Anyone tried Savella?

Hi all–I’m curious whether anyone has tried Savella, which I see is an SNRI that is FDA-approved for treating fibromyalgia.

Since it’s an SNRI, I wonder how it would work for VM.

And I wonder how it compares to Effexor with respect to level of action on serotonin versus norepinephrine.

I am looking for an alternative to Strattera, a (very expensive) norepinephrine reuptake inhibitor–it’s actually for ADD. I have been taking it for many years, not for ADD but in order to be able to concentrate through my constant “motion-sick-in-the-head” feeling, whose cause is officially undiagnosed but which I attribute to VM after many years of everything else being ruled out.

I probably have fibromyalgia too, though this has only been mentioned in passing by a couple of docs and without any real interest.

(It’s weird, some of them jump ALL OVER ME as to why I’m taking so much ibuprofen and why I’m taking Strattera, yet they are unconcerned to actually give me a diagnosis of anything!!)

After months of delay (long story), I’m hoping next week to FINALLY get my PCP to prescribe me an alternative to Strattera. Given Hain’s idea that people with lots of white spots in their brain should be treated aggressively, perhaps I should have a combination serotonin and norepinephrine reuptake inhibitor to see if I can lessen my migraine activity. (Which is never bad, but nor do I ever feel normal, and I know I’m still having mild migraines at times.)

I don’t know whether to ask him to try Effexor or Savella or what. I think he himself will not know any more than I do about it, as he’d never even heard of the connection between dizziness and migraine until I alerted him to it. (Not a good sign, because he is still a resident–they clearly aren’t teaching them this in med school yet!)

I’m very apprehensive about starting down a new medication path after so many years of relatively good “thinking” ability with Strattera, but I really have to give it a try.

I ONLY WISH I HAD A REAL GUIDE, a doctor who actually understands some of this stuff and could give me good advice instead of it being entirely up to me to do the “research” and make my case to the doctor–when I have no medical or scientific training and am just making stabs in the dark.

Nancy

Well, I think I answered at least one of my own questions by … duh … doing a little Googling.

"It is similar to duloxetine in that both drugs increase the supply of serotonin and norepinephrine (chemical messengers, also known as neurotransmitters) available to your brain. The difference is that** milnacipran gives your brain a larger boost in norepinephrine**. Neuroscientists refer to this property of milnacipran as “norepinephrine selectivity.”

“Savella, however, is the first drug reported to increase norepinephrine more than serotonin.”

“Milnacipran exerts higher selectivity for norepinephrine reuptake than venlafaxine (Effexor, Wyeth) or duloxetine.”

OK, I think I am going to ask for Savella…

i am actually on it for fibro but i am still on a tiny dose and it has only been a couple weeks, so cant report anything yet.

Hey Sarah, thanks for letting me know! I wish you good luck with it, and let’s for sure trade experiences! (If I can get the doc to prescribe it for me; in any case, I will be very interested to hear how it is working for you.)

Which causes you more trouble, the fibro or the VM? I guess your doc is prescribing it specifically for fibro, right?

What dose did you start at, and what is your next step-up and when? Just curious. Here is what the Savella site tells doctors about dosing:

Administer Savella in two divided doses per day.
• Based on efficacy and tolerability, dosing may be titrated according to the
following schedule:
Day 1: 12.5 mg once
Days 2-3: 25 mg/day (12.5 mg twice daily)
Days 4-7: 50 mg/day (25 mg twice daily)
After Day 7: 100 mg/day (50 mg twice daily)
• Recommended dose is 100 mg/day.
• May be increased to 200 mg/day based on individual patient response

Best of luck,
Nancy