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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by undecided on January 25, 2002, at 10:31:47
at my request, my fam. phy. has prescribed wellbutrin 100mg 2x daily along with klonopin to help w/anxiety (which is a MAJOR problem with me along w/depression). i have been taking serzone 100mg 2x daily since august of 2001. it hasn't really helped at all. i don't know if i should taper off the serzone then start the wb/klon, or just stop the serzone today and start the wb/klon tomorrow, or take all three together, tapering off the serzone. i am really nervous about this and confused. i have taken nearly every ad there is, and remeron caused me to gain 40lbs., so i really hope the wb helps me lose some of this extra weight and lifts my depression. please advise if anyone can help. thanks.
Posted by Ray on January 25, 2002, at 13:39:36
In reply to wellbutrin/klonopin/serzone, posted by undecided on January 25, 2002, at 10:31:47
Serzone is very mild. It is not used much and when it is, is usually an "add on" to a more powerful med.
SSRI's (and the similar newer meds) are prescribed most often but often are dropped due to side effects or lack of potent efficacy.Have you tried any of the MAOI's (Nardil, Parnate, Eldepryl)?
MAOI's are still easily the most effective antidepressants (ie; depression, anxiety, panic, social phobia, etc).
> at my request, my fam. phy. has prescribed wellbutrin 100mg 2x daily along with klonopin to help w/anxiety (which is a MAJOR problem with me along w/depression). i have been taking serzone 100mg 2x daily since august of 2001. it hasn't really helped at all. i don't know if i should taper off the serzone then start the wb/klon, or just stop the serzone today and start the wb/klon tomorrow, or take all three together, tapering off the serzone. i am really nervous about this and confused. i have taken nearly every ad there is, and remeron caused me to gain 40lbs., so i really hope the wb helps me lose some of this extra weight and lifts my depression. please advise if anyone can help. thanks.
Posted by finelinebob on January 25, 2002, at 14:40:37
In reply to wellbutrin/klonopin/serzone, posted by undecided on January 25, 2002, at 10:31:47
> at my request, my fam. phy. has prescribed...
hate to be a cramp in the butt, but have you considered asking your doc for a referral to a psychopharmacologist? Can your insurance handle that? Especially if you're going to start getting into cocktails, you're going to need more expertise on your end than a family practitioner can probably give you.
flb
Posted by undecided on January 25, 2002, at 15:26:30
In reply to Re: wellbutrin/klonopin/serzone, posted by finelinebob on January 25, 2002, at 14:40:37
> > at my request, my fam. phy. has prescribed...
>
> hate to be a cramp in the butt, but have you considered asking your doc for a referral to a psychopharmacologist? Can your insurance handle that? Especially if you're going to start getting into cocktails, you're going to need more expertise on your end than a family practitioner can probably give you.
>
> flbmy insurance only covers 50% of the cost, which is $275 up front just for the first visit, not only that, taking off work to see a doc is absolutely not an option for me, i see my doc on saturdays, but most don't have weekend appts. so i'm stuck trying to research meds myself and suggest them to my doc. my intent is to be off the serzone and on a combo of wellbutrin and klonopin. i'm just confused as to the proper way to discontinue the serzone while starting the new meds.
Posted by Tony P on February 16, 2003, at 12:54:21
In reply to Re: wellbutrin/klonopin/serzone » undecided, posted by Ray on January 25, 2002, at 13:39:36
This probably comes a bit late for "undecided" but may be useful experience for the future. I have taken both serzone and wellbutrin, separately & together.
Wellbutrin will certainly add a stronger activating component and an increaded sense of pleasure in life. I was the exception -- I GAINED weight on Wb, probably because my zest for food was much higher. But most people lose weight overall, because Wb speeds up your whole activity level and makes you metabolize food faster.
BTW, 200mg per day of Serzone is very low - the manufacter's suggested range is 300-600mg/day. I have used 200 mg but only when my depression is in remission. If you don't do well on the Wellbutrin you should conside going back to a higher dose of Serzone or a combination of the two.
Serzone clears your systen very quickly - 24 hours or so, half-life only about 3 hr. The Wb will likely cover the mild withdrawal anxiety from the Serzone. You should be able to switch quickly with no washout period; I belive I went straight over to Wellbutrin in 24hrs or less without any bad effects.
I am currently on:
Serzone 400 mg/day
Wellbutrin 100mg/day (I'm very sensitve to it)
Buspar 20/mg per day (sometimes 30-40)
Valium 10mg/day
Imovane/Zopiclone 15mg at bedtime to help sleepThis is workimg reasonably well for me, but I do experience some "serotonin syndrome" symptoms - or maybe excess NE (norepinephrine) - when I take the serzone: anxiety, insomnia, skin flushing / burning sensation. I also have trouble stopping doing things and going to bed at a resonable hour - I have been up all night in a hypomanic mood most of thr past week! But YMMV.
On higher doses of Wb. + Serzone I have also eperienced hyperpyrexia (i.e. a moderate fever) and extreme agitation. There are a few posts I made sometime in late 2001 or early 2002 describing in some detail the experience I had with high does of Wb (300 mg/day XR + 200-300 mg Serzone).
Klonopin is good for the Wellbutrin-induced anxiety and insomnia.
Robaxin (available OTC in Canada) also reduces the anxiety and tremors very well, but there is some risk of addiction over the long term (as there is for Klonopin), esp. if the recommended max dose is exceeded (> 6 grams per day, i.e. 8 Robaxin-750). While it helps sleep, it may have a rebound effect causing you to wake up in 4-5 hrs.
Please feel free to email me &/or post reply.
Tony P (tonyp@shaw.ca)
> Serzone is very mild. It is not used much and when it is, is usually an "add on" to a more powerful med.
> SSRI's (and the similar newer meds) are prescribed most often but often are dropped due to side effects or lack of potent efficacy.
>
> Have you tried any of the MAOI's (Nardil, Parnate, Eldepryl)?
> MAOI's are still easily the most effective antidepressants (ie; depression, anxiety, panic, social phobia, etc).
>
> Ray
> http://www.socialfear.com/
>
>
> > at my request, my fam. phy. has prescribed wellbutrin 100mg 2x daily along with klonopin to help w/anxiety (which is a MAJOR problem with me along w/depression). i have been taking serzone 100mg 2x daily since august of 2001. it hasn't really helped at all. i don't know if i should taper off the serzone then start the wb/klon, or just stop the serzone today and start the wb/klon tomorrow, or take all three together, tapering off the serzone. i am really nervous about this and confused. i have taken nearly every ad there is, and remeron caused me to gain 40lbs., so i really hope the wb helps me lose some of this extra weight and lifts my depression. please advise if anyone can help. thanks.
Posted by Stan on February 17, 2003, at 2:07:46
In reply to Re: wellbutrin/klonopin/serzone, posted by Tony P on February 16, 2003, at 12:54:21
>>>>>>>>>>>> I am currently on:
> Serzone 400 mg/day
> Wellbutrin 100mg/day (I'm very sensitve to it)
> Buspar 20/mg per day (sometimes 30-40)
> Valium 10mg/day
> Imovane/Zopiclone 15mg at bedtime to help sleep
>
> This is workimg reasonably well for me, but I do experience some "serotonin syndrome" symptoms - or maybe excess NE (norepinephrine) - when I take the serzone: anxiety, insomnia, skin flushing / burning sensation. I also have trouble stopping doing things and going to bed at a resonable hour - I have been up all night in a hypomanic mood most of thr past week! But YMMV.
>>>>>>>>>>>
you may well be experiencing "serotonin" syndrome and might want to consider drastically reducing your buspar dosage. read the "drug interactions" section of the package inserts for both buspar and serzone -- they are both cleared by the same liver sub-enzyme, and taking them together has caused plasma buspar levels to be elevated as high as 20-fold (sometimes even more) in study subjects -- other irregularities have been reported as well. ask your doctor if you can try taking 2.5 mg twice a day and see if the adverse effects you describe subside. you might be able to get away with even less, but more splitting of the 5 mg tabs would be necessary.Stan
Posted by Tony P on February 17, 2003, at 22:33:50
In reply to Re: use caution with buspar + serzone » Tony P, posted by Stan on February 17, 2003, at 2:07:46
Thanks for the suggestion, Stan. I will try cutting the buspar out altogether - from past experience there should be no serious withdrawal problems. I was already thinking of making an extra appointment with my Dr to re-evaluate my meds etc. so I'll try and get to see him this week. He's quite open to my adjusting doses and then reporting back to him on whether it helped.
Tony P
> >>>>>>>>>>>> I am currently on:
> > Serzone 400 mg/day
> > Wellbutrin 100mg/day (I'm very sensitve to it)
> > Buspar 20/mg per day (sometimes 30-40)
> > Valium 10mg/day
> > Imovane/Zopiclone 15mg at bedtime to help sleep
> >
> > This is workimg reasonably well for me, but I do experience some "serotonin syndrome" symptoms - or maybe excess NE (norepinephrine) - when I take the serzone: anxiety, insomnia, skin flushing / burning sensation. I also have trouble stopping doing things and going to bed at a resonable hour - I have been up all night in a hypomanic mood most of thr past week! But YMMV.
> >>>>>>>>>>>
>
> you may well be experiencing "serotonin" syndrome and might want to consider drastically reducing your buspar dosage. read the "drug interactions" section of the package inserts for both buspar and serzone -- they are both cleared by the same liver sub-enzyme, and taking them together has caused plasma buspar levels to be elevated as high as 20-fold (sometimes even more) in study subjects -- other irregularities have been reported as well. ask your doctor if you can try taking 2.5 mg twice a day and see if the adverse effects you describe subside. you might be able to get away with even less, but more splitting of the 5 mg tabs would be necessary.
>
> Stan
>
This is the end of the thread.
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