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Dr. Bob is Robert Hsiung, MD,
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Posted by former poster on August 23, 2012, at 1:41:45
In reply to Savella augmenter suggestions anyone?, posted by former poster on July 13, 2012, at 1:10:27
> I'm going through some stressful events/crisis and I'm on Savella 100mg/day for Chronic pain/fatigue. Savella seemed to boost my mood, help with some social anxiety issues as well as the pain, CFS. Lately I can't seem to cope with situations in my life and I'm worried I'll be sinking into deep depression. Maybe I should increase Savella to 150 or 200mg? Or add Bupropion?
>I tried 150mg/day for about 1 month. I noticed some improvement in mood. Maybe 200mg/day would have worked even better? I had to stop because of hot flashes and profuse sweating. I'm back on 100mg/day and the excess body warmth perspiration seems to still be a problem. Am I damaging my body with this drug? I don't really feel the serotonin reuptake effect. I have had other SSRI's and this doesn't feel anything like them.
Posted by phidippus on August 23, 2012, at 7:17:34
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by former poster on August 23, 2012, at 1:41:45
Savella is an SNRI that is not approved to treat depression in the US (are you in the US?) BUT, as a seratonin norepenephrine rreuptake inhibitor it will certainly confer antidepressant and anxiolytic effects-that's why it helped with your mood and social anxiety.
I'm sorry to hear things have gotten more stressful, but I think if you worry about becoming depressed it might put more pressure on you.
200 mg is the highest recommended dosage for Savella. If you had improvements at 150 mg, you might see more at the highest dose. I think the hot flashes will subside over time, however the profuse sweating may remain an issue-but its definitely about weighing pros over cons.
You are not damaging your body with this drug. If anything, it is neuroprotective.
If your mood is improving, you are feeling tthe benefits of seratonin reuptake inhibiition.
If you want to augment your treatment, I would recommend Lyrica or Tramadol-both treat fibromyalgia and Tramadol is an excellent mood enhancer. Bupropion might be helpful for your mood.
Eric
Posted by brynb on August 23, 2012, at 7:53:53
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by phidippus on August 23, 2012, at 7:17:34
> If you want to augment your treatment, I would recommend Lyrica or Tramadol-both treat fibromyalgia and Tramadol is an excellent mood enhancer.
>I'm on board with what Eric said above about Tramadol. It's been wonderful for me for both mood and pain. I wasn't able to tolerate any of the true NRIs (Cymbalta, etc.). They make me physically ill and just don't jive with my chemistry. Even though Tramadol works like an NRI, I can tolerate it.
Good luck,
-b
Posted by former poster on August 23, 2012, at 8:54:41
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by phidippus on August 23, 2012, at 7:17:34
Thanks for your post Eric. I asked my Dr. for a prescription of Tramadol and he refused because he said it's "very addictive." I might give the Bupropion a try in combination with it. Do you know of any SSRI's that would go well with Savella?
Posted by brynb on August 23, 2012, at 9:24:17
In reply to Re: Savella augmenter suggestions anyone? (Update), posted by former poster on August 23, 2012, at 8:54:41
> Thanks for your post Eric. I asked my Dr. for a prescription of Tramadol and he refused because he said it's "very addictive." I might give the Bupropion a try in combination with it. Do you know of any SSRI's that would go well with Savella?
Hi FP,
I just wanted to chime in again about Tramadol. A lot of pdocs won't prescribe it because it's technically not a "psych" drug. This so ridiculous; I mean if it works, it works. Who cares what it's characterized as? Yes, it's considered addictive, but again, that's nonsense; benzos are addictive, stimulants are addictive, and one can argue that SRIs and NRIs cause dependence too (it's certainly no picnic coming off of anti-depressants!).
If presented with the proper research/articles/etc., perhaps your doc would reconsider. It's an NRI that also works on the mu opioid receptors (it doesn't get you high at all) and apparently, as an NMDA antagonist, too. In working this way, it's a pretty effective AD (and good for pain).
My pdoc wanted me off of Tramadol (because I had substance abuse issues in the past), so to be a "good" patient and comply, I tapered off of it. I was surprised how easy it was (I was mildly sad for a few days, but also dealing with PMS!). I had my general internist refill my script so I could have it available and have only been using it as a prn.
Sorry for the rant, I just get incensed when doctors are too rigid in their approach to mental (or other) health issues. I'm seeing my pdoc in two weeks, and I intend to let him know how I feel about taking Tramadol.
Either way, good luck.
-b
Posted by former poster on August 23, 2012, at 12:57:47
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by brynb on August 23, 2012, at 9:24:17
Thanks for that input brynb. Unfortunate that the percentage of patients seeking a way to get high have to ruin it for the ones that truly need it. Then the government has to schedule it and play the role of baby-sitter at our expense and suffering.
Posted by former poster on August 23, 2012, at 13:53:40
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by former poster on August 23, 2012, at 1:41:45
I think Savella is a good appetite suppressant. I don't seem to gorge myself like I used to. It doesn't feel anything like an SSRI to me. No sedation. Ever! No cognitive impairment, memory impairment. I don't feel medicated. I feel like my natural self except for the headache and perspiration.
My sleep is improved but not perfect from Savella. I wake up after 5hrs of sleep, take my morning dose and I'm back to sleep for 3 more hrs. The afternoon dose is taken 6hrs before sleeping time. Deep sleep is something new for me since being on Savella.
I haven't found any med that has helped with social anxiety as much as Savella, except Nardil. I can't contribute all of my improvement to Savella because I'm also taking a number of supplements and herbs, most important Gotu Kola which has a stunning effect on sociability. I forgot to mention, I don't think it helps with my arthritis pain
I think Savella should be investigated further for it's benefit on sleep and anxiety. I hope this bit of rambling can benefit someone.
Posted by phidippus on August 23, 2012, at 17:16:12
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by former poster on August 23, 2012, at 13:53:40
Savella is an SNRI, not an SSRI.
Eric
Posted by phidippus on August 23, 2012, at 17:19:07
In reply to Re: Savella augmenter suggestions anyone? (Update), posted by former poster on August 23, 2012, at 8:54:41
What your doctor says is bullocks. Benzodiazapines are more addictive than Tramadol.
A good SSRI to compliment your Savella would be Viibryd, which is an SSRI plus 5ht1a partial agonist which is very good for depression and anxiety.
Did you ask about Lyrica?
Eric
Posted by former poster on August 24, 2012, at 1:05:48
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by phidippus on August 23, 2012, at 17:19:07
I saw my Dr. today and asked him if Tramadol would mix well. All I got out was, TRAMA- and he cut my sentence short saying "I'm not going to prescribe an addicting drug!" I felt like a junkie. Very humiliating to say the least. I have had it with this small town clinic.
Posted by SLS on August 24, 2012, at 1:53:58
In reply to Re: Savella augmenter suggestions anyone? (Update) » phidippus, posted by former poster on August 24, 2012, at 1:05:48
> I saw my Dr. today and asked him if Tramadol would mix well. All I got out was, TRAMA- and he cut my sentence short saying "I'm not going to prescribe an addicting drug!" I felt like a junkie. Very humiliating to say the least. I have had it with this small town clinic.
I'm sorry to hear that. I couldn't get my doctor to go along with buprenorphine. I never tested the waters for tramadol. I might ask him about his use of tramadol in clinical practice - just out of curiosity. Being that I am currently taking a MAOI, tramadol is contraindicated, as the combination would very likely precipitate serotonin syndrome.
- Scott
Posted by phidippus on August 24, 2012, at 15:14:23
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by SLS on August 24, 2012, at 1:53:58
Is it the MAOI specifically that going to cause an interaction with the Tramadol or just the fact it is an antidepressant?
I took Tramadol 100 mg alongside 200mg of Clomipramine and never encountered serotonin syndrome-I think Tramadol's SNRI effects are onn the weak side.
I think you would be fine trying Tramadol.
Eric
Posted by phidippus on August 24, 2012, at 15:15:57
In reply to Re: Savella augmenter suggestions anyone? (Update) » phidippus, posted by former poster on August 24, 2012, at 1:05:48
Your Dr. knows nothing about Tramadol.
Did you ask about Lyrica?
Eric
Posted by SLS on August 25, 2012, at 10:46:54
In reply to Re: Savella augmenter suggestions anyone? (Update) » SLS, posted by phidippus on August 24, 2012, at 15:14:23
> Is it the MAOI specifically that going to cause an interaction with the Tramadol or just the fact it is an antidepressant?
>
> I took Tramadol 100 mg alongside 200mg of Clomipramine and never encountered serotonin syndrome-I think Tramadol's SNRI effects are onn the weak side.
>
> I think you would be fine trying Tramadol.
You could be right. How does the SRI properties of tramadol compare to those of trazodone? I experienced some mild SS symptoms from combining trazodone with clorgyline, a potent MAO-A inhibitor.I am concerned whenever a serotonin reuptake inhibitor is combined with a MAOI. I don't think there is any greater risk of precipitating serotonin syndrome than combining these drugs. I am very afraid to add tramadol. Hopefully, I won't need to.
- Scott
Posted by former poster on August 25, 2012, at 14:14:51
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by phidippus on August 24, 2012, at 15:15:57
Lyrica is not an option for me. I had a bad response to Neurontin. I am terrified to take anything similar to it again.
Posted by SLS on August 25, 2012, at 16:40:52
In reply to Re: Savella augmenter suggestions anyone? (Update) » phidippus, posted by former poster on August 25, 2012, at 14:14:51
> Lyrica is not an option for me. I had a bad response to Neurontin. I am terrified to take anything similar to it again.
How did you react to Neurontin?
- Scott
Posted by phidippus on August 25, 2012, at 16:59:48
In reply to Re: Savella augmenter suggestions anyone? (Update) » phidippus, posted by SLS on August 25, 2012, at 10:46:54
I wouldn't be afraid to add Tramadol - I think its SRI properties are weaker than Trammadol.
Anyway, SS is not that big a deal. Sure you can die from it, but most of the time its quite reversible.
Eric
Posted by former poster on August 26, 2012, at 0:31:22
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by SLS on August 25, 2012, at 16:40:52
>How did you react to Neurontin?<
My Dr. said I had a "paradoxical response"...
Each week I was on it and each dose increase I began to feel more unstable to the point of feeling worse than I have ever felt in my life, weird unraveling, dissociative, anxiety. Around the 4th week in the late evening as I went to bed I began having incredible visual hallucinations. Thank God for Clonazepam! It helped relieve the fear, almost made me enjoy the trip, helped me sleep. I immediately felt relief after stopping the Neurontin.
Posted by SLS on August 26, 2012, at 5:50:13
In reply to Re: Savella augmenter suggestions anyone? (Update) » SLS, posted by former poster on August 26, 2012, at 0:31:22
> >How did you react to Neurontin?<
>
>
> My Dr. said I had a "paradoxical response"...
> Each week I was on it and each dose increase I began to feel more unstable to the point of feeling worse than I have ever felt in my life, weird unraveling, dissociative, anxiety. Around the 4th week in the late evening as I went to bed I began having incredible visual hallucinations. Thank God for Clonazepam! It helped relieve the fear, almost made me enjoy the trip, helped me sleep. I immediately felt relief after stopping the Neurontin.
Thanks for responding.I reacted very badly to Neurontin and Lyrica. My reactions to both of these drugs were the same. During the first few days, I experienced an antidepressant and anxiolytic effect. However, thereafter, I felt more depressed, dysphoric, and had profound "brain-fog" cognitive impairments. After discontinuing these drugs, it took at least two weeks for the negative effects to dissipate. I was afraid that I would be stuck in that altered state. I intend to stay away from any drug that binds to the alpha2delta subunit of the calcium channel.
- Scott
Posted by former poster on August 30, 2012, at 11:46:12
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by SLS on August 26, 2012, at 5:50:13
Scott.. We must have some of the same genetics. Thanks for posting that. I thought I was the only one with that response. I too was afraid I would be stuck in that altered state.
What other meds affect alpha2delta subunit of the calcium channel?
Posted by brynb on August 30, 2012, at 14:12:06
In reply to Re: Savella augmenter suggestions anyone? (Update) » former poster, posted by SLS on August 26, 2012, at 5:50:13
I also have a paradoxical response to Neurontin. It makes me manic (which stops when it wears off). Good to know some others here have had similar experiences. I've seen other people on various websites who had bad responses to Neurontin, too. Funny, because my pdoc thinks this paradoxical reaction is "curious".
Posted by SLS on August 30, 2012, at 15:02:44
In reply to Re: Savella augmenter suggestions anyone? (Update) » SLS, posted by former poster on August 30, 2012, at 11:46:12
> Scott.. We must have some of the same genetics. Thanks for posting that. I thought I was the only one with that response. I too was afraid I would be stuck in that altered state.
>
> What other meds affect alpha2delta subunit of the calcium channel?
The only ones that I'm aware of are Neurontin and Lyrica.
- Scott
Posted by phidippus on August 30, 2012, at 21:21:37
In reply to Re: Savella augmenter suggestions anyone? (Update) » SLS, posted by brynb on August 30, 2012, at 14:12:06
>my pdoc thinks this paradoxical reaction is >"curious".
It is curious, because nothing in the chemical makeup of Neurontin should provoke a mood change. Unless the direct action on alphawhatever voltage-gated calcium channels is causing the shift. Or maybe its that gabapentin halts the formation of new synapses. Hmmmm...
Curious.
Eric
Posted by phidippus on August 30, 2012, at 21:25:24
In reply to Re: Savella augmenter suggestions anyone? (Update) » SLS, posted by former poster on August 30, 2012, at 11:46:12
atagabalin
Eric
Posted by brynb on August 31, 2012, at 7:52:24
In reply to Re: Savella augmenter suggestions anyone? (Update), posted by phidippus on August 30, 2012, at 21:21:37
This is the end of the thread.
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