![[dr. bob]](/dr-bob-sm.gif)
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 a_nicholson1980 on August 10, 2010, at 2:18:43
Hi- I am interested in Milnacipran for depression/anxiety and I'm curious about others experiences. I was interested in it b/c it supposedly has a lower side effect profile. Did it cause side effects like lowered libido, weight gain, emotional blunting, or fatigue? Men- did it cause impotence?
Thank you in advance
Posted by Maxime on August 10, 2010, at 9:41:14
In reply to Milnacipran Experiences, posted by a_nicholson1980 on August 10, 2010, at 2:18:43
I hope that people will respond to your post. In the meantime, here is a thread that was started in May http://www.dr-bob.org/babble/20100514/msgs/947505.html
You can use the Google search field at the bottom of the main PB index and it will search for threads in PB. I find it to be a handy tool.
Posted by bleauberry on August 12, 2010, at 20:25:14
In reply to Milnacipran Experiences, posted by a_nicholson1980 on August 10, 2010, at 2:18:43
I have some experience with milnacipran, have read every study ever done on it around the world, and have followed everyone here that has tried it, and a couple other forums.
I would say...
The side effects are not any tamer than any other antidepressant. The internet makes it seem like it doesn't have side effects, but it does. Decreased appetite or nausea are common for at least a month. Weight gain not likely. Impotence possible but not nearly as bad as the others. Decreased desire likely at first, but can later turn into an increase. Sweating likely if dose too high. Insomnia or disturbed sleep likely at the start and if the dose is too high. Tiredness is the dose is too high. Can cause difficult urination, which was so bad in my case I had to stop the med.
My personal opinions...
Excellent antidepressant that can work even when ECT fails. As it did with me and at least two others I have read about.
Is too often used as monotherapy, but happens to combine very well with risperdal, zyprexa, ritalin, cymbalta, pindolol, buspar, ssris, and wellbutrin. I know I know, cymbalta (snri) and milnacipran (snri) together? Don't try to figure it out. These are all very different drugs and very different molecules. I'm just telling you what I've seen out there in my studies.
Is too often over-dosed when much smaller doses would have worked as well, or better, with far fewer side effects. My ideal dose was actually 6mg twice a day. That's the starter pill cut in half.
Has a short half life and needs to be dosed at least 2 to 4 times per day.
Can correct adrenal and thyroid problems in the longterm (6 to 9 months).
Benefits anhedonia very well unless the dose is too high, in which apathy will show up just like other antidepressants.
Side effects take longer to smooth out than other antidepressants.
It is not a "me-too" antidepressant but instead stands in a class all its own...it is actually the only true snri on the market.
I say it is definitely worth a try, but keep all of the above points in mind. Go for a dose higher than your body wants, and it will suck. Listen to your body. Forget what the books and internet say...listen to your body...it will tell you the correct dose.
As with all drugs, mileage varies. That said, I see high potential with milnacipran when it is handled properly...I do not agree with the dosing instructions given on the label or by the doctor.
Posted by a_nicholson1980 on August 13, 2010, at 1:28:33
In reply to Re: Milnacipran Experiences, posted by bleauberry on August 12, 2010, at 20:25:14
Thank you very much bleauberry. I really appreciate you sharing your experience and research. I guess I will go for the lowest dose to start at 12.5 mg. Thanks again.
Posted by a_nicholson1980 on August 13, 2010, at 1:40:58
In reply to Re: Milnacipran Experiences, posted by bleauberry on August 12, 2010, at 20:25:14
You say it can cause an increase?? Interesting. Did you experience this?
Posted by Minsc22 on August 13, 2010, at 5:33:58
In reply to Re: Milnacipran Experiences, posted by bleauberry on August 12, 2010, at 20:25:14
> I have some experience with milnacipran, have read every study ever done on it around the world, and have followed everyone here that has tried it, and a couple other forums.
>
> I would say...
>
> The side effects are not any tamer than any other antidepressant. The internet makes it seem like it doesn't have side effects, but it does. Decreased appetite or nausea are common for at least a month. Weight gain not likely. Impotence possible but not nearly as bad as the others. Decreased desire likely at first, but can later turn into an increase. Sweating likely if dose too high. Insomnia or disturbed sleep likely at the start and if the dose is too high. Tiredness is the dose is too high. Can cause difficult urination, which was so bad in my case I had to stop the med.
>
> My personal opinions...
>
> Excellent antidepressant that can work even when ECT fails. As it did with me and at least two others I have read about.
>
> Is too often used as monotherapy, but happens to combine very well with risperdal, zyprexa, ritalin, cymbalta, pindolol, buspar, ssris, and wellbutrin. I know I know, cymbalta (snri) and milnacipran (snri) together? Don't try to figure it out. These are all very different drugs and very different molecules. I'm just telling you what I've seen out there in my studies.
>
> Is too often over-dosed when much smaller doses would have worked as well, or better, with far fewer side effects. My ideal dose was actually 6mg twice a day. That's the starter pill cut in half.
>
> Has a short half life and needs to be dosed at least 2 to 4 times per day.
>
> Can correct adrenal and thyroid problems in the longterm (6 to 9 months).
>
> Benefits anhedonia very well unless the dose is too high, in which apathy will show up just like other antidepressants.
>
> Side effects take longer to smooth out than other antidepressants.
>
> It is not a "me-too" antidepressant but instead stands in a class all its own...it is actually the only true snri on the market.
>
> I say it is definitely worth a try, but keep all of the above points in mind. Go for a dose higher than your body wants, and it will suck. Listen to your body. Forget what the books and internet say...listen to your body...it will tell you the correct dose.
>
> As with all drugs, mileage varies. That said, I see high potential with milnacipran when it is handled properly...I do not agree with the dosing instructions given on the label or by the doctor.
>
>I took minalcipran at 100 mg during 6 months but i lost the activating effect at the end.
In a low dose, is it more stimulant?
Posted by a_nicholson1980 on August 13, 2010, at 13:47:44
In reply to Re: Milnacipran Experiences, posted by Minsc22 on August 13, 2010, at 5:33:58
Hi Minsc22,
Thank you very much for responding. How was your experience with Milnacipran? Did it help you? Was it tolerable?
Thank you.
Posted by bleauberry on August 13, 2010, at 19:03:00
In reply to Milnacipran Experiences, posted by a_nicholson1980 on August 10, 2010, at 2:18:43
I guess my overall message about milnacipran is that since it has displayed the ability to normalize longterm adrenal, thyroid, and immune problems with longerm treatment, it impacts a lot of stuff in the body. And since we don't know all those details within our own illnesses and bodies, it makes sense to approach the whole thing with gentleness. Which to me means starting, and sometimes staying at, minimum doses. The multiple dosing is also extremely important. Studies with once daily dosing were no better than placebo. The halflife is only 8 hours.
And I can't help but repeat, there are few monotherapy meds that can show improvement when someone fails ECT. But milnacipran did that to me, and I've read about it a couple other times at other forums. I don't see those same kinds of stories with things like lexapro, cymbalta, or effexor. And to think, it was a mere 6mg taken twice a day that blew ECT in the weeds? I mean, ya know, come on, there is potential there. I've seen people fail on milnacipran too, and they failed in clinical trials, so in that respect it is not the magic bullet. But certainly deserves a shot. With the exception of SLS, the failures I've seen here were either due to: too high of a dose; not frequent dosing; too quickly increasing dose; urination side effects; not trying common add-ons (ssri, zyprexa, risperdal).
The starter pack ramps up dose really fast. That's insane in my opinion. It should be literally 10 times slower than that. The people who wrote those instructions have obviously never ingested the drug themselves.
Posted by ed_uk2010 on August 13, 2010, at 22:50:42
In reply to Re: Milnacipran Experiences, posted by bleauberry on August 13, 2010, at 19:03:00
>I guess my overall message about milnacipran is that since it has displayed the ability to normalize long term adrenal, thyroid, and immune problems with longerm treatment, it impacts a lot of stuff in the body.
I'm not quite sure what you mean by this. I searched PubMed but I couldn't find any studies which looked at the effects of milnacipran on the thyroid or immune system.
>And I can't help but repeat, there are few monotherapy meds that can show improvement when someone fails ECT.
I agree that milnacipran has potential. It's fantastic that it's worked so well for you, but I don't think it's necessarily any better (following ECT) than other SNRIs - or tricyclic antidepressants for that matter. I do think it's important not to generalise your experiences too much to everyone else. Some people do well on milnacipran, some don't. The same can be said of all psych meds. I hope that we will see more research over the next few years. This should help to clarify the place of milnacipran in psychiatry.
Posted by bearfan on October 23, 2010, at 1:42:57
In reply to Re: Milnacipran Experiences » bleauberry, posted by ed_uk2010 on August 13, 2010, at 22:50:42
Did anyone notice an general antianxiety effect from Milnacipran/Savella longer term? I felt not calm on it for the few weeks I tried it. Forest is working on an 'improved' version with less side effects.
Posted by a_nicholson1980 on October 27, 2010, at 2:32:23
In reply to Re: Milnacipran Experiences, posted by bearfan on October 23, 2010, at 1:42:57
I took it for 3.5 months and did not have a great reaction to it. The start-up was especially rough. I felt like I had the flu everyday. After a few weeks I noticed a minor improvement in mood and decided to go up slightly in dose. This resulted in the fluish like fatigue coming back. In terms of anti-anxiety effects I didn't really notice any difference. Also, contrary to what I've read this drug does cause sexual side effects - primarily manifesting as a significant decrease in libido.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.