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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 anthonyg23 on April 6, 2011, at 14:05:16
I'm at the end of my rope on finding a med that has anything more than mediocre affects on my depression.
God, somebody has had to find a comparable replacement or a mix of rx's that have worked in similar fashion.........? Help. :(
Summary: I've tried many drugs as well as drug combos yet even after 10 years nothing at all has come close to the benefits I enjoyed on SERZONE. I'm really 'tired' of battling this and sometimes feel like giving up... it's like constantly being in a 12-round boxing match all the time. I have no options it seems.
God, somebody has had to find a comparable replacement or a mix of rx's that have worked in similar fashion.........? Help. :(Story:
I've seen it posted from time-to-time over the years (and even posted about it in the past) those of us who ONLY responded to Serzone yet were taking off of it due to black box (liver) warnings.
I'm really at the end of my rope... I'm reaching out to you all for direction on how to battle my atypical/resistant depr & anx. I'm 28 years old and for as long as I can remember I've fought anxiety, depression, social phobia and ADD. In my mind I know that the conditions I've listed are somehow interrelaetd although I'm uncertain as to which could be classified as the root cause and the catalyst for all the others. I've been through so many medications mostly with mediocre results.
To this day in 2011 the ONLY medication that showed amazing results was SERZONE (Nefazodone).
Serzone was my fist AD in 2000 and it immediately had a positive impact on all issues I listed above. I sufferred no side effects (sexual, focus, etc) and absoutely no weight gain.
It seems to work well on serotonin and dopamine and it definitely has anti-anxiety properties as I'm a completely different person (for the better) when I was taking it. I had energy, will-power from unhealthy foods, extremely sociable... (I didn't have a single girlfriend until High School - Senior year when I began taking it), confident, happy, sudden thirst for working hard on my education (3.7 GPA in Finance at Univ of Michigan), focus, drive, interestingly I suddenly became witty and funny... I really had become alive. I truthfully never believed in 'positive attitudes' or 'locusts of control', law of attraction, etc until I started taking Serzone. It was very strange (in a good way) in that people (new friends, women) were suddenly drawn to me - strangers would start conversations with me which NEVER happened on a single occassion before... I was normally reclusive and socially awkward.I remember my initial reaction when meeting people before Serzone was 'they won't like me', 'she isn't interested in me', etc, etc. On Serzone however I possessed this inherent feeling to meet people and build new positive relationships... my automatic thoughts when from a negative-tone to 'I'm interesting, these people are nice, we'll get along, etc'). Truly an amazing phenomenon. It may sound somewhat 'manic' but it wasn't - It seemed as if I finally was enjoying some of the qualities that those fortunate people whom were born with this confidence, etc.
So..... After being taken off of the drug in 2003 for liver warnings I was rx'd numerous meds with very mediocre results. It's truly been disappointing.
I've tried hard to understand Serzone's mode of action and why it had such unique affects on me.... the unique effect I beleive are b/c of it being a potent antagonist at the 5-HT2A receptors. It also has moderate affinity for the α1-adrenergic receptor (Kd 48 nM) and 5-HT1A receptor.
SSRI's especially do not share this same quality. After researching and being on every SSRI known to man in mid-2010 I began researching to find a possible cocktail of other meds that may replicate Serzone.
I presented that Info to my doc and was given the following med-mix:
Paxil 40MG, Adderral 20MG and Amitriptyline 100MG - Amitriptyline (elavil) seemed to show a similar profile to Serzone in the 5htp2 and 5htp1 receptors.
- This mix worked pretty decent... probably the best substitue I've had for Serz. However, I eat all junk-food in sight (was 185 lbs, now 205 lbs) and have ZERO ZERO ZERO libido... and not too much interested in socializing...
A month ago after deciding that the libido and weight gain were too significant to ignore I was switched to this mix:
-Paxil 40MG, Adderral 20MG and Trazodone 50MG at Night (trazodone being a 'cousin' of Serzone w/ similar characterisitics) - I had wishfully thought that Trazodone could somehow substitute for Serzone. Sadly, it's not provided the relief I had hoped for.... Although I stopped eating junk food everyday. Bottom line, it doesn't work like Amitriptyline had and nowhere near similar to Serzone.
So, once again I'm back to the drawing board........ I've thought about attempting to revisit Serzone but it's been strongly recommended against due to poss fatal side-effects.
let me know all... thank you so much.
Posted by Phillipa on April 6, 2011, at 17:04:28
In reply to I feel helpless...Serzone (nefazodone) replacment, posted by anthonyg23 on April 6, 2011, at 14:05:16
I feel if you have frequent liver checks the good outweighs the bad. Did you have abnormal liver function tests when taking serzone? If not I see not reason not to revisit it. Phillipa
Posted by mtdewcmu on April 6, 2011, at 18:12:01
In reply to I feel helpless...Serzone (nefazodone) replacment, posted by anthonyg23 on April 6, 2011, at 14:05:16
Remeron (mirtazapine) is a 5-ht2a/c antagonist, although it significantly increases appetite.
Buspar (buspirone) is a 5-ht1a partial agonist.
All of the newer antipsychotics are potent 5-ht2a antagonists, although they also have undesired effects on dopamine, and have potentially serious side effects.
You really make Serzone sound like a great med. Now I wish I had tried it. Let us know if you find something that works.
Posted by desolationrower on April 6, 2011, at 18:23:45
In reply to I feel helpless...Serzone (nefazodone) replacment, posted by anthonyg23 on April 6, 2011, at 14:05:16
I would go back on nefazadone.
a 1/million chance of dying is easily worth enjoying life vs. not.
you can get liver function tests.
nefazadone is hard to find consistent evidence on its binding. mostly it looks like 5ht1a, 2a/c are relevant. also the mpcc metabolite that is a 2c agonist. the 5ht1a might mean something like buspirone could be useful. i might try some of the atypical neuroleptics, like ziprasidone.
usually, phenelzine is considered the best social anxiety treatment.
-d/r
Posted by whitmore on April 6, 2011, at 22:20:01
In reply to Re: I feel helpless...Serzone (nefazodone) replacment, posted by desolationrower on April 6, 2011, at 18:23:45
I understand that the new medication Viibryd has a similar action, though I don't know when it's going to hit the market.
Posted by jrbecker76 on April 10, 2011, at 22:51:37
In reply to I feel helpless...Serzone (nefazodone) replacment, posted by anthonyg23 on April 6, 2011, at 14:05:16
> I'm at the end of my rope on finding a med that has anything more than mediocre affects on my depression.
>
> God, somebody has had to find a comparable replacement or a mix of rx's that have worked in similar fashion.........? Help. :(
>
> Summary: I've tried many drugs as well as drug combos yet even after 10 years nothing at all has come close to the benefits I enjoyed on SERZONE. I'm really 'tired' of battling this and sometimes feel like giving up... it's like constantly being in a 12-round boxing match all the time. I have no options it seems.
>
>
> God, somebody has had to find a comparable replacement or a mix of rx's that have worked in similar fashion.........? Help. :(
>
>
>
> Story:
>
> I've seen it posted from time-to-time over the years (and even posted about it in the past) those of us who ONLY responded to Serzone yet were taking off of it due to black box (liver) warnings.
>
> I'm really at the end of my rope... I'm reaching out to you all for direction on how to battle my atypical/resistant depr & anx. I'm 28 years old and for as long as I can remember I've fought anxiety, depression, social phobia and ADD. In my mind I know that the conditions I've listed are somehow interrelaetd although I'm uncertain as to which could be classified as the root cause and the catalyst for all the others. I've been through so many medications mostly with mediocre results.
>
> To this day in 2011 the ONLY medication that showed amazing results was SERZONE (Nefazodone).
>
> Serzone was my fist AD in 2000 and it immediately had a positive impact on all issues I listed above. I sufferred no side effects (sexual, focus, etc) and absoutely no weight gain.
> It seems to work well on serotonin and dopamine and it definitely has anti-anxiety properties as I'm a completely different person (for the better) when I was taking it. I had energy, will-power from unhealthy foods, extremely sociable... (I didn't have a single girlfriend until High School - Senior year when I began taking it), confident, happy, sudden thirst for working hard on my education (3.7 GPA in Finance at Univ of Michigan), focus, drive, interestingly I suddenly became witty and funny... I really had become alive. I truthfully never believed in 'positive attitudes' or 'locusts of control', law of attraction, etc until I started taking Serzone. It was very strange (in a good way) in that people (new friends, women) were suddenly drawn to me - strangers would start conversations with me which NEVER happened on a single occassion before... I was normally reclusive and socially awkward.
>
> I remember my initial reaction when meeting people before Serzone was 'they won't like me', 'she isn't interested in me', etc, etc. On Serzone however I possessed this inherent feeling to meet people and build new positive relationships... my automatic thoughts when from a negative-tone to 'I'm interesting, these people are nice, we'll get along, etc'). Truly an amazing phenomenon. It may sound somewhat 'manic' but it wasn't - It seemed as if I finally was enjoying some of the qualities that those fortunate people whom were born with this confidence, etc.
>
> So..... After being taken off of the drug in 2003 for liver warnings I was rx'd numerous meds with very mediocre results. It's truly been disappointing.
>
> I've tried hard to understand Serzone's mode of action and why it had such unique affects on me.... the unique effect I beleive are b/c of it being a potent antagonist at the 5-HT2A receptors. It also has moderate affinity for the α1-adrenergic receptor (Kd 48 nM) and 5-HT1A receptor.
>
> SSRI's especially do not share this same quality. After researching and being on every SSRI known to man in mid-2010 I began researching to find a possible cocktail of other meds that may replicate Serzone.
>
> I presented that Info to my doc and was given the following med-mix:
>
> Paxil 40MG, Adderral 20MG and Amitriptyline 100MG - Amitriptyline (elavil) seemed to show a similar profile to Serzone in the 5htp2 and 5htp1 receptors.
>
> - This mix worked pretty decent... probably the best substitue I've had for Serz. However, I eat all junk-food in sight (was 185 lbs, now 205 lbs) and have ZERO ZERO ZERO libido... and not too much interested in socializing...
>
> A month ago after deciding that the libido and weight gain were too significant to ignore I was switched to this mix:
>
> -Paxil 40MG, Adderral 20MG and Trazodone 50MG at Night (trazodone being a 'cousin' of Serzone w/ similar characterisitics) - I had wishfully thought that Trazodone could somehow substitute for Serzone. Sadly, it's not provided the relief I had hoped for.... Although I stopped eating junk food everyday. Bottom line, it doesn't work like Amitriptyline had and nowhere near similar to Serzone.
>
> So, once again I'm back to the drawing board........ I've thought about attempting to revisit Serzone but it's been strongly recommended against due to poss fatal side-effects.
>
>
> let me know all... thank you so much.
Were you tested for abnormal liver function or was your doctor just concerned by the black box warning itself?
Posted by jono_in_adelaide on April 11, 2011, at 17:47:47
In reply to I feel helpless...Serzone (nefazodone) replacment, posted by anthonyg23 on April 6, 2011, at 14:05:16
Teva still make generic nefazodone - ask your doc for a prescription for it, nefazodone is serzone is nefazodone
This is the end of the thread.
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