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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by brooke484 on March 23, 2009, at 21:09:25
I'm desperate for help. I began taking 300 mgs of nefazodone 1 week ago (all at night) and about 30 minutes after I take it my skin feels like it's on fire, I get all tingly, feel sick on my stomach, and then I either have a panic attack, or come close to having one (thank goodness for Ativan).
Just tonight I went down to 200 mgs but had the same feelings. I thought the half life was only 2-4 hours so why is this still happening to me? How long will this last? I've been on this drug a month.
Thank you so much.
brooke
Posted by Phillipa on March 23, 2009, at 21:21:31
In reply to Nefazodone causing panic attacks? Help!, posted by brooke484 on March 23, 2009, at 21:09:25
Brooke I don't know thought it had antihistamine properties so shouldn't it be sedating? Thankfully ativan works for you. Love Phillipa
Posted by brooke484 on March 23, 2009, at 21:29:46
In reply to Re: Nefazodone causing panic attacks? Help! » brooke484, posted by Phillipa on March 23, 2009, at 21:21:31
Right now it's anything but sedating. I feel like I'm going to jump out of my skin. We're leaving on a 2 week vacation in 1 week and I can't be like this. I took this medication twice before and never had this kind of reaction.
When will this anxiety stop?
brooke
Posted by myco on March 24, 2009, at 1:02:14
In reply to Nefazodone causing panic attacks? Help!, posted by brooke484 on March 23, 2009, at 21:09:25
You mentioned in another post (just below) you had taken this before but never experienced this side effect. the tingly and the nausea are common sides of serzone. I took this med years and years ago...it gave me flu like symptoms and nausea atr startup (nausea is my only deal breaker - within reason) ok...couple questions for you:
-you are not on a mood stabilizer or have taken one in the last week or 2 have you?
-you arent taking any over the counter antihistamines with it are you? or have in the past week?
-ativan is the only benzo you take correct? and have not taken any other in the past week? no xanax at correct?These are all "no-no's" with serzone. Could also be that you need to raise the dose of ativan...anxiety is common on startup and stopping of a medication. A good dr will know this and when asked will be ok with upping your benzo dosage during the startup and withdrawal. Just make sure no halcion and no xanax as choices for benzo's. Dont be affraid to raise the benzo dose...its only for a few weeks...you can wean yourself back down or "combo-it" using different acting benzo's (they arent all created equal). Hun I suspect that this is mere anxiety related issues due to startup and you will be fine....now will you be fine to go on that vacation? cant say....highly recommend you talking to dr about upping the benzo and mabye adding another to help through the anxiety of startup. Like I said....a good dr will understand...a bad one wont even listen to your idea/request.
all the best
Myco> I'm desperate for help. I began taking 300 mgs of nefazodone 1 week ago (all at night) and about 30 minutes after I take it my skin feels like it's on fire, I get all tingly, feel sick on my stomach, and then I either have a panic attack, or come close to having one (thank goodness for Ativan).
>
> Just tonight I went down to 200 mgs but had the same feelings. I thought the half life was only 2-4 hours so why is this still happening to me? How long will this last? I've been on this drug a month.
>
> Thank you so much.
>
> brooke
Posted by myco on March 24, 2009, at 1:12:52
In reply to Re: Nefazodone causing panic attacks? Help! » brooke484, posted by myco on March 24, 2009, at 1:02:14
Also (i dont remember typical dose range) youre dose may be to low or to high...a month is awhile to wait for any result for sure....you havent seen any positives at all? I dont want to discourage you here but you may want to consider this point also....sometimes when you "revisit" a med...go back and take some med again in the future after having stopped it....sometimes it doesnt work anymore or doesnt work the same way as it did...occasionally people will say not only doesnt my med work but now it causes me problems. This is an unexplained phenomena of psych meds. Ask your dr about it...may be that its not for you....but again dont overreact until youve had that visit with the dr...he will help formulate a plan for you with your vacation in mind.
> > I'm desperate for help. I began taking 300 mgs of nefazodone 1 week ago (all at night) and about 30 minutes after I take it my skin feels like it's on fire, I get all tingly, feel sick on my stomach, and then I either have a panic attack, or come close to having one (thank goodness for Ativan).
> >
> > Just tonight I went down to 200 mgs but had the same feelings. I thought the half life was only 2-4 hours so why is this still happening to me? How long will this last? I've been on this drug a month.
> >
> > Thank you so much.
> >
> > brooke
>
>
Posted by brooke484 on March 24, 2009, at 10:06:13
In reply to Re: Nefazodone causing panic attacks? Help! » brooke484, posted by myco on March 24, 2009, at 1:02:14
No, I'm not taking anything with it except for Ativan (1 mg up from .5 now). And I was feeling better when I was on 200 mgs 2 weeks ago and I'm kicking myself for upping the dose when I just should have stayed where I was.
Today I woke up with a tight chest and major anxiety and the ativan didn't help. I'm thinking about calling my doctor and asking for 10 tablets of klonopin for the trip. I'm freaking out!
Thanks for your reply.
brooke
Posted by jrbecker76 on March 24, 2009, at 10:44:38
In reply to Re: Nefazodone causing panic attacks? Help! Myco, posted by brooke484 on March 24, 2009, at 10:06:13
I recommend decreasing the dose (e.g., 150 mg) and going SLOW in titrating up.
I took a low-dose of Nefazodone for years and I found it to be a great augmentor to SSRIs/SNRIs. However, as you point out, it can have some activating side effects in some people. This is due to one of its metabolites -- m-CPP -- which is building up in your system. Every time you increase the dose, you might feel some of these same effects. It will take a few days for your body to adjust. What will happen is that another one of the drug's active metabolites -- hydroxy nefazodone -- will eventually begin to cancel out a lot of the activation problems caused by m-CPP.
So it takes a little patience. I've found that only a small minority of people who wait it out still end up reporting significant activation effects. So once again, my advice to you is to drop the dose until you have adjusted before you begin to titrate up.
http://www.dr-bob.org/babble/20060122/msgs/602044.html
JB
Posted by myco on March 24, 2009, at 18:02:30
In reply to Re: Nefazodone causing panic attacks? » brooke484, posted by jrbecker76 on March 24, 2009, at 10:44:38
I honestly didnt know this med was used anymore....it's been pulled from the market in Canada for years...figured the USA would have followed suit
> I recommend decreasing the dose (e.g., 150 mg) and going SLOW in titrating up.
>
> I took a low-dose of Nefazodone for years and I found it to be a great augmentor to SSRIs/SNRIs. However, as you point out, it can have some activating side effects in some people. This is due to one of its metabolites -- m-CPP -- which is building up in your system. Every time you increase the dose, you might feel some of these same effects. It will take a few days for your body to adjust. What will happen is that another one of the drug's active metabolites -- hydroxy nefazodone -- will eventually begin to cancel out a lot of the activation problems caused by m-CPP.
>
> So it takes a little patience. I've found that only a small minority of people who wait it out still end up reporting significant activation effects. So once again, my advice to you is to drop the dose until you have adjusted before you begin to titrate up.
>
> http://www.dr-bob.org/babble/20060122/msgs/602044.html
>
> JB
>
Posted by Phillipa on March 24, 2009, at 19:27:43
In reply to Re: Nefazodone causing panic attacks? » jrbecker76, posted by myco on March 24, 2009, at 18:02:30
Myco no the generic is available here had it prescribed for me two summers ago and guess what with xanax. Love Phillipa ps why no xanax?
Posted by brooke484 on March 24, 2009, at 19:35:12
In reply to Re: Nefazodone causing panic attacks? » brooke484, posted by jrbecker76 on March 24, 2009, at 10:44:38
Thank you so much for that explanation. I guess I might have increased it too soon, but I wasn't having any side effects so I said, what the heck, and went up to 300.
I just spoke with my doctor and he said to stop taking it for a few days and then go to 150 on Thurs. When I get back from my trip I'll attempt to increase it again (slowly this time).
Thanks so much!
brooke
Posted by myco on March 24, 2009, at 20:02:06
In reply to Re: Nefazodone causing panic attacks? » myco, posted by Phillipa on March 24, 2009, at 19:27:43
My bad...what I should have said was xanax dose needs to be lowered on serzone because serzone raises blood levels of xanax.
> Myco no the generic is available here had it prescribed for me two summers ago and guess what with xanax. Love Phillipa ps why no xanax?
Posted by Phillipa on March 24, 2009, at 21:02:50
In reply to Re: Nefazodone causing panic attacks? » Phillipa, posted by myco on March 24, 2009, at 20:02:06
Same with luvox but also includes valium along with xanax. Love Phillipa ps find her?
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