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Suggest Alternative Medication For Serzone

Posted on Wed, 24 Jun 2015

Question: I have been on serzone for around 15 years for dysthymia. It has worked fairly well for me and I don't have any significant side effects. My liver is checked through my PCP and there has not been any concerns. I had tried Zoloft before the serzone and I had low grade fevers when on that med. Do you suggest I look into another anti depressant or consider weaning off the Serzone?

Answered by Dr. Seikhoo Bishnoi (36 minutes later)

Brief Answer:
In my opinion doses should be reduced

Detailed Answer:
Hello, Welcome to Health Care Magic

I can understand your concern. Serzone is Nefazodone and the drug is an antidepressant drug. The drug is considered as a safe drug but some cases of severe hepatotoxicity have been reported with this drug, so chronic use of this drug should be avoided. Your liver tests have come normal so I don't think you are at risk.

You have been taking the drug since last 15 years and it has been working well still you never stopped the drug. In my opinion the doses of the drug should be weaned off because the drug has not resulted in remission of symptoms completely. Other drugs as Mirtazapine can be tried, which is relatively more potent as compared to Nefazodone and is also safer. SNRIs as Venlafaxine can also help you in these symptoms. Venlafaxine is also helpful in moderate to severe dysthymia and is tolerated with ease. These drugs wouldn't cause the mild fever like Zoloft caused.

So just to sum up-

"As Sezron has not resulted in remission of symptoms completely so even though you are feeling better with this drug still in my opinion you should consider weaning off the doses and start taking newer antidepressants"

Discuss with your doctor for prescription of these drugs.

Hope this helps you, if you have more doubts you can ask again.

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (12 hours later)

Thank you for your reply. In follow up, I would like to clarify that in the past my doctor stated that research us saying that it might be best to stay on a anti depressant for life if you have had dysthymia long term. She stated she thought this would be best for me. However, I am concerned due to some of the risk factors. I also looked up the meds you suggested. It states that venlafaxine has been discontinued in the us?? Also I have had one or two episodes in past of major depression. One before meds aftet a breakup and one while pregnant. While pregnant the serzones did not work. After trying other meds, finally was able to tolerate nortriptyline. Once over pregnancy went back to serzone and was fine

Answered by Dr. Seikhoo Bishnoi (18 minutes later)

Brief Answer:
Venlafaxine is an approved drug for use in depression by FDA

Detailed Answer:
Hello again and thanks for asking a follow up question

In my opinion and knowledge Venlafaxine hasn't be discontinued in USA. The drug is an approved drug for Major Depressive Disorder, Panic Disorder by FDA. So the drug can prove a good alternative for you in my opinion.

Yes to some extent I agree with your doctor but as some of your symptoms are persisting even with the drug so in my opinion either doses adjustments should be done or the drug should be replaced by some newer more potent drug. Yes some research studies say that drugs should be continued for life in patients of dysthymia.

But if you are doing good with Serzone then you can take the drug even for long periods of time. Your liver tests came normal and you are not at risk of hepatotoxicity so no need to fear.

Thanks, still have more doubts are you need more clarifications then please ask me again in follow up.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar