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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Mr. Scott on December 1, 2003, at 15:12:57
Is anyone still using this drug? I heard about the rare liver stuff, but may have to try it anyways. Your sharing of any experiences with this chemical is appreciated.
Rich
Posted by Larry Hoover on December 1, 2003, at 16:06:07
In reply to Serzone (Nefazodone), posted by Mr. Scott on December 1, 2003, at 15:12:57
> Is anyone still using this drug? I heard about the rare liver stuff, but may have to try it anyways. Your sharing of any experiences with this chemical is appreciated.
>
> RichIt's the worst drug I ever took, but hey! you might get lucky.
The totally sucky liver failure thing is rare. More problematic is the fact that nefazodone is a powerful inhibitor of the liver cytochrome enzyme isoform 3A4....which is responsible for the breakdown and excretion of about 50% of all drugs, in whole or in part....the risk of interaction is substantial. Moreover, many drugs that are metabolized by 3A4 are also worked on by 2D6, and if you're a "poor metabolizer" (like me), that can spell real trouble. There is a genetic variability in 2D6 activity that varies by 100-fold or more, across the population. People with low 2D6 activity do not metabolize codeine well, for example (all side effects, little analgesia). If you have low 2D6 activity, and you block 3A4, you could end up with some severe liver injury. Make sure you check a table like the one at the following site, for possible drug interactions. Do not take tylenol when using this drug. If you're taking stuff that's not in the tables, do a google search on the drug name and 3A4, and see if it comes up as a substrate. Google likes keywords like 3A4, cause it's not a common "word".
Good luck,
Larhttp://www.erowid.org/psychoactives/pharmacology/pharmacology_enzymes1.shtml
Posted by Waterlily on December 1, 2003, at 16:33:07
In reply to Serzone (Nefazodone), posted by Mr. Scott on December 1, 2003, at 15:12:57
I was on it for a while. I had a difficult time with it at first, but later did fine with it. It was added to my Wellbutrin to offset anxiety, but I couldn't really tell if it was working. After going off it, I realized that it did work to an extent. My pdoc had me get my liver enzyme levels tested when I first started it and at intervals after that. He said that if there was any elevation in the levels you'd be able to go off of Serzone before it caused much damage.
Posted by mattdds on December 1, 2003, at 19:30:08
In reply to Serzone (Nefazodone), posted by Mr. Scott on December 1, 2003, at 15:12:57
Hey,
I took Serzone, and really ramped up on it. For me, I did not have any side effects, other than a little better sleep / mild sedation. The downside? I did not have any positive effects either. I even ramped up to 400 mg daily, which I guess is pretty high.
I ditched it, because it did not do a damn thing (neither good nor bad). So I figured why risk the rare liver thing unless I was getting some real benefit.
I've heard of some (few) others that have a lot of success with this drug, but it doesn't seem to get a lot of positive responses in general. I think the cliche YMMV certainly applies here.
Best,
Matt
Posted by Emme on December 1, 2003, at 21:45:09
In reply to Re: Serzone (Nefazodone) » Mr. Scott, posted by mattdds on December 1, 2003, at 19:30:08
It didn't do anything for me by itself, but worked will in combination with Wellbutrin.
I had visual trails on it, but not enough to be annoying.
Larry, thanks for the enzyme info.
Emme
Posted by Bill LL on December 2, 2003, at 9:56:39
In reply to Serzone (Nefazodone), posted by Mr. Scott on December 1, 2003, at 15:12:57
Don't worry about the liver. If it is going to affect the liver, it does so right away. If your 6 month liver test is ok, you should be fine. If not, you would discontinue the drug.
> Is anyone still using this drug? I heard about the rare liver stuff, but may have to try it anyways. Your sharing of any experiences with this chemical is appreciated.
>
> Rich
This is the end of the thread.
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