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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by vic80 on May 24, 2010, at 9:32:31
> In a short 2 week experience on a very low dose of Savella I got from overseas, it increased the entire spectrum of anxieties (phobias, obsessional worries, fears, mountains out of molehills, etc) for about 3 days. Just as might be expected with a norepinephrine boost. From day 3 through 7 it got more tolerable. By the end of 2 weeks there was very good peace, excellent sleep, interest and motivation was on the rise, and a pronounced anti-anhedonia effect was beginning.
>
> After failing ECT, this med actually worked. Pretty good for any med to do that.
>
> Anyway, I found it excellent for anxiety except for the early days where it was made worse.
Your exp on Milnacipran has encouraged me a lot. I am now on day 10. The anxiety is quite bothersome. And yes, its taken some seriously freaky shapes- being sacred of the dark, sacred to look at non-smiling faces, fear of going crazy, unreality, nervousness, semi panic attacks. Plus Tachycardia 120-130 bpm. Fortunately bp is not too high and my ECG came out normal too. Mood seems to be better yet the initial euphoric bouts are gone.
Propranolol LA was added to curb rapid pulse and anxiety, but the first dose itself caused me to feel extreme fatigue malaise and depression. So i am back on Lorazepam 0.5 every 4 hours though its not as calming as it should be.
I wonder if Lexapro quick taper could have had an effect too - still feel the shocks on my scalp.
A high pulse rate with anxiety seems to be crashing me, no Propranolol since the bad 1st dose. Almost feeling giddy and dazed emotionally numbed or overwhelmed. Wonder if the high NE is too much for me to take.
Do you think i should stay put for a while?
Posted by bleauberry on May 24, 2010, at 16:20:35
In reply to Milnacipran - anxiety: bleauberry, posted by vic80 on May 24, 2010, at 9:32:31
The quick taper of lexapro is definitely a big player in what you are feeling. Serotonin is an inhibitory neurotransmitter. That inhibition was removed rather rapidly without time for the brain to readjust, which can take up from 4 weeks to 12 weeks to fully happen.
All that inhibition was replaced with an excitatory neurotransmitter NE. There is still some serotonin, but not as much as you were accustomed to. Dopamine is also indirectly increased in one part of the brain as a result of the NE reuptake of milnacipran.
I think it all would have gone smoothly if not rushed. The lex should have come down over a period of a couple months. Miln probably should have stayed at 12.5mg per day, divided into two 6.25mg doses, for at least a week, and then gently nudge it up over several weeks.
Rough guess. We're all different so it is hard to say. I've come off lexapro slow, and fast. So I know what both feel like. Same with zoloft. I've gone on miln and played with various doses. Rough guess as I see it is that about 70% of what you are feeling is lex withdrawal, and 30% is too much NE too fast.
I know I've said it before, but I still think if a low dose of lex and low dose of miln had been allowed more time you might have found the combo to work better than either alone. That's not uncommon with miln in other parts of the world.
I guess if you are completely set on keeping lex out of the mix, then maybe the best bet would be to lower the dose of miln and break it into smaller doses to spread out through the day. I mean, I found 6.25mg three times a day to be ideal. Could I be the only one? I don't think so.
This is the end of the thread.
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