Posted by SLS on April 19, 2010, at 17:44:19
In reply to Re: Savella at 200mg. » SLS, posted by bleauberry on April 19, 2010, at 17:28:26
Hi BB.
Yes, it is difficult to know what to do. I am leaning against the idea that there is a narrow therapeutic window for Savella that occurs at very low dosages. It just doesn't seem like the right thing to gamble on and commit 12 weeks to. I remain open-minded, though. I am still taking nortriptyline at a dosage of 150mg.
There is an interesting article on Medscape comparing milnacipran at dosages of 100mg and 150mg.
- Scott
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http://www.medscape.com/viewarticle/528303
Remission Rates With Milnacipran 100 mg/day and 150 mg/day in the Long-Term Treatment of Major DepressionKazuo Okumura; Toshiaki A. Furukawa
Background:
The aim of this study was to determine remission rates during treatment with two different dosages of milnacipran, and the effect of milnacipran therapy for at least 1 year on the maintenance of remission and tolerability, in outpatients with major depression.Methods:
The study included 41 outpatients with major depression who initially received milnacipran 50 mg/day for 12 weeks, followed by a dosage increase to 100 mg/day for 12 weeks. Patients who achieved remission (17-item Hamilton Depression Rating Scale [HDRS] scores =7) after 12 weeks of milnacipran 100 mg/day treatment continued at the same dosage and were followed for at least 1 year. For patients who had decreased HDRS scores, but failed to attain remission, the dosage of milnacipran was increased to 150 mg/day, and those who achieved remission were then followed for at least 1 year.Results:
Eight out of 41 patients were withdrawn from the study prematurely because of adverse events (eight events in six patients: nausea, thirst, urinary discomfort, rapid pulse, palpitations, staggering sensation or sweating) or as a result of the patient's decision (two patients). Thirteen (31.7%) of 41 patients achieved remission during treatment with milnacipran 100 mg/day. Of the remaining 20 patients, 17 underwent a dosage increase to 150 mg/day, and 13 achieved remission at a second assessment (cumulative remission rate: 63.4%). No adverse events or recurrence of symptoms were found in any of the patients who achieved remission during the subsequent follow-up period of a minimum of 1 year.Conclusions:
The results of this study showed milnacipran 150 mg/day and 100 mg/day to be effective and well tolerated in the long-term treatment of outpatients with major depression, and indicated that a dosage of 150 mg/day is an effective therapeutic option for depression when a dosage of 100 mg/day does not provide a satisfactory response.
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The measure of achievement lies not in how high the mountain,
but in how hard the climb.The measure of success lies only in how high one feels he must
climb to get there.
poster:SLS
thread:943974
URL: http://www.dr-bob.org/babble/20100416/msgs/944086.html