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Re: Will Savella (Milnacipran) stimulation go away?

Posted by bulldog2 on August 25, 2009, at 12:35:40

In reply to Re: Will Savella (Milnacipran) stimulation go away?, posted by bleauberry on August 24, 2009, at 18:32:00

> I find clinical studies misleading because the results of them say 100mg is the therapeutic dose, with 150mg being better if no response to 100mg. But hidden in there is that some of those people probably did well on 25mg or 50mg. They might have been the ones that dropped out because they couldn't tolerate the rapid escalation of dose.
> I found a couple cases of pubmed where patient's depression was alleviated with either 20mg or 25mg. I have also seen that at other forums. Probably not the norm, but it happens nonetheless.
> Me, my best dose was custom-made...6mg 3 times per day. Very slight stimulation, very good anti-anxiety, excellent sleep, good on anhedonia. 25mg or higher was too much. That's my story.
> You have your own story. Find your best dose. Your side effects may likely lessen if you can gut it out for another month or two. Me, I don't operate that way. I lower the dose to where I can function and just give it more time before making another decision.
> I am in another of my "disappointed in meds" phases. I go in cycles, sometimes cheering them and sometimes despising them. If I ever need one again, Milnacipran is one of the very few on my decent list. The only other two I would ever consider again are Trivastal or Parnate. Milnacipran, for me, is that good. But, and it's a big but, the dose has to be the correct dose, not someone else's dose.

I remember many years ago I had a doc who was also a pharmacologist. He thought that many people were being overdosed on ads.He told me a story about an elderly lady who could get an ad effect from breaking off a piece from an elavil pill once a day.
he said the dosage ranges were averages. But everyone had a different metabolism. Where most might need to get within the therapuetic dose range to get an effect some might need more and some less. We all have different metablisms. Maybe the p-docs should look for when is the person getting a clinical response rather than rushing to get them within the computed dosage range. Rushing to get get there you might bypass that person's therapeutic range and get a med failure because the person will also discontinue due to sides.




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