Posted by JohnL on April 27, 2000, at 4:56:06
In reply to Input requested on Serzone, posted by Lynn on April 25, 2000, at 16:56:53
> Hi, I'm new to this board. You all sound VERY knowledgable about antidepressant meds and switching and or using some in combination. I've been treated for depression with anxiety for the past four years with Zoloft(100mg) and a small amount of Doxepin(10)mg with moderate success. Recently it appeared to be less effective, and I found myself crying again. My Dr. wanted me to try Effexor, but I had heard its pretty activating (nervousnes/insomnia) and read horror stories about withdrawl should I ever need to get off it. I was put on Remeron instead, at a higher dose to combat sedation. I tried it for two weeks, but couldn't believe how stoned it makes you feel at first. It also caused a wierd "rush" feeling which caused an anxiety attack. So, I ended up going on St. John's Wort for a few weeks, but wasn't able to sleep and my Dr. said I couldn't mix anything with it as far as antidepressants to address the sleep problem.
> So, after a month of this, I went back to the Zoloft/Doxepin. I don't have much faith in this combination since it stopped working and I'm not even sure if starting it again after a month will work now or not. I am thinking of giving Serzone a try. I get really bad PMS though and don't need the "anger" symptoms that I've read about. Any advice would be very appreciated. Thanks and peace to all. LynnLynn,
I know one doctor who is actually having good success with Serzone in his patients. But he claims the success is due to his dosing strategy. He starts patients at 50mg a day, and then increases dose by 25mg to 50mg no faster than every four days. But he tries to keep dose increases in small steps spaced a week apart. This is considerably more conservative than the instructions in literature. But for some reason, the doc claims this low and slow approach works. I takes a few weeks longer to get to the higher doses, but the end result may be worth the patience.
To diminish side effects, he doses Serzone only once a day (usually late afternoon, early evening) up to 300mg. Controlled studies have shown once daily dosing is not significantly different from multiple dosing in desired results. He claims the low and slow approach goes a long way to diminishing side effects as well. Any amount over 300mg is taken in a second dose, at whatever time of the day works best for the patient.
I've also read sporadic accounts of a narrow therapeutic window with Serzone. The low and slow method allows us to find that window without blowing right past it.
poster:JohnL
thread:31249
URL: http://www.dr-bob.org/babble/20000420/msgs/31438.html