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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by iforgotmypassword on January 26, 2009, at 7:08:41
the disorientation and general felling of goofiness is still an issue, as is the weakness and exhaustion, but thankfully these are lessening quite a bit. i still delay taking it by an hour or two after when i would usually dose, so i can guarantee doing some things with my senses and wakefulness intact. this need is less of a problem now, thankfully. i would say that i have just reached the point that, with enough caffeine available as a precaution, i am tolerating 200mg (100mg b.i.d) reasonably well.
i was thinking of increasing to (150mg b.i.d.) as this will get me into the clinically effective range of the med (apparently 300mg-600mg). given that range, waiting for 200mg to be effective would seem to be counterproductive, on 200mg it seems i am not suppose to expect anything, i am merely waiting for the point where i tolerate it... which i think i am pretty close to, and would reasonably tolerate an increase (but i will just keep caffeine handy.)
i am very desperate to see if this drug will help me, and there are many factors in my life pressing this urgency (including my tenancy once again.)
again if this drug works, my plan may still be to switch from this drug onto trazodone, eplivanserin, volinanserin, or pimavanserin, since they similarly have the 5-ht2a antagonistic component, but most, apart from trazodone, do not have the 5-ht2c agonist component. this will get rid of the liver worries. it will be interesting when the other drugs come out, but in the meantime, if i benefit from nefazodone eventually, i imagine i will benefit from trazodone's similar actions, and be somewhat prepared for the anti-adrenergic fatigue. it does not seem to have H1 affinity (which i do not react well to at all), but i cannot confirm this. i am under the impression the assumptions that it did have H1 affinity, were just assumptions based on the fact that it is one of the most commonly used antidepressants as hypnotics, and came closely after the reign of major tricylics, where many antidepressants had notable H1 affinity.
Posted by Jimmyboy on January 26, 2009, at 9:16:04
In reply to Day 5 of nefazodone trial, increase?, posted by iforgotmypassword on January 26, 2009, at 7:08:41
I really think Nefazodone is much more realistic in the long run than Trazodone. Traz is just too damn sedating. Nefazodone will make you a bit spacy for a few weeks, but it always cleared up within a few weeks. Also, my doctor always had me taking the whole dose at night instead of splitting it day/night. Thsi was great for sleep and this made a major difference in the amount of fatigue I felt in the morning , therefore making that dosing strategy much more effective for me.
Posted by desolationrower on January 26, 2009, at 11:36:11
In reply to Day 5 of nefazodone trial, increase?, posted by iforgotmypassword on January 26, 2009, at 7:08:41
i've seen conflicting evidence on whether traz affects H1.
you could try a tca, some of them also block 5ht2, and have the 5ht and NE reuptake inhibition higher doses of nefazadone have. i think the nortriptyline + possible sri combo is a good one, doesn't have very strong h1 action. actually theres quite a few options.
-d/r
Posted by Phillipa on January 26, 2009, at 12:26:21
In reply to Re: Day 5 of nefazodone trial, increase?, posted by desolationrower on January 26, 2009, at 11:36:11
I was given the nefazadone all at night also. I admit didn't stick with it as the liver issues were of concern to me as mine had recently been off . Phillipa
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