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Re: Milnacipran: Severe sleepiness » vic80

Posted by Bob on June 19, 2010, at 17:11:00

In reply to Milnacipran: Severe sleepiness, posted by vic80 on June 19, 2010, at 16:23:44

> Ok, this is the start of the 6th week on Milnacipran 25 mg once daily at night - (the dose was upped back to 25mg twice daily just yesterday)
>
> had been taking MIL at nights, since past 20 days.
> What I have noticed over the past 4-5 days is excessive sleepiness - especially after waking up - after getting a good 8 hours of sleep which is like gold standard for me, I am still so sleepy - I am utterly unable to get out of bed - I am almost dead with sleepiness - I manage to have breakfast and then I am back to sleeping off - this has become really distressing.
>
> I had initially thought a sleep deficit of few days had been making me sleepy - but now I am sleeping like 14 hours in all a day - and the oversleeping is making me feel so disoriented, dizzy, tired, spaced out and out of it.
>
> I cannot really seem to blame it on MIL, because such effects should have started long back - especially given that I have been on the nightly dose for over 20 days now.
>
> I wonder if the med could do this in the 6th week -could such a radical new side effect just emerge out of the blue??
>
> I have no fever or any infections that I am aware of.
>
> I have taken the morning dose too today - and felt a little groggy at the end of 8-9 hours....
>
> tonight I sleep without MIL to make sure if its not the culprit.
>
> Wonder what has brought on this sudden Hypersomnia - I had sort of flu like symptoms a few days ago - but those have subsided now - plus I have been exposed to some terrible tropical heat a few days ago when the day time sleepiness started.
>
> I noticed sudden sleep like spells past 2 days - as though suddenly while talking to someone I'd feel a spell of sleep setting in, doesnt knock me out at all... but actually causes anxiety.
>
> The worst bit is that the combination of sleepiness and any anxiety makes me feel almost crazy.
>
> On 25mg twice daily - i feel sort of detached... the night dose was okay for me - but the increased negativity and depressive bouts made me agree to try the whole 50 mg.
>
> My pdoc says for my huge BMI i need to be on atleast 50mg for any effects to show - I wonder if there is some logic behind this....
>

vic80,

If it were me in your situation I would be blaming the milnacipran. I have had serious trouble with sedating effects of SSRIs for many years now - even the ones that are supposed to be activating. It is always a chronological phenomenon. In the beginning the SRI is often activating, sometimes even intolerably so. Then, slowly it starts to switch over and I go through a period of semi-response. Eventually if I'm on the drug long enough the activating/anti-depressant effects drain away and I am left with apathy and iatrogenic narcolepsy. It becomes harder and harder to wake up in the morning and and I become a hypersomniac. Nothing matters any longer except staying in bed and sleeping more. It can get so bad that I sleep through almost anything, or if I do hear something like a phone ringing it's almost like it's a dream.

At it's worst I was sleeping 14 to 15 hours a day, even on healthy doses of venlaflaxine. I've had similar problems with paroxetine, fluoxetine, and citalopram also. No augmentation strategy would work for more than a few days, but they did bring on plenty of side effects.

I've had sedation problems with many psychiatric drugs (mood stabilizers too) and I'd say other than my mental illness itself, it is possibly the biggest problem I've faced on a daily basis over the years. But I digress. Like I said, for me, I wouldn't hesitate to blame the milnacipran.

Bob

 

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