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Re: Seeing tracers! » Miss Amy

Posted by Sunnely on April 4, 2001, at 19:26:00

In reply to Seeing tracers!, posted by Miss Amy on April 4, 2001, at 9:26:44

Hi Miss Amy,

I believe this question was asked a few months ago but will revisit to answer your question/concerns.

Visual disturbances, such as the one you described, have been reported with the use of Serzone (nefazodone). Sometimes described as "visual trails," or "ghost shadows," or "trailing phenomenon," they are technically termed, "palinopsia."

The exact cause or reason as to why they occur is unknown. This phenomenon seems to occur in a dose-related fashion that is, the higher the dose, the higher the chance of it occurring. Palinopsia is commonly considered one of the visual effects from hallucinogen use, but it has also been reported as a result of medications and structural brain lesion. Serzone-induced palinopsia may be due to its serotonin effects. It has been described that dysfunction in the inhibitory mechanisms of the visual circuitry may be involved in palinopsia in users of LSD. LSD and serotonin have structural similarities, and LSD blocks serotonin 2A (5-HT2A) receptors in the cerebral cortex. One theory proposes that LSD binds to and destroys these receptors, eliminating serotonin-mediated inhibition of the visual pathways. Serzone is a phenylpiperazine antidepressant with a unique mechanism of action: it is a potent, selective antagonist (blocker) of the 5-HT2A receptor and has serotonin and norepinephrine reuptake inhibitory effects as well. Thus, 5-HT2A blockade may be the mechanism responsible for Serzone-induced palinopsia.

It is not exactly known how long they last. One patient reported in a psychiatric literature experienced this phenomenon for approximately 3 months but it became shorter in duration and he became adapted to it. After Serzone was stopped, the palinopsia remained for approximately 3 days before resolving completely.

If these visual tracers are distressful for you, lowering the dose of Serzone may alleviate the problem. On the other hand, if you find it "cool" to wake up in the morning and start the day in "living color," you may opt to keep same dose. No long-term or permanent harmful effects known.

Incidentally, this visual phenomenon has also been reported with trazodone (Desyrel) which has some similarity in chemical structure with Serzone.

Happy "Trails" To You! :-)

++++++++++++++++++++++

> Okay. I have had NO side effects from Serzone until night before last. I had heard from my mother's doctor that they found it more effective to take Serzone as a once a night dose, instead of dividing it between morning/night. I've been taking 200mg. at night and 100mg. in the morning. So I asked my doctor about it. Now I am taking 350mg. every night (doc raised my dose--thought it would help me) and for the last two mornings upon rising, I am seeing tracers/auras and some crazy visual stuff. The serzone is obviously working though---the old me would have crapped my pants (pardon the phrase) if I had started hallucinating. Now I am just kind of cool with it, even though I don't like it. Will this go away? Am I suddenly taking too much? Am I harming myself? If anyone has an opinion or experience with this please let me know. Hope everyone is having a good day!!!!
> Miss A


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