Q. 1. As Serzone is a newer drug, not much research is available, especially with regards to BPD. I had previously been prescribed Serzone for combined depression and anxiety, but found it too sedating and stopped, given my difficulty with concentration in the first place. Night-time dosage makes sense, and apparently side-effects do subside after a few weeks. What is your experience with Serzone? It seems though that out of all AD medications Prozac has the least side-effects, at least according to the drug info at Medscape.com.

2. I do display some of the OCD traits, the constant worries, expecting the worst, etc. Does Serzone not help in any way?

3. As I have to consider mental performance, how would Prozac and Effexor compare in this regard? Would Gingko Biloba help with sexual dysfunction when taking Effexor?

A. 1. Serzone is effective as a once daily dose taken at bedtime. With BPD, my clinical experience has indicated an average dosage of 500 mg at bedtime. Sedation usually passes in a week or so.

2. Serzone is not good if you have real OCD. If you just worry, its great since there is no sexual dysfunction and its cheap to use. If you smoke, you will likely need 600 mg at bedtime if its going to work.

3. Effexor has less sexual dysfunction than Prozac. We published on both. The higher the dosage of Effexor, the less the sexual dysfunction. As you increase Prozac, Celexa, Zoloft, Luvox, or Paxil dosage, sexual dysfunction increases.