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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by iforgotmypassword on January 22, 2009, at 14:18:49
i just started nefazodone today, and i already mindlessly had two energy drinks with grapefruit in it. they even had warnings specifically relating to "sensitivity to grapefruit" on them that i did not realize until 15 minutes ago.
as usual, i'm not playing with a full deck. should i be worried? is the grapefruit thing with nefazodone sustantial, particularly given that it's my first dose (i.e. 100mg a few hours ago, 100mg again planned for sometime later today), and the liver issue?
Posted by Larry Hoover on January 22, 2009, at 17:41:38
In reply to nefazdone + grapefruit, posted by iforgotmypassword on January 22, 2009, at 14:18:49
> i just started nefazodone today, and i already mindlessly had two energy drinks with grapefruit in it. they even had warnings specifically relating to "sensitivity to grapefruit" on them that i did not realize until 15 minutes ago.
>
> as usual, i'm not playing with a full deck. should i be worried? is the grapefruit thing with nefazodone sustantial, particularly given that it's my first dose (i.e. 100mg a few hours ago, 100mg again planned for sometime later today), and the liver issue?I'm not worried at all. The effect should be inconsequential because it was only your first dose.
Nefazodone is both a substrate and inhibitor of enzyme 3A4. It is its own inhibitor. Blood concentrations rise to 2 to 4 times what would be predicted by dose alone, after one week of twice a day dosing. So, please avoid grapefruit hereafter.
I wish you well with this drug.
Lar
Posted by Phillipa on January 22, 2009, at 19:25:00
In reply to Re: nefazdone + grapefruit » iforgotmypassword, posted by Larry Hoover on January 22, 2009, at 17:41:38
Doc here only prescribed it for before bed for me. Prescribed l00mg also up to two tabs which is 200mg???? Isn't that a high starting dose? Phillipa ps do you find it sedating?
Posted by iforgotmypassword on January 22, 2009, at 20:21:51
In reply to Re: nefazdone + grapefruit, posted by Phillipa on January 22, 2009, at 19:25:00
> Doc here only prescribed it for before bed for me. Prescribed l00mg also up to two tabs which is 200mg???? Isn't that a high starting dose? Phillipa ps do you find it sedating?
i find it something or other. i have no idea what, if it's notable, or just a fleeting acute effect from a slight adjustment(or major adjustment in my dulled psyche.) i was definitely something like sedated earlier today. i can't say if it's bad or good, but some feelings are polarized somehow. i hope this isn't an SRI effect that's coming on quick. i feel less stiff and jittery physically, but functionally having the same or more difficulty moving and acting.
not too happy i won't be able to mix this drug with selegiline or rasagiline, i wanted to take one of these to try to have some level of precaution not knowing when i will ever find what is wrong with my system.
Posted by iforgotmypassword on January 22, 2009, at 20:36:14
In reply to Re: nefazdone + grapefruit » iforgotmypassword, posted by Larry Hoover on January 22, 2009, at 17:41:38
> > i just started nefazodone today, and i already mindlessly had two energy drinks with grapefruit in it. they even had warnings specifically relating to "sensitivity to grapefruit" on them that i did not realize until 15 minutes ago.
> >
> > as usual, i'm not playing with a full deck. should i be worried? is the grapefruit thing with nefazodone sustantial, particularly given that it's my first dose (i.e. 100mg a few hours ago, 100mg again planned for sometime later today), and the liver issue?
>
> I'm not worried at all. The effect should be inconsequential because it was only your first dose.
>
> Nefazodone is both a substrate and inhibitor of enzyme 3A4. It is its own inhibitor. Blood concentrations rise to 2 to 4 times what would be predicted by dose alone, after one week of twice a day dosing. So, please avoid grapefruit hereafter.
>
> I wish you well with this drug.
>
> Lar
>thanks. at this point, i think i can keep that in my mind. it's hard to continue sentences without the next in mind just being literal redundancy making even any power to type useless. i'm going to have to reinforce this in my mind later, but that's already the pattern of my life: having to rest, procrastinate, reinforce simple ideas later.
my eventual plan may be to switch from this to eplivanserin, if it shows up out of nowhere, i am pessimistic about here in canada (if it will be available); or volinanserin (last time i looked up this drug, no mention of 5-ht2c at all, so it may not even be a neutral antagonist), or pimavanserin, if it's an ideal non-dulling (as a "partial agonist") dopaminergic and the M1 agonism is very drawing. i have no idea what would be ideal... maybe just stick to hoping one becomes available, unless for some reason 5ht-2c agonism ends up helping me (seems unlikely given my problems seeming to be hyperserotonergic/antidopaminergic, mentally and causing extrapyramidal sx)
This is the end of the thread.
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