![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by bleauberry on August 24, 2008, at 19:19:16
In reply to Ixel (milnacipran), posted by Quintal on August 23, 2008, at 7:54:59
I am quite med sensitive and found my best dose was customized at 6mg 3 times per day.
There were for me some startup anxiety or sleep issues the first 1 to 3 days, but after that things changed fast. The startup side effects were nowhere near as intense as other ADs. The antidepressant effect was actually noticable already by day 2. By week 2 depression was getting better and previously rampant anxiety was almost nonexistent.
I think it worked so fast because of the initial boost in NE and 5ht. After that, I believe further improvements are slow and gradual over weeks and months. On a 1 to 10 scale, I think I improved about 2 or 3 points in just a few days. After that I was improving about 1/10th of a point each day. In contrast with every other med out there that get me feeling worse over time. Milnacipran was creeping along in the correct direction.
Overall I rate Milnacipran a topline AD. In Japan it is characterized in a couple pubmed abstracts as remarkable. For it to help me, a failure of countless meds and ECT, says a lot. Endure the startup if any, and give it a go. If for any reason it is too rough, get some empty gel caps and make your own dose sizes like I did.
Currently not on it, but when I feel I really need something, it is the one. Getting through the first few days is not very hard for me, which says a lot. Just start low if apprehensive.
The lingering side effects for me were decreased appetite, urinary difficulty, and a slight headache if too much time elapsed between doses. I found that the med Flomax (Tamsulosin) blocks the urinary side effects. Tried it and it indeed worked.
> I was curious because noradrenergic drugs seem to help (in moderation), but reboxetine is too strong and Wellbutrin is too long acting and disturbs my sleep. Milnacipran looks as though it might fit the bill due to its shorter half life (8 hours), and the evidence showing that it can improve sleep quality and duration. I'm a bit nervous of taking my first dose in case it makes my anxiety worse. Any advice from people who've taken it?
>
> Q
Posted by West on August 28, 2008, at 6:46:24
In reply to Re: Ixel (milnacipran), posted by bleauberry on August 24, 2008, at 19:19:16
Hey, i'm 3 weeks in to duloxetine and while extremely glad to no longer be as depressed I have lots of fatigue: i'm afraid of driving and crashing the car. Major side effects are insomnia, brain fog, somnolence, mild jaundice and constipation . I have ordered some Ixel to try in two weeks if this continues. To bleauberry seriously though I don't think 6mg x 3 a day is really giving a proper go of things antidepressant wise, did you do a trial at prescribed doses: like 50,75,100,125mg bid?
The only thing that bothers me is the testicular pain - roll out the co-codamol for that sidey!
Posted by Quintal on August 28, 2008, at 9:15:36
In reply to Re: Ixel (milnacipran), posted by bleauberry on August 24, 2008, at 19:19:16
I took it on Saturday and again yesterday. It feels very strongly noradrenergic to me. Possibly a bit of seretonin action, but I'm taking tianeptine so I don't know if it interferes with that. I find it's good for focus, but I find it very stressful like with other noradreneric drugs. Bupropion feels less harsh and more sensual. It has some very... interesting sexual side effects. I seem to have developed cloudy urine and urethral pain since yesterday. Don't know what that's about. I hope not a UTI.
Q
Posted by West on August 28, 2008, at 12:30:52
In reply to Re: Ixel (milnacipran), posted by Quintal on August 28, 2008, at 9:15:36
Dysuria is a listed side effect i think - i hope it doesn't continue to be a problem. I couldn't handle either selegiline or bupropion when i took them with cymbalta, both worsened the insomnia. Bupropion made for a very rough ride with quite unpleasant stimulation about 5 hours after dosing (presumably when the active metabolites were formed) whilst the selegiline gave me head pressure, although i felt a robustness and positivity i hadn't felt in a while.
I've had the insomnia issue with zyban before when i took w/cipralex - i would be up until 3am. How people get by without a sleep aid i don't know, it seems to be an intrinsic part of the pharmacological effect for me. I'm thinking of reducing the cymb. to 40mg to curb some of the nausea (on monday) then doing a straight switchover to the Ixel in a couple of weeks. But Q are you taking on a daily basis or just dipping in and out to gauge the effects - if not would you be willing to do a diary?
Posted by Quintal on August 28, 2008, at 16:07:36
In reply to Re: Ixel (milnacipran), posted by West on August 28, 2008, at 12:30:52
The other side effect I forgot to mention was severe nausea. A few times I only just managed to stop myself from puking. Also goosebumps and penile shrinkage. And a general 'cold' feeling. This drug gave me a much rougher ride than bupropion, so much so that I'm thinking of going back to bupropion if I need something stimulating - so be careful if you're sensitive to those types of meds. I was just gauging the effects, it's not something I'll be taking long term. Tianeptine is working quite well on the depressive side, just at times it leaves me feeling very laid back and unfocussed. Maybe a few caffeine tablets would do instead?
Q
Posted by West on August 29, 2008, at 18:58:00
In reply to Ixel (milnacipran), posted by Quintal on August 23, 2008, at 7:54:59
Posted by Quintal on August 30, 2008, at 17:33:07
In reply to Re: Ixel (milnacipran), posted by West on August 29, 2008, at 18:58:00
Thank you West. It was very interesting, I notice a lot of people had the same side effects, but it seems a good drug for some. One of things is that it's so expensive to buy online. It might be easier if it was on prescription here.
Q
Posted by West on August 31, 2008, at 9:40:48
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on August 30, 2008, at 17:33:07
Yes, it seems even milnacipran is not without the weight gain side effect. I enjoyed this:
"While I am still morose bent on myself, but there are moments of joy and happiness. I am no longer obsessed by the most effective way of me "f*ck in the air" and it's not bad!"
From what i can tell it seems the most frequently reported side effects are flushing, hotness & sweating, dysuria,testicular pain & delayed ejaculation (men), as well as what sound like some of the usual ssri induced excessive 'normality'.
I actually quite enjoy reading bad translations- many of them have an odd poetry to them and seem to reveal interesting aspects about language, others are just plain incomprehensible. I am mildly curious to see if anyone could come up with a credible interpretation of this for example (my french doesn't even come close to basic):
"I am trouille a ploy, I visualize the situation and I glue in the skin of Rambo and I broke what caught me, it takes time, a daily mental work, finally realizes that the brain we return what he gives. I stopped radically any negative thought as soon as it pointed nose...
Result after 5 months, a few problems side effects but a sin to hell and everything has reptris correct."
!
Posted by Quintal on August 31, 2008, at 20:07:07
In reply to Re: Ixel (milnacipran), posted by West on August 31, 2008, at 9:40:48
Yes, I enjoyed it too! I wonder if foreign people really think back to front and inside out like that? Maybe it's just an error in the translating machine.
>From what i can tell it seems the most frequently reported side effects are flushing, hotness & sweating, dysuria,testicular pain & delayed ejaculation (men), as well as what sound like some of the usual ssri induced excessive 'normality'.
It did cause delayed ejacuation, but orgasm was very prolonged (30 seconds+) and a lot of semen produced. I felt more satisfied after that than I have done in a long time. It was so intense I was almost afraid to let myself ejaculate in case it hurt. For a few seconds afterward I feared I might have harmed myself because my ureathra/prostrate/testes were locked in a spasm. It relaxed after I'd had a wee, but if I were taking it long term I'd want some tamsulosin on hand.
Q
Posted by West on September 1, 2008, at 8:45:20
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on August 31, 2008, at 20:07:07
WELL that was candid - but any info is good info, and from what i can gather it sounds quite sweet and sour from a sexual standpoint.
I will probably do a diary when mine arrives in about 10 days. I have doubts about dropping the cymbalta though to try it since i went down to 45mg from 60mg, and had an increase in intrusive thoughts, so something must be working, either that or it's got its claws in me good and proper.Maybe it won't work again if i go off and back on? It seems a toss up between tolerability and antidepressant effects. Off to see my lovely GP Diane today about some modafinil for somnolence and some more zolpidem for sleep, which is still a nightmare (sort of makes her sound like my pharmacological 'connect', which is really what she is when you think about it). I hope things are looking up for you Quin and give me a shout if you want to do some babblechatting sometime.
West
Posted by Quintal on September 1, 2008, at 13:43:56
In reply to Re: Ixel (milnacipran), posted by West on September 1, 2008, at 8:45:20
Sorry for revealing too much West, I was posting under the influence of zopiclone and it loosened my tongue. I think I wrote a few other posts elsewhere but I'm afraid to look. Do you find zolpidem more effective than other hypnotics?
I hope Ixel works better than Cymbalta for you. What does Cymbalta feel like? My new pdoc suggested it when I asked for an antidepressant last, but I wanted to try lofepramine instead. I don't trust these newer drugs and don't respond well to anything that shores up too much serotonin either. I ended up with Lyrica, but it caused strange side effects and disinhibition. Maybe I should do what blueberry does any try smaller doses? I find Ixel hair-raisingly strong at normal doses. I'd be interested to see how you get on with Ixel.
Q
Posted by West on September 1, 2008, at 15:21:13
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on September 1, 2008, at 13:43:56
> Sorry for revealing too much West, I was posting under the influence of zopiclone and it loosened my tongue. I think I wrote a few other posts elsewhere but I'm afraid to look. Do you find zolpidem more effective than other hypnotics?
>
> I hope Ixel works better than Cymbalta for you. What does Cymbalta feel like? My new pdoc suggested it when I asked for an antidepressant last, but I wanted to try lofepramine instead. I don't trust these newer drugs and don't respond well to anything that shores up too much serotonin either. I ended up with Lyrica, but it caused strange side effects and disinhibition. Maybe I should do what blueberry does any try smaller doses? I find Ixel hair-raisingly strong at normal doses. I'd be interested to see how you get on with Ixel.
>
> QI think zolpidem does help to put me to sleep faster than zopiclone. It feels completely different too. I only take the 5mg but within 5 minutes i start to yawn and my eyes begin to water. With zopiclone there's the intital pleasant feeling and muscle relaxation - my body feels heavier on the mattress, but although the hypnotic effect is heavier/headier than with zolpidem, i am perfectly happy to just read or watch tv for an hour or two, like a bad (different? i suppose it's subjective) approximation of the anxiolysis one might get from a benzo, just more hypnotic.
I try not to read or watch anything i actually enjoy or follow since i don't remember a moment of it the next day (actually i exaggerate: worse than not remembering something is having the faint idea that you know that scene comes next. Or something like that. None of the surprise, all of the familiarity.)
Cymbalta to me seems very distinct in its two seperate mechanisms, like taking two different drugs. As someone had said before, the serotonin effect is very strong at 60mg, but there is definitely the norepinephrine band marching away in the background. This is important as it offsets the fog and apathetic response one would get from an ssri alone, and at times it is surprisingly strong. I have charged dizzily up hills and through thickets and bracken, got heated and grandly vocal on subjects i know i would have payed no heed to before, and generally felt more powerful and in charge of things, (when not lying on my bed passed out in the middle of the day in the throes of lassitude) so for now there exists a bit of dichotomy in its effect which may transform into a joyful union a few weeks down the road, who can really say though. Mostly though you don't notice the jazzing up of the CNS until you try and have a nap and you realise that nodding off really isn't a reality despite the fatigue, or that your heart is subtly beating a good bit faster than normal.
Yes. I would try giving smaller doses a try, you have nothing to lose after all. It sounds as though like me, you probably have what might be termed a 'sensitive disposition' which could be a better description than the more popular 'med-sensitive.' Your paradoxical reaction to sedatives is evidence of this (possibly), although all of us are presumably lacking in some areas more than others, or have lower tolerances to stimulatory/sedative effects of drugs, and your reasoning that lofepramine be a better option than cymbalta may be well founded in this respect.
I got the prescription today for everything i requested. I simply said "I'd like to try x and have 2 weeks more of y so that..." She didn't even consider the studies i had prepared, just said she didn't see why not to give it a go. Before i went i was ridiculous enough to print a sort of script so i would now what to say and exactly how to word it, the chief goal being that i sound informed and responsible (I had a premonition before going there that since our mental health is in question, many doctors must naturally question what we say). I think your care makes such a huge difference + depends on which doctor you happen to end up with. If you feel as if you're being painted in an untrustworthy light i would just register with someone else until you find someone responsive and kind. I'm lucky in that my GP is basically my next door neighbour out here and knows my family. I must say i am sort of pleased about getting modafinil. Quicker than any internet pharmacy and infintesimally cheaper, it arrives tomorrow, no doubt couriered in on some sleek motorbike specially, and at great cost to the NHS. Ah, good old NHS.
BTW i think you SHOULD try taking the ixel more regularly, albeit at small doses, and if it feels safe, WITH your tianeptine. (make a post in geography to your address and make a link from the main board and i will put my hoarded stash in the mail for you) The premise of this is that it's unlikely you will reap any benefit from taking something inconsistently and that doing so is probably little more than a waste of your funds and an added complication to the daily functioning of your brain.
God, what a rambler. My apologies.
West
Posted by Quintal on September 1, 2008, at 17:17:25
In reply to Re: Ixel (milnacipran), posted by West on September 1, 2008, at 15:21:13
Hi West,
I found the same thing with zolpidem - it put me to sleep very quickly when it worked. Walking around on zolpidem was quite interesting but not very pleasent like with zopiclone. I like to take half a tablet before my supper for two reasons, first because if I eat anything fatty it takes so long to get into my bloodstream that I feel no benefit, and second because I like to unwind at the end of the day with that nice warm, floaty 'beery' feeling. Zolpidem was almost wearing off by the time I'd actually got into bed, and if I tried to take only while in bed I found myself putting it off until the sun came up. That completely threw my sleep patterns out of whack.
My consultant prescribes the sleeping tablets in order to spare my GP's feelings. He has no hangups about benzos and isn't too bothered if I abuse them, so long as it's nothing genuinely serious. He's a good guy. I suggested alternating zolpidem with zopiclone and he thought it was a good idea, but that didn't work out in practice. I saw a schedule that (I think Heather Ashton) had made, alternating various sedatives on different days of the week. I have wondered about trying zopiclone and zolpidem on random days rather than a month on month off kind of thing, but I haven't run that by him yet. I was using carisoprodol as a sedative when the zolpidem ran out, but it didn't help me sleep. For some reason it was causing palpitations and irregular heartbeat - not a relaxing sensation. I've also been vaguely worried about having a serious accident and being found to have traces of meprobamate in my bloodstream.
There was a time when I would take literally handfuls of tablets and capsules with every meal and it didn't bother me. I think we tend to become more sensitized with time and maybe a little more cynical from experience. Right from the beginning I needed the maximum dose of lorazepam (and often a lot more) to acheive a proper sedative effect. My nervous system seems to lack an off switch. Have you read about the catatonic schizophrenics that 'wake up' when they're given benzos and barbiturates? There seems to be an imbalance in the tone of the central nervous system. I think I have a touch of that. Stimulants aren't very helpful, but sometimes an (ever so slight) boost in noradrenaline has a head-clearing effect.
I was going to suggest tianeptine to you in my last post, but when I checked in the archives I saw you'd tried it already. I'm lucky in that it worked first time and has worked every time I've gone back to it. My pdoc knows I'm taking it, but he has never heard of it. Like the other stuff he doesn't seem bothered either way. He's pretty malleable. It's funny, I was thinking of asking for modafinil next. I've taken adrafinil but it wasn't helpful because I don't have any difficulty staying awake. I was just wondering if with modafinil having a bit more punch it would give me an incentive to get out of bed around eight instead of lying in until noon? Someone here said it was one of the best 'sleep aids' she'd tried because she could get into a better routine that way.
Anyway, regarding the Ixel, I don't think it's a drug for me. Like most of the other drugs I've taken, I took it because I was curious more than anything. If I were to need a noradrenergic drug I might try taking smaller doses, but I think it's best just to leave it alone. Reboxetine is the closest thing I've taken to Ixel, and that made me feel very ill and with no improvement at all. I'm waiting to hear my pdoc's verdict on Subutex, so that's what I'm hoping I'll get next. I took the buprenorphine studies in and he read them and said he'd consult with a collegue who is an addiction specialist. It's probably best not to commit to any new trials until I find out what's happening about that. I have a feeling the addiction specialist will say no, so keep me posted on the modafinil!
Q
Posted by West on September 2, 2008, at 10:50:04
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on September 1, 2008, at 17:17:25
It's interesting comparing the evening wind-down of a couple of beers with a half-tab of zopiclone or zolpidem. I have no moral qualms over either, since i believe we should all be as happy as possible, all the time, and that far from being a sunny life view it is an absolute impreative (i'm something of a david pearce convert). Among my worries would be habituation or addiction, the latter of which admittedly is less of an issue with the Zs than with the benzos despite the common binding site.I personally feel that for some (and really i mean myself here) those taking antidepressants, particularly reuptake-inhibitors, are often unwittingly disrupting their natural sleep cycles, hence adjunctive sleep meds might be a necessity as long as one is taking them. This poses a problem for both the patient suffering poor sleep and the doctor in charge of prescribing sedatives, since they cannot be given for for periods over two weeks(at least in the UK).
>It sounds like you do better on anxiolytic drugs. But i must ask one question, mainly out of curiosity rather than disapproval - are you abusing the lorazepam/sleep drugs? I just wonder about whether depression is worsened when the sedative load is increased.
I think the nervous system has a chameleon effect with its environment. Stressful situations, both immediate (as in physical, what surrounds you) and philosophical (the wider life situation) will impact on your levels of stimulation. I found living alone extremely stressful in itself and would always crave turning my brain 'off' with pills. Yeah, so i suppose what i'm saying is that the most useful agents might have as much to do with your situation as your personal biology.
>I think sleeping is underrated actually, including naps, especially for those with busy minds. Unfortunately sleep deprivation has proved useful in depression, although all of us feel better when we are well rested, so a degree of degree of relativity must be applied when assessing these things. I'm glad tianeptine is helping, i found it lacked the potency i require, though i liked it, especially for its emotion enhancing effects and occasionally weird and magical sensations. Oh and I meant 'social' when i said 'geography' - just post a message to me there and with your address. I think i have been banned from babblemail for trying to sell it before so i can't go down the normal channels.
>Have you confessed to any addictions before? Just curious as this may colour their decision, and NHS docs don't tend to forcibly encourage experimental drug treatment - bonne chance nonetheless, i would be extremely extremely interested in the results. Yes i will keep you updated over the modafinil, though i've taken it before in various guises (from the downright toxic 'modalert' to brand name provigil and australian 'modiodal') and the effects it has engendered are usually far from exciting- Slight mood brightening, minor headache, sometimes feels unpleasant if you are down on your sleep - i predict i will probably take it every other day, or as and when, depending on how rested i feel. Anyway, off for a 2-mile jaunt in the country now, all the best.
West
Posted by annabamma on September 3, 2008, at 1:14:04
In reply to Re: Ixel (milnacipran), posted by West on September 2, 2008, at 10:50:04
>Hi- just a quick question-I was looking at your comments about Ixel and modafinil-what do you mean by the "downright toxic Modalert"??? I've been taking it -Modalert- lately with uneven results. So you think the brand makes a big difference? Thanks! Annabamma
> It's interesting comparing the evening wind-down of a couple of beers with a half-tab of zopiclone or zolpidem. I have no moral qualms over either, since i believe we should all be as happy as possible, all the time, and that far from being a sunny life view it is an absolute impreative (i'm something of a david pearce convert). Among my worries would be habituation or addiction, the latter of which admittedly is less of an issue with the Zs than with the benzos despite the common binding site.
>
> I personally feel that for some (and really i mean myself here) those taking antidepressants, particularly reuptake-inhibitors, are often unwittingly disrupting their natural sleep cycles, hence adjunctive sleep meds might be a necessity as long as one is taking them. This poses a problem for both the patient suffering poor sleep and the doctor in charge of prescribing sedatives, since they cannot be given for for periods over two weeks(at least in the UK).
> >
>
> It sounds like you do better on anxiolytic drugs. But i must ask one question, mainly out of curiosity rather than disapproval - are you abusing the lorazepam/sleep drugs? I just wonder about whether depression is worsened when the sedative load is increased.
>
> I think the nervous system has a chameleon effect with its environment. Stressful situations, both immediate (as in physical, what surrounds you) and philosophical (the wider life situation) will impact on your levels of stimulation. I found living alone extremely stressful in itself and would always crave turning my brain 'off' with pills. Yeah, so i suppose what i'm saying is that the most useful agents might have as much to do with your situation as your personal biology.
> >
>
> I think sleeping is underrated actually, including naps, especially for those with busy minds. Unfortunately sleep deprivation has proved useful in depression, although all of us feel better when we are well rested, so a degree of degree of relativity must be applied when assessing these things. I'm glad tianeptine is helping, i found it lacked the potency i require, though i liked it, especially for its emotion enhancing effects and occasionally weird and magical sensations. Oh and I meant 'social' when i said 'geography' - just post a message to me there and with your address. I think i have been banned from babblemail for trying to sell it before so i can't go down the normal channels.
> >
>
> Have you confessed to any addictions before? Just curious as this may colour their decision, and NHS docs don't tend to forcibly encourage experimental drug treatment - bonne chance nonetheless, i would be extremely extremely interested in the results. Yes i will keep you updated over the modafinil, though i've taken it before in various guises (from the downright toxic 'modalert' to brand name provigil and australian 'modiodal') and the effects it has engendered are usually far from exciting- Slight mood brightening, minor headache, sometimes feels unpleasant if you are down on your sleep - i predict i will probably take it every other day, or as and when, depending on how rested i feel. Anyway, off for a 2-mile jaunt in the country now, all the best.
>
> West
>
>
Posted by West on September 3, 2008, at 4:32:44
In reply to Re: Ixel (milnacipran), posted by annabamma on September 3, 2008, at 1:14:04
Don't worry, i don't think it's actually toxic in case you were wondering. It was meant as an indicator of the subjectively rough feel modalert gives in comparison to brand name provigil, which is smoother than a snooker ball. Something to do with particle size.
http://www.imminst.org/forum/index.php?act=Print&client=printer&f=169&t=10522
West
> >Hi- just a quick question-I was looking at your comments about Ixel and modafinil-what do you mean by the "downright toxic Modalert"??? I've been taking it -Modalert- lately with uneven results. So you think the brand makes a big difference? Thanks! Annabamma
>
> > It's interesting comparing the evening wind-down of a couple of beers with a half-tab of zopiclone or zolpidem. I have no moral qualms over either, since i believe we should all be as happy as possible, all the time, and that far from being a sunny life view it is an absolute impreative (i'm something of a david pearce convert). Among my worries would be habituation or addiction, the latter of which admittedly is less of an issue with the Zs than with the benzos despite the common binding site.
> >
> > I personally feel that for some (and really i mean myself here) those taking antidepressants, particularly reuptake-inhibitors, are often unwittingly disrupting their natural sleep cycles, hence adjunctive sleep meds might be a necessity as long as one is taking them. This poses a problem for both the patient suffering poor sleep and the doctor in charge of prescribing sedatives, since they cannot be given for for periods over two weeks(at least in the UK).
> > >
> >
> > It sounds like you do better on anxiolytic drugs. But i must ask one question, mainly out of curiosity rather than disapproval - are you abusing the lorazepam/sleep drugs? I just wonder about whether depression is worsened when the sedative load is increased.
> >
> > I think the nervous system has a chameleon effect with its environment. Stressful situations, both immediate (as in physical, what surrounds you) and philosophical (the wider life situation) will impact on your levels of stimulation. I found living alone extremely stressful in itself and would always crave turning my brain 'off' with pills. Yeah, so i suppose what i'm saying is that the most useful agents might have as much to do with your situation as your personal biology.
> > >
> >
> > I think sleeping is underrated actually, including naps, especially for those with busy minds. Unfortunately sleep deprivation has proved useful in depression, although all of us feel better when we are well rested, so a degree of degree of relativity must be applied when assessing these things. I'm glad tianeptine is helping, i found it lacked the potency i require, though i liked it, especially for its emotion enhancing effects and occasionally weird and magical sensations. Oh and I meant 'social' when i said 'geography' - just post a message to me there and with your address. I think i have been banned from babblemail for trying to sell it before so i can't go down the normal channels.
> > >
> >
> > Have you confessed to any addictions before? Just curious as this may colour their decision, and NHS docs don't tend to forcibly encourage experimental drug treatment - bonne chance nonetheless, i would be extremely extremely interested in the results. Yes i will keep you updated over the modafinil, though i've taken it before in various guises (from the downright toxic 'modalert' to brand name provigil and australian 'modiodal') and the effects it has engendered are usually far from exciting- Slight mood brightening, minor headache, sometimes feels unpleasant if you are down on your sleep - i predict i will probably take it every other day, or as and when, depending on how rested i feel. Anyway, off for a 2-mile jaunt in the country now, all the best.
> >
> > West
> >
> >
>
>
Posted by annabamma on September 3, 2008, at 19:28:23
In reply to Re: Ixel (milnacipran), posted by West on September 3, 2008, at 4:32:44
Yes,I didn't think you meant DEADLY toxic-just 'junky-chemical-toxic'-I've been taking modafinil from India-Modapro, and I'm still indecisive whether I'll reorder or not.Brand Provigil is not covered by my "health"insurance. Annabamma
Posted by elanor roosevelt on September 6, 2008, at 10:16:31
In reply to Re: Ixel (milnacipran), posted by West on August 29, 2008, at 18:58:00
I found some ixel stashed away and had to google myself to find my old posting
I took ixel for a while but it made me irritable,unsociable and it made my mouth uncomforable
Posted by Quintal on September 6, 2008, at 19:34:28
In reply to Re: Ixel (milnacipran), posted by West on September 2, 2008, at 10:50:04
>I personally feel that for some (and really i mean myself here) those taking antidepressants, particularly reuptake-inhibitors, are often unwittingly disrupting their natural sleep cycles, hence adjunctive sleep meds might be a necessity as long as one is taking them. This poses a problem for both the patient suffering poor sleep and the doctor in charge of prescribing sedatives, since they cannot be given for for periods over two weeks(at least in the UK).
Yes, they won't give them out to just anyone who complains of insomnia. There is the rule about 2-4 weeks with hypnotics, but my pdoc doesn't see a big problem with long term use so long as it's working. I have had doctors with almost fanatical views about sleeping tablets and other benzos, so it's good to have one like that, as you can imagine.
>Have you confessed to any addictions before? Just curious as this may colour their decision, and NHS docs don't tend to forcibly encourage experimental drug treatment - bonne chance nonetheless, i would be extremely extremely interested in the results. Yes i will keep you updated over the modafinil, though i've taken it before in various guises (from the downright toxic 'modalert' to brand name provigil and australian 'modiodal') and the effects it has engendered are usually far from exciting- Slight mood brightening, minor headache, sometimes feels unpleasant if you are down on your sleep - i predict i will probably take it every other day, or as and when, depending on how rested i feel. Anyway, off for a 2-mile jaunt in the country now, all the best.
I was addicted to benzos for about four years. I started buying them from online pharmacies after my pdoc cut off my supply abruptly, and they know about that. Still, this one doesn't have a problem with giving benzos in reasonable amounts. He gave me 5 lorazepam last week for a short-term anxiety provoking situation. I managed to resist so far.
How is the modafinil going? I'll find out on Thursday about the Suboxone.
Q
Posted by West on September 7, 2008, at 9:09:41
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on September 6, 2008, at 19:34:28
Hey! Modafinil is genuinely great. It has worked amazingly today and in synergy with cymbalta, it definitely has mood brightening effects and is really subtle (and balanced) compared to the other ones i have tried. It seems to be memory improving and improve verbal ability too which was unexpected + also has acted like a stimulant in making me more productive and raised energy and anticipation (i think there is some dopaminergic component), also good with coffee!
Could be just that it works well to offset the the dips cymb. sometimes gives, but i don't think it would be overstimulating in someone taking nothing else or an anxiolytic AD like Tianeptine.
Cymbalta is working well. I am slowly working to counter the side effects: soon i will be a finely tuned psychopharmacologically-enhanced superhuman! My final course of action will be to ask about taking a low dose of trazodone to remedy the prevailing insomnia (the only thing currently jeopardising the treatment.) I wonder if you've heard of it? It's virtue seems to be that it has none of habit forming risks that put the GPs off the hypnotics. Faintly got the idea that it might offer more restful sleep too (though that will vary) from looking it up on the net. Looking up drugs on the net must have taken up a good deal of my waking life over the past 6 months and is something i intend to cut down on soon! Can't be healthy.
West
Posted by Quintal on September 7, 2008, at 10:04:01
In reply to Re: Ixel (milnacipran), posted by West on September 7, 2008, at 9:09:41
Good to hear. Modafinil might be one of the things I'll ask for if I don't get buprenorphine. The other thing I was thinking of trying was Nardil. I've never wanted to take it because of the severe side effects, but I suppose I'm just curious.
I took trazodone as an antidepressant (300mg) years ago and it made me very drowsy. I tried it at 50mg as a sleep aid, but it causes nasal congestion and a feeling of suffocation, so I got no sleep from it. Had the same proble with Seroquel. I know someone who takes it to counteract the insomnia from amisulpride though and he likes it. Mirtazapine is another option but tends to cause daytime drowsiness even when taken at night.
Q
Posted by bulldog2 on September 7, 2008, at 15:15:34
In reply to Re: Ixel (milnacipran) » West, posted by Quintal on September 7, 2008, at 10:04:01
> Good to hear. Modafinil might be one of the things I'll ask for if I don't get buprenorphine. The other thing I was thinking of trying was Nardil. I've never wanted to take it because of the severe side effects, but I suppose I'm just curious.
>
> I took trazodone as an antidepressant (300mg) years ago and it made me very drowsy. I tried it at 50mg as a sleep aid, but it causes nasal congestion and a feeling of suffocation, so I got no sleep from it. Had the same proble with Seroquel. I know someone who takes it to counteract the insomnia from amisulpride though and he likes it. Mirtazapine is another option but tends to cause daytime drowsiness even when taken at night.
>
> QPersonally like elavil in small doses such as 10 to 20 milligrams. Helps with sleep and perks me up the next day. I know its a tca but in low doses really no sides for me. Might be a good adjunct to another ad.
Posted by maverick76 on September 7, 2008, at 21:04:16
In reply to Re: Ixel (milnacipran), posted by bulldog2 on September 7, 2008, at 15:15:34
So what is the bottom line on Ixel? I have depression, anxiety, and fibromyalgia. My sleep is terrible. SSRI's make me drowsy and unmotivated, and I have erectile dysfunction from it. The SNRI's are a little better. I have a little more energy, but it dries me out. I have dry eyes and mouth to begin with. I heard that it will get FDA approval in October. Does anyone know if that is correct. I would greatly appreciate any responses. Thank you.
Posted by maverick76 on September 18, 2008, at 22:51:06
In reply to Re: Ixel (milnacipran), posted by bleauberry on August 24, 2008, at 19:19:16
> I am quite med sensitive and found my best dose was customized at 6mg 3 times per day.
>
> There were for me some startup anxiety or sleep issues the first 1 to 3 days, but after that things changed fast. The startup side effects were nowhere near as intense as other ADs. The antidepressant effect was actually noticable already by day 2. By week 2 depression was getting better and previously rampant anxiety was almost nonexistent.
>
> I think it worked so fast because of the initial boost in NE and 5ht. After that, I believe further improvements are slow and gradual over weeks and months. On a 1 to 10 scale, I think I improved about 2 or 3 points in just a few days. After that I was improving about 1/10th of a point each day. In contrast with every other med out there that get me feeling worse over time. Milnacipran was creeping along in the correct direction.
>
> Overall I rate Milnacipran a topline AD. In Japan it is characterized in a couple pubmed abstracts as remarkable. For it to help me, a failure of countless meds and ECT, says a lot. Endure the startup if any, and give it a go. If for any reason it is too rough, get some empty gel caps and make your own dose sizes like I did.
>
> Currently not on it, but when I feel I really need something, it is the one. Getting through the first few days is not very hard for me, which says a lot. Just start low if apprehensive.
>
> The lingering side effects for me were decreased appetite, urinary difficulty, and a slight headache if too much time elapsed between doses. I found that the med Flomax (Tamsulosin) blocks the urinary side effects. Tried it and it indeed worked.
>
>
> > I was curious because noradrenergic drugs seem to help (in moderation), but reboxetine is too strong and Wellbutrin is too long acting and disturbs my sleep. Milnacipran looks as though it might fit the bill due to its shorter half life (8 hours), and the evidence showing that it can improve sleep quality and duration. I'm a bit nervous of taking my first dose in case it makes my anxiety worse. Any advice from people who've taken it?
> >
bleauberry - where do you get your milnacipran? What do you think the chances are that the FDA will approve of this medication by 10/08? Or, do you think they'll ask for additional studies and time to followup? I'm dying to try this stuff, but I probably will be disappointed (if I ever get the chance).
Posted by Phillipa on September 21, 2008, at 18:48:26
In reply to Re: Ixel (milnacipran), posted by maverick76 on September 7, 2008, at 21:04:16
Welcome to babble. How someone comes back and answers you question. Unfortunately I'm not familiar with the med. Phillipa
This is the end of the thread.
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