Posted by bleauberry on March 17, 2010, at 17:16:54
In reply to Pristiq to Savella, posted by Frustratedmama on March 16, 2010, at 17:45:03
I am excited for you!
I also have some cautious reservations, so please bear with me on that.
Some people know I am a fan of savella. Why is that? Because when ECT failed, and all other meds (didn't try MAOIs at the time) failed, Savella worked and did so fast. I mean, come on, a med like that is hard to find.
Does anyone think that if someone came out of ECT super depressed and took lexapro they would in short time feel great? Not. Prozac? Not. Wellbutrin? Not. SSRI+AP? Probably not. SSRI+TCA? Slight maybe. MAOI? Possible. So putting it all in perspective like that, I think the fact that savella all by itself lifted me from the dark following a failed ECT deserves a look.
Since we are all different, I think it is tempting to think the drug could work as well for everyone but in reality probably won't. It's just that on pubmed there are a couple small studies where treatment resistant patients improved markedly on savella, with remission in 3 out of 5 for example. The difference there was that it was not monotherapy...it had either low dose risperdal (.25mg-1mg) or zyprexa (5mg-10mg) along with it. My good response came with just monotherapy.
Here are my cautious reservations.
Pristiq is likely going to be nasty coming off. That weaning schedule you were given is extremely aggressive. I think you could be in for a very rough ride. I hope I'm wrong. But if it is as rough as I think, you will have no way of knowing what savella can do. It or anything else will just be totally swamped by the horror of such quick withdrawal.
My other reservation is that...surfing the web, visiting other forums, etc,...the general trend in savella failures mostly have one thing in common...doses ramped up too fast and too high.
I can point out a couple pubmed case studies where remission resulted from just 20mg. Me, I responded robustly to a single 25mg dose split in thirds, taken 1/3 at a time 3 times in a day.
SLS is very tolerant of meds and a rapid metabolizer so I think he will not have much problem handling savella. For the general population I think there needs to be a good sense of suspicion at the commonly advertised dose schedules. The starter pack, going from 12.5mg to 100mg in a short time, is in my opinion extremely aggressive and begging for failure.
Another person here a few months ago had to quit savella because even though it helped mood some, the side effect of rage was unmanageable and intolerable. I can sure understand that. My point is...I think that dose, whatever it was, dosens't matter, whatever it was, was too high. Shooting for a predetermined target is something I do not agree with.
I read comments from several of the people who were actually in the savella clinical trials. They all had similar experiences, in that the best benefits of the med came with time...but that time would never happen if the dose was ramped up too high causing side effects blamed for early termination. Some of those people who did have excellent response to savella would have been early dropouts except for the fact that they were in a clinical study and encouraged to stay the course.
So while I am excited about savella, I am almost grimacing over the rapid pristiq withdrawal and the super aggressive dosing of savella. Now in the pharmaceutical world and clinical world those things are not viewed as overly aggressive. I just happen to live in the real world. My eyes have seen and experienced more than those people in white coats have.
I'm just trying to share all I know about savella, because I want you to feel better!
My only final note is that when savella by itself doesn't do the job, the addition of a minimum dose AP seems to do great.
Don't let any rough ride in your near future shake you off course.
poster:bleauberry
thread:939737
URL: http://www.dr-bob.org/babble/20100305/msgs/939841.html