serzone
Question:
Has anyone had any experience with serzone for their insominia. I’ve heard good things about it: non-habit forming, anti depressant and anti anxiety. Helps some people sleep. Brian
Response:
I’ve been on Serzone for a number of years for depression and one of the great side effects is the tremendous improvement in my sleep. Basically, I take it, put on the C-Pap, lie down and wake up 7 hours later with absolutely no idea that there were an intervening bunch of hours. I just sleep! We had a HUGE electrical storm last week with intense lightening and thunder all night long that was all over the news and I didn’t even know about it! The great thing about Serzone, and it’s cousin Trazadone, is that they don’t foul up your sleep architecture so that for most people, it doesn’t effect your dream cycles. Much better than most other things used for sleep. Susan BFRIEDBOY <bfried…@aol.com> wrote:
: Has anyone had any experience with serzone for their insominia. I’ve heard : good things about it: non-habit forming, anti depressant and anti anxiety. : Helps some people sleep. : Brian — polit…@netcom.com
Response:
Is serzone like prozac in that it ups the seretonin? Jo
Response:
Serzone (nefazodone) prevents seratonin reuptake, but not as much as the Prozac (fluoxetine) and the 4 other medications that specifically target seratonin reuptake – Zoloft (sertraline), Paxil (paraxotine) and Luvox (fluvoxamine) and Celexa (citalopam). <<The brand names in caps are those used in the US. Other countries have different names but the generic names (in parenthesis) will be the same anywhere.>> However, as the name SSRI indicates, those 5 meds are SELECTIVE seratonin reuptake inhibitors. In other words, they act SELECTIVELY on seratonin. Serzone also acts a little on the norepenephrine (also called noradrenaline) neurotransmitter system. Susan Jo <can’tfin…@zoomnet.net> wrote:
: Is serzone like prozac in that it ups the seretonin? : Jo — polit…@netcom.com
Response:
At best, scientists and drug companies have an incomplete and ambiguous understanding of how antidepressants work. Psychopharmacologists know of compounds that *should* relieve depression, according to the theoretical models, but actually make it worse, and vice-versa. In actual practice, the benefits and side effects of all antidepressants have to be determined from actual use in humans. They cannot be predicted from their theoretical models. Serzone is a good antidepressant in some ways because it has few side effects. In other respects, it is "just another antidepressant." Like many antidepressants, there was some hope when it was first released that it would turn out to be a major improvement over the others. Didn’t work out that way. I have seen patients fail on other antidepressants and then respond very well to Serzone. I have seen other patients fail to respond at all to Serzone and then respond very well to some other antidepressant. This could be said, with equal accuracy, of any other antidepressant. No antidepressant has ever been shown superior to imipramine (Tofranil), the very first antidepressant approved for human use, more than thirty years ago. There is some suspicion that amond psychiatrists Wellbutrin and Effexor might be somewhat more potent, or more generally effective, than other antidepressants, but this has not yet been demonstrated in clinical trials. All antidepressants are about equally likely to help with sleep disturbance, in the long run. But any antidepressant can also *cause* sleep disturbance, in the short run or the long run. In the short run, some antidepressants have a sedative side effect, which can help with sleep. Elavil (amitriptylene) is the classic example of this. Some patients, but not all, become tolerant to the sedative side effect after awhile. In actual practice, good psychiatrists most often prescribe trazadone at bedtime for sleep disturbance, possibly because, based purely on clinical experience, this particular agent is somewhat more helpful than others for the average patient for sleep disturbance. Trazadone is otherwise "just another antidepressant." It was also expected to be an antidepressant miracle when first released, but didn’t work out that way. Hope this is helpful. Tim Miller – Hide quoted text — Show quoted text -Wachob wrote: > Serzone (nefazodone) prevents seratonin reuptake, but not as much as the > Prozac (fluoxetine) and the 4 other medications that specifically target > seratonin reuptake – Zoloft (sertraline), Paxil (paraxotine) and Luvox > (fluvoxamine) and Celexa (citalopam). <<The brand names in caps are those > used in the US. Other countries have different names but the generic > names (in parenthesis) will be the same anywhere.>> However, as the name > SSRI indicates, those 5 meds are SELECTIVE seratonin reuptake inhibitors. > In other words, they act SELECTIVELY on seratonin. Serzone also acts > a little on the norepenephrine (also called noradrenaline) > neurotransmitter system. > Susan > Jo <can’tfin…@zoomnet.net> wrote: > : Is serzone like prozac in that it ups the seretonin? > : Jo > — > polit…@netcom.com
Response:
Hi Tim, I had really good results with amitriptyline after a miscarriage. My doc says its no longer the drug of choice as it has too many bad side effects. Is this true? Talking depression here, not sleep. Marg <snip> > No antidepressant has ever been shown superior to imipramine (Tofranil), > the very first antidepressant approved for human use, more than thirty > years ago. There is some suspicion that amond psychiatrists Wellbutrin > and Effexor might be somewhat more potent, or more generally effective, > than other antidepressants, but this has not yet been demonstrated in > clinical trials.
<snip>
Response:
Hi Marg, Three main problems with Elavil (amitriptylelene). Severe weight gain in many people, and more likely in women. Too sedating for many people. The generic name is way too hard to spell. Weight gain is a severe problem with all antidepressants in this drug family–the "tricyclic antidepressants." Also difficult spelling. These include Pamelor (nortriptylele) desipramine, imipramine (Tofranil) and a few others. Almost all the first generation antidepressants (1965 to 1980 or so were tricyclics.) Minor problems with Elavil– and other tricyclics, dry mouth, constipation. Hope this is helpful, or at least interesting. Tim Miller
Response:
Correct me if I am wrong, but is serzone related to trazodone? Also, anyone know if it is used for the treatment of fibromyalgia? Specifically, anyone have any knowledge of using serzone to treat alpha intrusions?
Response:
Serzone belongs to the same drug family as trazadone, but is generally less sedating. Trazadone occasionally cause severe priapism, with possible irreversible damage to the penis in some men. Serzone doesn’t have this side effect. All antidepressants are probably equally effective in alleviating the symptoms of fibromyalgia, though this is not entirely clear. This raises the possibility that fibromyalgia is a variant of major depression, at least in some cases. Some experts think so, others disagree. There is no need to assume that the symptoms of fibromyalgia represent just one disease. Symptoms are vague and variable over time and between patients. Elavil is traditionally used for fibromyalgia, but probably only because it is a drug well-known to primary care physicians. Elavil is very commonly prescribed in placebo (or near-placebo) doses (e.g. 25 mg. at bedtime) by primary care physicians and neurologists, for a variety of complaints. Don’t know about alpha intrusions. Is that like narcolepsy? Tim Miller
Response:
On 14 Sep 1999 18:39:43 GMT, TM <70611….@CompuServe.COM> wrote: >Don’t know about alpha intrusions. Is that like narcolepsy? >Tim Miller
Tim, Alpha intrusions can be described as the case when the brain basically doesn’t go to sleep. The alpha waves of the quiet wakeful state constantly "intrude" on the slow wave or delta stage of sleep. Some people think the lack of slow wave sleep in people with fibromyalgia may be one of the causes of the pain and fatigue such people experience. People with Lyme disease also exhibit alpha intrusions. Rather than go into a lot more detail, you can check out the Mayo clinic web site that discusses this. http://www.mayohealth.org/mayo/9904/htm/fibromyla.htm I think that many people with fibro take elavil or trazodone — and possibly this alleviates the alpha intrusions, although I’ve never seen a scientific article on the subject. I do know a number of people who are taking one or the other drug and it certainly seems to help. I wonder if serzone would act similarly without some of the side effects of the other two drugs? Joe
Response:
Well, Joe, I learned something new today. Very interesting. I’ll check out this link. What you say about alpha intrusions seems reasonable. However, it’s a complex subject. Many experts say that major depression inevitably involves sleep disturbance, and that any effective treatment for depression also corrects sleep disturbance. There’s a very interesting though not very practical treatment for very severe depression, even depression that has resisted other attempts at treatment. Keep the patient awake all night and all the following day. For a day or two, most such patients experience normal or even cheerful mood. The most common biological marker of major depression is that the patient begins rem sleep too early in the night and has too little delta sleep. This probably isn’t useful information, but maybe interesting. Best regards, Tim Miller
Response:
On 14 Sep 1999 21:15:53 GMT, TM <70611….@CompuServe.COM> wrote: >Well, Joe, I learned something new today.
… as did I ! >There’s a very interesting though not very practical treatment for >very severe depression, even depression that has resisted other >attempts at treatment. Keep the patient awake all night and all the >following day. For a day or two, most such patients experience >normal or even cheerful mood.
So, do you have any idea why this is true? Regards, Joe
Response:
I was wondering if it prevents alpha intrusions. Then I realized I was speculating out of my depth. I’ve not heard about alpha intrusions before. My guess is that it is a new area of scientific inquiry. Cheers, Tim Miller – Hide quoted text — Show quoted text -Joe Talmadge wrote: > On 14 Sep 1999 21:15:53 GMT, TM <70611….@CompuServe.COM> wrote: > >Well, Joe, I learned something new today. > … as did I ! > >There’s a very interesting though not very practical treatment for > >very severe depression, even depression that has resisted other > >attempts at treatment. Keep the patient awake all night and all the > >following day. For a day or two, most such patients experience > >normal or even cheerful mood. > So, do you have any idea why this is true? > Regards, > Joe
Response:
. All antidepressants are > probably equally effective in alleviating the symptoms of > fibromyalgia, though this is not entirely clear. This raises the > possibility that fibromyalgia is a variant of major depression, at > least in some cases. >
Tim, I don’t know where you got this information, but anti-depressants per se are NOT used in general for fibromyalgia (FM) for their A/D effects, unless tha patient also concurrently has depression ( which a fair percentage of FM’ers do). In fact a number of brain imaging studies have clearly shown the the etiology of FM and depression are quite different. I believe the NIMH also has accepted that they are different syndromes. >Elavil is traditionally used for fibromyalgia, but probably only > because it is a drug well-known to primary care physicians. Elavil > is very commonly prescribed in placebo (or near-placebo) doses (e.g. > 25 mg. at bedtime) by primary care physicians and neurologists, for > a variety of complaints.
Elavil, trazadone, flexiril (cyclobenzaprine, a muscle relaxant), benadryl and 5htp are among the most common drugs prescibed for FMS to enhance deep sleep. For the first two the doses happen to be less than those used for alleviating depression. There are papers comparing these drugs to placebo, though the results are somewhat mixed. For me, both trazadone and flexiril contributed to a significant increase in PLMD. Your mileage may vary of course. Ash
Response:
On Tue, 14 Sep 1999 17:11:47 -0700, "Ash" <a…@sprintmail.com> wrote: >Elavil, trazadone, flexiril (cyclobenzaprine, a muscle relaxant), benadryl >and 5htp are among the most common drugs prescibed for FMS to enhance deep >sleep. For the first two the doses happen to be less than those used for >alleviating depression. There are papers comparing these drugs to placebo, >though the results are somewhat mixed. >For me, both trazadone and flexiril contributed to a significant increase in >PLMD. Your mileage may vary of course. >Ash
Hi Ash, So here’s my question: I know there are papers describing for example how 5htp is used to treat fibromyalgia — and perhaps they exist for the other drugs as well. BUT … did you ever come across any paper that proves that any of these drugs actually enhance deep sleep as you suggest? My own experience looking very briefly at the literature on 5htp is that, unlike what is claimed in the popular book by Murray on the benefits of 5htp, there actually is no evidence whatsoever that it enhances slow wave sleep. In fact, if you check the reference that Murray cites you find that the authors actually states EXACTLY THE OPPOSITE — that is 5htp does NOT extend slow wave sleep (it does however extend REM sleep, but that’s a different story). I was wondering if there is clinical evidence that ANY of these drugs enhance slow wave sleep (including the subject of this thread, serzone) — and whether the mechanism by which it acts is by suppressing the alpha intrusions? Regards, Joe
Response:
Ash writes, > I don’t know where you got this information, but anti-depressants
per <………snip…………> > I believe the NIMH also has accepted that they are > different syndromes.
Last time I checked, there was no scientific consensus, or anything close, on fibromyalgia. Some scientists suspect fibromyalgia is an alternate expression of depression. Others doubt it. Gulf War syndrome. Chronic Fatigue syndrome, and other mystery diseases share the same fate. For that matter, major depression itself might be an expression of an unidentified biological disease, perhaps an infectious one or a nutritional one. Some scientists suspect a link with Borna virus for instance. It could be a fish oil deficiency. We lay people can discuss scientific findings, and try to understand them, but we can’t do the work for scientists. Unfortunately, we have to wait patiently while they figure it out. That’s hard if you’re suffering, and especially if you’re dying. Tim Miller
Response:
I don’t think 5htp will cross the blood-brain barrier. I’ve been wrong before, though. Tim Miller
Response:
Joe, I totally agree with you that the hard data on the ability of the various drugs purported to enhance deep sleep in FM’ers is ambiguous at best. If you follow the alt.med.fms newsgroup, you will find many people who have been helped by one or another of these drugs, and probably even more who get no relief. Even the alpha-delta sleep anomaly is not considered to be a hard and fast rule for FM; some individuals have this and others don’t. I suppose that is why it is considered a "syndrome" The rheumatologists have adopted the objective criterion of 11 out of 16 tender points to judge whether a person has FM. Speaking for myself, I know for a fact that these medications did nothing to promote deep sleep as verified by a sleep study. I had zero Stage 3 and 4 sleep before and after a trial of these. It is worth noting that the criterion for scoring slow wave sleep is quite arbitrary; if the band of slow waves do not reach an amplitude of 75 microvolts, they will not be scored in this category, even though the individual may have pretty decent periods of low frequency waves. The only drug that I am aware of that has been proven conclusively to promote deep sleep is GHB. As I am sure you are aware, GHB is banned in the US by the FDA but is available in some other countries. There are clinical trials going on here for a number of medical disorders, notably narcolepsy and FMS. Serzone has been variously described as an A/D that promotes a more normal sleep architecture to one that does not disrupt REM sleep unlike most other A/D’s. I have been on 450mg of Serzone for nine months without any benefit; my sleep disorder medical situation however is not typical at all. Best regards, Ash Joe Talmadge <talma…@facstaff.wisc.edu> wrote in message
news:37def163.116865954@news.doit.wisc.edu… – Hide quoted text — Show quoted text -> On Tue, 14 Sep 1999 17:11:47 -0700, "Ash" <a…@sprintmail.com> wrote: > >Elavil, trazadone, flexiril (cyclobenzaprine, a muscle relaxant), benadryl > >and 5htp are among the most common drugs prescibed for FMS to enhance deep > >sleep. For the first two the doses happen to be less than those used for > >alleviating depression. There are papers comparing these drugs to placebo, > >though the results are somewhat mixed. > >For me, both trazadone and flexiril contributed to a significant increase in > >PLMD. Your mileage may vary of course. > >Ash > Hi Ash, > So here’s my question: I know there are papers describing for example > how 5htp is used to treat fibromyalgia — and perhaps they exist for > the other drugs as well. BUT … did you ever come across any paper > that proves that any of these drugs actually enhance deep sleep as you > suggest? > My own experience looking very briefly at the literature on 5htp is > that, unlike what is claimed in the popular book by Murray on the > benefits of 5htp, there actually is no evidence whatsoever that it > enhances slow wave sleep. In fact, if you check the reference that > Murray cites you find that the authors actually states EXACTLY THE > OPPOSITE — that is 5htp does NOT extend slow wave sleep (it does > however extend REM sleep, but that’s a different story). I was > wondering if there is clinical evidence that ANY of these drugs > enhance slow wave sleep (including the subject of this thread, > serzone) — and whether the mechanism by which it acts is by > suppressing the alpha intrusions? > Regards, > Joe
Response:
> Alpha intrusions can be described as the case when the brain basically > doesn’t go to sleep.
Do these alpha intrusions show up on the average sleep study? Jo
Response:
On Thu, 16 Sep 1999 11:34:50 -0700, "Ash" <a…@sprintmail.com> wrote:
Ash, Thanks for the very informative post! >The only drug that I am aware of that has been proven conclusively to >promote deep sleep is GHB. As I am sure you are aware, GHB is banned in the >US by the FDA but is available in some other countries. There are clinical >trials going on here for a number of medical disorders, notably narcolepsy >and FMS.
You’re right — I just did a quick check and was able to come up with: J Rheumatol 1998 Oct;25(10):1986-90 Effect of gamma-hydroxybutyrate on pain, fatigue, and the alpha sleep anomaly in patients with fibromyalgia. Preliminary report. Scharf MB, Hauck M, Stover R, McDannold M, Berkowitz D Center for Research in Sleep Disorders, Cincinnati, Ohio, USA. OBJECTIVE: To evaluate the effects of using a gamma-hydroxybutyrate (GHB) administered in divided doses at night in 11 patients previously diagnosed with fibromyalgia (FM). METHODS: Subjects completed daily diaries assessing their pain and fatigue levels and slept in the sleep laboratory before and one month after initiating GHB treatment. Polysomnographic recordings were evaluated for sleep stages, sleep efficiency and the presence of the alpha anomaly in non-REM sleep. RESULTS: There was a significant improvement in both fatigue and pain, with an increase in slow wave sleep and a decrease in the severity of the alpha anomaly. CONCLUSION: Further controlled studies are needed to characterize the clinical improvement and the polysomnographic changes we observed. So without having to go into tremendous detail — why is everyone so hot and bothered about keeping this drug illegal? Should it be? >Serzone has been variously described as an A/D that promotes a more normal >sleep architecture to one that does not disrupt REM sleep unlike most other >A/D’s. I have been on 450mg of Serzone for nine months without any benefit; >my sleep disorder medical situation however is not typical at all.
You’re taking the Serzone for A/D? So, I’ll ask the obvious question — if it doesn’t help, why keep taking it? Thanks again for the interesting posts! Regards, Joe
Response:
On Fri, 17 Sep 1999 17:33:31 -0400, "Jo" <can’tfin…@zoomnet.net> wrote: >> Alpha intrusions can be described as the case when the brain basically >> doesn’t go to sleep. > Do these alpha intrusions show up on the average sleep study?
I think the answer to this question is yes, but I’m not completely sure how they score an alpha intrusion versus a plain old arousal. If anyone knows, post it here. Joe
Response:
Sorry, I just replied and I remembered that the doc at Stanford said that there is a chance that my brain does not sleep which would seem similar, but she mentioned stimulants. But that does not make sense, if there are arousals, I don’t think stimulants will help much. The arousals need to be stopped or lessened to a greater degree. – Hide quoted text — Show quoted text -Joe Talmadge wrote: > On Fri, 17 Sep 1999 17:33:31 -0400, "Jo" <can’tfin…@zoomnet.net> > wrote: > >> Alpha intrusions can be described as the case when the brain basically > >> doesn’t go to sleep. > > Do these alpha intrusions show up on the average sleep study? > I think the answer to this question is yes, but I’m not completely > sure how they score an alpha intrusion versus a plain old arousal. > If anyone knows, post it here. > Joe
Response:
My last sleep study showed 24 arousals and they do not know why. When I go to Stanford this Wednesday for my sleep study I will ask a tech if they know. I was trying trazadone, but I did not have enough doctor supervision (I had a doctor write the script) and it made me extremely tired so I quit it after two days. I mentioned it to the Stanford doc and she said they is no way that I should have taken the drug. But I go arousals and no one except me has been trying to find out why I am tired. Now that I am going to Stanford, I hope that they will do the research (they have several sleep docs) so I should have a good chance. – Hide quoted text — Show quoted text -Joe Talmadge wrote: > On Fri, 17 Sep 1999 17:33:31 -0400, "Jo" <can’tfin…@zoomnet.net> > wrote: > >> Alpha intrusions can be described as the case when the brain basically > >> doesn’t go to sleep. > > Do these alpha intrusions show up on the average sleep study? > I think the answer to this question is yes, but I’m not completely > sure how they score an alpha intrusion versus a plain old arousal. > If anyone knows, post it here. > Joe
Response:
> So without having to go into tremendous detail — why is everyone so > hot and bothered about keeping this drug illegal? Should it be?
Short answer–there have been a number of deaths. This does not necessarily justify the uproar about GHB, however. I understand that most or all of the deaths have been associated with large overdoses, abuse of alcohol or other drugs that can suppress vital signs, and often dehydration, from dancing at hot sweaty dance clubs or raves all night while intoxicated. Multi-level marketers who have hard-sold this drug as a sleep aid, harmless recreational drug, sex enhancer and body building aid certainly deserve much of the responsibility. Very interesting about GHB and stage four sleep. Learn something new every day. I don’t know how this effect relates to the sleep benefits of antidepressants. They do delay onset of REM sleep during the first few hours of sleep, so they may be deep sleep enhancers to some degree. Tim Miller
Response:
> I was trying trazadone, but I did not have enough doctor supervision > (I had a doctor write the script) and it made me extremely tired so I > quit it after two days. I mentioned it to the Stanford doc and she > said they is no way that I should have taken the drug.
Most people will feel less drowsy if they take Trazadone at bedtime every night for a couple of weeks. It’s not for everyone of course. Increasing the dose gradually helps also. The ideal dose could be anywhere from 50 mg. at bedtime to 300 mg. at bedtime. Sad to say, this has to be determined by trial and error. Most people will do best with 100 to 150. Millions of people take trazadone at bedtime because of various sleep problems. I don’t know what particular kind of sleep problem you have, but the comments of the Stanford doctor seem a little strident. The problem with sleep clinics is that they have few interventions to offer aside from CPAP, standard good advice, and meds that any psychiatrist routinely prescribes. I once went to Stanford sleep clinic for sleep trouble and was disappointed. I’m much happier with my psychiatrist. He takes sleep trouble seriously and is very well informed. Tim Miller
