Posted by vic80 on June 30, 2010, at 15:09:34
Hi, on 7th week Milnacipran - upped to 50 mg - in 25mg twice daily doses, 6 days ago.
The Pdoc told me that for my 'high BMI' , I need to up my 25mg Milnacipran to 50mg, mainly because I was not feeling any good.
I have anyways been suffering from hypersomnia and excessive daytime sleepiness since past 15 days on the single 25mg dose.
The effect of 50mg on me was what initially felt like a sense of calmness - no obsessive thinking, no feelings of going down the dark hole, lessening of suicidal thoughts to almost zero and being able to watch TV without feeling all over the place etc.
The first 2 days of the high dosage did make me feel more active and energetic than I have been in days and the hypersomnia turned into shallow sleep and insomnia.
in another day I started to feel more 'calm' - which meant I am not talking to people around me... I am just sitting around and watching TV, surfing the internet, reading newspapers etc, BUT WITHOUT FEELING much.
Now past 2 days along with severe sleepiness through the day - including unmanagable sleep urges - I have been feeling NUMB, Zombiefied.
I just go through the happenings of the day without reacting or feeling anything.
Severely fatigued, NO MENTAL energy and a general feeling of being totally mentally-locked up. Unable to enjoy anything and over all not giving a damn, (not giving a damn to the extent that at the Pdoc's yesterday, i didnt even bother to discuss the side-effects without her insistence.)the pdoc adviced me to take the whole 50mg before bed. She did not have much expaination to my problem except for contending that its just heightened depression or a small phase of it.
I was refused addition of modafinil to deal with daytime sleepiness as 'its duration has not been long enough to call it a disorder' yet.
Today having skipped the day dose to facilitate the 50mg night one, I felt the mental-numbness to alleviate, but it was replaced with anxiety, disorientation, dizziness, and almost a panic attack.The numbness is such that it makes me feel unable to even think clearly - it just makes me be in the zombie zone.
Club this with frequent flu like symptoms and dyspnea and tachycardia, I am wondering if my drug is failing.
I have read a few people advising low dose use of MIL - at around 20-25mg a day - which I tried and felt it just made me feel worse.
This being my first ever SNRI, previously I was on lexapro the darling fav of pdocs as a first line anti-depressant, which just never worked and cuased severe fatigue, derealization and dissociation among a bevy of other things like emotional flatness and apathy.
The way mil is working on me, its almost reminding me of lexapro. The apathy and brain-deadness is exactly how I felt on 20mg lexapro.
My question is - how can a noradrenergic reuptake inhibitor cause one to feel brain-numbed and unreactive and tired and sleepy. Milnacipran is supposed to be the most potent of all SNRIs with a 3:1 RI ratio of 5HT vs NE - which apparently makes it technically equal RI for both neurotransmitters.
In the past - which is just till 10 days ago - i used to feel these rushes of good mood, motivation, inspiration etc along with zero fatigue and good mental clarity. Though the daytime used to be full of dysphoria, desperation and depressive bouts.
I would say that the emotionality it brought to my life helped me actually sift through the happenings of my life and helped me to understand myself better. BUT THATS GONE NOW. I cannot feel a thing listening to music, talking to people or the activities which were bringing me certain amount of stimulation.I had read someone comment about the upstreams and the downstream regulation/deregulation of neurotransmitters.....
Could there also be some relation of the mental-deadness to the excessive sleepiness.... perhaps its causing me have lesser consciousness....
poster:vic80
thread:952708
URL: http://www.dr-bob.org/babble/20100628/msgs/952708.html