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Serzone to Paxil for social phobia

Posted by Joe Schmoe on June 10, 2001, at 20:49:26

I started on Serzone 67 days ago for social anxiety. I gradually raised the dosage to 550mg/day, split between morning and evening. As the dosage got higer I always gave it a week or ten days to assess the effect at that dosage before raising it by 50 mg.

While taking it I read portions of Listening to Prozac. I recognized myself in the descriptions of people with sensitivity and social inhibition - I have not suffered from major depressive episodes, but rather from nervousness and a tendancy toward pessimism and frequent minor depression. In adulthood I developed full blown social phobia, which was misdiagnosed as panic disorder. I have managed to get by over the years with occasional use of Xanax and inderal. I was even on imipramine which helped me to get over the worst of it a decade ago. While I can survive on occasional use of xanax, even a small amount (0.25 or 0.5 mg) at once makes me very dopey. I decided to try an antidepressant again (imipramine had very harsh side effects so I discontinued it after a year and a half, long ago) and Serzone seemed to have the most benign side effects profile in terms of weight gain and sexual disfunction.

The first week on Serzone I felt a little manic. Then a depression started which lasted for six weeks, getting worse and worse. It finally lifted soon after I hit 550 mg/day. While I was still able to perform sexually, my desire definitely decreased. I began to feel tired all the time, and dopey during the day at work - people asked if I was on some cold medication or something. I waited for it to wear off, but it never did. My blood pressure was 100/58, very low for me. Emotionally I felt pretty good most of the time, at least when I was not dopey, and my backaches I have been suffering from for months definitely decreased. However, in unpleasant or even just crowded social conditions, I did not feel significantly better in terms of anxiety even at 550/day and after being on the stuff two months. Oh yeah, I had those trippy visual trails too anytime I emerged from darkness into light, typically early in the morning or when getting up during the night.

My doctor was unimpressed with Serzone and now has me weaning off it, going down 50 mg at a time every four days. She wants to try me on Paxil, which is notorious for weight gain and sexual disfunction - it doesn't sound very appealing. But the constant tiredness of Serzone and the dopiness at work is not practical. I was hoping that it would eventually go away, but after two months and then some, it hasn't.

I hate to give up on it, because I have heard it takes a long time to work, but this is getting ridiculous. Who ever heard of a medicine that takes three or four months to work? Paxil, if it works, is supposed to be much faster than that. Serzone would be worth waiting for if the tiredness (and low blood pressure) wore off, because then I would not have the weight or sexual problems of the other drugs, but it seems unlikely to work any better after three months than after two. And so far it is not worth the side effects. It has not done any wonders for my social anxiety. The drug studies done on Serzone were for 4 to 6 weeks, I don't recall reading anything about it taking three months to kick in anywhere but an occasional post on the Internet. I have not seen any literature to support that claim, and indeed where would they get the evidence? Typically if a medicine doesn't work in a month they take the patient off it and try something else.

I am down to 450 mg/day now. My backaches are coming back and I feel somewhat depressed, but my libido is returning a bit. I am curious if anyone has gone from Serzone to Paxil and what the result was. Is there any reason why I should stay on Serzone at a certain dosage for awhile? It seems clear it doesn't work and the tiredness is not going away. Tapering off at this rate will take 40 days!


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poster:Joe Schmoe thread:66074
URL: http://www.dr-bob.org/babble/20010605/msgs/66074.html