Re: Serzone & its generics can damage liver

[Guest guest]

I blame antidepressants (was tried on them for three years for " chronic

depression " prior to diagnosis of HCV), for making me feel worse, not to

mention I

think they were assaulting my liver (even the so-called " liver friendly "

ones, such as " Lexapro " ). I see so many people with Hep C (due to the

fatigue)

talking about how bad they feel and how they're probably going to " try

another anti-depressant this time " . While I can only speak for myself and from

personal experience, it was after I refused to ever take another one that --

eventually -- I began feeling better. A lot better.

I tend to push hard, sometimes, on the Anti D thing, (I bash them mostly)

but it's only because I believe it was Anti D's that were making me feel like I

was dying (and I kept taking them because I believed, as the doc said, if I

stayed on them long enough, they would probably begin to work). They never

worked! And Lexapro? Don't EVEN ask my opinion on that so-called " liver

friendly " SSRI that GI docs are pushing (or at least my GI doc pushed it). Oh

--

I tried it, and it zombified me and made me think I had hepatic

encephalopathy!

And here's a tid-bit of info my shrink shared with me last year (when I

refused to ever take another Anti D, no matter what, even with a diagnosis of

Hep

C and attempt at treatment) -- she said " we give patients what's new and what

comes through in sample packs, and only 30% of them ever respond favorably " .

I tend to believe that MANY I see with complaints, " I'm tired, I don't feel

good, I'm exhausted, they want to put me on a new AntiD " , etc -- I think

their exhaustion would be IMPROVED if they would get off the AntiD's.

If they work to help the patient feel better, then that's great, but many

still feel bad while taking them and CONTINUE taking them because of what their

doctors tell them or because of " commercials " .

I better get off my box. lol. Thanks for the info on Serzone.

In a message dated 5/20/2004 4:26:17 PM Eastern Standard Time,

alleypat@... writes:

> May 19, 2004

> Serzone Withdrawal Insufficient; Complete Ban Needed

>

> Statement of Dr. Sidney Wolfe, Director, Public Citizen s Health Research

> Group

>

> Bristol-Myers Squibb (BMS) announced today that as of June 14, it will no

> longer ship its widely used antidepressant nefazodone (Serzone). Although

> stating this is being done for business reasons, this is questionable

> because retail sales of Serzone topped $100 million in 2003. Perhaps the

> real reason is the liver toxicity of the drug, which has brought massive

> litigation against the company.

>

> There are two serious deficiencies in the action announced today by BMS:

> First, because the company is not ordering a recall of the drug and will

> merely stop shipping after June 14, patients will be able to fill (or

> refill) prescriptions for many more months because the drug will still be

> available in channels of commerce including wholesalers and retail

> pharmacies. The failure to order a recall is irresponsible. BMS should

> immediately send letters to all doctors to facilitate the change to any of a

> variety of other safer, equally effective antidepressants.

>

> Second, although BMS's Serzone has sold by far the largest share of

> nefazodone, generic versions are now available. The U.S. Food and Drug

> Administration (FDA) must force those companies to remove their drugs from

> the market. Otherwise, the cases of liver failure, liver transplant and

> death will continue with the generic versions of nefazodone. We strongly

> urge all people using either Serzone or generic nefazodone to contact their

> physicians about switching to a safer antidepressant.

>

> Public Citizen sued the FDA on March 15 over its failure to act on a

> petition we filed a year ago seeking a ban of nefazodone because it had been

> linked to a mounting number of deaths and serious injuries from liver

> failure. That petition cited 21 cases of liver failure and 11 deaths between

> 1994, when nefazodone was first marketed, and spring 2002. A supplemental

> petition, submitted to the FDA in October 2003, said that from April 1,

> 2002, through May 12, 2003, there were 33 additional reports of liver

> failure, including nine deaths, for a total of 55 patients with liver

> failure, including 20 deaths.

>

> The liver toxicity dangers of nefazodone are compounded by the fact that it

> inhibits a key enzyme that is involved in the metabolism of about half of

> all prescribed drugs, including itself, so nefazodone increases the toxicity

> dangers of other drugs a patient may be taking. Also, by inhibiting this

> enzyme, nefazodone can increase its own concentration, with potentially

> toxic results.

>

> Serzone has not been shown to be more effective in controlling depression

> than other drugs in its class. Nefazodone has already been removed from the

> market in Canada and Europe and is being taken off the market in Australia

> and New Zealand in May. Since January 2002, a black box warning has been

> included in its U.S. packing insert, warning of life-threatening liver

> damage and recommending that physicians advise patients to be aware of signs

> of liver problems.

>

>

>

[Guest guest]

I blame antidepressants (was tried on them for three years for " chronic

depression " prior to diagnosis of HCV), for making me feel worse, not to

mention I

think they were assaulting my liver (even the so-called " liver friendly "

ones, such as " Lexapro " ). I see so many people with Hep C (due to the

fatigue)

talking about how bad they feel and how they're probably going to " try

another anti-depressant this time " . While I can only speak for myself and from

personal experience, it was after I refused to ever take another one that --

eventually -- I began feeling better. A lot better.

I tend to push hard, sometimes, on the Anti D thing, (I bash them mostly)

but it's only because I believe it was Anti D's that were making me feel like I

was dying (and I kept taking them because I believed, as the doc said, if I

stayed on them long enough, they would probably begin to work). They never

worked! And Lexapro? Don't EVEN ask my opinion on that so-called " liver

friendly " SSRI that GI docs are pushing (or at least my GI doc pushed it). Oh

--

I tried it, and it zombified me and made me think I had hepatic

encephalopathy!

And here's a tid-bit of info my shrink shared with me last year (when I

refused to ever take another Anti D, no matter what, even with a diagnosis of

Hep

C and attempt at treatment) -- she said " we give patients what's new and what

comes through in sample packs, and only 30% of them ever respond favorably " .

I tend to believe that MANY I see with complaints, " I'm tired, I don't feel

good, I'm exhausted, they want to put me on a new AntiD " , etc -- I think

their exhaustion would be IMPROVED if they would get off the AntiD's.

If they work to help the patient feel better, then that's great, but many

still feel bad while taking them and CONTINUE taking them because of what their

doctors tell them or because of " commercials " .

I better get off my box. lol. Thanks for the info on Serzone.

In a message dated 5/20/2004 4:26:17 PM Eastern Standard Time,

alleypat@... writes:

> May 19, 2004

> Serzone Withdrawal Insufficient; Complete Ban Needed

>

> Statement of Dr. Sidney Wolfe, Director, Public Citizen s Health Research

> Group

>

> Bristol-Myers Squibb (BMS) announced today that as of June 14, it will no

> longer ship its widely used antidepressant nefazodone (Serzone). Although

> stating this is being done for business reasons, this is questionable

> because retail sales of Serzone topped $100 million in 2003. Perhaps the

> real reason is the liver toxicity of the drug, which has brought massive

> litigation against the company.

>

> There are two serious deficiencies in the action announced today by BMS:

> First, because the company is not ordering a recall of the drug and will

> merely stop shipping after June 14, patients will be able to fill (or

> refill) prescriptions for many more months because the drug will still be

> available in channels of commerce including wholesalers and retail

> pharmacies. The failure to order a recall is irresponsible. BMS should

> immediately send letters to all doctors to facilitate the change to any of a

> variety of other safer, equally effective antidepressants.

>

> Second, although BMS's Serzone has sold by far the largest share of

> nefazodone, generic versions are now available. The U.S. Food and Drug

> Administration (FDA) must force those companies to remove their drugs from

> the market. Otherwise, the cases of liver failure, liver transplant and

> death will continue with the generic versions of nefazodone. We strongly

> urge all people using either Serzone or generic nefazodone to contact their

> physicians about switching to a safer antidepressant.

>

> Public Citizen sued the FDA on March 15 over its failure to act on a

> petition we filed a year ago seeking a ban of nefazodone because it had been

> linked to a mounting number of deaths and serious injuries from liver

> failure. That petition cited 21 cases of liver failure and 11 deaths between

> 1994, when nefazodone was first marketed, and spring 2002. A supplemental

> petition, submitted to the FDA in October 2003, said that from April 1,

> 2002, through May 12, 2003, there were 33 additional reports of liver

> failure, including nine deaths, for a total of 55 patients with liver

> failure, including 20 deaths.

>

> The liver toxicity dangers of nefazodone are compounded by the fact that it

> inhibits a key enzyme that is involved in the metabolism of about half of

> all prescribed drugs, including itself, so nefazodone increases the toxicity

> dangers of other drugs a patient may be taking. Also, by inhibiting this

> enzyme, nefazodone can increase its own concentration, with potentially

> toxic results.

>

> Serzone has not been shown to be more effective in controlling depression

> than other drugs in its class. Nefazodone has already been removed from the

> market in Canada and Europe and is being taken off the market in Australia

> and New Zealand in May. Since January 2002, a black box warning has been

> included in its U.S. packing insert, warning of life-threatening liver

> damage and recommending that physicians advise patients to be aware of signs

> of liver problems.

>

>

>

[Guest guest]

Also, it might be the wrong antidepressant and some doctors give them out like

candy. An antidepressant should be given by a psychiatrist, not an MD, in my

opinion.

In my case, I respond terribly to SSRI's (like Lexapro, Zoloft, Effexor, Paxil,

etc). They make me moody, depressed, tired.

However, I've found Wellbutrin to be a godsend. It gives me energy, perks me up.

There isn't always a pill to " fix " us. But, we should let the doctor who

specializes in that area to diagnose that problem. Only after I saw a

psychiatrist who specialized in chronic condtions did I really understand my

reactions to SSRI's and he admitted I might not even respond to Wellbutrin (acts

on dopamine).

When I was on high dose Interferon for malignant melanoma I asked my oncologist

what antidepressant did he recommend and he said he rarely put his patients on

any. He said he just didn't see the need.

So a lot depends.

Do your research, work with your doc, or docs

Alley

[Guest guest]

Also, it might be the wrong antidepressant and some doctors give them out like

candy. An antidepressant should be given by a psychiatrist, not an MD, in my

opinion.

In my case, I respond terribly to SSRI's (like Lexapro, Zoloft, Effexor, Paxil,

etc). They make me moody, depressed, tired.

However, I've found Wellbutrin to be a godsend. It gives me energy, perks me up.

There isn't always a pill to " fix " us. But, we should let the doctor who

specializes in that area to diagnose that problem. Only after I saw a

psychiatrist who specialized in chronic condtions did I really understand my

reactions to SSRI's and he admitted I might not even respond to Wellbutrin (acts

on dopamine).

When I was on high dose Interferon for malignant melanoma I asked my oncologist

what antidepressant did he recommend and he said he rarely put his patients on

any. He said he just didn't see the need.

So a lot depends.

Do your research, work with your doc, or docs

Alley

[Guest guest]

In a message dated 5/20/2004 10:21:04 PM Eastern Daylight Time,

alleypat@... writes:

When I was on high dose Interferon for malignant melanoma I asked my

oncologist what antidepressant did he recommend and he said he rarely put his

patients

on any. He said he just didn't see the need.

Wise physician. I thought that Zoloft had been taken off the market along

with Prozac......

[Guest guest]

In a message dated 5/20/2004 10:21:04 PM Eastern Daylight Time,

alleypat@... writes:

When I was on high dose Interferon for malignant melanoma I asked my

oncologist what antidepressant did he recommend and he said he rarely put his

patients

on any. He said he just didn't see the need.

Wise physician. I thought that Zoloft had been taken off the market along

with Prozac......

[Guest guest]

<<I thought that Zoloft had been taken off the market along

with Prozac......>>

why would you think that? They are widely used and work quite well for many

people.

However, Seratonin Reuptake Inhibitors act the opposite on me. Instead of fixing

depression they make me depressed. Go figure. I'm like that with a lot of meds.

Bassackwards oy!

Ya know what works the best for me, just plain old aspirin for a headache (take

a BC Powder and come back strong haha), or a good old fashioned backrub.

Remember, treatment is temporary

alley

[Guest guest]

<<I thought that Zoloft had been taken off the market along

with Prozac......>>

why would you think that? They are widely used and work quite well for many

people.

However, Seratonin Reuptake Inhibitors act the opposite on me. Instead of fixing

depression they make me depressed. Go figure. I'm like that with a lot of meds.

Bassackwards oy!

Ya know what works the best for me, just plain old aspirin for a headache (take

a BC Powder and come back strong haha), or a good old fashioned backrub.

Remember, treatment is temporary

alley

[Guest guest]

Alley,

I have been off treatment for two years. This is the problem. No

headaches before treatment. Constant headaches after. I have been through

all the tests. BC does help a little. Terry

Re: Serzone & its generics can damage liver

> <<I thought that Zoloft had been taken off the market along

> with Prozac......>>

>

> why would you think that? They are widely used and work quite well for

many people.

>

> However, Seratonin Reuptake Inhibitors act the opposite on me. Instead of

fixing depression they make me depressed. Go figure. I'm like that with a

lot of meds. Bassackwards oy!

>

> Ya know what works the best for me, just plain old aspirin for a headache

(take a BC Powder and come back strong haha), or a good old fashioned

backrub.

>

> Remember, treatment is temporary

>

> alley

>

>

[Guest guest]

Fatigue is a big part of depression because you have no reason to get up out of

bed and do anything. I've seen antidepressants work miracles with people who

have a physiological imbalance of neurotransmitters. I don't know about liver

friendly or not...but when one is truly depressed and it's physiological (vs " oh

pitiful me " ), it is much healthier to get your body back in sync than to worry

about how the antidepressant is affecting your liver. Depression is an awful

disease...and one that many can't live with.

But antidepressants are also overused (abused) by western medical professionals

as a quick fix type thing...back in the 40s and 50s, tranquilizers were the

quick fix...70s-90s, antibiotics were the quick fix. When western medicine comes

across something they don't understand, they start prescribing chemicals...it's

the western world way.

Tatezi

Re: Serzone & its generics can damage liver

..... I see so many people with Hep C (due to the fatigue)

talking about how bad they feel and how they're probably going to " try another

anti-depressant this time " .

[Guest guest]

My mother takes prozac and has for abou 8 years...she's never mentioned to me

that she could no longer get it.

Why was zoloft taken off the market...

Re: Serzone & its generics can damage liver

I thought that Zoloft had been taken off the market along

with Prozac......

[Guest guest]

In a message dated 5/21/2004 5:58:45 PM Eastern Daylight Time,

alleypat@... writes:

However, Seratonin Reuptake Inhibitors act the opposite on me. Instead of

fixing depression they make me depressed. Go figure. I'm like that with a lot of

meds. Bassackwards oy!

That's probably why I've always thought Anti d's were not one of our more

useful pharmalogical accomplishments.

[Guest guest]

Prozac and Zoloft have not been taken off the market.

Alley

[Guest guest]

In a message dated 5/22/2004 11:08:57 AM Eastern Daylight Time,

tatezi@... writes:

When western medicine comes across something they don't understand, they

start prescribing chemicals...it's the western world way.

Much to my dismay, that statement is, at least, true for some doctors, not

all. Anne

[Guest guest]

In a message dated 5/22/2004 11:46:54 AM Eastern Daylight Time,

tatezi@... writes:

My mother takes prozac and has for abou 8 years...she's never mentioned to me

that she could no longer get it.

Why was zoloft taken off the market...

My goof. Zoloft was taken off for awhile, reworked and brought back with a

slightly different formula. I thought that prozac went bye bye permanently,

but my info isn't up to date on anti depressents.

[Guest guest]

Hi all. Hope everyone is feeling OK!! This Anti D topic really hits home

for me.

When a patient is depressed (regardless the etiology) it is sometimes very

difficult for the patient / doctor to differentiate between side effects of

the Anti D's (some unpleasant) and signs of worsening depression. I think

this holds particularly true for the HCV patient since symptoms of HCV can

include chronic fatigue, insomnia, and mental status changes.

All Anti'd's (since all can cause worsening depression in some patients)

carry the risk of increased suicidal ideation. Some HCV patients don't

metabolize

drugs due to an impaired liver. This can lead to toxicity. Toxicity can

make the side effects of the drug more pronounced (not to mention it can damage

the liver).

Side effects from Anti D's, SSRI-intolerance, risk of toxicity, withdrawal

syndrome, etc., are frequently (unfortunately) not discussed with the patient

prior to beginning therapy with antidepressants. Many psychiatrists push one

antidepressant after the next to treat " symptoms " . It's the standard to try,

try, and try again. I think, overall, that is good practice because it does

improve -- in my cases -- the patient's quality of life when an antidepressant

is found to treat the symptoms effectively and safely.

Frequently, though, only one antidepressant works effectively in a clinically

depressed patient. Serzone, for example, may be the only antidepressant that

improves the patient's symptoms, but the use of this antidepressant has been

linked to liver failure. Even though the HCV patient's depression may improve

on this drug, the patient is at risk of liver failiure (and death) if they

continue taking it.

If someone being treated for depression is not responding favorably or begins

to feel worse, I think it's healthy to consider alternatives -- one of which

is to keep trying different AntiD's. Another is to consider stopping them

(under the care of a psychiatrist) and see if you feel better. My

psychiatrist

was not pleased with my decision to stop attempting Anti D's, but I was

adamant I wasn't taking another one. Off the AntiD's, I still felt tired, I

still

had insomnia, I still had to take naps everyday, but I wasn't as " zonked out "

feeling.

When I was diagnosed HCV, I had been off all AntiD's for about a year. My GI

doc strongly recommended that I get back on an AntiD, and he recommended the

new " liver friendly " SSRI called Lexapro, termed " liver friendly " by the

manufacturer (and therefore frequently prescribed by GI docs to newly diagnosed

HCV patients). I agreed to give it a try. During the first few days, my

energy was much increased (I felt like I was doing speed, which was OK because

at

least I had some energy). I was very pleased (even enthusiastic) that this

new AntiD seemed to be working. My enthusiasm was short-lived, though.

During the second week on this SSRI, I began to feel like I couldn't raise my

head. I did nothing but lay on the couch when I wasn't in the bed, and whether

in

bed or on the couch, I had vivid nightmares (I could not escape the

nightmares). I was horizontal 14 to 16 hours out of the day -- everyday. I

felt

worse than tranquilized and thought I had hepatic encephalopathy. Both my

shrink and GI doc reassured me I did not have hepatic encephalopathy, and they

advised cutting the dose from 10 mg per day to 5 mg per day. I saw no reason

whatsoever to continue this drug Anti D -- even at a reduced dose -- and I

stopped

it altogether. That was a huge no-no on my part. Even though I felt better

almost immediately (began to have some energy back) I began to have strange

sensations all over my body, as if someone was shocking me. " Brain buzzes "

is what this sensation is affectionately termed (SSRI withdrawal is the

syndrome it's been named). I knew nothing about SSRI withdrawal syndrome.

This

syndrome came about because reports to the drug manufacturer that some patient's

on SSRIs were complaining of having strange electric shock sensations. I had

complained of this sensation in June 2000, and sure enough -- it was found

noted in my chart " patient believes she has multiple sclerosis " . (The reason

I

thought I had MS was because I was so depressed for so long, I had dramatic

mental status changes going on, I wasn't getting any better on any antiD, and I

had begun to note strange sensations shooting through my body -- especially

my face). I kept telling my shrink " something is seriously wrong with me -- I

have something more than depression " . I did. I had HCV, undiagnosed, the

entire time while being treated for depression. My CBCs, LFTs, and enzymes

were always within normal limits, and liver disease was therefore not suspected

-- even though it was well documented that I had Hep NonA NonB in the 70's

from IV drug abuse.

I get pretty angry today when I look back from 1998 to 2002 and recall how

much I was complaining to the docs " something is seriously wrong with me " and

how the docs acted like I was hysterical or a hypochondriac (not much

difference in the two). Even I began to believe I was a hypochondriac and

hysterical.

I had all the signs of being a hysterical, perhaps premenopausal female -

LOL! Strange rashes, hives, itching, sweating, insomnia, and " buzzy "

sensations.

Anyhow... after the experience with Lexapro, I was deemed SSRI intolerant. I

was no doubt SSRI intolerant the entire time while being treated for chronic

depression with SSRI's for many years. It was agreed last year by my shrink

and GI doc that since I had never responded favorably to Anti D's, I would

probably never respond favorably to them. SSRIs are now considered

contraindicated in me.

Many people cannot tolerate SSRIs. If you're ever placed on one and react

badly, advise you doctor. If you're ever told you cannot tolerate SSRI's, do

not ever take them again because you will only respond the same way (or worse)

to another one. Don't EVER stop an SSRI suddenly.

I've been off Anti D's for over a year now, and I feel 100% improved (no more

fatigue, no more insomnia, no more exhaustion, no more night sweats, no more

withdrawal syndrome). If I didn't know I had HCV, I wouldn't know it.

If I feel better not taking antiD's, then maybe someone else who's got HCV

and has felt awful while on antidepressants may begin to feel better if they

stop taking them, too. Chronic depression is an awful thing to live with.

I hope everyone out there who is suffering from depression (regardless the

etiology) finds something that works for them. BUT ( BIG BUT ) please

don't take Serzone to treat your depression. If you've to HCV, you should be

very concerned about how antiD's might affect your liver. While it's important

to combat depression and fatigue, it's not always possible to do so when one is

symptomatic with HCV. If you've got HCV, it's more important and more

healthy to avoid hepatotoxic substances and learn to live with the fatigue.

If your doctor (specialist, GP, shrink, GI doc, neuro doc) acts like they

don't want to hear you out or attempt something else or attempt something you

think might help you feel better, put your foot down and take some control back

into your own hands. It's your life. Depression and chronic fatigue are

awful things to live with, but you CAN live with it. Serzone is an

antidepressant that could kill you. Other antidepressants can also cause liver

damage.

There is not always a cure through medicine. Be careful.