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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by bulldog2 on February 25, 2010, at 17:17:02
The patients on askapient seem to be having severe sides on savella. I think the therapuetic doses of this med may be to high for many to tolerate.
http://www.askapatient.com/viewrating.asp?drug=22256&name=SAVELLA
Posted by conundrum on February 25, 2010, at 22:33:44
In reply to Savella - Patients Evaluate Sides, posted by bulldog2 on February 25, 2010, at 17:17:02
I think you are right. Patients should be instructed to wait a month before increasing doses on these meds, because they might miss the window of effectiveness for them. The drug companies know that everyone responds differently.
The current way of dosing seems to be a way for uninformed GPs to prescibe more mood pills that drug companies push on them. Giving them simple one size fits all instructions is easier than going by how the patient feels.
Posted by Sigismund on February 26, 2010, at 22:35:19
In reply to Savella - Patients Evaluate Sides, posted by bulldog2 on February 25, 2010, at 17:17:02
Very low doses of Savella before the NE(?) kicked in were pleasant for me.
Posted by bleauberry on February 27, 2010, at 17:56:26
In reply to Savella - Patients Evaluate Sides, posted by bulldog2 on February 25, 2010, at 17:17:02
My opinion expressed here numerous times is that Savella is overdosed at normal doses.
As with the previous poster, I found very small doses to be quite impressive. My largest dose was about 18mg per day (6.25mg three times). To get that dose requires customizing your own capsules (if from overseas) or splitting pills (if from USA).
I stumbled on a couple pubmed case stories where the therapeutic dose in those cases was 20mg. But in our own doc's office, the target is 100mg as fast as possible. Yikes.
At askapatient those ratings are based on fibromyalgia, not depression. For that purpose I do not have any experience with what appropriate doses should be. But it is obvious that whatever the appropriate dose should be, those people were given too much too fast.
Nothing works for everyone. Every drug will produce bizarre intense side effects for a minority of people. It happens. All drugs. No miracle cures. But in the case of Savella, I personally believe that many of those people who did poorly were victims of doses that were increased too high too fast. They might have done just fine by splitting the starting dose...12.5mg...in two, and take 6.25mg twice a day for a month before doing anything else.
When I saw the prescribing instructions with the starter pack I was frieking out. That is way too aggressive. That is begging for unwarranted trouble.
Just my opinion.
Posted by mommyron on February 28, 2010, at 22:31:48
In reply to Re: Savella - Patients Evaluate Sides, posted by bleauberry on February 27, 2010, at 17:56:26
My pdoc and I are considering this drug if I give up on Emsam. Bleuberry--you've said a couple times that you really like it--do you still take it?--if not, how was it dc'ing it? Also--any noteworthy side effects?? Same questions for any other users/ex-users! Thanks! Teresa
Posted by bleauberry on March 1, 2010, at 19:06:45
In reply to Re: Savella - ex-users (bleuberry + any others?), posted by mommyron on February 28, 2010, at 22:31:48
> My pdoc and I are considering this drug if I give up on Emsam. Bleuberry--you've said a couple times that you really like it--do you still take it?--if not, how was it dc'ing it? Also--any noteworthy side effects?? Same questions for any other users/ex-users! Thanks! Teresa
It is one of my few standby meds. I can't seem to stay on any med for very long because some very bizarre very disturbing physical side effect happens. My standby list includes Savella, Amisulpride, Abilify, Parnate.
The reason I like Savella is because in a few days it had me lifting out of the dark after ECT had failed and after every other drug combination you can think of failed. To me, that is pretty impressive. This was also seen in a small case study on pubmed where 3 of 5 treatment resistant patients saw remission when a tiny dose of risperdal was added to their savella. The drug just has the potential. I don't think lexapro or any of its cousins could do that. Savella can.
Side effects were diminished appetite, deep sleep (beginning after 3 nights of disturbed sleep), waking headache that went away quickly, and the killer for me...extreme difficulty going pee. Probably the norepinephrine constriction on the urinary system. It is said that Flomax will prevent that. So next time, Flomax will be onboard.
Regular doses were too much for me. The norepinephrine effect gave me waves of goosebumps and hairs standing up. Felt good though. It was a smiling kind of thing. But too much because I couldn't pee. I made custom size doses in 6.25mg sizes and took 2 or 3 a day.
Withdrawal was minor. Maybe a day or two of some returning blueness, and that was about it.
Nest time I think I will take it with a tiny dose of Abilify.
Amisulpride is also an excellent med. For those in the USA who aren't familiar with it, that's a shame.
Posted by mommyron on March 2, 2010, at 12:41:07
In reply to Re: Savella - ex-users (bleuberry + any others?), posted by bleauberry on March 1, 2010, at 19:06:45
Dear Bleauberry, Thank you for sharing. My doctor is leaning towards Parnate for me. He's a pumpkin and will prescribe pretty much anything I ask for (& we discuss), so he will go with Savella if I feel strongly. I'm pretty depressed, so it makes it hard to tease out which drug seems to make most sense. (He has no experience with Savella, hadn't even heard of it so he can't really comment too much on it.) I just want to feel better...
Posted by bleauberry on March 2, 2010, at 16:29:28
In reply to Re: Savella - ex-users (bleuberry + any others?), posted by mommyron on March 2, 2010, at 12:41:07
> Dear Bleauberry, Thank you for sharing. My doctor is leaning towards Parnate for me. He's a pumpkin and will prescribe pretty much anything I ask for (& we discuss), so he will go with Savella if I feel strongly. I'm pretty depressed, so it makes it hard to tease out which drug seems to make most sense. (He has no experience with Savella, hadn't even heard of it so he can't really comment too much on it.) I just want to feel better...
Mmm. That is a tough decision.
Parnate has the longer track record.
A washout period after stopping a failed Savella would only be about 4 to 5 days, and withdrawals are relatively tame. A washout period after a failed Parnate would be 2 weeks, with challenging withdrawals.
So yeah, it's a tough decision. One of my next two meds will be either savella or parnate, so I'm in the same boat as you.
Posted by mommyron on March 2, 2010, at 22:57:47
In reply to Re: Savella - ex-users (bleuberry + any others?), posted by bleauberry on March 2, 2010, at 16:29:28
Bleauberry (I hope you don't mind me asking you these questions....)--and others, what are the Parnate withdrawal issues?
Posted by bleauberry on March 3, 2010, at 17:18:09
In reply to Savella or Parnate/ + Parnate withdrawal, posted by mommyron on March 2, 2010, at 22:57:47
> Bleauberry (I hope you don't mind me asking you these questions....)--and others, what are the Parnate withdrawal issues?
I'm sure this is probably an individual thing that varies from person to person. I know I've seen it here multiple times when people stopping Parnate felt aweful. Usually stuff like really down blue mood and anxiety. Not so much the nausea and other bizarreness of SSRI withdrawals.
For me the the Parnate withdrawal depression was intensely worse than the depression I started with. And the anxiety was oh my god. It was truly a fearful handful of days beginning about 3 days after the final dose.
Savella in comparison was quite mild. No wild swings. So the decision between the two is tough. Halflife versus withdrawal are the deciding factors when I contemplate these two in competition. And I'm still on the fence on that one.
Posted by meltingpot on March 9, 2010, at 14:09:48
In reply to Re: Savella or Parnate/ + Parnate withdrawal, posted by bleauberry on March 3, 2010, at 17:18:09
Hi,
My psychiatrist was on about adding Savella (Milnacipran?) to this Seroxat that I'm taking if I'm still not feeling well on the Seroxat (which I'm not), the anxiety is the only thing which is better.
I'm concentrating better at work and the physical symptoms of anxiety aren't so bad, I'm more chatty and interested in others but to be honest deep down inside I just feel so flat and apathetic and sort of couldn't really care less about anything, although I can fight that feeling quite well at work. But when it comes to doing things for me, half the time I can't even really be bothered to put my shoes on in the morning.
I'll give Savella a try and it's nice to see that other people have found it very effective but I won't be suprised if it doesn't work for me as nothing really seems to work for me anymore.
I hope I prove myself to be wrong, I really do, I just want another few years of feeling alive and enjoying life properly, as I guess a lot of people on this board want.
Sorry didn't mean to hijack this thread, just wanted a general moan.
Denise
This is the end of the thread.
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