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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by bleauberry on August 5, 2008, at 18:59:23
Milnacipran. Wonderful AD. For someone with a frustrating 13 years of FDA med cocktails, and failed ECT on top of it, Milnacipran works.
Problems that keep me from taking it:
1. Severe unrinary retention. Almost went to the emergency room for a catheter.
2. Flare-up of dormant previously cured DeGuerveins Tinnitus (the thumb tendon running up the side of the wrist). It goes away when Milnacipran is withdrawn and comes back when restarted. Several trials to confirm. Accompanying this is cold fingers, indicating to me some constriction of blood vessels.The above side effects kick in within hours of the first dose. No delayed effect. I thus can't help pointing the guilty finger at NE, which was immediately boosted as soon as the med was absorbed.
My theory: A noradrenergic deficit over several years has left my entire biochemistry oversensitive to NE, especially boosted NE from a medicine. My brain loves it, but not my body.
To block the urinary retention of Milnacipran a psychopharmacology book recommends Flomax as a prophalactic against it. Someone else here a couple months ago said Flomax worked for the same problem on Desipramine.
But the squeezing of muscles and tendons? What NE blockers would work for that? I need an alpha or beta blocker, not sure which, or one that does both maybe, that works systemically but spares the nervous system. ??? I have Flomax onhand but haven't tried it yet, and am slightly curious if it might even work on the tendonitis thing.
Any advice on this topic is much appreciated. Alpha blockers are not something I know much about, other than Propranolol for stage fright, and Clonidine often causes depression. That's about all I know.
Posted by Bob on August 5, 2008, at 20:57:23
In reply to Alpha Blockers for AD Side Effects?, posted by bleauberry on August 5, 2008, at 18:59:23
> Milnacipran. Wonderful AD. For someone with a frustrating 13 years of FDA med cocktails, and failed ECT on top of it, Milnacipran works.
>
> Problems that keep me from taking it:
> 1. Severe unrinary retention. Almost went to the emergency room for a catheter.
> 2. Flare-up of dormant previously cured DeGuerveins Tinnitus (the thumb tendon running up the side of the wrist). It goes away when Milnacipran is withdrawn and comes back when restarted. Several trials to confirm. Accompanying this is cold fingers, indicating to me some constriction of blood vessels.
>
> The above side effects kick in within hours of the first dose. No delayed effect. I thus can't help pointing the guilty finger at NE, which was immediately boosted as soon as the med was absorbed.
>
> My theory: A noradrenergic deficit over several years has left my entire biochemistry oversensitive to NE, especially boosted NE from a medicine. My brain loves it, but not my body.
>
> To block the urinary retention of Milnacipran a psychopharmacology book recommends Flomax as a prophalactic against it. Someone else here a couple months ago said Flomax worked for the same problem on Desipramine.
>
> But the squeezing of muscles and tendons? What NE blockers would work for that? I need an alpha or beta blocker, not sure which, or one that does both maybe, that works systemically but spares the nervous system. ??? I have Flomax onhand but haven't tried it yet, and am slightly curious if it might even work on the tendonitis thing.
>
> Any advice on this topic is much appreciated. Alpha blockers are not something I know much about, other than Propranolol for stage fright, and Clonidine often causes depression. That's about all I know.
>
>Bleauberry, your experience parallels mine quite remarkably in some ways. I too have struggled with med trials for about 15 years and had a nasty course of ECT about 3 years ago. I now have problems with activating drugs causing me joint pains and aches, especially in my hands. I don't really have any answers, but was struck by the similarity.
BTW, do you think that urinary hesitancy would lessen over time?
Posted by Bob on August 5, 2008, at 20:57:30
In reply to Alpha Blockers for AD Side Effects?, posted by bleauberry on August 5, 2008, at 18:59:23
> Milnacipran. Wonderful AD. For someone with a frustrating 13 years of FDA med cocktails, and failed ECT on top of it, Milnacipran works.
>
> Problems that keep me from taking it:
> 1. Severe unrinary retention. Almost went to the emergency room for a catheter.
> 2. Flare-up of dormant previously cured DeGuerveins Tinnitus (the thumb tendon running up the side of the wrist). It goes away when Milnacipran is withdrawn and comes back when restarted. Several trials to confirm. Accompanying this is cold fingers, indicating to me some constriction of blood vessels.
>
> The above side effects kick in within hours of the first dose. No delayed effect. I thus can't help pointing the guilty finger at NE, which was immediately boosted as soon as the med was absorbed.
>
> My theory: A noradrenergic deficit over several years has left my entire biochemistry oversensitive to NE, especially boosted NE from a medicine. My brain loves it, but not my body.
>
> To block the urinary retention of Milnacipran a psychopharmacology book recommends Flomax as a prophalactic against it. Someone else here a couple months ago said Flomax worked for the same problem on Desipramine.
>
> But the squeezing of muscles and tendons? What NE blockers would work for that? I need an alpha or beta blocker, not sure which, or one that does both maybe, that works systemically but spares the nervous system. ??? I have Flomax onhand but haven't tried it yet, and am slightly curious if it might even work on the tendonitis thing.
>
> Any advice on this topic is much appreciated. Alpha blockers are not something I know much about, other than Propranolol for stage fright, and Clonidine often causes depression. That's about all I know.
>
>Bleauberry, your experience parallels mine quite remarkably in some ways. I too have struggled with med trials for about 15 years and had a nasty course of ECT about 3 years ago. I now have problems with activating drugs causing me joint pains and aches, especially in my hands. I don't really have any answers, but was struck by the similarity.
BTW, do you think that urinary hesitancy would lessen over time?
Posted by Marty on August 5, 2008, at 21:24:35
In reply to Re: Alpha Blockers for AD Side Effects? » bleauberry, posted by Bob on August 5, 2008, at 20:57:30
Hi Bleauberry,Before trying those kind of meds I would try other things first. For your Severe unrinary retention you should check for Bethanechol first.
http://en.wikipedia.org/wiki/Bethanechol
Bethanechol doesn't enter the CNS and cannot induce depression (just in case someone rings the 'cholinergic = depression' bell).
For your thumb/wrist I'm less sure ... if you think it's vasoconstriction related you could try some agents known to dilate vessels; supplements or meds. Or try to treat the inflamation ? I guess you already tried that eh? I'll think about it and if I have any descent idea I'll post you. I find it strange that something that's increasing NE actually cause you some pain as it usually decrease the pain threashold.In any way I wouldn't touch the blockers with a 15 foot poles if I were you.. especially if you didn't try everything else before.
/\/\arty
Posted by tensor on August 6, 2008, at 15:33:32
In reply to Alpha Blockers for AD Side Effects?, posted by bleauberry on August 5, 2008, at 18:59:23
Been there, you get the same symptoms from reboxetine/Edronax. The remedy is tamsulosin, an adrenergic alpha1 blocker. Tamsulosin is the active substance in Flomax.
Regards,
Mattias
Posted by Marty on August 6, 2008, at 16:00:05
In reply to Re: Alpha Blockers for AD Side Effects? » bleauberry, posted by tensor on August 6, 2008, at 15:33:32
Flomax = Max FLOW .. what a good name for what it does.
lol
/\/\arty
Posted by bleauberry on August 6, 2008, at 18:22:05
In reply to Re: Alpha Blockers for AD Side Effects? » bleauberry, posted by tensor on August 6, 2008, at 15:33:32
Thanks tensor. Flomax is what I have onhand. Just haven't tried it yet. I am so gunshy of meds. I make a mistake of looking at side effect listings and then hesitate.
What about you? Did you use tamsulosin? If yes, what side effects for you?
> Been there, you get the same symptoms from reboxetine/Edronax. The remedy is tamsulosin, an adrenergic alpha1 blocker. Tamsulosin is the active substance in Flomax.
>
> Regards,
> Mattias
This is the end of the thread.
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