Posted by Cam W. on February 9, 2000, at 7:35:27
In reply to Re: How Do Prozac & Serzone Work Different?, posted by JohnL on February 9, 2000, at 4:34:45
> > In a reply to an earlier post, I had stated that my doctor had put me on Serzone, and for about 2 months I suffered through treatment on it. It had no effect on my depression. In fact, it almost seemed to make matters worse--my irritability, anxiety, and outbursts seemed to intensify. I then insisted my doctor put me back on Prozac, which I had previously taken for more than 6 years very successfully. I am wondering if anyone out there can explain to me how these two drugs work so differently? What is it that Prozac does in the brain that Serzone doesn't do? Has anyone else experienced anything like this? Any info would be helpful. Thanx!
>
> Tough questions. I don't think anyone knows for sure why one works and another doesn't. It all has to do with how well a particular drug targets the underlying problem. Metabolites and liver enzymes probably have some poorly understood connection as well I think.
>
> Prozac and Serzone both inhibit reuptake of serotonin. Serzone also has some norepinephrine reuptake inhibition as well. And Serzone blocks certain receptors, which theoretically aids sleep and sexual function as well as serotonin stimulation. Prozac doesn't do that. Sounds good in theory. But if it doesn't address the underlying problem, or influences something that isn't a problem to begin with, there will be negative results.
>
> I too got worse on Serzone. It's just my own theory, and my doc chuckled at it, but I think maybe in some people blocking those receptors is not a good idea. And in some people, increased norepinephrine will make things worse. Those are my own far fetched theories of why Serzone makes some people worse. Wild guesses. I guess it all depends on how a particular person's brain is wired. And what chemical imbalance exists. All that really matters though, I think, is accepting when something works or doesn't work, whether we understand why or not. So often we find that what works in theory doesn't actually work in reality for each person. And often a drug from a different psychiatric class works wonderfully, when more appropriate drugs didn't work at all. Only through medication reactions can we find the best fit and find a clue as to what the underlying chemical imbalance/failure/instability is.
>
> Why does Prozac work with you but Serzone doesn't? Your guess is as good as mine. :) JohnLAlice - Actually Serzone has very little norepinephrine reuptake inhibition (John may be thinking of venlafaxine - Effexor). Serzone, or more accurately its major metabolite, block serotonin reuptake and also blocks the serotonin-type 2 receptor. This is supposed to give the drug less side effects than the SSRIs (decreased anxiety, insomnia & sexual dysfunction), although Serzone can stillexhibit these side effects. Serzone does seem to improve the quality of sleep, but this may be due to its antidepressant action, rather than an extra feature. Serzone does mildly block alpha-1 adrenergic receptors, but not enough to cause any heart problems (like the TCAs).
Perhaps why Prozac works for you and Serzone doesn't, could be that Prozac's half-life, a measure of the length of time it works in the body is much longer than that of Serzone (with metabolites - approx. 3 - 5 days vs under 1 day). In some people, short acting drugs like Serzone don't seem to improve depressive symptoms as well as the longer acting agents. Hope this helps. Cam W
poster:Cam W.
thread:20849
URL: http://www.dr-bob.org/babble/20000209/msgs/20894.html