Posted by Cam W. on January 26, 2000, at 7:20:48
In reply to Re: Cam W: med augmentation for Serzone?, posted by Cam W. on January 25, 2000, at 22:55:19
> > How kind of you to offer your expert help. Thank you so much. What about augmentation for Serzone? It doesn't have the side effects of sweating, and appetite stimulation and weight gain that I have had on other AD's. But even at 500 mgs a day, I am still having lots of rummination, anger problems, sometimes, and insomnia. Also have to go to bathroom VERY frequently. I wake up several times each night and sometimes wake at 2 AM and can't ever get back to sleep. My only other medication is Prevacid for stomach ulcers. Any suggestions?
>
> Mrs.G. - You can basically think of Serzone as an SSRI like Paxil, Prozac, Zoloft, etc. with the added features of Serotonin-2 & Serotonin-3 receptor blockade. What this means is that they tried to make a selective serotonin reuptake inhibitor (SSRI) without the side effects. By blocking serotonin-3 receptors they are trying to (in theory) stop the SSRI-induced stomach upset and diarrhea. It didn't really work that well, but Serzone is an effective antidepressant in many people.
>
> It is interesting that you brought up that you are taking Prevacid. Serzone and Prevacid are metabolized partially by the same enzyme system (called the cytochrome P-450 system 3A4 - CYP-3A4)
> Serzone inhibits this enzyme system, meaning that it causes less of the CYP-3A4 isoenzyme to be produced. With less enzyme present to metabolize both the Serzone and especially the Prevacid may not be (and I do mean MAY not be - other enzymes systems are also involved - CYP-2C19-, so the effect MAY be insignificant) being metabolized and you MAY have higher levels of Prevacid in your body than you should. The effect would be like taking extra Prevacid. This could be causing some of your side effects, especially the diarrhea and perhaps abnomal thinking, agitation, confusion, anxiety and nervousness.
>
> Now, again I caution you on taking this as gospel because it would be hard to prove. Discuss it with your doctor and maybe a change of stomach medicine might be in order to see if the bothersome side effects subside. Perhaps suggest Axid (nizatidine) or Pepcid (famotidine) to your doctor for a trial. If the side effects clear up, then you know it was the Prevacid (probably) and if they don't, you can always go back to taking the Prevacid. Give the Axid (or Pepcid) a trial of at least a month to ensure that the Prevacid is washed out of the body.
>
> Let me know how things turn out. I would be EXTREMELY interested to see what happens. Contact me through this forum if you doctor wants to talk to me about this. Good luck - Cam W.
>
Mrs. G. - Further to my last comments. I did a little more digging and have found that another side-effect of Prevacid is urinary urgency. Hmmm, I wonder, Prevacid by itself could be the culpert in you side-effects or it's they are being augmented by the Serzone. Cam W.
poster:Cam W.
thread:19639
URL: http://www.dr-bob.org/babble/20000112/msgs/19719.html