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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by garyengelm on January 20, 2008, at 3:27:53
I've been on the drug for years at 400mg. It pooped out on me months ago. I have dropped down in intervals of 25mg about every 1-2 weeks. This latest drop from 275 to 250mg really increased my anxiety. Started feeling an Akathisia rxn today around noon. I immediately took 25mg benedryl and got some relief, but within 2 hours, it started coming back. I decided to pop 12.5mg of Serzone back in me. The Akathesia has pretty much subsided, but not sure where to go from here. I am very med sensative. I started Lexapro a few weeks ago at only 1.25mg. After a week, I tried to go to 2.5mg and got very sick. I know from the past that the Serzone interferes with SSRI metabolism, at least with me. So I went back to 1.25mg on the Lexapro, and even at that tiny dose, I feel a little lift in my depression. I know I need to go higher, but I also know I need the Serzone dose lower first.
I'd appreciate any advice. Thanks in advance....
Gary
Posted by bleauberry on January 20, 2008, at 3:27:53
In reply to Serzone withdrawal, need some help getting off !!!, posted by garyengelm on January 17, 2008, at 16:22:02
I'm sorry I didn't get back to you earlier. I did get your message. I feel for you bigtime. I've been swamped myself. I apologize.
Though I was on different drugs, I have been in your shoes. And it aint easy. Wow. It's like a survival test from hour to hour every single day.
Lexapro comes in liquid. You could customize your doses by 1mg at a time.
For serzone I think the only option is to continue what you are doing. That is, drop it down slowly in small steps, yet as quickly as tolerable, and jump back to adding in the smallest dose needed when the going is just too rough to sweat it out. Keep the eye on the goal and realize that a step back here and there is no big deal as long as the overall progress is forward.! Kind of like a football team fighting its way down the field toward the goal line.
Hey I wonder, since remeron has similar 5ht blocking characteristics as serzone, if maybe it could help substitute serzone. With its longer halflife, and it being a newer molecule your body hasn't had months or years to get accustomed to, maybe it could serve a role in the weaning process. Just a thought. Another candidate would be zyprexa. The most obvious strategy would be to increase the benzo doses to whatever you need.
With me it was kind of like do whatever needs to be done to fight this battlefield, and then once the battle is won go about cleaning up the mess. Cleaning up the mess aint that much fun either, but it is a whole lot easier than the battle. By that time hopefully the lexapro or whatever else will have had time to take a leading role in your new direction so there won't be much mess to clean up.
Posted by jrbecker76 on January 20, 2008, at 3:27:53
In reply to Re: Serzone withdrawal, need some help getting off !!!, posted by bleauberry on January 17, 2008, at 21:01:53
I would also echo Bleauberry's suggestion of cross-titrating on Remeron, and then slowly coming off of this (although you might want to give it a shot longterm as well). I was on a very low dose of Serzone (Nefazodone) on and off for quite a few years. I found that it was a very successful adjunct to my mainstay treatment of SNRIs (Cymbalta now, before Effexor). The only thing that led me to come off of Nefazodone was the fact that [due to my med sensitivity], Nefazodone had a significant effect on my cognition -- including memory and word recall -- and was getting in the way of my work performance. Beyond that though, the antidepressant, anti-anxiety, hypnotic and sexual-side-effect-antidote effects of Nefazodone puts it as one of the most under-utilized drugs in the arsenal (too bad for that whole liver failure scare). On another occassion, I also successfully came off Nefazodone using Klonopin (clonazepam), however, it wasn't as useful bolstering against the depression rebound as Remeron was. But be assured of this though, there is indeed a withdrawal coming off of Nefazodone, and the extreme acuteness of your current panic symptoms will at least subside in time.
Posted by Phillipa on January 20, 2008, at 3:27:53
In reply to Re: Serzone withdrawal, need some help getting off, posted by jrbecker76 on January 17, 2008, at 23:22:17
Have you checked the withdrawal board to see if anyone else also is coming off serzone? If not try googling the archieves and see what people before did to withdraw. Sounds like above two posters have given good options to you. Best of luck Phillipa
Posted by Lobo on January 20, 2008, at 3:27:53
In reply to Re: Serzone withdrawal, need some help getting off, posted by Phillipa on January 17, 2008, at 23:48:51
I am currently trying to come off Serzone - I have been on it for 10 years and last Friday was my first night off of it. I was on 75 mg and my doc told me that was a low dose, so I could stop from there and start Lexapro 10 mg. I have not felt good since. I have had horrible nights including waking up in the middle of the night with hotflashes, unusual sensations to the body and feeling "out of it", not to mention my anxiety is back and I have NO appetite. I called the doc and she acted like I was overreacting. I have stopped the Lexapro and am supposed to start Effexor 37.5 mg for one week. I do not know anything about this drug. I am feeling physically better each day (except I cannot stay asleep), but scared that the depression is going to kick back in at full force or the Effexor will not work, or make me feel worse.
Posted by upsndowns on January 20, 2008, at 3:27:54
In reply to Re: Serzone withdrawal, need some help getting off, posted by Lobo on January 18, 2008, at 7:45:40
I was on Serzone for probably 10 years or so and was only at 25mg,but I am very sensitive to drug dosages. It took me shaving that pill down and down and weeks and weeks and ups and downs before I finally got off the stuff. I think you got some good advice and just keep with it, knowing that it is a very hard one to get off of. I thought the fact that I was on such a low dose would make it easy, but it doesn't seem to matter how much you take. take it slowly, don't get impatient, but find a remedy for your withdrawal symptoms.
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