Posted by Scott L. Schofield on April 23, 2000, at 11:27:36
In reply to Re: Serzone--have I overlooked its potential?, posted by ChrisK on April 23, 2000, at 6:56:54
Noa - Adding mirtazapine (Remeron) to nefazodone (Serzone) is supposed to be a very effective combination. I imagine the Remeron would also help with sleep.
Can the addition of thyroid hormone interfere with sleep?
Cindy - It makes a great deal of sense to combine Serzone with an SSRI. Doing so is a well recognized strategy to treat any residual OCD symptoms that Serzone has missed. Note that in the excerpt below, it is suggested that Serzone be started first, and the SSRI added afterwards. Although two SSRIs are suggested because they tend to interact less with Serzone metabolically, neither may be the one drug that your OCD symptoms will respond to best. If you have already had success with a particular SSRI, it might make sense to try that one first. If you decide on one, post a question to Cam W for his input on how the two drugs interact pharmacokinetically (how the two drugs affect each other's levels in the blood and/or tissues). If he is unavailable, your pharmacist should be able to find out for you. Many such combinations are managed without too much difficulty.
- Scott---------------------------------------------
Excerpts from:
Combining Antidepressants Can Boost Efficacy
Carl Sherman, Contributing Writer
[Clinical Psychiatry News 27(4):20, 1999. © 1999 International Medical News Group.]This article was a summary of a lecture given by Dr. Lauren Marangell. She is a research clinician at New York University.
* Noa - When Dr Marangell was working at the NIMH, she had begun a project in 1993 studying thyroid function in mood-disorders, which included intrathecal TRH challenges. I never looked into what her group came up with.
...Nefazodone is a rational addition to venlafaxine because there is no pharmacokinetic interaction, and it appears to improve sleep and sexual function. Anecdotal reports suggest that mirtazapine can achieve "fantastic results" when combined with venlafaxine, she said.
...
When nefazodone -- a weak serotonin and norepinephrine reuptake inhibitor that blocks 5-HT2 receptors -- is the first drug, an added SSRI is often helpful for residual depressive and obsessive symptoms. This sequence is better tolerated than the reverse order, which promotes the buildup of a nefazodone metabolite (mCPP) that can provoke anxiety, Dr. Marangell said.
Citalopram or low-dose sertraline have the least pharmacokinetic interaction with nefazodone, she said.
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poster:Scott L. Schofield
thread:30979
URL: http://www.dr-bob.org/babble/20000420/msgs/31067.html