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Dudeness37pa: Nefazodone (Serzone) nightmare


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Hello everyone, I have been a reader of this site for many years but I am finally making a post. As most of you, I have been tried on various drugs for 20 years but after going through most of the SSRIs and a tricyclic and Welbbutrin while Serzone was off- market, I ended up on Serzone (Nefazodone) generic again in 2004. It seemed to work well for my anxiety. I never really had depression. I also had gastric bypass with duodenal switch in 2000 and lost 200 lbs. This surgery is   a sleeve gastrectomy and they rearrange your small intestine so you absorb less fat.


In 2007, I started getting these weird instances where I would get constipated, and then have more anxiety, blood pressure increase, flu symptoms, and panic. Back then I related them to malabsorption of my medication and my body's inability to breakdown heavy carbs. Antibiotics would also cause these symptoms to occur. I cut heavy carbs out of my diet and would deal with these episodes every few months  for a month or two. I was sure it had to do with my digestion.


Fast forward to 2015 - these episodes had been becoming worse. In September of 2015 I started getting really anxious all of the time. My blood pressure and pulse would be really high for days, I'd get migraines, I'd get very hot and then very shivery. I'd break out all over my head. The anxiety would become unreal, like I drank 5 pots of coffee. Then I'd crash and feel like I have the flu. This kept getting worse until I finally could not go to work anymore. I went on disability in January 2016. New psych doc said it sounded like mild serotonin syndrome. He thought it would be best to cut my dose. We did a 12.5% cut. About two weeks later, I ended up in the ER with BP that scared me 160/100 and a resting pulse of 100. They gave me Ativan of course and let me go. These symptoms continued for 5 months and more. My doc doubled my Klonopin - no help. Actually seemed paradoxical. Tried me on Propanolol - had to go off because it caused asthma. Tried me on Neurontin - no effect. Finally, hydroxyzine (Vistaril) provided some relief. Some other symptoms during this time were jaw pain and clenching, shivering, constipation and diarrhea, urination frequency, sweating profusely, sobbing spells, panic attacks, migraine aura, restlessness, cortisol mornings on and on. Long story short, somehow I pulled myself back together enough to return to work in June. In September 2016 I got a new job in a different state, so I had to move. While not nearly as intense as in the beginning, these episodes continued in small bursts and of way less intensity throughout the rest of 2016 and half of 2017. A Vistaril here and there kept me functional.


Fast forward number 2 - August 2017. Had tooth pulled and had to take antibiotic. I knew what might be coming. As expected, I started getting the same symptoms. Migraine, jaw tightness and muscle tightness, sobbing, anxiety, panic attacks, migraine aura, flu feeling. I kept truckin. In December 2017, couldn't drive to work anymore. My work let me work from home. It was rough and I couldn't focus. January 2018 - back on disability.


It was at this point that I started moving away from the idea that it was my surgery that was causing all the problems. I thought my malabsorption was causing unintended withdrawals. By the end of January, my fed up pill pusher was trying to put me on another double dose of Klonopin or to switch to an SSRI, which I would never do having felt horrible on all of them. I said how about Desyrel (Trazodone). It's in the same class as Nefazodone and my mom's been taking it for years with no problems and she had the same surgery as me! Ok - do a fast switch to 150 mgs Trazodone. The first few weeks were ok. I wasn't really getting the EXTREME tired everyone said I would get. I mean, after all, this drug is used mostly as a sleeping aid. I also found it weird that my blood pressure went up and my pulse went way up (around 95 BPM laying down right after taking the med) Something wasn't right. By the third week, I started having the same symptoms as I did while on Nefazodone but 10 times worse. Panic I couldn't imagine, headaches, tingling feet, crawling things in my head, maybe 2 hours of sleep a night - not supposed to happen!


To get to the point - At the end of February 2018, my Dr told me to stop taking Trazodone. Just like that. No there won't be any withdrawal she says. This is what has brought me to this page now - after 20 years of antidepressants - I was cold-turkeyed off by a psychiatrist. Shouldn't they know?!


What I think I have figured out at this point is that my liver was not processing the Metabolite of both Nefazodone and Trazodone - MCPP. What is MCPP you may ask? Well, it's a stimulant used in street drugs to cheapen the cost of things like Ecstasy and MDMA!


I am now 3 months out from cold turkey and here's what's happened:

First week was hell with 24/7 migraines, tingling all over, and hellish panic attacks. No Sleep. My doctor had thrown a bottle of Ativan at me to deal with it. Doesn't she sound awesome?! I knew enough to only take it to avoid checking into the mental hospital and then wean off ASAP which I did.


The next 6 weeks consisted of super tension headaches, multiple sobbing spells daily, dizziness, tingling, tremors, urinary frequency, urinary incontinence, no appetite, shivering, restlessness, RLS, and a gradual lessening of my BP and pulse. It was day to day. I was angry at everyone and everything. A pin dropping would annoy me. Every noise was super loud. I couldn't focus on anything. Trapped in the house trying to survive. My job, my parents, driving, Drs appointments - everything on hold.


Then I saw slight improvement. I could feel happy again. I could sleep more. I was eating again. I started driving. Found a new psychologist and a new psychiatrist that supposedly wouldn't push drugs on me. I felt like the worst was over. At week 9 after going cold turkey, talk of returning to work started. I didn't feel ready but FMLA was up and I could lose my job. My work had Kindly let me have another month past FMLA.  So psychologist highly recommended I attempt to return to work part time working from home. I agreed. The Friday prior to restarting work I started getting palpitations and a new foreboding anxiety. I thought it must just be anticipatory anxiety, I had dealt with that before. Well I started back at work and the first two days were OK, then bam! The worst panic attacks I have ever felt. They lasted all day and night. I was in bed. Checking my pulse and BP. Debating whether to go to the hospital. I had to take Ativan. I would take a quarter of a pill, just enough to keep me out of the psych ward. I barely got anything done work-wise. Just a wave perhaps? The next week went better, I had symptoms but nothing I couldn't deal with at home for four hours a day working. OK, must've just been a blip. The next week starts and bam again! Severe panic, sobbing, restlessness, no focus, blood pressure going high and low inexplicably and regardless of anxiety state. Pulse fluctuating. Crushing tight chest and back. Adrenaline surges. Hunger gone. I'm not going to make it. I took Ativan for four days in a row taking a full pill on the last day that had little effect. I knew if I kept going with it, it would be yet another drug to come off of. So I stop that and dealt with the crippling anxiety, panic, tightness, and horrid thoughts all weekend.


At this point, I am not sure whether to try go back on disability, quit my job, succumb to taking an antidepressant again? I couldn't live like that for one more day. It seems clear to me that returning to work added stress, however little, to my already sensitized nervous system. Then I got a day of less anxiety. OK phew must be over. Next day BAM! back to the panic, anxiety, sobbing, tingling, shivering, no focus, pacing, tight everything and I refuse to take anymore Ativan!

This has been this past week. I have had 1 day of extreme anxiety followed by 1 day of less extreme anxiety or more normalcy back and forth. The day changes at my 4pm Klonopin pill everyday. Is that crazy? It's on a timer?! Also, I have been either get 3 hours of sleep or 6 hours of sleep depending on which day it is. I've been waking up at 2am everyday, sometimes for the whole day, sometimes I can go back to sleep. Weird tinnitus on the worse days. Sometimes physical panic symptoms but I am fine in my head.


**I will flesh this out more later**


My immediate questions:


Anyone have highly variable blood pressure? Mine can be 150/90 in the morning one day, and 110/67 on the next evening. 

Anyone experience low pulse one day and high pulse the next? My normal pulse was around 70. Now it can be anywhere from 59 - 95 resting. Regardless of panic.

Anyone have explosive sweating either before bed or right when you get up?

Anyone shiver uncontrollably or are you mostly cold all the time?

Anyone have a psychiatrist recommend you be tested for Carcinoid Syndrome or Pheochromocytoma because you don't have "normal" antidepressant withdrawal symptoms? 

Are there actually people who can stop antidepressants and only have withdrawal symptoms for 6-8 weeks like the psych docs say? Is it that you are either like them or automatically a protracted withdrawal person?



1997 - 2000 Tried Zoloft, Paxil, Pamelor with Buspar and Xanax  

2000 Serzone 100mg T.I.D.

2004 - Tried Effexor, Lexapro, Celexa, Wellbutrin, Wellbutrin with Desyrel

2007 - Serzone (Nefazodone) 150mg T.I.D two months

2007 Serzone (Nefazodone) 125mg T.I.D and Xanax as needed

2010 Serzone (Nefazodone) 100mg T.I.D and Klonopin 0.25mg T.I.D

Early 2016 Serzone (Nefazodone) 87.5mg T.I.D. and Klonopin .5mg T.I.D. (Tried Neurontin, Propanolol, and Vistaril)

September 2016 Serzone (Nefazodone) 87.5mg T.I.D. and Klonopin .5mg T.I.D., Vistaril 25mg as needed (1 Day switch to Desyrel)

February 2018 Desyrel 50mg T.I.D. and Klonopin .5mg T.I.D (Desyrel one month then cold turkeyed by psych)

Present - .5mg Klonopin T.I.D., Ativan as needed to prevent hospital visit

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  • ChessieCat changed the title to Dudeness37pa: Nefazodone (Serzone) nightmare
  • Moderator Emeritus

Welcome Dudeness37pa,

I'm glad you decided to post and share your story. It sounds like you have a lot to deal with, I'm sorry you are going through this.


A lot of what you are describing does sound like withdrawal, and yes normally Desyrel does need to be tapered.  But symptoms of an adverse reaction can be similar and as you suggested, you might not have been metabolizing the Desyrel properly, which may have caused similar symptoms while you were taking it. The proverbial rock and hard place situation.  I wouldn't recommend reinstatement in your situation.


Your situation is complex, so I'm not sure what to suggest. The best I can offer by way of advice is to listen to your body and avoid those things that set off symptoms as much as possible. Aside from a high quality fish oil and magnesium, avoid supplements. (See King of Supplements: Omega 3 Fatty Acids (Fish Oil) and Magnesium, Nature's Calcium Channel Blocker). They've been helpful to many of us. 


Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.


To answer your questions:


Personally I've experienced the extreme sweating, temperature dysregulation, and shivering even when its not cold.


From my experience almost any symptom can be caused by withdrawal, and it makes sense because these drugs effect our whole body and its systems, so recovery from them could cause changes anywhere. I don't think there is such a thing as 'normal' antidepressant withdrawal, perhaps some symptoms tend to be more common, but you just have to look through our symptoms forum to see the wide variety of symptoms members in withdrawal have reported over the years.


Changes in blood pressure is a fairly common withdrawal effect and I found one topic which may provide some clues about your particular problem:


Blood pressure spikes? The tyramine connection


If you google 'survivingantidepressants.org' plus the symptom you are interested in, you will get a list of topics and discussions to choose from, there are several related to blood pressure. The search function in site isn't very good.


13 hours ago, Dudeness37pa said:

Are there actually people who can stop antidepressants and only have withdrawal symptoms for 6-8 weeks like the psych docs say? Is it that you are either like them or automatically a protracted withdrawal person?


Apparently there are. What some people find is that they are able to stop them once, or maybe twice with few, or no problems, but the damage seems to be cumulative and later attempts bring increasing symptoms of withdrawal and nervous system sensitization. I personally had problems the first time I tried quitting my antidepressant and had to go back on after a few days, the symptoms were overwhelming.


I expect there are many factors involved in what determines who will have problems and who wont, including length of time taken, number of drugs, number of drugs tried and dose changes over the years, age, individual genetics, existing health issues etc.


Because this is a site for tapering and withdrawal, most of what we see here are people who have problems.


Its good you have decided not to take any more Ativan, irregular use of benzodiazepines can cause paradoxical effects in a sensitized nervous system. Its important that you take your Klonopin regularly until you have recovered from your current withdrawal. For more information and help with this, please see our

Members-only benzo forum


It may take a while before you become stable again, but you will recover. I just can't tell you how long it will take.


You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Please stay in touch and let us know how you are doing.






I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?

VIDEO: How are psychiatric diagnoses made?

VIDEO: Why do psychiatric drugs have withdrawal syndromes?

VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes




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