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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by bearfan on August 28, 2009, at 17:26:22
Started the Savella (new SNRI) for depression/anxiety and even at low dose feeling innertension/restless and a bit restless. I even took a .25 xanax and did not make much a difference. The feeling reminds me of Pristiq. Is this the norepinephrine effect and does Savella (milnacipran) have an anti-anxiety effect at higher doses or more of the same?
Posted by Dr. Zoidberg on August 29, 2009, at 6:36:26
In reply to Started Savella Titration Pack and feeling jittery, posted by bearfan on August 28, 2009, at 17:26:22
hi, the same thig for me, just copied my message from another thread:
just started milnacipran (Ixel, 25 mg x 2) and here is the thing: I'm feeling a very strong 'NE rush' - a lot of physical anxiety symptoms, goose bumps, sweating, but on the other hand it definitely helps with my social anxiety and it could be felt right away just after the first pill.
The strangest thing: one of my anxiety-related problems is axillar-palmar hyperhidrosis and, under milnacipran, it is better - I sweat A LOT, but only from my trunk, NOT from my usual anxiety zones, it feels like a strong thermal sweating in a hot day.
So for anxiety - a feel strong 'physical anxiety', but my social anxiety almost vanished, it feels very strange and paradoxical and really hard to explain!
Posted by SLS on August 29, 2009, at 6:49:21
In reply to Re: Started Savella Titration Pack and feeling jittery, posted by Dr. Zoidberg on August 29, 2009, at 6:36:26
Just so that you don't become disppointed, if you should lose the beneficial effects of milnacipran within the next few days, it doesn't mean that the drug has stopped working. On the contrary, it is just beginning to do its work. (Actually, it is the brain that is doing all the work). Sometimes, a drug will effect a positive "blip" improvement within the first few days. Then the improvement disappears and shows up again after a few weeks. I don't know that this is the scenario that you will experience, but just in case, don't stop taking the drug until you have been on it for 3-4 weeks. Of course, you can abort the trial early if you find the drug otherwise intolerable.
- Scott
Posted by bearfan on August 29, 2009, at 14:52:06
In reply to Re: Started Savella Titration Pack and feeling jittery, posted by Dr. Zoidberg on August 29, 2009, at 6:36:26
The sweating and increased anxiety is very annoying and quite uncomfortable. I also have been noticing more 'comfort' eating so I can relax. Seems hard to imagine that this will get much better.
Posted by Sigismund on August 29, 2009, at 18:08:22
In reply to Re: Started Savella Titration Pack and feeling jittery, posted by bearfan on August 29, 2009, at 14:52:06
On a half dose of Ixel I liked the relaxing feeling (SRI?) and disliked the ants under the skin type feeling (NRI?).
I'd lower the dose for a bit and see how it goes.
Posted by bearfan on August 29, 2009, at 18:19:09
In reply to Re: Started Savella Titration Pack and feeling jittery, posted by Sigismund on August 29, 2009, at 18:08:22
Does anyone know if the SSRI effect increases with an increase of Doseage or makes the NRI effect even stronger? I cut that needles under the skin feeling as well and it's pretty uncomfortable to even ride out.
Posted by Sigismund on August 29, 2009, at 21:01:08
In reply to Re: Started Savella Titration Pack and feeling jittery, posted by bearfan on August 29, 2009, at 18:19:09
>Does anyone know if the SSRI effect increases with an increase of Doseage or makes the NRI effect even stronger
Is that what ki(?) values tell us?
I don't know the answer as to which is more prominent at differing doses. I could never take much of it.
The thing that was positive was the nice calm feeling.
Posted by bleauberry on August 31, 2009, at 21:12:12
In reply to Started Savella Titration Pack and feeling jittery, posted by bearfan on August 28, 2009, at 17:26:22
My opinion only, but I feel the suggested doses are too high. I would start with 1/4 of the 12mg tabs 3 time per day until they are gone. Then 1/2s of the next size up. While almost all of the clinical studies went right for 100mg doses, I can show you other smaller studies that used only 25mg and got the same good results.
Actually the jittery thing I believe is common. Happened to me too. The norepinephrine effect actually gave me goosebumps and raised the hairs up off my arm. Felt good though. Much better than the blue dumps. In a way it almost has kind of a Ritalin feel to it.
But that is short lived. For me things calmed down by about day 3 and then a rather pronounced anti anxiety pro social thing kicked in. It felt like some feedback loops had kicked in by that point. A couple weeks later anhedonia was a lot less and I wasn't very blue anymore. Just couldn't pee.
This is the end of the thread.
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