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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 Mary Ann on March 6, 2001, at 17:53:40
I have been on Serzone for about 2 weeks, gradually increasing my dose from 50 mg/bedtime to 200 mg/bedtime. My optimal dose will be 200 mg/bedtime and 100 mg/morning. When my dosage was at 100 mg/bedtime, I began having insomnia and bad dreams (I've woken up crying a few times) when I was finally able to sleep with the help of Benadryl. Has anyone else experienced this? What has worked with others? I have a call in to my P-doc to see what he recommends. I might switch back to Prozac and incorporate Wellbutrin (to combat the negative sexual side effects from Prozac). My P-doc said the Prozac/Wellbutrin was another option to the Serzone. Thanks for your help!
Posted by terra miller on March 6, 2001, at 18:35:46
In reply to Serzone Insomnia, posted by Mary Ann on March 6, 2001, at 17:53:40
> I have been on Serzone for about 2 weeks, gradually increasing my dose from 50 mg/bedtime to 200 mg/bedtime. My optimal dose will be 200 mg/bedtime and 100 mg/morning. When my dosage was at 100 mg/bedtime, I began having insomnia and bad dreams (I've woken up crying a few times) when I was finally able to sleep with the help of Benadryl. Has anyone else experienced this? What has worked with others? I have a call in to my P-doc to see what he recommends. I might switch back to Prozac and incorporate Wellbutrin (to combat the negative sexual side effects from Prozac). My P-doc said the Prozac/Wellbutrin was another option to the Serzone. Thanks for your help!
hi, i took serzone for quite a while using 300mg-350mg at bedtime so that i COULD sleep. splitting the dose made the morning dose knock me out. i haven't heard about not being able to sleep on serzone. but i do know that especially in the first weeks-months that serzone will really make you dream and remember the dreams. for me, i found that to be an asset to my therapy and we got a lot done. but mine were mostly dreams and not of the nightmare variety. i found ativan to be helpful if i had a nightmare and couldn't get back to sleep. probably what you are talking about is that increased-dream thing that's pretty common. it does get better. take care, terra. oh, the serzone doesn't have the sexual sideeffects like other meds do.
Posted by Sunnely on March 6, 2001, at 19:57:12
In reply to Serzone Insomnia, posted by Mary Ann on March 6, 2001, at 17:53:40
Allow me to express my 2-cent opinion.
I'm not clear as to when you took Prozac and if you were directly switched from Prozac to Serzone. For the sake of discussion, I will suppose you were directly switched from Prozac to Serzone within the past 2 weeks.
Even though you are no longer taking Prozac, it remains in your system for several weeks (approximately 5-8 weeks). This is due to its very long half-life. Therefore, it continues to exert some pharmacological effects and interactions with Serzone.
Prozac is a potent inhibitor of a liver enzyme called CYP2D6. Serzone is metabolized into 3 different compounds (metabolites) via the liver enzyme called CYP3A4. In turn, these metabolites are further metabolized by different liver enzymes before they can be eliminated, usually via the kidneys. One of the metabolites of Serzone called mCPP (meta-chlorophenylpiperazine) has an activating effect, which can promote anxiety, even agitation and insomnia. Normally, this is not a problem. However, mCPP requires the action of the liver enzyme CYP2D6 for metabolism. Prozac, which can remain in your system for 5-8 weeks, is a potent inhibitor of this liver enzyme. Even though you are no longer taking Prozac, it continues to inhibit the metabolism of mCPP, leading to its accumulation and causing activating effect (anxiety and insomnia). This effect should wear off as Prozac's blood level continues to drop to insignificant level (5-8 weeks).
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> I have been on Serzone for about 2 weeks, gradually increasing my dose from 50 mg/bedtime to 200 mg/bedtime. My optimal dose will be 200 mg/bedtime and 100 mg/morning. When my dosage was at 100 mg/bedtime, I began having insomnia and bad dreams (I've woken up crying a few times) when I was finally able to sleep with the help of Benadryl. Has anyone else experienced this? What has worked with others? I have a call in to my P-doc to see what he recommends. I might switch back to Prozac and incorporate Wellbutrin (to combat the negative sexual side effects from Prozac). My P-doc said the Prozac/Wellbutrin was another option to the Serzone. Thanks for your help!
Posted by Mary Ann on March 6, 2001, at 22:21:18
In reply to Re: Serzone Insomnia » Mary Ann, posted by Sunnely on March 6, 2001, at 19:57:12
Your opinion is definitely worth more than two cents! Thank you very much for the information, Sunnely. I was only taking 20 mg/daily of Prozac, and I weaned off that for a period of four days, then immediately started taking the Serzone. I started off with Serzone 50 mg/bedtime for four days, then stepped up to 100 mg/bedtime for four days, and now I am taking 200 mg/bedtime for four days. Then I will add 100 mg/morning to that dose. I see the P-doc in April, but have called the P-nurse to report the insomnia and other side effects. I am also keeping a daily journal. I also noticed that I am having negative thoughts (like my husband is cheating on me), even though I know in my right mind that this is absolutely not true! When I was taking Prozac those type of thoughts went away, and so did some of my OCD behaviors, high anxiety and panic attacks. If this doesn't get better soon, I think I will ask to switch back to Prozac and add Wellbutrin to it. Do you have any experience with that combination? Thanks for your input, Sunnely, I appreciate it.
Posted by Joy on March 7, 2001, at 20:41:06
In reply to Re: Serzone Insomnia » Mary Ann, posted by terra miller on March 6, 2001, at 18:35:46
Serzone gave me terrible insomnia and agitation with crying jags. Prozac works much better for me. The problem adding Wellbutrin to Prozac is that it agitates seemingly a lot of people. My friend tried this combo after being on Prozac alone, and she was so speeded up in speech, etc. it was terrible. She had to drop the Wellbutrin. Now she's fine again just on Prozac 60 mg.
> > I have been on Serzone for about 2 weeks, gradually increasing my dose from 50 mg/bedtime to 200 mg/bedtime. My optimal dose will be 200 mg/bedtime and 100 mg/morning. When my dosage was at 100 mg/bedtime, I began having insomnia and bad dreams (I've woken up crying a few times) when I was finally able to sleep with the help of Benadryl. Has anyone else experienced this? What has worked with others? I have a call in to my P-doc to see what he recommends. I might switch back to Prozac and incorporate Wellbutrin (to combat the negative sexual side effects from Prozac). My P-doc said the Prozac/Wellbutrin was another option to the Serzone. Thanks for your help!
>
>
> hi, i took serzone for quite a while using 300mg-350mg at bedtime so that i COULD sleep. splitting the dose made the morning dose knock me out. i haven't heard about not being able to sleep on serzone. but i do know that especially in the first weeks-months that serzone will really make you dream and remember the dreams. for me, i found that to be an asset to my therapy and we got a lot done. but mine were mostly dreams and not of the nightmare variety. i found ativan to be helpful if i had a nightmare and couldn't get back to sleep. probably what you are talking about is that increased-dream thing that's pretty common. it does get better. take care, terra. oh, the serzone doesn't have the sexual sideeffects like other meds do.
Posted by Noa on March 10, 2001, at 12:42:46
In reply to Re: Serzone Insomnia, posted by Joy on March 7, 2001, at 20:41:06
This thread is a great illustration of how different people can have nearly opposite reactions to the same medication!
I am in the category of those whose sleep is better with Serzone. Someday, we will understand why some of us react one way and some, the other.
This is the end of the thread.
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