![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 30. This is the beginning of the thread.
Posted by sageblue on July 24, 2004, at 21:48:57
I have pretty horrid anxiety and concentration, not to mention common migraines.
These were not a serious problem back when I was on Serzone, but I developed bad reactions to it and had to come off of it.
What could I take that could do the same things that Serzone does, without _being_ Serzone?
Posted by King Vultan on July 24, 2004, at 23:58:09
In reply to what med would have a similar effect to serzone?, posted by sageblue on July 24, 2004, at 21:48:57
Trazodone is the most similar drug pharmacologically to Serzone, but it is much more sedating. I can't really recommend it. However, from your symptoms, I would suggest considering nortriptyline. I personally found it very good for anxiety and for eliminating my chronic headaches, and I believe its selective blockade of norepinephrine reuptake was what was responsible for improving my concentration. It is moderately sedating, less so than trazodone, but perhaps somewhat more so than Serzone.
Todd
Posted by HappyGirl on July 25, 2004, at 10:46:36
In reply to what med would have a similar effect to serzone?, posted by sageblue on July 24, 2004, at 21:48:57
Hi:
In my case, a sister AD to Serzone, 'Trazodone' is 'WONDER' on me. However, your symptoms are quite complexed, saying 'migraine' on top of depression. Then, seriously, I have NO good clue in regard to a good replacement of Serzone.The reason why I got off of Serzone was because it seemed 'toxicity' I started to develpe due to the long-term use along with relatively 'high' dosage of Serzone. On my last appt. with my pdoc., I complained about a massive liquid intake during the nights that interfered my sleep-pattern tremendouly. After a 'baby dosage'/beginner-dosage of Trazodone, I started to sleep VERY soundly with just once to the bathroom which is nothing unusal for me before my Bp. Also, I started experiencing MORE alert during the day without sedating effect that caused by 'mass' dose of Serzone, mostly 450 mg.
However, Serzone DID help me so much until this, tremendous thirst developed that I credited to the use of Serzone for the past three years.
For me, the Serzone did 'WONDER' on both AD and Anxiety. As to concentration, I've been on WB sr 200 mg. that helps, but not 100%. But, having Bp, I can live with this degree of concentration problem brought up by Bp.
H.G.
Posted by Sad Panda on July 26, 2004, at 11:05:41
In reply to Re: what med would have a similar effect to serzone?, posted by King Vultan on July 24, 2004, at 23:58:09
> Trazodone is the most similar drug pharmacologically to Serzone, but it is much more sedating. I can't really recommend it. However, from your symptoms, I would suggest considering nortriptyline. I personally found it very good for anxiety and for eliminating my chronic headaches, and I believe its selective blockade of norepinephrine reuptake was what was responsible for improving my concentration. It is moderately sedating, less so than trazodone, but perhaps somewhat more so than Serzone.
>
> Todd
>I would vote for Nortriptyline too.
Cheers,
Panda.
Posted by KaraS on July 26, 2004, at 14:03:47
In reply to Re: what med would have a similar effect to serzone?, posted by Sad Panda on July 26, 2004, at 11:05:41
> > Trazodone is the most similar drug pharmacologically to Serzone, but it is much more sedating. I can't really recommend it. However, from your symptoms, I would suggest considering nortriptyline. I personally found it very good for anxiety and for eliminating my chronic headaches, and I believe its selective blockade of norepinephrine reuptake was what was responsible for improving my concentration. It is moderately sedating, less so than trazodone, but perhaps somewhat more so than Serzone.
> >
> > Todd
> >
>
> I would vote for Nortriptyline too.
>
> Cheers,
> Panda.
>
>
Just one caveat. Some people find nortriptyline very stimulating. It had that effect on me. If you start on it, start it slowly. You'll know right away if you're one of those people.
Hope it works for out for you!
Kara
Posted by sageblue on July 27, 2004, at 0:38:11
In reply to what med would have a similar effect to serzone?, posted by sageblue on July 24, 2004, at 21:48:57
thanks for everyone's suggestions -- nortrip might be a good idea, as i know it is also used as a migraine med.
honestly, on serzone, i felt a _little_ sedate, but not too bad -- and mentally stimulated in a positive way, where my focus was very good. so maybe it would work.
right now i'm working with a neurologist who seems very interested in using a beta blocker to prevent my migraine. it probably works well for a lot of people, but i felt depressive and unmotivated.
*sigh*
was i wrong to hope that effexor could be like a friendlier version of serzone?
Posted by sageblue on July 27, 2004, at 0:52:50
In reply to what med would have a similar effect to serzone?, posted by sageblue on July 24, 2004, at 21:48:57
oh, another thing, i just saw that nortrip is not as friendly for patients who are receiving thyroid medication, like me. (i have an endocrine problem.) so ?
Posted by Sad Panda on July 27, 2004, at 1:51:03
In reply to Re: what med would have a similar effect to serzone?, posted by sageblue on July 27, 2004, at 0:52:50
> oh, another thing, i just saw that nortrip is not as friendly for patients who are receiving thyroid medication, like me. (i have an endocrine problem.) so ?
>
>I haven't seen that info written anywhere, can you point me to a web page?
Nort is a 5-HT2A blocker like Serzone is & it has proven efficacy as a migraine prevention drug. Other drugs used for migraine prophylaxis are also 5-HT2A blockers.
I am taking Effexor, Nort & Thyroxine & I would definately try Nort first as you might find it's side effects profile to your liking. For me, Nort has practically no side effects at 75mg, it's like eating candy compared to Effexor & SSRI's. I'm just waiting to see my pdoc before I go higher.
Cheers,
Panda.
Posted by flipsactown on July 27, 2004, at 2:55:11
In reply to Re: what med would have a similar effect to serzone? » sageblue, posted by Sad Panda on July 27, 2004, at 1:51:03
Panda,
What about weight gain on Nort? I am thinking of trying Nort to augment Lexapro not so much for AD effect but for chronic pain relief, but want to stay away from gaining weight.
FST
> > oh, another thing, i just saw that nortrip is not as friendly for patients who are receiving thyroid medication, like me. (i have an endocrine problem.) so ?
> >
> >
>
> I haven't seen that info written anywhere, can you point me to a web page?
>
> Nort is a 5-HT2A blocker like Serzone is & it has proven efficacy as a migraine prevention drug. Other drugs used for migraine prophylaxis are also 5-HT2A blockers.
>
> I am taking Effexor, Nort & Thyroxine & I would definately try Nort first as you might find it's side effects profile to your liking. For me, Nort has practically no side effects at 75mg, it's like eating candy compared to Effexor & SSRI's. I'm just waiting to see my pdoc before I go higher.
>
> Cheers,
> Panda.
>
>
>
>
>
>
Posted by Sad Panda on July 27, 2004, at 5:28:20
In reply to Re: what med would have a similar effect to serzone? » Sad Panda, posted by flipsactown on July 27, 2004, at 2:55:11
> Panda,
>
> What about weight gain on Nort? I am thinking of trying Nort to augment Lexapro not so much for AD effect but for chronic pain relief, but want to stay away from gaining weight.
>
> FST
>
>Nort would be alot better than the tertiary TCA's, but you would have to try it to find out. It's is only a very modest antihistamine, so I would expect it to be fine. If it's side effects don't give you trouble then I think it is the ideal thing to add to an SSRI.
Cheers,
Panda.
Posted by zeebop on July 28, 2004, at 4:47:48
In reply to Re: what med would have a similar effect to serzone?, posted by Sad Panda on July 26, 2004, at 11:05:41
AD's that have potent 5ht2 antagonism apart from Nefazodone :
Amitriptyline
Trimipramine
Clomipramine
Nortriptyline
Dothiepin
Trazodone
Mianserin
Mirtazapine
Posted by Larry Hoover on July 28, 2004, at 9:10:20
In reply to what med would have a similar effect to serzone?, posted by sageblue on July 24, 2004, at 21:48:57
> I have pretty horrid anxiety and concentration, not to mention common migraines.
>
> These were not a serious problem back when I was on Serzone, but I developed bad reactions to it and had to come off of it.
>
> What could I take that could do the same things that Serzone does, without _being_ Serzone?Hmmm, I didn't see this one suggested (and I'm not a pharmacology geek, just maybe pharmacology-aware), but what about Remeron (mirtazapine)?
I had thought its development was spurred by trying to develop a "better" Serzone. Non?
Lar
Posted by Sad Panda on July 28, 2004, at 10:28:15
In reply to Re: what med would have a similar effect to serzone? » sageblue, posted by Larry Hoover on July 28, 2004, at 9:10:20
> > I have pretty horrid anxiety and concentration, not to mention common migraines.
> >
> > These were not a serious problem back when I was on Serzone, but I developed bad reactions to it and had to come off of it.
> >
> > What could I take that could do the same things that Serzone does, without _being_ Serzone?
>
> Hmmm, I didn't see this one suggested (and I'm not a pharmacology geek, just maybe pharmacology-aware), but what about Remeron (mirtazapine)?
>
> I had thought its development was spurred by trying to develop a "better" Serzone. Non?
>
> Lar
>
>Mirtazapine was developed as the better Mianserin, Mirtazapine is 6-aza-mianserin. Mianserin was tarnished because it sometimes causes agranulocytosis, Mirtazapine was supposed to correct this problem, but it can cause agranulocytosis too.
Serzone was developed as a better Trazodone, but the only real advantage was a new patent.
Cheers,
Panda.
Posted by sageblue on July 28, 2004, at 11:41:05
In reply to Close » Larry Hoover, posted by Sad Panda on July 28, 2004, at 10:28:15
Posted by HappyGirl on July 28, 2004, at 13:16:30
In reply to Re: what med would have a similar effect to serzone?, posted by zeebop on July 28, 2004, at 4:47:48
Hi Zeebop:
I never heard/read the following meds. except Trazodone.
It sounds to me like all of those ADs are 'older,' ... but I wonder about their 'efficacy?'>>>AD's that have potent 5ht2 antagonism apart from Nefazodone :
Amitriptyline
Trimipramine
Clomipramine
Nortriptyline
Dothiepin
Trazodone
Mianserin
Mirtazapin<<<
Since I had no tolerance on all of SSRIs, then my pdoc. rxed Serzone which did help me tremendously. However, due to the mass' dosage along with more than 3 years' use, my system seemed NOT able to handle Serzone.Currently, I'm on around 100 mg. Trazodone, although I was on 450 mg. Serzone/Nefadone for the past three years. For me, it's so amazing this, 'tiny' dosage 100 mg. Traz. has been taking place of 450 mg. Serzone.
However, I'm worrying about whether this 'small' dosage continue helping the depressive side of my Bp.Your opinion and suggestion would be greatly appreciated.
H.G.
Posted by Sad Panda on July 30, 2004, at 7:07:41
In reply to what's agranulocytosis? (nm) » Sad Panda, posted by sageblue on July 28, 2004, at 11:41:05
Is a disease that reduces the amount of white blood cells you have in circulation which makes you susceptible to infection. Without enough white blood cells a common cold can kill you. It corrects itself as soon as you stop taking the med that is causing it.
Cheers,
Panda.
Posted by Sad Panda on July 30, 2004, at 7:23:35
In reply to Question to zeebop, posted by HappyGirl on July 28, 2004, at 13:16:30
> Hi Zeebop:
> I never heard/read the following meds. except Trazodone.
> It sounds to me like all of those ADs are 'older,' ... but I wonder about their 'efficacy?'
>
> >>>AD's that have potent 5ht2 antagonism apart from Nefazodone :
> Amitriptyline
> Trimipramine
> Clomipramine
> Nortriptyline
> Dothiepin
> Trazodone
> Mianserin
> Mirtazapin<<<
> Since I had no tolerance on all of SSRIs, then my pdoc. rxed Serzone which did help me tremendously. However, due to the mass' dosage along with more than 3 years' use, my system seemed NOT able to handle Serzone.
>
> Currently, I'm on around 100 mg. Trazodone, although I was on 450 mg. Serzone/Nefadone for the past three years. For me, it's so amazing this, 'tiny' dosage 100 mg. Traz. has been taking place of 450 mg. Serzone.
> However, I'm worrying about whether this 'small' dosage continue helping the depressive side of my Bp.
>
> Your opinion and suggestion would be greatly appreciated.
> H.G.
>Mirtazapine is the generic name of Remeron, Mianserin is an older version or Mirtazapine. Trazodone(Desyrel) is a bit like the older version of Nefazodone(Serzone). Amitriptyline(Elavil, Tryptanol, Endep), Trimipramine(Surmontil), Clomipramine(Anafranil), Nortriptyline(Pamelor, Allegron), Dothiepin(Prothiadin, Dothep) & Doxepin(Sinequan, Deptran)
are TCA's. Imipramine(Tofranil) & Desipramine are also TCA, but they aren't 5-HT2A antagonists.
Most of the TCA's have better efficacy than the SSRI's & Effexor, it just depends which set of side effects you prefer.Cheers,
Panda.
Posted by HappyGirl on July 30, 2004, at 8:27:59
In reply to Re: Question to zeebop » HappyGirl, posted by Sad Panda on July 30, 2004, at 7:23:35
Hi:
Thanks for a good information/knowledge regarding the 'older' version of meds. similar to the Serzone.At first, I thought the Trazodone was a terrific 'replacement' of the Serzone. However, I can NOT take more than 100 mg. Traz. because of the drowsiness/sedation I feel during the morning hours, ... until noon-time. Then, I started thinking about 150 mg. Serzone during the day because I still feel depressive feelings on which I suspect 'low' dosage of the Traz. I was on *450 Mg.* Serzone most of the time for the past three years.
Besides this fact, since the depressive side of my Bp is a type of 'major depression,' then my system seems looking for the Serzone. I know I can NOT take the 450 mg. Serzone due to the intense thirst during the sleep, however I strongly feel my system is able to handle this min. '150 mg.' Serzone combined with the 100 mg. Trazodone.
About a week ago, my pdoc. originally rxed *300 mg* Trazodone before the bed-time, ... however on this 'massive' dosage of the Traz., I must admit to never wake up, ... just sleep through all day long. Anyhow, I'm trying to manage my moods by taking Traz. 100 mg. before sleep, but I certainly feel a need of the Serzone very urgently and badly.
Also, the reason I felt 'GOOD' during the first three days after on 100 mg. Trazodone was because of residual efficacy of the Serzone in my system. Now, it must have all GONE, ... NO Serzone at all.If there is/are any more information regarding this, 'Serzone/Trazodone,' I would be very grateful.
H.G.
Posted by Sad Panda on July 30, 2004, at 9:19:32
In reply to Re: Trazodone and Serzone combo.//Sad Panda, posted by HappyGirl on July 30, 2004, at 8:27:59
> Hi:
> Thanks for a good information/knowledge regarding the 'older' version of meds. similar to the Serzone.
>
> At first, I thought the Trazodone was a terrific 'replacement' of the Serzone. However, I can NOT take more than 100 mg. Traz. because of the drowsiness/sedation I feel during the morning hours, ... until noon-time. Then, I started thinking about 150 mg. Serzone during the day because I still feel depressive feelings on which I suspect 'low' dosage of the Traz. I was on *450 Mg.* Serzone most of the time for the past three years.
>
> Besides this fact, since the depressive side of my Bp is a type of 'major depression,' then my system seems looking for the Serzone. I know I can NOT take the 450 mg. Serzone due to the intense thirst during the sleep, however I strongly feel my system is able to handle this min. '150 mg.' Serzone combined with the 100 mg. Trazodone.
>
> About a week ago, my pdoc. originally rxed *300 mg* Trazodone before the bed-time, ... however on this 'massive' dosage of the Traz., I must admit to never wake up, ... just sleep through all day long. Anyhow, I'm trying to manage my moods by taking Traz. 100 mg. before sleep, but I certainly feel a need of the Serzone very urgently and badly.
> Also, the reason I felt 'GOOD' during the first three days after on 100 mg. Trazodone was because of residual efficacy of the Serzone in my system. Now, it must have all GONE, ... NO Serzone at all.
>
> If there is/are any more information regarding this, 'Serzone/Trazodone,' I would be very grateful.
> H.G.
>
>Was it liver problems that caused you to drop Serzone? Could you possibly take a smaller doseage of Traz at lunch time? What sort of problems did you have with SSRI's?
Cheers,
Panda.
Posted by HappyGirl on July 30, 2004, at 10:27:51
In reply to Re: Trazodone and Serzone combo.//Sad Panda » HappyGirl, posted by Sad Panda on July 30, 2004, at 9:19:32
Hi S.P:
Quite luckily, I have *NO* liver problem at all. However, 'intense thirst' might be something to do with this, 'Liver.' Thus, my pdoc. was cautious enough NOT to continue being on Serzone with the 'mass' dosage, 450 mg. However, this is just 'my guess-work,' then I can NOT be sure. There are several reasons for NOT on the Serzone? Or, simply, ... my pdoc. does not like 'generic form of Serzone,' since he always rxes 'new, ... new,... freshly made med. coming into the market.' Thus, I never knew those 'older' form of ADs similar to the Serzone until I read the above/said posts.Next, 'Lunch-time' dosage, ... this is a BIG question, because my systems still has some 'sedating effect' from Trazodone I took before the bed.
Regarding, ... SSRIs, ... I am NEVER tolerable to those form of ADs, as knowing that I had a terrible experience in both, Zoloft and Effexor. The former offered me 'no' relief except 'suicidal thouths' after three days on Zoloft. The latter made me 'heart racing' that almost sent me to the E.R. Then, my pdoc. made a conclusion 'NO SSRIs.' It's quite sad, since I know some of SSRIs have extremely good efficacy on the depressive side of Bp.
Any thoughts would be truly appreciated.
H.G.
Posted by Sad Panda on July 30, 2004, at 11:05:47
In reply to Re: Trazodone and Serzone combo.//Sad Panda, posted by HappyGirl on July 30, 2004, at 10:27:51
> Hi S.P:
> Quite luckily, I have *NO* liver problem at all. However, 'intense thirst' might be something to do with this, 'Liver.' Thus, my pdoc. was cautious enough NOT to continue being on Serzone with the 'mass' dosage, 450 mg. However, this is just 'my guess-work,' then I can NOT be sure. There are several reasons for NOT on the Serzone? Or, simply, ... my pdoc. does not like 'generic form of Serzone,' since he always rxes 'new, ... new,... freshly made med. coming into the market.' Thus, I never knew those 'older' form of ADs similar to the Serzone until I read the above/said posts.
>
> Next, 'Lunch-time' dosage, ... this is a BIG question, because my systems still has some 'sedating effect' from Trazodone I took before the bed.
>
> Regarding, ... SSRIs, ... I am NEVER tolerable to those form of ADs, as knowing that I had a terrible experience in both, Zoloft and Effexor. The former offered me 'no' relief except 'suicidal thouths' after three days on Zoloft. The latter made me 'heart racing' that almost sent me to the E.R. Then, my pdoc. made a conclusion 'NO SSRIs.' It's quite sad, since I know some of SSRIs have extremely good efficacy on the depressive side of Bp.
>
> Any thoughts would be truly appreciated.
> H.G.
>Intense thirst: How is your blood sugar levels?
I would ask your pdoc about Nortriptyline or Desipramine. They are both TCA's which are stimulating(NE ruptake inhibitors) with less side effects than the tertiary TCA's. Nortriptyline is a 5-HT2A blocker like Serzone & Trazodone & could possibly be used as a replacement for either of them, while Desipramine could be used with Traz to see if you like it.
Cheers,
Panda.
Posted by sageblue on July 30, 2004, at 11:32:15
In reply to Question to zeebop, posted by HappyGirl on July 28, 2004, at 13:16:30
H.G.,
hey, serzone withdrawal was the hardest ever. i can relate to where you're coming from with wanting to continue taking it. i also developed odd symptoms and had to get off. in fact, i had to get off of it quite quickly (after 3+ years of accumulated use) as my body thought i was allergic to it.
but, i think it's going to be hard to continue getting a supply of it. are you self-choosing to take 1 serzone a day? are you trying to taper off?
i think you might be looking for the norepinephrine reuptake provided by the serzone -- i personally think that's the aspect that made withdrawal hard, as pure ssri's have never caused me much trouble when withdrawing.
i wonder if another med could give you that noripenephrine stimulus?
Posted by cpallen79 on July 30, 2004, at 12:19:19
In reply to Re: serzone withdrawal, posted by sageblue on July 30, 2004, at 11:32:15
I've heard that Straterra has NE uptake inhibition qualities.. Even though it is prescribed for ADHD, could it perhaps be used for other purpsoes like those listed below? Maybe that would help out Happygirl.
> H.G.,
>
> hey, serzone withdrawal was the hardest ever. i can relate to where you're coming from with wanting to continue taking it. i also developed odd symptoms and had to get off. in fact, i had to get off of it quite quickly (after 3+ years of accumulated use) as my body thought i was allergic to it.
>
> but, i think it's going to be hard to continue getting a supply of it. are you self-choosing to take 1 serzone a day? are you trying to taper off?
>
> i think you might be looking for the norepinephrine reuptake provided by the serzone -- i personally think that's the aspect that made withdrawal hard, as pure ssri's have never caused me much trouble when withdrawing.
>
> i wonder if another med could give you that noripenephrine stimulus?
>
>
>
Posted by HappyGirl on July 31, 2004, at 23:50:51
In reply to Re: Trazodone and Serzone combo » HappyGirl, posted by Sad Panda on July 30, 2004, at 11:05:47
Hi:
Thanks for your info. regarding 'Blood Sugar.' Actually, I, too started suspecting whether the Serzone could affect 'Blood Sugar' level that has some relation to 'Diabetic?'
Since, I have no knowledge as to 'Diabetic,' it's quite 'new/strange' to me. However, one 'Big' change was I started to crave 'sugary drinks.' After stopped the 'Mass' dosage of Serzone, my crave for 'sugary drinks' was over.
Now, somehow, I started 'Grape' drinks. In my recollection, 'Grape' Drinks have some 'chemical,' ... but I can not remember which one.On the Internet, most of the time, people are SO worrisome about the 'Liver,' however there are any other problem due to the Serzone? Not only the Serzone also any other 'potent' psycho.meds., there are some 'risk' as being on them?
Concerning Trazodone and Serzone combo., it seems to work on me, ... not perfect, but much better than Traz. alone. Then, I plan to stick with this combo., ... as long as my mood stays in 'decent' shape. Just a bit over a week on Traz., ... it seems MORE time to help me out.Thanks for your informative response.
H.G.
Posted by HappyGirl on August 1, 2004, at 0:09:29
In reply to Re: serzone withdrawal, posted by sageblue on July 30, 2004, at 11:32:15
Hi:
In regard to 'Serzone Withdrawal,' ... I have NONE, practically, because Trazodone which is a sister med. to the Serzone seems taking care pretty well. Normally, I can NOT remember 'withdrawal symptoms,' not only the Serzone also other psycho.-meds. on which I was for the past five years. In this respect, I might be a 'rare' case. But, of cource, I have no complain about this. As long as it does not bother me, it's OK to me. Once, I was on Busper, I never had any W.D.As to 'self-rx,' .... my pdoc. knew VERY WELL I'm pretty active on the web, ... M.I. support and other related reading materials. Then, he neither complains nor asks about. Rather, he seems to content with this, 'self-rx,' since just 15 min. conversation with him is NOT enough time for me to ask several different questions in the first place.
For me, so far, the Traz. and Serzone combo. seems to start working on me. Then, I plan to stick with this combo.
H.G.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.