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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by rmshed on October 3, 2001, at 22:02:19
I have been on 40mg of Prozac for 13 years. Within the last few years, the drug does not help the way it did in the beginning. I am searching for a boost from my depression and have not had much luck with several other anti-depressants. My doctor has never suggested an increase in Prozac. I tolerate the drug well. Has anyone had an experience with this type of situation?
Posted by rmshed on October 3, 2001, at 22:02:57
I have been on 40mg of Prozac for 13 years. Within the last few years, the drug does not help the way it did in the beginning. I am searching for a boost from my depression and have not had much luck with several other anti-depressants. My doctor has never suggested an increase in Prozac. I tolerate the drug well. Has anyone had an experience with this type of situation?
Posted by SalArmy4me on October 4, 2001, at 0:01:17
In reply to Will more Prozac help?, posted by rmshed on October 3, 2001, at 22:02:57
What other stuff have you tried before?
Posted by Cam W. on October 4, 2001, at 2:13:44
In reply to Will more Prozac help?, posted by rmshed on October 3, 2001, at 22:02:57
Rmshed - Prozac does eventually plateau with respect to dosage increases. Above a certain dose, taking more does not result in any increased effect, but some side effects continue to get worse. Unfortunately, the dose at which this happens is not easy to predict in advance. The old YMMV (your mileage may vary) adage applies, as everyone is physiologically unique.
The only way to find if an increase in dose will result in improved efficacy is to raise the dose for a month or so and see if there is an increased effect. Ask your doc if he/she thinks a dose increase is a viable option in your case.
In some people, the SSRIs do "poop-out" and not work as well as they originally did. When this happens, raising the dose usually does not result in greater effect. Occasionally increasing after poop-out does result in increased effect, but so does decreasing the dose, in some instances). Again, the only way to find out is trial and error.
I hope that this wishy-washy answer is of some help. - Cam
Posted by Marie1 on October 4, 2001, at 6:59:23
In reply to Re: Will more Prozac help? » rmshed, posted by Cam W. on October 4, 2001, at 2:13:44
Cam,
I was always successful with Prozac until I switched to Wellbutrin (for weight loss, on the advice of my GP). Ater maybe a month, I crashed horribly into a major depression. I started seeing a Pdoc who put me back on Prozac, up to 60 mgs, but there was barely any relief. Then he added Buspar to boost the action of the Prozac (not for GAD; I don't have that.) Buspar did the trick. Whenever I read about cases of Prozac poop-out I'm tempted to tell people to try adding Buspar before giving up. Actually, I wouldn't say Prozac quit working for me, it just couldn't get ahead of the depths of my depression that occurred when I stopped taking taking it. Does this make sense to you? I mean, is mine a different situation from the usual poop-out scenerio? To state it differently, if Prozac poops-out for someone (i.e., quits working), would it help to add a booster? Thanks for your opinion.Marie
> Rmshed - Prozac does eventually plateau with respect to dosage increases. Above a certain dose, taking more does not result in any increased effect, but some side effects continue to get worse. Unfortunately, the dose at which this happens is not easy to predict in advance. The old YMMV (your mileage may vary) adage applies, as everyone is physiologically unique.
>
> The only way to find if an increase in dose will result in improved efficacy is to raise the dose for a month or so and see if there is an increased effect. Ask your doc if he/she thinks a dose increase is a viable option in your case.
>
> In some people, the SSRIs do "poop-out" and not work as well as they originally did. When this happens, raising the dose usually does not result in greater effect. Occasionally increasing after poop-out does result in increased effect, but so does decreasing the dose, in some instances). Again, the only way to find out is trial and error.
>
> I hope that this wishy-washy answer is of some help. - Cam
Posted by Roo on October 4, 2001, at 9:05:58
In reply to Will more Prozac help?, posted by rmshed on October 3, 2001, at 22:02:19
I've experienced it. I tried more prozac and it
didn't do anything for me. I've been told by a lot
of people to try adding a low dose of zyprexa, but
i'm reluctant b/c of the weight gain. Let me know
if you end up finding a solution.
Posted by Cam W. on October 4, 2001, at 11:24:12
In reply to Re: Will more Prozac help? » Cam W., posted by Marie1 on October 4, 2001, at 6:59:23
Marie - I don't really think that there is a clinical definition of "poop-out". It could be caused by several situations, to varying degrees. I have a paper that is 3 or 4 years old that talks about reasons for the loss of efficacy of antidepressants. If I remember correctly, the article listed causes and 7 potential strategies to counter what we on this board call poop-out (I'm not sure if the term was invented on PB or not, but a few of us here have big enough egos that we can claim it was). I would like to dig out the paper, but my files are still piled in 12 boxes in the garage (I gotta get a file cabinet or two). I believe that poop-out occurs most often in SSRIs, but has been seen in most all ADs.
I believe that they listed things like change in disease state (worsening of depression), changes in the kinetics of the AD &/or it's metabolites, changes in concentration of neurotransmitters &/or their receptors (not just serotonin, but possibly serotonin-induced changes in other NTs - like dopamine, GABA, acetylcholine, norepinephrine, etc - or neuroreceptors - for glucocorticoids, CRH, ACTH, etc.), age-related changes in physiology (menopause), thyroid hormone changes, etc.
I found it interesting that strategies to combat poop-out included lowering the antidepressant dose, as well as raising it. I would assume that lowering the dose may decrease secondary side effects, while maintaining AD effect. In other words, side effects such as cognitive blunting from cholinergic receptor blockade may resemble symptoms of depression, and when some of this blockade is removed through lowering of the dose, the AD appears to work again.
Anyway, back to your question. There is still a debate in the literature whether to augment an AD in treatment-resistant depression or to try a different AD (either within the same class or one with a different mechanism of action).
Most studies of augmentation of ADs are open-label, but there are some double-blind placebo controlled trials, as well (although, most of these are of short duration - eg. 6 - 12 weeks).
Dr.Mauricio Fava article, "Augmentation and Combination Strategies in Treatment-Resistant Depression" (p. 4-11), in the recent Eli Lilly-funded Journal of Clinical Psychiatry Supplemental (Vol.62, Suppl. 18, 2001), "Management of Treatment-Resistant Depression"
A) CLEAR EFFICACY:
a)lithium
b)liothyronine (thyroid hormone T3)B) SUGGESTED EFFICACY:
a) dopaminergic agents (pergolide, amantadine, pramipexole)
b) psychostimulants (methylphenidate, dextroamphetamine)
c) atypical antipsychotics (risperidone, olanzapine)
d) folate/methylfolate (methyltetrahydrofolate - MTHF)C) ANECDOTAL EFFICACY:
a) modafinil
b) anticonvulsants (VPA, carbamazepine, lamotrigine, gabapentin, topiramate)
c) opiates (oxycodone, oxymorphone, buprenorphine)
d) SAMe
e) DHEA
f) estrogensD) DISPUTED EFFICACY:
a) buspirone
b) pindolol
c) inositolAs for BuSpar™ (buspirone) augmentation of SSRIs, many earlier open-label, small studies showed significant improvement in treatment-resistant patients. More recently, the only double-blind, placebo-controlled trial have failed to replicate the findings of the earlier studies. There was no significant difference between the placebo or BuSpar when added to an SSRI in those with treatment-resistant depression.
The upside is that BuSpar does reverse the SSRI-induced sexual dysfunction in about 20% of those who try it.
As for you recommending BuSpar to those who have had SSRI poop-out, go for it! Tell your story and the doses you used. You may want to tell people that it doesn't work for everyone, but it worked for you. That's the difference between how most studies are read and clinical (real world) experience. We tend to forget the people in the negative studies that responded to the BuSpar + SSRI combination, and therefore, do not to use this augmentation strategy.
Posted by SLS on October 4, 2001, at 12:20:02
In reply to Re: Will more Prozac help? » Marie1, posted by Cam W. on October 4, 2001, at 11:24:12
> Marie - I don't really think that there is a clinical definition of "poop-out". It could be caused by several situations, to varying degrees. I have a paper that is 3 or 4 years old that talks about reasons for the loss of efficacy of antidepressants.
I think one of the biggest reasons for the dimunition of efficacy of SSRIs is their discontinuation. I think doctors should evaluate more closely a patient's history, family epidemiology, and index presentation before making a decision to withdraw an effective antidepressant.
> If I remember correctly, the article listed causes and 7 potential strategies to counter what we on this board call poop-out (I'm not sure if the term was invented on PB or not, but a few of us here have big enough egos that we can claim it was).
I keep telling you Cam - I hadn't yet started posting here when I invented it! :-) Actually, the term "poop-out" has been around for a long time - at least 5 years. What's funny is that researchers have yet to come up with a better term.
> I would like to dig out the paper, but my files are still piled in 12 boxes in the garage (I gotta get a file cabinet or two). I believe that poop-out occurs most often in SSRIs, but has been seen in most all ADs.
Nardil seems to be a big one too. Maybe it's because more people use it than Parnate, I don't know.
> I found it interesting that strategies to combat poop-out included lowering the antidepressant dose, as well as raising it. I would assume that lowering the dose may decrease secondary side effects, while maintaining AD effect. In other words, side effects such as cognitive blunting from cholinergic receptor blockade may resemble symptoms of depression, and when some of this blockade is removed through lowering of the dose, the AD appears to work again.
I can tell you with surety that in many cases for which lowering the dosage helps, it is a true recapturing of an antidepressant response that had been lost. I haven't really seen it occur too much with drugs other than nortriptyline (kinetic changes), and MAOIs, particularly Nardil. I have seen a few people here describe it occurring with Effexor.
Cam - thanks for posting such a concise review of treatment strategies. I hadn't known the relative standings of the various methods used.
I hope gepirone becomes available. It is a buspirone-like drug that exhibits 5-HT1a partial agonism. I believe it is cleaner than buspirone and has been developed as an antidepressant rather than an anxiolytic.
- Scott
Posted by Marie1 on October 4, 2001, at 20:12:51
In reply to Re: Will more Prozac help? » Cam W., posted by SLS on October 4, 2001, at 12:20:02
Cam,
Thanks for your reply. I'd like to say I understood it all; suffice it to say I'm flattered that you may have thought I *would* understand it all :-). Anyway, you certainly answered my question.
My pdoc claims his patients have had a lot of success with the Prozac/Buspar combo. I guess it would be worth a post to people desparate for relief from depression. Thanks again.Marie
> > Marie - I don't really think that there is a clinical definition of "poop-out". It could be caused by several situations, to varying degrees. I have a paper that is 3 or 4 years old that talks about reasons for the loss of efficacy of antidepressants.
>
> I think one of the biggest reasons for the dimunition of efficacy of SSRIs is their discontinuation. I think doctors should evaluate more closely a patient's history, family epidemiology, and index presentation before making a decision to withdraw an effective antidepressant.
>
> > If I remember correctly, the article listed causes and 7 potential strategies to counter what we on this board call poop-out (I'm not sure if the term was invented on PB or not, but a few of us here have big enough egos that we can claim it was).
>
> I keep telling you Cam - I hadn't yet started posting here when I invented it! :-) Actually, the term "poop-out" has been around for a long time - at least 5 years. What's funny is that researchers have yet to come up with a better term.
>
> > I would like to dig out the paper, but my files are still piled in 12 boxes in the garage (I gotta get a file cabinet or two). I believe that poop-out occurs most often in SSRIs, but has been seen in most all ADs.
>
> Nardil seems to be a big one too. Maybe it's because more people use it than Parnate, I don't know.
>
> > I found it interesting that strategies to combat poop-out included lowering the antidepressant dose, as well as raising it. I would assume that lowering the dose may decrease secondary side effects, while maintaining AD effect. In other words, side effects such as cognitive blunting from cholinergic receptor blockade may resemble symptoms of depression, and when some of this blockade is removed through lowering of the dose, the AD appears to work again.
>
> I can tell you with surety that in many cases for which lowering the dosage helps, it is a true recapturing of an antidepressant response that had been lost. I haven't really seen it occur too much with drugs other than nortriptyline (kinetic changes), and MAOIs, particularly Nardil. I have seen a few people here describe it occurring with Effexor.
>
> Cam - thanks for posting such a concise review of treatment strategies. I hadn't known the relative standings of the various methods used.
>
> I hope gepirone becomes available. It is a buspirone-like drug that exhibits 5-HT1a partial agonism. I believe it is cleaner than buspirone and has been developed as an antidepressant rather than an anxiolytic.
>
>
> - Scott
Posted by vicky on October 4, 2001, at 21:13:11
In reply to Will more Prozac help?, posted by rmshed on October 3, 2001, at 22:02:19
> I have been on 40mg of Prozac for 13 years. Within the last few years, the drug does not help the way it did in the beginning. I am searching for a boost from my depression and have not had much luck with several other anti-depressants. My doctor has never suggested an increase in Prozac. I tolerate the drug well. Has anyone had an experience with this type of situation?
Hi! I have been on prozac 20-40mg for 10 years now
Had problem with fatigue. (also on buspar, perphenazine) and a new drug just 2 days ago was added
for extreme fatigue. Provigil.
I've been very happy for the past 10 years with the meds, just tired
provigil with the prozac and the rest seems to be working!!!
Knock on wood!!!
Posted by rmshed on October 4, 2001, at 21:46:45
In reply to Re: Will more Prozac help? » rmshed, posted by SalArmy4me on October 4, 2001, at 0:01:17
> What other stuff have you tried before?
I have tried Paxil, Zoloft, Remeron (sp?)Celexa. My doctor tried augmenting Cytomel to help with Prozac, this did nothing. I have tried Wellbutrin, Effexor XR. I also take doxepin and Xanax. Effexor XR did wonders for my type of depression, but I could not deal with the physical side effects. My doctor says that I have treatment resistant depression. My doctor doesn't know what to try, I am very reluctant to begin another drug that is jammed packed with clinical studied side effects. I guess I am stuck with no place to go!
Posted by SLS on October 4, 2001, at 22:06:32
In reply to Re: Will more Prozac help?, posted by rmshed on October 4, 2001, at 21:46:45
> > What other stuff have you tried before?
>
> I have tried Paxil, Zoloft, Remeron (sp?)Celexa. My doctor tried augmenting Cytomel to help with Prozac, this did nothing. I have tried Wellbutrin, Effexor XR. I also take doxepin and Xanax. Effexor XR did wonders for my type of depression, but I could not deal with the physical side effects. My doctor says that I have treatment resistant depression. My doctor doesn't know what to try, I am very reluctant to begin another drug that is jammed packed with clinical studied side effects. I guess I am stuck with no place to go!Hi rmshed.
People who respond well to Effexor often respond well to MAOIs - Parnate and Nardil. I have never found the special diet much of a big deal, and these drugs are often very well tolerated with respect to side effects.
Just a thought.
- Scott
Posted by pat c. on November 3, 2001, at 15:24:24
In reply to Re: Will more Prozac help? » Cam W., posted by SLS on October 4, 2001, at 12:20:02
Do you know if Gepirone will be available soon?
I heard it's good for atypical depression.
Other than MAOIs and Klonopin, are there
any other drugs that have been affective against atypical depression.Will Buspar work? I think I rememeber trying it, and it didn't work.
Thanks.
Pat
Posted by SLS on November 4, 2001, at 10:27:45
In reply to Gepirone and Atypical Depression, posted by pat c. on November 3, 2001, at 15:24:24
> Do you know if Gepirone will be available soon?
>
> I heard it's good for atypical depression.
>
> Other than MAOIs and Klonopin, are there
> any other drugs that have been affective against atypical depression.
>
> Will Buspar work? I think I rememeber trying it, and it didn't work.
>
> Thanks.
>
> Pat
Hi Pat.Where did you find the information declaring gepirone as being effective specifically for atypical depression? I know that Columbia has announced wanting to conduct a study of this, but I don't know that they have concluded it.
The only thing I could find on Google regarding FDA approval of gepirone indicated that it is currently under review. I imagine this means that the results of phase III clinical trials have been submitted.
August 8, 2001
http://www.centrere.com/newsroom/press/2001_08_08.html
Gepirone is an azapirone (buspirone, gepirone, ipsapirone, etc.) that is a partial agonist at serotonin 5-HT1a receptors, and is somewhat selective for autoreceptors. Unlike buspirone, a related drug, it does not bind to dopamine receptors and seems to be less sedating. Although gepirone has shown modest anxiolytic (anti-anxiety) effects, it is being developed as an antidepressant. An important feature of gepirone is that its major metabolite, 1-PP, is a potent norepinephrine NE alpha-2 receptor antagonist. This is a property it shares with Remeron.
As anxiolytics, it seems that both buspirone and gepirone can be very effective, but their therapeutic effects often take 2 - 6 weeks to develop. It probably makes sense to co-administer a faster-acting anxiolytic in the beginning.
- Scott
Posted by pat c. on November 4, 2001, at 14:19:34
In reply to Re: Gepirone and Atypical Depression » pat c., posted by SLS on November 4, 2001, at 10:27:45
One of the top doctors at NY Psychiatric (don't want to name him) told me that the first trial showed that people with atypical depression had 40% positive response to Gepirone.
It blew his mind, and he has been doing this for decades.
He said that Bristol Meyers Squibb was crazy for selling it to Organon.
Now they're doing another trial, I guess for Organon.
Pat
Posted by Cam W. on November 4, 2001, at 15:28:01
In reply to Re: Gepirone and Atypical Depression » pat c., posted by SLS on November 4, 2001, at 10:27:45
Scott - I seem to recall (although very unclearly) that there was some hold-up with gepirone release in Europe. Do you remember what the problem was? - Cam
Posted by SLS on November 6, 2001, at 10:46:59
In reply to Re: Gepirone and Atypical Depression » SLS, posted by pat c. on November 4, 2001, at 14:19:34
> One of the top doctors at NY Psychiatric (don't want to name him) told me that the first trial showed that people with atypical depression had 40% positive response to Gepirone.
>
> It blew his mind, and he has been doing this for decades.
>
> He said that Bristol Meyers Squibb was crazy for selling it to Organon.
>
> Now they're doing another trial, I guess for Organon.
>
> Pat
>
Hi Pat.Thanks for the information.
I would be interested to speak to some people up at Columbia myself. I know some of the doctors up there, including Fred Quitkin.
If you wouldn't mind, I would be grateful for you to correspond with me directly for further discussions.
For me, it is probably very unfortunate that gepirone and the other azapirones are extensively metabolized in the body to 1-PP, a potent NE alpha-2 receptor antagonist. Of course, this is probably a good thing for the vast majority of people. Idazoxan and mirtazepine, both alpha-2 antagonists, make my depression substantially worse. I'm worried that my taking gepirone will lead to a similar exacerbation.
http://www.acnp.org/g4/GN401000109/CH107.html
"An additional mechanism that might contribute is the metabolism of the azapirones to 1-(2-pyramidal)-piperazine (1-PP), which achieves brain concentrations tenfold higher than the parent component (13); 1-PP is an a2-adrenergic antagonist, a drug class that has been hypothesized to have antidepressant properties (see below). In one clinical study, 1-PP plasma levels were significantly correlated with improvement in depressive symptoms in patients treated with buspirone (79)."
Take care.
- Scott
Posted by SLS on November 6, 2001, at 10:49:16
In reply to Re: Gepirone and Atypical Depression » SLS, posted by pat c. on November 4, 2001, at 14:19:34
Oops. Forgot.
- Scott
Posted by pat c. on November 6, 2001, at 16:29:22
In reply to Re: Gepirone and Atypical Depression » pat c., posted by SLS on November 6, 2001, at 10:46:59
Yeh, Quitkin told me about McGrath's first study on Gepirone.
Quitkin was amazed by McGrath's findings that
Giperone had a 40%+ success rate.I guess McGrath is doing another study now.
Pat
Posted by SLS on November 6, 2001, at 18:49:29
In reply to Re: Gepirone and Atypical Depression » SLS, posted by pat c. on November 6, 2001, at 16:29:22
> Yeh, Quitkin told me about McGrath's first study on Gepirone.
>
> Quitkin was amazed by McGrath's findings that
> Giperone had a 40%+ success rate.
>
> I guess McGrath is doing another study now.
>
> Pat
Hi Pat.I saw Pat McGrath last year. Wonderful guy. Perhaps I'll give him a call.
Thanks.
- Scott
Posted by jrbecker on August 20, 2002, at 12:52:35
In reply to Re: Gepirone and Atypical Depression » pat c., posted by SLS on November 6, 2001, at 18:49:29
I'm currently in the Columbia Univ phase III study. According to the head researcher (shall go un-named), gepirone will be on the market 8-12 months from now, so presumably, somewhere around summer 2003 (when and if approved -- looks very hopeful that it will though).
Fairly excited for this drug myself. Seems like it will be an advantageous addition to the treatment arsenal (especially for atypical depressive sufferers). I'll let you know any progress as it comes up.
Posted by pc on August 21, 2002, at 20:50:57
In reply to Re: Gepirone and Atypical Depression, posted by jrbecker on August 20, 2002, at 12:52:35
Yes. Please let me know if this helps your atypical depression. I suffer from atypical depression and the only stuff that's helped me has been Nardil and Klonopin. I don't take Nardil any more, because of the side effects, especially the weight gain and I also built up tolerance to it. Klonopin is addictive, and I would like to get off that as well. I'm only on 0.75 mg right now, but I also take 4800 mg of Neurontin.
Anyway, I have had e-mail discussions with Dr. McGrath, who I guess you've worked with. I used to see Dr. Quitkin, but I moved to FL. I heard that Gepirone has a high success rate amongst atypical depressants -- over 60%, so I can't wait to try it.
God bless.
Pat
Posted by jrbecker on August 22, 2002, at 13:24:00
In reply to Re: Gepirone and Atypical Depression » jrbecker, posted by pc on August 21, 2002, at 20:50:57
pat-
I'll let you know how it goes. I start the treatment phase tomorrow. Of course, there's only a 1/3 chance I'll get the gepirone treatment since it's being tested against both Paxil and placebo.
Although rumors have been positive coming back from the study, I am trying not to be too overly-optimistic about this drug. My hunch is that it will be unlikely that anybody who has very severe depressive symptoms will choose this treatment over the SSRIs/MAOIs. It's basically a close cousin to Buspar (which I've taken and didnt find effective against my depression). HOWEVER, all of the data has shown that gepirone has much more AD efficacy than buspar. And it is mildly stimulating, another plus for for some atypical depressives. Moreover, it will most likely have negligible weight gain, somnolescence, and sexual side effects (big yes!). So for moderate atypical types, it sounds right up our alley.I've always thought my depression was somewhat mild to moderate, so I've never wanted to go the way of MAOIs despite being unsatisfied with most SSRIs.
Couple of questions for you now:1)Never tried Klononpin. What's it like, any AD effect?
2)Do you have soft biploar 2 symptoms or is this or anxiety? Have occassionally used Neurontin, although I usually only take 100-200mg three times daily. Only finds it knocks me out and might even be making my depression worse at times. Can't believe you're able to handle that high of a dosage. As an atypical sufferer, doesn't this make your already hypersomnolescence symptomology worse?
> Yes. Please let me know if this helps your atypical depression. I suffer from atypical depression and the only stuff that's helped me has been Nardil and Klonopin. I don't take Nardil any more, because of the side effects, especially the weight gain and I also built up tolerance to it. Klonopin is addictive, and I would like to get off that as well. I'm only on 0.75 mg right now, but I also take 4800 mg of Neurontin.
>
> Anyway, I have had e-mail discussions with Dr. McGrath, who I guess you've worked with. I used to see Dr. Quitkin, but I moved to FL. I heard that Gepirone has a high success rate amongst atypical depressants -- over 60%, so I can't wait to try it.
>
> God bless.
>
> Pat
>
Posted by pc on August 25, 2002, at 9:03:26
In reply to Re: Gepirone and Atypical Depression, posted by jrbecker on August 22, 2002, at 13:24:00
Hi.
Klonopin is quite effective against GAD, social phobia and even panic attacks. It is questionable whether it fights depression. I don't think it does directly, but indirectly it might, because it provides relief for the other problems. These other problems (i.e GAD, social phobia, panic) can cause one to be depressed. However, "major" depression has established a foothold in my atypical depression over the last couple of years (out of the 16) and Klonopin and Neurontin haven't been able to fully combat it. Neurontin, I believe, has antidepressant properties. It cetaintly is a good mood stabilizer which also fights GAD, panic and social phobia.
I'm not bipolar, because I don't have the manic symptons. Neurontin does make me tired, but not overly so.
Pat
Posted by jrbecker on March 25, 2003, at 15:52:54
In reply to Re: Gepirone and Atypical Depression » jrbecker, posted by pc on August 25, 2002, at 9:03:26
Today I talked with my old doc at NY Psych institute about any recent involvements in the Gepirone debacle. He mentioned that the study has nine more weeks to go before they are closing it for new subjects. If the results are positive, then it will probably be another 3-5 months before Organon will submit the results to the FDA.
I asked if there was any preliminary rumors about how the current study (gepirone v. paxil) is going. Unfortunately, there seems to be no real news. However, Organon has initiated two other gepirone studies recently which might mean something positive.
Back to guessing timelines, my doc guessed that if it does make it to market, the soonest would be early spring '04.
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