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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by porkpiehat on July 26, 2023, at 13:48:46
I added a small dose of serzone/nefazadone to my Prozac, which I have been on almost 4 months. The idea was to offset some of the anhedonia, apathy, headache, and perhaps irritability that came with the prozac.
Man, it worked far better than expected. It helped with anxiety that prozac wasn't addressing, lack of desire for human interactions, and the irritability and detachment that I increasingly get on SSRIs.
There is a feeling of dizziness/impairment/fog that is becoming a problem. Worse than that is that instead of the easy sleep I had on Prozac, I can't get to sleep and if so I get. terrible night sweats and pretty bad dreams.
I'm worried that I might be doing some damage. I'm also super curious about what is happening on a neuro/pharmacological standpoint.
Here are some interesting points:
-Prozac strongly inhibits the metabolism of both nefazodone and meta-Chlorophenylpiperazine (mCPP), its metabolite. Hence I'm not taking more than 50mgs at a time of serzone and my prozac is at 20mg.
-mCCP is an ecstacy-like substance that acts almost opposite to the receptor blocking mechanism of serzone. I do feel this gooey, connected, cuddly, "this music is awesome" feeling. Everything that is missing in an SSRI essentially.
-I'm also taking 100mg lamictal/day. The confusion and memory problems kinda feels like I felt when I first started taking Lamictal at higher doses.
Im a little worried that I'm just offsetting the side effects of prozac by getting high on ecstacy, which doesn't seem tenable. Thoughts?
Posted by Hugh on July 29, 2023, at 14:35:25
In reply to Actions of Nefazadone as SSRI add-on, posted by porkpiehat on July 26, 2023, at 13:48:46
I used to take Serzone. I took it on its own, and I later took it in combination with Remeron. It made me very irritable. The higher the dose, the more irritable it made me.
I'm glad Serzone is working for you. Maybe it would have worked better for me if I'd taken a low dose like you're doing. Sometimes less is more. I've found this to be the case with lithium. Taking a tiny dose of lithium makes me feel better than a larger -- but still very low -- dose. And I've found this to be the case with low-dose naltrexone (LDN). The maximum dosage for LDN is 4.5 mg. LDN at 0.5 mg or 0.25 mg makes me feel better than 4.5 mg.
> I added a small dose of serzone/nefazadone to my Prozac, which I have been on almost 4 months. The idea was to offset some of the anhedonia, apathy, headache, and perhaps irritability that came with the prozac.
>
> Man, it worked far better than expected. It helped with anxiety that prozac wasn't addressing, lack of desire for human interactions, and the irritability and detachment that I increasingly get on SSRIs.
>
> There is a feeling of dizziness/impairment/fog that is becoming a problem. Worse than that is that instead of the easy sleep I had on Prozac, I can't get to sleep and if so I get. terrible night sweats and pretty bad dreams.
>
> I'm worried that I might be doing some damage. I'm also super curious about what is happening on a neuro/pharmacological standpoint.
>
> Here are some interesting points:
>
> -Prozac strongly inhibits the metabolism of both nefazodone and meta-Chlorophenylpiperazine (mCPP), its metabolite. Hence I'm not taking more than 50mgs at a time of serzone and my prozac is at 20mg.
>
> -mCCP is an ecstacy-like substance that acts almost opposite to the receptor blocking mechanism of serzone. I do feel this gooey, connected, cuddly, "this music is awesome" feeling. Everything that is missing in an SSRI essentially.
>
> -I'm also taking 100mg lamictal/day. The confusion and memory problems kinda feels like I felt when I first started taking Lamictal at higher doses.
>
> Im a little worried that I'm just offsetting the side effects of prozac by getting high on ecstacy, which doesn't seem tenable. Thoughts?
>
Posted by SLS on July 31, 2023, at 23:14:44
In reply to Actions of Nefazadone as SSRI add-on, posted by porkpiehat on July 26, 2023, at 13:48:46
mCPP often produces anxiety, headaches, reduced appetite, and sweating. i think it is a metabolite of mCPP that has properties similar to ecstasy. If fluoxetine inhibits the metabolism of mCPP, I would look at its increased accumulation as a possible culprit for the effects you describe. I have never heard of mCPP itself to have positive effect on depression. If anything, it might actually worsen depression.
I don't know enough to be certain.
My guess is that your initial robust response to nefazodone was real and due to the actions of nefazodone (parent compound), and not its mCPP metabolite (daughter compound). Try looking for a drug with the same properties as the nefazodone molecule without a mCPP metabolite.
Just guessing.
https://en.wikipedia.org/wiki/Meta-Chlorophenylpiperazine
meta-Chlorophenylpiperazine (mCPP) is a psychoactive drug of the phenylpiperazine class. It was initially developed in the late-1970s and used in scientific research before being sold as a designer drug in the mid-2000s.[3][4] It has been detected in pills touted as legal alternatives to illicit stimulants in New Zealand and pills sold as "ecstasy" in Europe and the United States.[5][6]Despite its advertisement as a recreational substance, mCPP is actually generally considered to be an unpleasant experience and is not desired by drug users.[5] It lacks any reinforcing effects, but has "psychostimulant, anxiety-provoking, and hallucinogenic effects."[7][8][9][10] It is also known to produce dysphoric, depressive, and anxiogenic effects in rodents and humans,[11][12] and can induce panic attacks in individuals susceptible to them.[13][14][15][16] It also worsens obsessivecompulsive symptoms in people with the disorder.[17][18][19]
mCPP is known to induce headaches in humans and has been used for testing potential antimigraine medications.[20][21][22] It has potent anorectic effects and has encouraged the development of selective 5-HT2C receptor agonists for the treatment of obesity as well.[23][24][25][26]
- Scott
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