Posted by Cam W. on October 20, 2001, at 4:01:16
In reply to Re: Proposed Mechanisms of Action of Lamotrigine » Cam W., posted by Hattree on October 19, 2001, at 21:56:11
Hattree - I have personally had no experience with Serzone™ (nefazodone) and Lamictal™ (lamotrigine), but this does not mean that they couldn't be used together, but the dosing of the Lamictal "might" possibly be tricky.
Serzone is a very potent inhibitor of the cytochrome-P450-3A4 (CYP-3A4) system, an enzyme system that is responsible for metabolizing many medications. Although Lamictal is not listed as being metabolized in the CYP-3A4 system, Lamictal's main metabolite is formed by glucuronidization in the liver, which (I believe, not absolutely sure) is one mechanism of metabolism used by the cytochrome system.
It may be prudent to watch carefully for an increase in Lamictal side effects if you switched from Zoloft™ (sertraline) to Serzone.
I am also a believer in "If it ain't broke, don't fix it". Unless the side effects from the Zoloft are intolerable, I would be reluctant to switch to Zoloft. If you switch, and Serzone doesn't hold your depression (or whatever syndrome you are using it for) at bay, "sometimes" upon retrial, an SSRI does not seem to work as well as it did originally. This is not always the case, but I say why risk it.
Talk to your doc about this and get his/her opinion on this, as well. I do hope that this has been of some help. - Cam
poster:Cam W.
thread:81710
URL: http://www.dr-bob.org/babble/20011015/msgs/81760.html