Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health
This answer was rated:

I have dysthymia and anxiety disorders. A time ago I took an

I have dysthymia and anxiety...
I have dysthymia and anxiety disorders. A long time ago I took an antidepressant called
Serzone. It worked great for me. Then it was taken off the market. Ssri's don't seem to work. Any suggestions for a med or combination that may work in a similar way. Thank you.
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 5 minutes by:
9/5/2013
Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10,643
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Verified
DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you have been experiencing these symptoms associated with anxiety and dysthymia, I can imagine how distressing this is for you

DoctorZ :

Serzone was a very potent antidepressant that was effective, but it also caused severe liver damage in some patients and that is why it was taken off the market.

DoctorZ :

May I ask, how long have you been diagnosed with dysthymia and anxiety disorders for?

DoctorZ :

Serzone is 5-HT2a antagonist, so you may get benefits from another 5-HT2a antagonist, like Valdoxan, which I believed was approved for use in Canada in 2009. Seroquel XR also has 5-HT2a antagonist properties as well

DoctorZ :

How has the Trazadone been working for you so far?

DoctorZ :

In addition, adding Abilify to an antidepressant can be beneficial as well. Abilify has been shown to increase the effectiveness of antidepressants in recent studies and you can take it along with the Trazadone if you feel the Trazadone has been effective for you.

DoctorZ :

Also Serzone has a moderate affinity to the 5-HT1a receptor as well, so it is possible that Buspar or Viibryd could be beneficial for you as well as these medications are partial agonists for this receptor.

DoctorZ :

Serzone actually had a low affinity for Serotonin, norepinephrine, and dopamine receptors, so this could explain why the SSRI and NDRI (e.g. Wellbutrin) medications were not effective for you and why the SNRI and NRI medications may not be as beneficial for you because your symptoms respond better to medications that target the 5-HT2a, 5-HT1a, adrenergic receptors. This is most likely why the Serzone was so effective for you.

DoctorZ :

I see that you are offline right now, but when you get back online I would be very interested in continuing this discussion with you and talking about anything further you would like to share regarding your concern, so if you respond in the chat box I will be able to get back to you as soon as possible.

Customer: I have suffered from dysthymia since very young, but of course, thought it was a normal way to feel, until my early 30's. What does low
DoctorZ :

I am sorry, I can imagine that feeling a chronic depressive disorder like dysthymia at such a young age would make you feel like it was normal because you had nothing to compare it to. But I am glad that you are seeking treatment for it since. I believe your question was cut off you started to say "What does low" and then it was cut off

Customer: I think the trazadone may not be working as well now! How does ability work to improve the antidepressant ? What is valdoxan?
DoctorZ :

The Abilify attaches to key receptors like the antidepressant and enhances the antidepressant's effectiveness in this way. The Valdoxan is a 5-HT2a antagonist like the Serzone, so that is why I thought it would be a good replacement medication for the Serzone you tried years ago.

DoctorZ :

Valdoxan is still relatively new and not prescribed a lot, but I believe you can bring it up with your prescribing physician since it is a major 5-HT2a antagonist like your Serzone

Customer: Can you list other meds that that target the 5ht2a, 5ht1a adrenergic receptors? Also, what does that mean in lay mans terms:) ?
DoctorZ :

Well Seroquel does have those effects as well, but not as strongly as the Serzone did or the Valdoxan. So 5ht2a, 5ht1a adrenergic receptors are neurotransmitter sites in your brain that effect your mood. So those medications react mainly with those neurotransmitters that I mentioned in your brain to help lessen your symptoms

DoctorZ :

In addition, Trimipramine is also a strong antagonist for the 5ht2a receptor like Serzone, so that could be effective for you as well. So in my opinion I would ask about Valdoxan and Trimipramine first, and see if that helps relieve your symptoms. You should start to see benefits in 2-3 weeks and then maximum benefits in 6-8 weeks

DoctorZ :

If those two medications do not work then you can try adding abilify to one of your antidepressants that you believe you had the most success with to enhance its effectiveness for you. But I believe you will find success with Valdoxan and Trimipramine as these medications are so closely similar to the Serzone

Customer: What class of antideppresant are valdoxan and trimipramine ?Are they definitely available in Canada thanks
DoctorZ :

Valdoxan and Trimipramine is available in Canada and they are actually called 5-HT2a antagonist antidepressants, same class as the Serzone was. The Valdoxan is much more recent and supposedly has much less side effects than the Trimipramine

DoctorZ :

Because Valdoxan is new, some doctors are not familiar with it, so you will have to bring it up with the doctor

DoctorZ :

And definitely mention how Serzone worked for you in the past and how Valdoxan is a similar class medication

Customer: As mentioned the trazadone doesn't seem to be working now. I thought it was similar to serzone ?
DoctorZ :

No actually Trazadone is in the Serotonin antagonist and reuptake inhibitors class (SARI) and has a strong connection with serotonin like most antidepressants. Serzone worked differently and did not have a strong connection with Serotonin. Serzone was 5-HT2a antagonist receptor class antidepressant

DoctorZ :

I am sorry I mistyped, Trazadone did work by blocking Serotonin lreuptake like Serzone, but it did not effect the 5-HT2a antagonist like the Serzone and that is what makes them inherently different

DoctorZ :

For some reason I thought you mentioned Thorazine and that is why I was mistyped.

DoctorZ :

I still think the Valdoxan would be a good choice over the Trazadone because of it 5-HT2a antagonist profile like Serzone.

DoctorZ :

Unfortunately psychotropic medications are not an exact science because every body reacts differently to the medications, so trying to find the right combination of medications may take some trial and error approach

Customer: Are you familiar with dysthymia?
DoctorZ :

Yes dysthymia is often called a less severe form of depression because it usually does not have as severe symptoms as a major depressive disorder, but I feel is a very severe depressive disorder due to its chronic nature and feelings of hopelessness commonly attached to it.

DoctorZ :

It is also a difficult disorder to treat as well due to the chronic nature of it

Customer: I was considering Pristiq, does it work on the 5ht2a 5ht1a receptors? The serzone worked so well on my anxiety also. I felt I didn't need the ativan for my anxiety. You don't mention the ativan. Do many people still find the need for a benzo, since not all antidepprasants work on both illnesses. So often we hear that certain antideppressant work on both. I think that is rare, do you agree?
DoctorZ :

Pristiq works mostly on serotonin and norepinephrine, so it will not have strong binds to those receptors that the Serzone has binds to. Many antidepressants work well for anxiety, but not all of them. Also anxiety and depression often co-occur (around 60-65 percent of the time do they occur together) so it is possibly that when your dysthymia symptoms lessen, so will your anxiety symptoms and that is probably why the Serzone worked so well. Yes many individuals do find the need to take a benzodiazepine in conjunction with an antidepressant if their anxiety is moderate to severe, so you can continue to take the Ativan if you wish and if it is still beneficial to you

DoctorZ :

In addition, if the medication is not working you may also want to try Transcranial Magnetic Stimulation (TMS). Which has shown in some studies to be effective in treating resistant depressive disorders

DoctorZ :

Here are couple links describing it

DoctorZ :

http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MY00185

Customer: Ok I will do some research and ask my doc about valdoxan. Does valdoxan work on melatonin ?
DoctorZ :

It does effect melatonin, so there are no insomnia or day time sleep effects associated with this medication. So this medication will actually improve your sleep quality

Customer: Have you heard of any positive feedback with using valdoxan? Why haven't I heard do this med before today?
Customer: I am always researching for a similar drug to serzone, this one has never come up.
DoctorZ :

Well like I said this medication is new, it will get approval in the United States later this year or possibly early next year, and it has been allowed in Canada since 2009, and yes there have been some positive results from studies that show its effectiveness.

DoctorZ :

Here is a study about Valdoxan for you

Customer: Thank you so much. Your patience is much appreciated. Keep your fingers and toes crossed for me:) I will first call my pharmacy to
DoctorZ :

Also that author wrote another study on it as well, not sure if it is very different, but I want to give you everything I have.

DoctorZ :

It is my pleasure, I am happy to help you today and I truly hope this medication is the key in helping you

Customer: If you think of anything else that might be of help, you have my email:) once again thanks!
DoctorZ :

I actually do not have your email, only the administrators do, but I can follow up using the Q&A format after you rate me and post anything that I think would be helpful for you

DoctorZ :

Is there anything else I can assist you with today?

DoctorZ :

Here is one last study for you too

DoctorZ :

Sorry I am big nerd on studies

Customer: Believe it or not I think that is it!! Bye and god bless!
DoctorZ :

I am happy that I was able to help you, I hope everything works out for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer: Oh really, I can pick your brain again at another time, how would I do that?
DoctorZ :

Well all you have to do is put "For Doctor Z only" to ask another question, but if you have follow up questions on this matter, you can ask me them for free at anytime. You should have a link in your email to this chat, so you can click on that and ask me follow up questions for free at anytime in the future.

Customer: Ok thanks, ***** ***** now.
DoctorZ :

Good bye and good luck :)

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10,643
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Verified
Dr. Z and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Ask Dr. Z Your Own Question
Dr. Z
Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10,643
10,643 Satisfied Customers
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.

Dr. Z is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

4,021 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
I suffer from anxiety, and have been taking Ativan 0.5mg,
I suffer from anxiety, and have been taking Ativan 0.5mg, one a day for 23 years. Recently my doctor told me, (because of some anxiety issues) I could take up to three of my 0.5mg Ativan. Is there a p… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
I'm a Bipolar 36 year-old male with severe anxiety and
I'm a Bipolar 36 year-old male with severe anxiety and depression. What is the best anxiety medicine I should be taken? I've taken Clonazepam for 8 years and it no longer helps. Would another drug lik… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,677 satisfied customers
I am currently weaning from one anxiety medications to
I am currently weaning from one anxiety medications to another for hypochondriasis. I am under the guidance of my psychiatrist. I am finding my health worries are very high whilst I am switching meds.… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
I was diagnosed with social anxiety by my psychiatrist at 16
Hi Dr. Wilson, I was diagnosed with social anxiety by my psychiatrist at 16 years old. Fast forward 6 years, and I feel like I am still struggling. I am always nervous when it comes to social engageme… read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
I have anxiety and recently think it is playing tricks with
Second opinion] Hi. I have anxiety and recently think it is playing tricks with my eyes. Is this possible? Sometimes feel things are moving when there not etc. Thank you… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
204 satisfied customers
My adult daughter is struggling tremendously with anxiety
My adult daughter is struggling tremendously with anxiety and depression. She is on prozac but it's not helping that much. What is the best way to treat depression and anxiety in your opinion. She doe… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
I have anxiety and recently think it is playing tricks with
Hi. I have anxiety and recently think it is playing tricks with my eyes. Is this possible? Sometimes feel things are moving when there not etc. Thank you… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,677 satisfied customers
I've been taking Prozac and Buspar for some anxiety and
I've been taking Prozac and Buspar for some anxiety and depression. My therapist just added Abilify to help with some lingering depression. At first she was going to add Wellbutrin but decided on Abil… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
I have issues with anxiety. I meet with a behavioral
I have issues with anxiety. I meet with a behavioral therapist and have practices to help with my anxiety, but I'm feeling super anxious with some current ongoing stress that may continue for the next… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
Im struggling with anxiety and depression and i have taken
im struggling with anxiety and depression and i have taken several medications cymbalta cipralax and now i am on a new one i forget what it is called … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
Various diagnosis since 2010; generalized anxiety was the
Various diagnosis since 2010; generalized anxiety was the most popular. PTSD diagnosis in 2016 because of a loss of a child in 2009 as well as the end of my 10 year relationship in 2013. Possible re t… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
768 satisfied customers
Is this a paid service? History of depression and anxiety.
Past 8 months. Relationship problems make it worse.… read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
OKMH124211 What is the vest way to prevent anxiety, gain
OKMH124211 What is the vest way to prevent anxiety, gain more self confidence and get rid of tmj syndrome-sometimes teeth grinding affects night into daytime as a bad habit?… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
I have generalized anxiety disorder with panic attacks that
I have generalized anxiety disorder with panic attacks that I treat and keep managed with BCT, exercise, eating a well balanced diet, and breathing exercises. For the most part this works well. This p… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
4,021 satisfied customers
I have generalized anxiety disorder with panic attacks at
I have generalized anxiety disorder with panic attacks at times. For the most part I have improved a great deal through BCT and other lifestyle changes. I had it terrible after I quit smoking for abou… read more
Linda D.
Linda D.
Master\u0027s Degree
794 satisfied customers
I would like to know if it is possible for anxiety to cause
Hello,I would like to know if it is possible for anxiety to cause bladderproblems like urinary retention and bladder overactivity. Like if you fear it and you are constantly conscious regarding it, it… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
4,021 satisfied customers
I've had anxiety due to trauma... I've had anxiety due to
Hello, I've had anxiety due to trauma... Hello, I've had anxiety due to trauma in the city I lived in, I moved out to a different city, I accidentally spoke to somebody associated with the trauma , in… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,983 satisfied customers
I I have extreme anxiety especially social anxiety I over
I I have extreme anxiety especially social anxiety I over worry about everything and I have PTSD from being stabbed and assaulted I've been prescribed Xanax for years and I got up to 2 mg which was wo… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,983 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x