greenwell3977: Introducing myself

[greenwell3977]

Hello all,

 

I am 34 years old and I have been on Serzone (nefazadone) and Wellbutrin (buoproprin) for over ten years for both depression and anxiety. I am currently taking 150 mg of serzone and 300 mg of wellbutrin. I have not been depressed in years and my anxiety has decreased now that I am seeing a social anxiety therapist. I am ready to get off these drugs mainly because the sexual side effects have ruined every relationship I have been in. I am ready to have a healthy relationship for the first time.

 

I tried to get off the serzone a couple years ago but the withdrawal effects were so difficult I had to go back on. I had trouble sleeping, couldn't concentrate at work, was often dizzy walking around, cloudiness in the brain, depression, trouble connecting thoughts in my brain, and severe anxiety in social situations. My performance suffered so much at work that I got written up and received a demotion. All this was so difficult for me that I went back to my normal dosage.

 

Looking back at my experience, I know there were some things working against me. I just got out of a two year relationship and was living by myself for the first time. My job at the time was super stressful and I was doing the work of two or three people. I was taking ambien to sleep which can cause confusion with the brain. I was not seeing a therapist. Finally, while I did taper off slowly (about 25% every couple months), I probably did it too fast.

 

Now, I am in another relationship with a girl and I think having her support will help with the withdrawal symptoms. I'm also seeing the social anxiety therapist who will help me each week. My job is less stressful. Finally, I am going to try the 10% every 3 or 4 week rule that I learn about on this site. i think I will be more prepared this time.

 

While I am excited about getting off serzone (and later wellbutrin), I am scared based on my experience from last time. I am worried about my job performance. I'm worried about not being able to sleep. I'm worried about having social anxiety and depression. I'm worried that my libido and performance will not increase when I am off the drugs.

 

Thank you for reading my story. I plan to cut my serzone from 150mg to 135mg this weekend. After three weeks of that, I will see if I am ready for 120 mg. If you guys have any advice, please let me know. I will continue to post throughout my tapering journey. Wish me luck!

[Altostrata]

Good to hear from you, matt! Thank you for introducing yourself.

 

Your plan sounds like a good one. If you feel the 10% drop is too much for you, you can always back up a bit and try 5%.

 

It may take a while, but it's worth it to protect your nervous system.

 

Are your therapist and doctor supportive of your decision to go off the medications?

[greenwell3977]

Hi Altostrata,

 

My psychiatrist wanted me to get off serzone because of the potential damage it can do to your kidney and wanted me to go onto cymbalta since he said his clients didn't have sexual side effects. But I was hesitant to try a new drug as I feared I would grow dependent on cymbalta, like i am with serzone. Once I told him I am committed to get off these drugs, he was okay with my 10% plan. He said lowering my medication 25% would be the same as 10%, but I told him I prefer to go as slow as possible to minimize the withdrawal effects.

 

My social anxiety therapist is definitely on board with me discontinuing the medication. He believes therapy is a lot more beneficial than medication and thinks he will be able to help me deal with the withdrawal symptoms. I'm glad I have his support.

 

Thank you for your question.

[Altostrata]

You are right, Cymbalta causes just as much physical dependency. It also causes sexual dysfunction.

 

Your psychiatrist is wrong about the 10% vs 25% reduction as well. Few get the need for slow tapering. I'm glad he is willing to work with you.

 

Very happy you've decided to go slow with your taper. You'll want to use that nervous system again in the future.

 

Your therapist sounds like a gem.

 

Please let us know in this topic how your taper is going!

[Rhiannon]

Hi Matt! Sounds like you have a good support net and a reasonable taper plan. Like Alto says, pay attention to your symptoms and make smaller cuts if need be.

 

I think your approach sounds sensible. It's nice to meet someone who shows up on the board with reasonable expectations at the beginning of a taper. I think you're going to do fine. I understand your fears about work and losing your ability to function--I've been there. But with a slow taper, breaks between cuts, lots of patience, you'll do fine.

 

The main thing at this point is don't assume just because your first few cuts go great that you can suddenly ramp up the rate of tapering. Often there's a "lag" effect and it's possible to cut too much so that by the time it catches up with you and bites you, it's too late to fix it. So look out for that. But your plan sounds solid to me.

[Shanti]

Hi Matt. Welcome to the forum. I'm glad you chose not to switch to Cymbalta. I had a severe withdrawal syndrome from that, almost as bad as the Paxil withdrawals I'm experiencing now. Especially severe akathisia which is torture. I wish I could find doctors like that. My doctor is mad at me for wanting to go off my meds. She took me to task the other day again. Smh. Glad you joined us!

[alexjuice]

Hey Matt-

Welcome to the forum. Besides welcoming you, lemme tell ya I also share a lot of your issues and hopes. When I was on Drugs, sexual dysfunction was a major major problem for me -- it still is unfortunately. I was on a whole array of medications for what started as simple 'anxiety and depression'. As the years went by, new diagnoses attached themselves to me the way lint attaches to a passing lintroller. New diagnoses brought more drugs and, naturally, more side effects which brought more diagnoses. Ahhh, like a VH1 show - I love the 90s! Anyway, I ended up pretty much wrecked. I went off my meds way too fast and experienced more wreckage.

 

In late 2010 I started therapeutic techniques for anxiety which have helped my anziety problem. Parenthetically, my anxiety was primary of a social sort but on mass Drugs I developed other the symptoms of neurotic conditions like those of OCD and hypochondriasis. You mentioned your anxiety is social anxiety as well. I'm glad you're seeing signs with your therapist, my CBT program has helped me so much. I've found the methods help with withdrawal symptoms a great deal as well.

 

I'd say, based on my experience, to be prepared for the possibility of an uptick in social anxiety as you decrease your AD. By going slowly hopefully you won't have much of an issue with this. In one sense you're in luck (relatively at least). I never knew to go slow. Most of the folks on this board, I venture to say, feel they tapered too rapidly, knowing no better. I mention this preemptively because it's human nature to want to speed up an unpleasant process to 'just get it over'. Tapering Drugs best conducted counter to this instinct, the more unpleasant symptoms become the more you are likely to do best by slowing the process down.

 

Out of curiosity, did your doctor add the Wellbutrin in response to sexual side effects?

 

Again, welcome to the board Matt. Please let us know how things are going.

 

Alex

[compsports]

Hi Matt,

 

Welcome to the forum.

 

Serzone was one of my first drugs during my psych med "fun". Eight psychiatrists kept me on it even though it clearly wasn't working. Finally, the 8th one realized that when I was at the maximum dosage.

 

As my signature indicates, Wellbutrin XL was one of my later drugs.

 

Anyway, is there any reason why you are tapering Serzone before Wellbutrin XL since that is the more activating drug? Just wondering as I am sure you have a very good reason.

 

Again, welcome.

 

CS

[greenwell3977]

Thank you for all your responses. Sorry for not replying earlier. I didn't get email notification this time that there were responses.

 

I am on day three of my tapering from 150mg to 135mg. The first two days were great - felt really good. Today I have had a hard time focusing and performing complex thinking. This is what I experienced a couple years ago when I first tapered. This lack of ability to think and focus normally caused a lot of anxiety for me in meetings and my job performance suffered, as I already mentioned. Does anyone have any advice on how to deal with the decrease in concentration and thinking abilities that come with tapering, assuming this continues? Should I increase my medication so i'm at 5% of my starting point, instead of 10%? Should I take any supplements? Should I just wait it out and expect it to improve?

 

Alex, regarding me taking Wellbutrin, about 10 years ago my doctor prescribed it since it was known to not have any sexual side effects and can actually improve performance. When I first took Wellbutrin it did have this effect - my libido and performance improved so much that i actually had pre-ejaculation issues. A few months later I went off Wellbutrin because it was interfering with my sleep. About a year or two later I went back on Wellbutrin and oddly enough this time it hurt my sexual performance and libido. To this day, I don't understand why the first time it increase my performance so much and the second time actually hurt it. The only difference between the first time and the second time is that the second time I was taking Serzone (I don't remember what I was taking the first time). If anyone has any insight to this, i would GREATLY appreciate it. As some of you have experienced, sexual disfunction can cause so many issues in life and lead to depression and other unwanted consequences. It has hurt every relationship I have been involved in. Any insight would be appreciated.

 

CS, I am tapering the Serzone first for three reasons. One, I'm guessing this drug is causing most of the sexual disfunction since Wellbutrin is not known to cause disfunction. This could be a false assumption, though. Second, I was told that you should taper off the more difficult drug first so that the other drug can help negate the adverse withdrawal effects (or something along those lines). Lastly, Serzone is known to be bad for the kidney. I'm guessing you aren't a doctor, but do you feel I should be tapering off the Wellbutrin first? What's your experience been?

 

Thanks again for each and every one of your comments. It's really helpful to be able to communicate with people who have gone through similar experiences.

[Barbarannamated]

Matt,

That's interesting about your different responses to Wellbutrin. Do you feel that it has caused problems recently or has it not HELPED as it did when you we're on it previously? Are you on same dose and formulation? There are odd formulations and branded generics that reportedly work differently although they theoretically shouldn't.

Wellbutrin

Bupropion HCl

Budeprion (I don't understand how this is dispensed as the generic for Wellbutrin as the chemical name is not even the same)

Aplenzin is bupropion HBr (I think!)

 

Im usually able to follow the 'tweaking of the molecules for patent extension' game, but this one is baffling.

[Altostrata]

Right, matt, if a 10% reduction causes unacceptable withdrawal effects, back up a little and try 5%.

 

A very common side effect of Wellbutrin is insomnia. Also anxiety. (Which is why it's a terrible idea if someone is suffering withdrawal symptoms.)

 

The reason you had a different reaction to it is because the nervous system is dynamic. The second time you tried Wellbutrin, your nervous system had changed in some way to give you a different result.

 

Perhaps you had made some change in your other medications. Or perhaps the antidepressant had caused such a degree of serotonergic downregulation that your overall hormonal profile was more distorted.

 

Our nervous systems are not made of rubber, they don't just spring back after stopping psychiatric drugs. They've shaped themselves around the drugs and it will take a while -- varying from person to person -- for them to approximate normal again.

[greenwell3977]

Hi Barbarannamated,

 

The Wellbutrin has hurt my sexual performance since i started taking it for the second time, many years ago. The first time i took it was the extended release Wellbutrin but that caused sleeping issues so I stopped . The second time I took it (which is what I am on now) was the SR short release. According to my psychiatrist it shouldn't make a difference if it is the extended or short release, in terms of how it affects my sexual performance.

 

I don't know why it would increase my sexual performance so much the first time and not the second time, and actually hurt it the second time.

[compsports]

""CS, I am tapering the Serzone first for three reasons. One, I'm guessing this drug is causing most of the sexual disfunction since Wellbutrin is not known to cause disfunction. This could be a false assumption, though. Second, I was told that you should taper off the more difficult drug first so that the other drug can help negate the adverse withdrawal effects (or something along those lines). Lastly, Serzone is known to be bad for the kidney. I'm guessing you aren't a doctor, but do you feel I should be tapering off the Wellbutrin first? What's your experience been?""

 

Hi Matt,

 

I think I was concerned that you might have difficulty sleeping if you left Wellbutrin as the last drug to taper. But your reasoning makes sense regarding Serzone.

 

As my signature indicates, I tapered off of 4 meds. Even though I was very concerned that Remeron was causing damage, I chose to taper off of Adderall and Wellbutrin XL before I tackled the Remeron and Doxepin due to concerns about sleep issues. Unfortunately, I did have sleep issues in trying to get off of the last two drugs so my fears proved to be correct.

 

CS

[greenwell3977]

Hi all,

 

I just wanted to give everyone an update two weeks into my 10% every 3-4 weeks tapering plan. The first week I suffered issues with sleep, concentration, and some mood swings. Luckily, those have gone away and I feel pretty close to normal. I feel happier than I did before I started tapering and my sex drive has increased a little bit. I know it will get a lot tougher when I get closer to 100mg and eventually 0 mg, but I feel optimistic at this point. Part of me wants to speed up the plan, but from past experience I know that slower is better and that things can get nasty really quick if you go too fast. I want this to be the last time I taper off anti-depressants so I'm willing to be as patient as possible, even if it takes me two years to get off them.

 

CS, I had never thought about the fact that tapering off Serzone and continuing Wellbutrin could cause an increase in sleep issues. But it makes sense that Serzone (somewhat of a sedative) would mask some of the stimulant effects of the Wellbutrin. Do you have any advice on how to deal with this increase in sleep issues? One option is to take the Wellbutrin earlier in the day. I want to avoid Ambien as it has it's own side effects and dependency issues.

 

Thanks everyone for your help. I can almost taste having a normal, healthy life. I really appreciate your support!

[Altostrata]

Hi, Matt. How long did it take you to recover from the sleep, concentration, mood swings etc. resulting from your first decrease?

 

Good to hear you're feeling so well!

[greenwell3977]

Hi Altostrata, it took me about five or six days to recover from the issues with sleep, concentration, and mood swings with my first 10% decrease. Overall, the first decrease was a success.

[Altostrata]

That doesn't sound bad at all.

 

Suggestion: Next time, try a 5% reduction. Maybe you can get away with only a day of symptoms.

 

Sometimes you can make tinier drops, but faster, maybe every 2 weeks.

[greenwell3977]

Hi Altostrata, thank you for your response. I like your suggestion to do it at 5% instead of 10%, if 10% has bigger withdrawal symptoms than i prefer.

 

I am considering doing this plan: At a high level, I still want to taper at 10% and stick to that dosage for three to four weeks before the next taper. But instead of going down 10% all at once, I'm thinking about spreading it out over a few weeks by tapering at 3.3% until I reach 10%. For example, i'm currently at 135mg serzone. Under this new plan, I would go to 130mg, then 125 mg the next week, and finally 120 mg the next week. Once I reach 120mg, I would stay at 120mg for 3 to 4 weeks until my next taper.

 

I like this plan because of two reasons (1) the tapering amount is less, 3% instead of 10% and (2) there is a still a three or four week stability period for my body to adjust. Of course, it'll take longer this way but like I've said before I'm willing to be patient.

 

Please let me know your thoughts on this plan. Thanks!

[Altostrata]

Tinier dosage reductions more frequently may work fine for you, Matt. The point is to make slide your nervous system down a ramp as gently as possible. Listen to your body, if it seems too fast, slow down.

 

For your first go at this, you might want to do the 3.3mg reduction and wait 2 weeks, to see how you do. If you don't get any withdrawal symptoms, you might speed up a bit.

 

You can control the rate of your taper according to your own tolerance.

 

Excellent plan!

[greenwell3977]

Hi all,

 

Just wanted to check in again. In summary, with the first 10% taper, I had trouble concentrating and some difficulty sleeping but overall things got better after the first week or two. For the second 10%, I tried something different where instead of doing 10% all at once, I broke it down into 3.3% increments over a couple weeks. This made the initial withdrawals symptoms a lot easier and I recommend it for anyone who trouble with 10% all at once. I have not had any difficulties with concentrating or sleeping this time.

 

Unfortunately, the withdrawal symptom I am having from my second 10% is depression. I have been sad and down the past few weeks without good reason. While it seems to be getting slightly better with time, I am still depressed each day. I am either depressed for no apparent reason or I am more sensitive to things that before wouldn't make me that sad.

 

Does anyone have any recommendation for the depression withdrawal effect? How can i handle this? Just be patient? How do I know if this is a withdrawal symptom or just depression coming back when you decrease the anti-depressant?

 

Also, I am due for another 10% taper. Do I continue with that? Or do I wait until the depression goes away before decreasing again?

 

Thanks!

[Karma]

Hi Mattslatt5

 

Having just gone through depression as withdrawal symptom, my recent experience would lead me to hold on the current dose until the depression symptoms resolve. I know that it is difficult and you want to keep moving forward, but I've just been holding for 8 weeks and I am amazed at the fact that I feel normal and joyful with no hint of the dread, depression, irrational fears or anxiety that I experienced in withdrawal.

 

In my case I'm coming off of Effexor and had been reducing at 6.25 mg every two weeks ... I didn't recognize the withdrawal symptoms which first showed up as depression and I kept on my schedule of tapering ... that eventually led to worse symptoms and I had to up-dose to get relief. So, just from my experience I would hold. Based on what I've learned on this site it is more likely that the depression is a withdrawal symptom than a return of the original condition.

 

FWIW

Karma

[Altostrata]

I like Karma's suggestion, let your nervous system adapt before a new dosage change.

 

In the meantime, mindful meditation can help with the depression: "This, too, shall pass." You'll see that emotions seem so real but then drift away like clouds.

 

Or take a nice walk whenever the low feelings hit. Gentle exercise can help the nervous system re-regulate.

 

Glad you found a method that minimizes withdrawal symptoms, matt. Sometimes people can make minute drops more often.

 

And thank you for checking in and letting us know how you're doing. Someone will read your post who can use the same method.

[greenwell3977]

Hi Karma/Altostrata,

 

Thank you for your advice. I have been struggling with some depression since I have been down to 120. I think it is best that I stay at this level until things get normal. I am also having some relationship issues right now that are also adding to the depression. I may consider going back up to 125 if the depression persists.

 

It's disappointing that i am having this much depression in my first 20% tapering. During the first 10%, things were relatively easy and I was very hopeful that this process wouldn't be too difficult. Now that I am experiencing difficulties, I am losing hope that I will ever be able to get off these things.

 

Anyways, I am going to be patient and not give up. No one said it was going to be easy. I am lucky you have you guys. Thanks.

[Rhiannon]

Hi Altostrata, thank you for your response. I like your suggestion to do it at 5% instead of 10%, if 10% has bigger withdrawal symptoms than i prefer.

 

I am considering doing this plan: At a high level, I still want to taper at 10% and stick to that dosage for three to four weeks before the next taper. But instead of going down 10% all at once, I'm thinking about spreading it out over a few weeks by tapering at 3.3% until I reach 10%. For example, i'm currently at 135mg serzone. Under this new plan, I would go to 130mg, then 125 mg the next week, and finally 120 mg the next week. Once I reach 120mg, I would stay at 120mg for 3 to 4 weeks until my next taper.

 

I like this plan because of two reasons (1) the tapering amount is less, 3% instead of 10% and (2) there is a still a three or four week stability period for my body to adjust. Of course, it'll take longer this way but like I've said before I'm willing to be patient.

 

Please let me know your thoughts on this plan. Thanks!

 

This is the way I taper and it works great for me. Small reductions regularly with intermittent longer holds as needed. I'm so glad you're being so sensible and patient--I think you're going to do fine. Just let it take as long as it takes.

 

As far as the depression you're experiencing now, I agree with the advice you've been given. Hold until you start to feel better. It really helps me when I hold until my symptoms clear up and I start to actually feel good. It gives me hope, because I see that I actually CAN feel good, better than I ever did on the drugs. And I think it means that my brain is actually healing, adapting as I go, that I'm not going too fast and harming myself. Like Alto says, I'm going to want to use this nervous system. It's been through enough already so I want to pamper and love it now.

 

I find that exercise helps a lot with my depression. I also respond well to light therapy (either natural sunlight or those artificial therapy lamps). And with all withdrawal symptoms, just remembering "this too shall pass" and hanging in there.

 

I feel really optimistic about your taper. You're going to do great. Just take your time--it's worth it in the long run.

[Rhiannon]

Oh, something I want to add: I know it can be hard to taper for a long time, but one thing that is happening for me is that the side effects and negative effects of the meds are actually decreasing as the taper goes along. I am definitely feeling better in every way than I was a year ago and MUCH better than two years ago at the start of my multi-drug taper. It makes it easier to face the next two years of tapering, knowing that I'm probably going to continue to feel less and less of the effects of the drugs as I go along.

 

Lately the thing I've noticed most is that I'm getting my brain back. I'm the only person my age I know whose memory is actually IMPROVING! Makes me feel great!

 

Hopefully this will be true for you too, if you take it slow enough. You may find that the sexual side effects diminish enough to improve your sex life, long before you're actually all the way off the meds.

[Altostrata]

That's excellent news, Rhi!

[greenwell3977]

It's inspiring to hear your story, Rhi. As I am going through depression with my latest taper, I am getting doubtful that I will ever be able to do this. Your story gives me hope that things can get better. While they may take a while (which I have come to accept), they can get better.

 

My question: When should I up the dose a little? It has been about six weeks since I went down from 135mg to 120mg and I have been depressed every day on this dosage. I am wondering if I should go up to 125mg to relieve myself a little bit or should I just hold out a little longer.

[Altostrata]

How are your symptoms now, Matt?

[greenwell3977]

My depression has actually improved in the past few days, Altostrata. This is a good sign after feeling weighted down each day for the past six weeks. I was beginning to lose hope that I would ever be able to get off the Serzone. I was beginning to believe that I was just naturally depressed and that I would always need to be on the medication. The fact that the depression has reduced in the past few days has given me hope that, while it will take me a while to get off these things (maybe years), I will some day be able to get off them.

 

In addition to time, I attribute my improvement to me "fighting" the depression by exercising more, sleeping better, and trying to think positively. I hope to continue this.

 

Thank you for asking.

[greenwell3977]

HI all,

 

I just wanted to give a quick update. I am now at 105mg serzone (from 150mg originally) and doing relatively well. I have some depression, anxiety, and sleeping issues, but it's relatively mild and is manageable. I have learned the following works for me:

1) Decrease at 5% or less rather than 10%. 10% was a little too much for me.

2) Don't lower dosage again until feeling close to normal. If still feeling withdrawal symptoms after a few weeks, it's best to wait until they go away before lowing the dosage again.

3) Exercise, think positively, etc in order to fight the depression and anxiety. Be proactive in fighting the symptoms.

4) If possible, see a cognitive therapist to help you deal with the withdrawal symptoms.

 

So, while I am dealing with increased depression and anxiety, it's nothing severe and I am hopeful. I do have a question about sexual side effects. When can I expect them to go away? Will my sexual libido and performance come back gradually as I taper? Or will it not come back until I am completely off the meds? What is normal? So far, I have been getting a boost in libido and performance the first couple days I taper but then after that it goes back to normal. So, other than these brief boosts, overall my sex drive/performance has not improved at all. Any insight will help.

[greenwell3977]

Hi all,

 

I just wanted to check in with everyone again. Last time I checked in I was at 105 mg and now I am at 50mg. Going from 105 mg to 60 mg wasn't too bad. But now that I am at 50 mg I am having trouble sleeping. I am able to fall asleep but I wake up early every day and only get 4 or 5 hours sleep. I am starting to get sick most likely due to the lack of sleep.

 

Does anyone have any recommendations for this? Should I just wait it out and stay at 50 mg? Should I go back up a little? Is it normal to have sleeping issues when tapering?

 

Any advice would be helpful.

[Altostrata]

Hi, Matt --

 

Dropping 10mg from 60mg is a 16.667% drop. Your decreases have been getting proportionately larger as your dosages decrease. Your nervous system is beginning to notice the change in dosage.

 

I suggest you back up a little, to 55mg. Stay there for 5 days to see if your sleep improves, then decrease by 10% of your *current* dosage. At 55mg, that would be 5.5mg; at 49.5mg (55mg - 5.5mg = 49.5mg), 10% would be 4.9mg.

 

The decreases will be getting smaller in size as your dosage decreases.

[greenwell3977]

FYI: I requested a screen name change to greenwell3977.

 

Altostrata, thank you for the tip. I didn't realize the 10% rule applied at each stage. I thought it was just at the beginning to figure out the amount to decrease each time. I will follow the 10% of the current dosage from now on. Thanks, that gives me hope!

 

My next question is regarding sexual libido and function and when I can expect improvement. So far, after the few first days of each taper I experience an increase in libido and function but after that it goes back to normal. Assuming the medication is causing sexual side effects, when can i expect things to permanently improve? What is the normal experience?

 

Thanks.

[Altostrata]

My next question is regarding sexual libido and function and when I can expect improvement. So far, after the few first days of each taper I experience an increase in libido and function but after that it goes back to normal. Assuming the medication is causing sexual side effects, when can i expect things to permanently improve? What is the normal experience?

 

Thanks.

 

Hi, greenwell, sorry I missed this question before.

 

This is the way I interpret this when I experience it: Your nervous system is somewhat reliant on the medication. This produces an artificial homeostasis (balance). When you reduce the medication, it upsets the homeostasis until your nervous system rebalances again. While homeostasis is up in the air, the adverse effect of the drug is relieved. When homeostasis is reasserted, the drug takes over again, hopefully somewhat weaker. This happens each time you reduce, until the dose of the drug is so low it isn't causing the adverse effect any more.

 

I would take this experience as a positive sign.

 

Most people recover within months after tapering completely off the medication. It's a minority who has long-term problems, and even these tend to fade with time.

[greenwell3977]

Hi Altostrata,

 

I have raised the serzone 5 mg but I am still having trouble sleeping. I am getting three hours a night. Keep in mind, I am going through interviews and a breakup so my life is pretty stressful right now.

 

Do you suggest I raise the serzone a little more? Also, do you suggest I try sleeping pills like ambien as a short term solution just do I can get some sleep?

 

Thanks.

[Altostrata]

How long have you updosed 5mg?

 

I'd avoid Ambien, it can go paradoxical. See Important topics about symptoms, including sleep problems