Posted by bleauberry on October 5, 2008, at 11:47:30
In reply to Re: Milnacipran plan, posted by Sigismund on October 5, 2008, at 1:56:47
Wow, so I'm not the only one. You seem to describe me when you talk about you and milnacipran. For me, I know that when the urinary difficulty and goosebumps happen, my dose is too high. My most tolerable dose was 12.5mg in a day, taken in two divided doses of 6.25mg. That was a good compromise between the good and the bad.
The longest I was on it was 2 weeks. Looking back, I was stupid to stop. I just figured I couldn't get any higher than 12.5 and so what was the point. I mean, 50mg or 100mg was way out of reach. But, with the benefit of hindsight, I can see I was actually making decent progress at the end of those two weeks. It was subtle, not noticable on a day to day basis. But it was happening. I had become more comfortable in a crowd. More confident. I was more talkative. I was more interested in things. Making plans. The biggest thing though was my guitar. Instead of forcing myself to sit down and practice eadh day, I was actually really enjoying it and played for hours. Even though my skill level was already way higher than average, I took a fairly large step up to a new higher level in a short time. I miss that feeling. I mean, maybe my improvement was mostly evident in guitar enjoyment, but hey, it was only two weeks. That was probably just the starting hint of other things to come?
The stupid urinary stuff, which wasn't too bad at the low dose, the ocassional headaches, the slight finger tremors, the groggy withdrawal grouchy feeling at waking, and the loss of appetite...these were why I stopped. Mistake. All of those most likely would have been gone within 4 to 6 weeks, based on what others who have used milnacipran at other forums have said.
It is at the top of my list for another go. This time I had already planned to do exactly what you said...stay real low on dose, give it a lot of time, and just keep my eye on a couple months down the road, rather than tomorrow or next week.
As a sidenote just for pondering, pubmed has a few anecdotal and scientific stories of things that combine well with milnacipran. In one, a low dose of Risperdal turned partial response into full response within 4 days of adding risperdal. And 3 of the 5 patients who achieved remission had been treatment resistant up to that point. Another success story was adding low dose Zyprexa, for delusional resistant depression. In Japan it is common to combine milnacipran with ssris.
Before I ever consider those things though, I would give milnacipran a solid 8 weeks minimum, preferably 12 weeks.
The drug is doing other stuff besides Ne and 5htp. One lady who had low body temperature that did not respond to thyroid treatment, developed normal body temperature at 3 months on milnacipran. Somehow the drug had balanced some autonomic dysfunction in the adrenal/thyroid axis. She remained well even after stopping milnacipran. A few other people in fibromylagia studies said that the best pain relief kicked in at about 8 months. Yeah, 8 months. I think the clinical trials are obviously too short. In the real world, people that benefit the most from milnacipran are those that have been on it the longest.
> On day 2 I took 12.5mg (so I thought it was) for my second dose of the day and that was OK, albeit with a few vodkas.
>
> Day 3 I took 12.5mg am, thinking it would be OK. So I get this bloody awful nasty feeling, one of the many varieties that seems to come with psych drugs, not too much, not too bad, but not too good either. The very beginnings of urinary difficulty and goosebumps, hardly worth talking about except that it's relevant.
>
> So my second dose on the third day was back to around 8mg, which was better....like a mixture of something nice with something awful.
>
> So maybe my best plan is to take sufficiently little to avoid the nasty stuff, and to do it for weeks, and see how things go?
>
> I can't say it's done much for my state of mind, the contents of which are unprintable, but isn't that the usual thing?
poster:bleauberry
thread:855289
URL: http://www.dr-bob.org/babble/20080926/msgs/855857.html