![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 43. Go back in thread:
Posted by Larry Hoover on April 5, 2007, at 6:40:27
In reply to New med Serzone any experiences?, posted by Phillipa on April 4, 2007, at 17:08:57
> Well the pdoc is starting me on serzone know it carries a black box warning for liver. Anyone know anything about it or take? I am as usual frightened as I told him about the benzo withdrawal he said no. I'm so anxious it said it would be good for insomnia and anxiety. Along with the valium. Love Phillipa ps saw the therapist first who stirred up med and trust issues with me. Poor timing.
Nefazodone profoundly inhibits the function of two workhorse enzymes, 3A4 and 2D6, which is probably the underlying mechanism by which liver toxicity occurs in vulnerable people. Valium is a substrate for 3A4, so you're going to get an interaction there. You're going to get an increased AUC for this drug, meaning prolonged and enhanced effect. Considering your symptoms, this may be beneficial. Be wary, though, that you may develop symptoms of overdose, including dizziness and loss of coordination. Just take it easy until you get used to it. And whatever you do, no alcohol!
Lar
Posted by Larry Hoover on April 5, 2007, at 6:46:16
In reply to Re: New med Serzone any experiences?, posted by bassman on April 5, 2007, at 5:58:22
> Phillipa, I'm confused...so you don't live in the US? Serzone was taken off the market in 2004(?)...I know nefazodone ("generic Serzone") is still available. If you are taking it, please be careful...not fearful, careful. The liver toxicity is profound in some people-no sense exchanging one problem for another.
Having had the liver toxicity reaction, I can affirm that it is fully reversible, if caught in time. On day 11 of this drug, I became so disoriented that I could not avoid walking into a telephone pole. It's more likely to develop liver problems on depakote (or other variants on valproate). It's really important to balance benefit and risk on a case by case basis. I think that Jan's case supports this drug trial, with appropriate monitoring for adverse reactions.
Lar
Posted by ramsea on April 5, 2007, at 10:41:10
In reply to Re: New med Serzone any experiences? » bassman, posted by Larry Hoover on April 5, 2007, at 6:46:16
i was upset when the liver damage report came out. i was on it for 2 years and it worked for where many drugs dont. i am bipolar with a strong anxiety disorder too and this helped me a lot. i was fond of it. wish i could take it again. G/L
ramsea
Posted by bassman on April 5, 2007, at 11:01:20
In reply to Re: New med Serzone any experiences?, posted by ramsea on April 5, 2007, at 10:41:10
Well...as I understand it, you can still get the generic in the US. Providing you are in the US-I'm so provincial I'm amazed when anyone isn't from the US.:>}
Posted by Phillipa on April 5, 2007, at 12:59:06
In reply to Re: New med Serzone any experiences?, posted by bassman on April 5, 2007, at 11:01:20
I'm in the USA. Yes the liver issue scares me to death. Especially with the autoimmune factored in as I do have autoimmune disease with a weak link to some autoimmune liver thing. I am metabolizing the valium only getting two hours out of it. I posted a thread below since this has never happened to me before. Sleep is in two hours spurts. So tired. Love Jan
Posted by Fivefires on April 5, 2007, at 13:29:48
In reply to Re: Did he say why he chose that? » Racer, posted by Phillipa on April 4, 2007, at 19:06:13
> Racer that's funny about the dirt. Anyway he said it was sedating and one time in the past I had been given one dose and it put me to sleep. And when they took my BP at the internist it was up to 140/?. Too anxious to even remember diastolic. So in a way that would be a good thing.>
>I don't understand why this would be a good thing Phillipa? Your a nurse, so mayB you're speaking about something re: the BP?
5f
Posted by Fivefires on April 5, 2007, at 13:32:19
In reply to Re: New med Serzone any experiences? » Fivefires, posted by Phillipa on April 4, 2007, at 19:13:55
Like an antihistamine?
That's very interesting.
5f
Posted by Phillipa on April 5, 2007, at 14:38:31
In reply to Re: New med Serzone any experiences?, posted by Fivefires on April 5, 2007, at 13:32:19
Well now we can't even find a pharmacy that carries it this is just great. Love Jan ps CVS ordered it and it's not in.
Posted by Fivefires on April 5, 2007, at 14:59:14
In reply to Re: old med Serzone any experiences?, posted by flmm on April 4, 2007, at 21:04:51
Remember why d.c. flmm?
5f
Posted by Phillipa on April 5, 2007, at 15:24:12
In reply to Re: New med Serzone any experiences?, posted by Phillipa on April 5, 2007, at 14:38:31
Called all the pharmacies in Charlotte found one with l00mg emergency call to pdoc who said no he can't call in a script as he's camping with his family so another day goes by. Some fool at CVS forgot to order it. Love Jan
Posted by Phillipa on April 5, 2007, at 15:42:37
In reply to Re: New med Serzone any experiences?, posted by Phillipa on April 5, 2007, at 15:24:12
Called CVS myself and they do have l00mg tabs so she's giving me two as they couldn't guarantee having them til Monday. Love Jan
Posted by Racer on April 5, 2007, at 15:48:18
In reply to Re: New med Serzone any experiences?, posted by Phillipa on April 5, 2007, at 15:24:12
Hi, Jan.
You asked about my experience with Serzone, and you sound worried about taking it. I'm going to answer a bit of your question, but I'm also going to remind you of something -- this is ME, it doesn't mean anything at all for you. You may have a wildly successful ride on it, it may be the best thing you've ever done, you might even win the lottery because of it! (OK, you're unlikely to win the lottery just because of a drug, but you get the point, right?) I nearly refused to answer, because I'm afraid of giving your anxiety more ammunition than it already has. I know many people have had a great ride on Serzone, think it's the best med they've ever taken, and have had no problems on it. You just might be one of those people, and I hope you can start this drug with your eyes on that prize, and not worrying about side effects.
When I took Serzone, it lowered my blood pressure and caused insomnia. The insomnia might even have been related to the hypotension, since that tends to make me feel panicky. (Too bad the panic doesn't increase my BP, huh?) The hypotension is something that happens to me with a lot of medications, and it's one reason I doubt I'll ever be able to take an MAOI. For some reason, even very low doses of some medications cause hypotension for me -- but that's MY chemistry. It's not something you can extrapolate from to predict your own response.
I'm sorry that you're so afraid to try new medications. I don't know what else to tell you, to help you get over it. All I can think of is to remind you that you won't know your reaction until you try it. And that the adjustment phase effects GO AWAY after the adjustment phase is over.
Good luck.
Posted by Fivefires on April 5, 2007, at 16:25:22
In reply to Re: New med Serzone any experiences? » Phillipa, posted by Larry Hoover on April 5, 2007, at 6:40:27
Might it be best if she only take this at bedtime Lar?
5f
Posted by Phillipa on April 5, 2007, at 18:27:35
In reply to Re: old med Serzone any experiences?, posted by mattye on April 5, 2007, at 1:55:29
Finally got two l00mg pills after much effort believe me. 25mg to start. I couldn't believe the print out that accompanies to med. It compared it to trazadone and said it is a med that is used when others have failed? Love Phillipa
Posted by Phillipa on April 5, 2007, at 19:03:29
In reply to Response to Phillipa, posted by Racer on April 5, 2007, at 15:48:18
Racer thanks. I did some archieve research this afternoon and think I found where you were going to start serzone and were kind of scared yourself. Just got two l00mg tabs from the pharmacy as they messed up and didn't order it. So I'm starting on 25mg with the valium and lunesta. I also did take my BP while there not that I trust those machines as they were wrong so often when nursing we also used a manual cuff and stethescope for an accurate one. First one I took was l06/74. That made me happy as mine had been so high the other day when I got the EKG. Two minutes later took another one and was ll6/76. So I quit while I was ahead. If only the endos had the decency to call with the labs as since this thyroid thing my body is so wierd. I feel horrible throughout the day and am cold then at night the sleeplessness despite high doses of meds. Multiple bad nightmares too. That really scare me. It makes no sense that valium is so high now. Want off of the high doses and today during the day have only taken 5mg as that is my quota. Although I haven't done a thing I'm drained . So I guess what I'm saying is that I have to give it a shot. Love Jan
Posted by Phillipa on April 5, 2007, at 19:11:59
In reply to Re: New med Serzone any experiences? » bassman, posted by Larry Hoover on April 5, 2007, at 6:46:16
Lar gave up all alchohol ll years ago. My other worry is that I have an auto immune slight to one of the smooth muscle antigens I think it was for hepatitis. No treatment was necessary. But I seriously do believe that the thyroid and my always elevated ANA plays a role in what's happening. Love Jan
Posted by Sandra62 on April 5, 2007, at 20:52:58
In reply to Re: New med Serzone any experiences? » Larry Hoover, posted by Phillipa on April 5, 2007, at 19:11:59
Hi Phillipa, years ago I tried Serzone and it was very sedating for me. I couldn't get past that. I hope it works out for you. You deserve some relief!
Posted by Phillipa on April 5, 2007, at 21:04:02
In reply to Re: New med Serzone any experiences?, posted by Sandra62 on April 5, 2007, at 20:52:58
Sandra that's what I need sedation I'm wired and depressed very right now . Worst it's ever been. Love Jan
Posted by Fivefires on April 5, 2007, at 22:57:45
In reply to Re: New med Serzone any experiences?, posted by linkadge on April 4, 2007, at 18:05:15
When I saw my P today I decided to add trazodone back into my life.
I'd been on it for many years for bedtime 50-150mg. Since some of my threads have been interpreted as depression, thought try again.
I threw this in here, as it seems, I guess, to be somewhat related to Serzone.
I have the trazodone here to take instead of Soma, which I've been on for at least a year.
My P wrote Xanax 2mg 3x a day instead of Librium, and then the prior. That's my regimen.
Will someone pls, as u are explaing to Phillipa, give me some insight about 'how brain should work better w/ this, an AD' alongside my Xanax.
I'm sorry if I'm intruding Phillipa but I felt becuz' traz is sort of like serz, well you know.
Even if I had a PDR, I'd not understand phamacokinetics ... or whatever(?)
Can some1 tell me via a babble, or if it is very similar to Serzone, here?
My P spent barely 15m w/ me & during this time an asst was looking up the effects on our brain of trazodone. By time he found info I was standing and leaving.)
5f
Posted by Racer on April 6, 2007, at 1:37:00
In reply to Re: old med Serzone any experiences? » mattye, posted by Phillipa on April 5, 2007, at 18:27:35
> I couldn't believe the print out that accompanies to med. It compared it to trazadone and said it is a med that is used when others have failed? Love Phillipa
I think that's only because of the black box warning. At one point, when nefazodone was looking as though it would be pulled from the market, there was talk about grandfathering it -- only patients who were already on it would be able to take it. That didn't go anywhere, obviously, but many doctors didn't want the liability of prescribing it. Also, because it was a fairly newish drug when it was given the black box, I don't think an awful lot of doctors had all that much experience with it. So, if you're a doctor, and a drug you've never used much is nearly pulled from the market, you're probably not going to prescribe it much. My guess is that there are a core group of doctors who've used it, had good results with it, and continue to prescribe it. It looks as though you've got one of those, and I think it's lucky for you.
Good luck.
Posted by Phillipa on April 6, 2007, at 12:44:05
In reply to Re: old med Serzone any experiences? » Phillipa, posted by Racer on April 6, 2007, at 1:37:00
Well first dose last night and didn't sleep a wink this was with 20mg of valium and 2 3mgs of lunesta about the fifth day in a row with no sleep. So now I'm abusing valium and don't feel a thing. So tired I could cry. My body won't let me sleep. Pdoc away and all docs offices closed any suggestions? thanks Jan
Posted by Sandra62 on April 6, 2007, at 13:56:58
In reply to Re: old med Serzone any experiences?, posted by Phillipa on April 6, 2007, at 12:44:05
Hi Jan, sorry you are having so much trouble! How much Serzone were you prescribed, and have you an idea of what a therapeutic dosage would be? Should you raise it? I was really hoping that this would be the ticket for you. Feel better!
Posted by Phillipa on April 6, 2007, at 20:39:20
In reply to Re: old med Serzone any experiences?, posted by Sandra62 on April 6, 2007, at 13:56:58
Sandra he started real low at 25mg. Which half what he usally starts with. And was in the ER all day and blood work is okay and was happy with that til my husband started yelling at me that he had thought of leaving me and taking off in his truck for at least a week when he went home to feed and walk the dogs. Doc and nurse heard him and now my Bp as over l40/? . And she tried to calm him down and then the doc took me back in the room and asked me if he was beating me said no. And he yelled and pounded the stearing wheel all the way home. So I know now why the high anxiety I'm in PTSD mode 24/7 as he does this out of the blue. I'm always on alert. Love Jan ps he even read the nicole richie article to me and said why don't you take more valium I said no. Love Jan
Posted by Sandra62 on April 6, 2007, at 20:45:40
In reply to Re: old med Serzone any experiences? » Sandra62, posted by Phillipa on April 6, 2007, at 20:39:20
O Dear Jan! Your husband sounds like he needs some Valium. I'm so sorry all of this is happening to you. So when do you get to raise the dosage of Serzone? Wishing you luck!
Posted by Phillipa on April 6, 2007, at 22:29:38
In reply to Re: old med Serzone any experiences?, posted by Sandra62 on April 6, 2007, at 20:45:40
Yup its a mess. He had said a week but the ER doc called him. Interestingly the ER doc said that the low dose luvox must have been working somewhere in my body and that maybe going up on it was what I should do and that's what I said to Greg when He was talking to my pdoc and in the background I'm say luvox and up the dose he's saying serzone. Who's body is it anyway? Reason he was on the phone with him is that he answered when he called about not finding the pills . Love Jan
This is the end of the 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.