality - went to emergency room. So I was and am determined to not take an anti-depressant that interferes with my ability to have a normal & enjoyful sex life, which is the effect Paxil had on me. Paxil & Serzone are the only anti-depressants I have tried & to be frank I am fearful of trying others.
What is strange about this Serzone is that as many days that I have inappropiate anger and feel I want to just rage, I have great days where I feel so at peace & think everything is alright with the world!!! The bad days do out weigh the good, unfortunately. I am starting to suspect the good days are linked to my ability (if I am lucky) to get good quality sleep the night before.May be not! Judy did you have any good days on Serzone? Thanks!!!
Posted by Judy on July 18, 1999, at 10:17:55
In reply to Re: Serzone users please reply - Thanks Judy!!, posted by Carolyn T on July 18, 1999, at 8:09:22
I'm sorry to say that I have to answer your question about having any good days on Serzone with a loud, resounding NO! If there was any benefit at all, I may have slept through it! I too am searching for an even close-to-normal sex life on AD's. If Serzone allowed it, I don't know - I was too exhausted to even find out!
I know well your fear of trying other AD's; but always keep in mind that you can't judge how you'll respond to an AD by anyone else's experience or even the side effects listed on the bottle. It does seem to me, though, where you have seen some improvement with Serzone, that maybe a different dose might be a possible answer (ask your doctor what he/she thinks about this). It also seems a good sign that, even if Serzone is not quite the right drug for you, your brain has responded positively at least in part, which seems to suggest that you're on the right track and you might respond even more positively to a different but similar AD.
What a shame that we all have to play this trial and error "game" with AD's; but when you DO find the right one (or combo), you're golden!
Good luck - you're never alone! Judy
> Judy, Thank-you for sharing your experience with me. I was on Paxil for about 18 months and felt it was time to be done with treatment for my depression. With my Phyiscian's approval I tapered off Paxil and had been off it for a year when depression reared it's ugly head at me again. It reared up at me in the form of extreme anxiety with feelings of unreality - went to emergency room. So I was and am determined to not take an anti-depressant that interferes with my ability to have a normal & enjoyful sex life, which is the effect Paxil had on me. Paxil & Serzone are the only anti-depressants I have tried & to be frank I am fearful of trying others.
> What is strange about this Serzone is that as many days that I have inappropiate anger and feel I want to just rage, I have great days where I feel so at peace & think everything is alright with the world!!! The bad days do out weigh the good, unfortunately. I am starting to suspect the good days are linked to my ability (if I am lucky) to get good quality sleep the night before.May be not! Judy did you have any good days on Serzone? Thanks!!!
Posted by Roman on July 18, 1999, at 16:08:38
In reply to Re: Erin, posted by JohnL on July 11, 1999, at 5:54:00
Divided into Intro and Main body, for those who
want to skip:Intro:
I have read with interest this column and would
like to share my own experiences. I have suffered
from depression for a long time, and after having
tried all natural alternatives such as tryptophan
and st. johns wort I have finally decided it is
time I tried a strong anti-depressant. I once took
Prozac three years ago for 1 month, and found its
effect very profound, except for problems with sex.After having been diagnosed with ADHD (I am 27 yr old now)
I have done major research into that condition
and depression, and found depression to be the
prevailing problem. I tried prozac for a couple
of days, and again it had an amazing effect within
three to four days. then I heard about serzone and
wanted to give that a try rather.Main Body:
After a clear-out period of 7 days to rid my body
of Prozac left-overs, I went onto 100mg twice
daily of Serzone, and found it did very little
for my depression; it did help me fall asleep
better at nights, yet seemed to promote early
awakenings. I have been on Serzone now for 2 weeks,
and still no effect, even after having tried the
200mg twice daily option, which, much to my dismay,
seems to make the depression worse, probably
partially due to its sedatory effect.What am I to do? I am very tempted to switch back
to Prozac... $400 million annual sales cant be wrong,
and if I had to choose between depression or sexual
problems, I'd choose the latter. Nevertheless,
after having read this column I am wondering
whether I shouldnt give it more of a chance,
as difficult as that might be.Any comments and advice warmly welcome!
> > John-
> >
> > I took my first dose of 50 mg last night- really didn't have too many problems (just a tad bit sleepy). I have a few questions about the slow initial dosage- Why did your doctor recommend the slow dosage increase (by 25 mg weekly, instead of the jump from 100 to 200 mg after a one week period) before hitting the 200 mg mark? It seems like the therapeutic dosage is at least 200 mg and if I read it correctly it looked like your was about 275 mg. Are some people's ideal dosing range lower than 200 mg? I hope that what I asked is somewhat clear- I may have to clarify later.
> >
> > I'm augmenting my 50 mg dose with 1 mg of Lorazepam at night to help me sleep. My anxiety level seems to have increase more in the evening when I have time to contemplate my situation.
> >
> > I think I remember reading that you might be dealing with BiPolar II. What did your doctor recommend for dealing with the hypomanic times? I'm still trying to figure out if that's what I'm dealing with. I don't remember ever having a manic episode but I may have had a hypomanic episode where I was incredibly irritated and agitated. I've never had the wilder side of a manic episode I've read about in books. I really need to get some more recent info about this condition- any recommendations?
> >
> > Thanks again for your time and consideration,
> >
> > Erin
>
>
> Hello Erin. I'm certainly no expert, just a troubled patient struggling to get better. But I have learned a lot in my travels and I will try my best to answer your good questions.
>
> First, I have heard of people doing fine at lower doses, but you are correct that at least 200mg is considered therapeutic. Usually 300mg-600mg. I even heard of one case at 1000mg in addition to Zoloft! Holy cow! That person must be tough as a tank. The purpose of increasing in small steps is three-fold: 1)It's easier to get the body used to side effects, 2)Serzone can give unexpected erratic results when increased too fast. By that I mean worsening depression, excessive sedation, agitation, and who knows what else. 3)That is the method used by a doctor who has discovered it works best through painful trial and error. It really seems to me to be a finicky drug. I got up to 200mg real fast because, like you, the side effects seemed so easy to handle. But looking back I still believe that was what caused the drug to act so weird with me. And perhaps others who have tried it too. It's really hard to argue against a doctor's successful approach, even if we can't pinpoint exactly why it is successful.
>
> I may be dealing with Bipolar II, but 3 psychiatrists, a family doc, and a counselor are all in disagreement on that. I think I've had hypomania before, but without agitation, just lots of energy and creativity. I wouldn't mind getting stuck there..."the manic advantage" they call it. Never had a real mania. That would be a completely different picture, quite crippling and scary I would think.
>
> There are no clearcut bounderies, and one form of hypomania is called a mixed state, because it has irritation and agitation mixed in with it. I've never had that, but it sounds like you maybe have. That's a maybe...3 different doctors, 3 different answers.
>
> In any case, an anticonvulsant treats those symptoms. I take 25mg Lamictal (very low dose), and may go higher. I find it does wonders. It helps the depression, it smooths my moods, it calms by bladder and I go to the bathroom a lot less, and it quiets my tinnitus. Of all the mood stabilizers, Lamictal and Neurontin are the newer ones with a much easier side effect profile, and stronger action on depression. In addition, I'm in my 2nd week of Prozac+Naltrexone. If I need a real good night's sleep, I take a crumb (maybe 5mg) of Remeron which I have lots leftover.
>
> For more info on Lamictal or Neurontin, click on tips at the top of the page, then go down to search and push that button. You'll have a huge page of topics to explore, with bipolar, anticonvusant, and Lamictal issues to choose from. Nice talking with you, and wishing you a smooth day. JohnL.
Posted by Roo on July 19, 1999, at 6:57:48
In reply to Erin - worsening depression & sedation w. Serzone, posted by Roman on July 18, 1999, at 16:08:38
Hi Carolyn and Judy,I'm sorry the two of you had bad experiences on
serzone--but I feel a little less crazy hearing
about your experiences. I had the rage and hostility
too, but like you Carolyn, I also had some good
days, so it confused me. I really wanted the drug
to work, b/c I was so tired of sexual side effects,
and missed that part of my life so dearly, but
I eventually started feeling suicidal, so I went off
after about a month....I'm amazed when I read that
it has a "sedating" effect, boy I wish! I felt
very anxious and unstable on it....
Well let's all keep each other informed on the
search for finding an AD without sexual side effects.
People have been rather discouraging to me in this
regard, saying "it aint gonna happen", but I believe
it can, it's just gonna take some time, patience,
and frustration first...Hang in there
Roo
Posted by Carolyn T on July 19, 1999, at 7:44:38
In reply to serzone: carolyn t. and judy, posted by Roo on July 19, 1999, at 6:57:48
>Roo,
Thanks for your experience. May I ask what you are currently taking? I ask because I go back to my Doc this Thursday for an evalution of how Serzone is working for me. This is indeed a strange drug. Sometimes I wonder if what I am experiencing can be the drug or the actual depression - who knows? But thanks for your input!! Have a great day!!!
> Hi Carolyn and Judy,
>
> I'm sorry the two of you had bad experiences on
> serzone--but I feel a little less crazy hearing
> about your experiences. I had the rage and hostility
> too, but like you Carolyn, I also had some good
> days, so it confused me. I really wanted the drug
> to work, b/c I was so tired of sexual side effects,
> and missed that part of my life so dearly, but
> I eventually started feeling suicidal, so I went off
> after about a month....I'm amazed when I read that
> it has a "sedating" effect, boy I wish! I felt
> very anxious and unstable on it....
> Well let's all keep each other informed on the
> search for finding an AD without sexual side effects.
> People have been rather discouraging to me in this
> regard, saying "it aint gonna happen", but I believe
> it can, it's just gonna take some time, patience,
> and frustration first...
>
> Hang in there
> Roo
Posted by RG on July 19, 1999, at 9:25:17
In reply to Erin - worsening depression & sedation w. Serzone, posted by Roman on July 18, 1999, at 16:08:38
> Divided into Intro and Main body, for those who
> want to skip:
>
> Intro:
>
> I have read with interest this column and would
> like to share my own experiences. I have suffered
> from depression for a long time, and after having
> tried all natural alternatives such as tryptophan
> and st. johns wort I have finally decided it is
> time I tried a strong anti-depressant. I once took
> Prozac three years ago for 1 month, and found its
> effect very profound, except for problems with sex.
>
> After having been diagnosed with ADHD (I am 27 yr old now)
> I have done major research into that condition
> and depression, and found depression to be the
> prevailing problem. I tried prozac for a couple
> of days, and again it had an amazing effect within
> three to four days. then I heard about serzone and
> wanted to give that a try rather.
>
> Main Body:
>
> After a clear-out period of 7 days to rid my body
> of Prozac left-overs, I went onto 100mg twice
> daily of Serzone, and found it did very little
> for my depression; it did help me fall asleep
> better at nights, yet seemed to promote early
> awakenings. I have been on Serzone now for 2 weeks,
> and still no effect, even after having tried the
> 200mg twice daily option, which, much to my dismay,
> seems to make the depression worse, probably
> partially due to its sedatory effect.
>
> What am I to do? I am very tempted to switch back
> to Prozac... $400 million annual sales cant be wrong,
> and if I had to choose between depression or sexual
> problems, I'd choose the latter. Nevertheless,
> after having read this column I am wondering
> whether I shouldnt give it more of a chance,
> as difficult as that might be.
>
> Any comments and advice warmly welcome!
>
>
> > > John-
> > >
> > > I took my first dose of 50 mg last night- really didn't have too many problems (just a tad bit sleepy). I have a few questions about the slow initial dosage- Why did your doctor recommend the slow dosage increase (by 25 mg weekly, instead of the jump from 100 to 200 mg after a one week period) before hitting the 200 mg mark? It seems like the therapeutic dosage is at least 200 mg and if I read it correctly it looked like your was about 275 mg. Are some people's ideal dosing range lower than 200 mg? I hope that what I asked is somewhat clear- I may have to clarify later.
> > >
> > > I'm augmenting my 50 mg dose with 1 mg of Lorazepam at night to help me sleep. My anxiety level seems to have increase more in the evening when I have time to contemplate my situation.
> > >
> > > I think I remember reading that you might be dealing with BiPolar II. What did your doctor recommend for dealing with the hypomanic times? I'm still trying to figure out if that's what I'm dealing with. I don't remember ever having a manic episode but I may have had a hypomanic episode where I was incredibly irritated and agitated. I've never had the wilder side of a manic episode I've read about in books. I really need to get some more recent info about this condition- any recommendations?
> > >
> > > Thanks again for your time and consideration,
> > >
> > > Erin
> >
> >
> > Hello Erin. I'm certainly no expert, just a troubled patient struggling to get better. But I have learned a lot in my travels and I will try my best to answer your good questions.
> >
> > First, I have heard of people doing fine at lower doses, but you are correct that at least 200mg is considered therapeutic. Usually 300mg-600mg. I even heard of one case at 1000mg in addition to Zoloft! Holy cow! That person must be tough as a tank. The purpose of increasing in small steps is three-fold: 1)It's easier to get the body used to side effects, 2)Serzone can give unexpected erratic results when increased too fast. By that I mean worsening depression, excessive sedation, agitation, and who knows what else. 3)That is the method used by a doctor who has discovered it works best through painful trial and error. It really seems to me to be a finicky drug. I got up to 200mg real fast because, like you, the side effects seemed so easy to handle. But looking back I still believe that was what caused the drug to act so weird with me. And perhaps others who have tried it too. It's really hard to argue against a doctor's successful approach, even if we can't pinpoint exactly why it is successful.
> >
> > I may be dealing with Bipolar II, but 3 psychiatrists, a family doc, and a counselor are all in disagreement on that. I think I've had hypomania before, but without agitation, just lots of energy and creativity. I wouldn't mind getting stuck there..."the manic advantage" they call it. Never had a real mania. That would be a completely different picture, quite crippling and scary I would think.
> >
> > There are no clearcut bounderies, and one form of hypomania is called a mixed state, because it has irritation and agitation mixed in with it. I've never had that, but it sounds like you maybe have. That's a maybe...3 different doctors, 3 different answers.
> >
> > In any case, an anticonvulsant treats those symptoms. I take 25mg Lamictal (very low dose), and may go higher. I find it does wonders. It helps the depression, it smooths my moods, it calms by bladder and I go to the bathroom a lot less, and it quiets my tinnitus. Of all the mood stabilizers, Lamictal and Neurontin are the newer ones with a much easier side effect profile, and stronger action on depression. In addition, I'm in my 2nd week of Prozac+Naltrexone. If I need a real good night's sleep, I take a crumb (maybe 5mg) of Remeron which I have lots leftover.
> >
> > For more info on Lamictal or Neurontin, click on tips at the top of the page, then go down to search and push that button. You'll have a huge page of topics to explore, with bipolar, anticonvusant, and Lamictal issues to choose from. Nice talking with you, and wishing you a smooth day. JohnL.SERZONE FOR ME CAUSED HIVES AT 150 MGS. I DID NOT LIKE IT AT ALL AND FOUND NO RELIEF WITH IT.
Posted by Roo on July 19, 1999, at 10:43:53
In reply to Re: serzone: carolyn t. and judy - Thanks Roo!!, posted by Carolyn T on July 19, 1999, at 7:44:38
Carolyn,
I wondered the same thing...was it the drug or just
my depression. I've come to the conclusion that, for
me, it was probably the drug. My depression dosen't
usually have that sharp rage edge to it that it did
with Serzone, it's usually mostly tears and saddness.
I wrote a post earlier, while I was taking it, and
someone posted to me that in a small percentage of
users it stimulates some sort of receptor that is
responsible for hostility.
Someone else wrote me that if it's augmented with
pinnadol, it can help depression more. I still think
about trying that sometime. I experimented for
10 months with different things (celexa, serzone, wellbutrin),
nothing really worked...I slipped back into depression.
So FOR NOW, I'm taking a break from experimenting
and taking good ole prozac, which has always worked
well for me. It DOES have the sexual side effects
though. I'm just going to grit my teeth and bear
that aspect until I'm ready to resume experimenting
again. I see a pharmacologist in a few weeks about
this sex issue. I'll pass on whatever I learn...
Posted by annette on August 11, 1999, at 22:10:05
In reply to Serzone users please reply, posted by Erin on July 7, 1999, at 1:25:06
> Had a visit with a new doc today - complete jerk - when I told him I was seriously depressed he told me that I wasn't -that- seriously depressed because I was able to make jokes about my condition (how the hell else do you cope? The day I can no longer laugh at the absurdity of it all will be the day I have completely given up). I am now trying not to think too much about the session or I will burst some type of blood vessel. I have another meeting with him on Thursday to "straighten" some things out (I have visions of straightening things out with a large golf club, ok, not really, but it is fun to visualize).
>
> So, the result of all of this is that this so-called doctor wants to prescribe Serzone. I've been through several SSRIs with only temporary success at high doses. What are other's experiences on Serzone?
>
> Thanks for the feedback, I'm going to try to let go of some of this stress I'm harboring.
>
> ErinErin,
I hope you are now taking Serzone. It was the last ssri I had to try that finally worked and didn't cause the weight gain that I experienced with Prozac and Zoloft. As long as I take it before I go to bed, I seem to feel really good. I take it in combination with Klonopin for anxiety. The anxiety is basically gone. However, it did take a while to kick in--3-5 weeks. If I skip a dose, though I feel really sick the next time I take it, so stay on the regimen. And Good Luck.
Posted by Steve on August 13, 1999, at 23:18:08
In reply to Serzone users please reply, posted by Erin on July 7, 1999, at 1:25:06
Erin
I took Serzone early last year and it really seemed to make a difference. But I would go up and up and up and plateau and go up and plateau and eventually the whole thing seemed to break down.The real problem is that all the literauture talks about being on it until you can come off it. But I just seem to have to get up to high doses of everything and when I ask the Doc when am I coming off it she just says ....well some people are just going on it for life.
Any way.........that's beside the point....while it was working I was able to day that I felt better than I had for 30 years....pity it stopped working.
I had taken Sinequan, Prozac, and am now back on Dothep.....same thing is happening.
Then another counsellor said to me ( what I already know) "You know the research seems to be saying that you cope just as well when you're off as when you're on.
I find this fairly depressing!!!
Steve
Posted by TAMARA on February 23, 2000, at 13:00:04
In reply to Re: Serzone users please reply, posted by doug t on July 13, 1999, at 16:43:37
i did take serzone for awhile and really liked it . the only side affect that I had which drove my nuts was itchiness on my face, only with a slight rash. has anyone else experienced itching at all?
i think that was the only problem I had and some flushing in the face?
i just want to know if anyone else has that or if I am crazy.I have tried all the ssri,s and they all give me severe migraines and interfere with my sleep. I have also tried wellbutrin, and remeron. I like serzone because I sleep so well and actually have nice dreams.
Posted by Elizabeth on February 23, 2000, at 14:59:52
In reply to itchiness?, posted by TAMARA on February 23, 2000, at 13:00:04
Sounds like a mild allergic reaction to me. Rash is often a sign of allergies (I've heard of people being allergic to SSRIs, though never Serzone).
If it's okay with your doctor, you might try adding an antihistamine -- maybe one of the nonsedating ones (Zyrtec, Allegra, Claritin) -- or augmenting with an antihistaminic antidepressant (a tricyclic (e.g. doxepin) or Remeron).
This is the end of the thread.
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