I recently started seeing a psychiatrist and I asked him about milnacipran. He said that it could be a good option for me down the line as an adjunct to my current medication bupropion, which has helped my depression but done nothing for my POIS. So I expect to be able to trial milnacipran in a few months and add some more data here! I have had fairly good responses to various drugs in the past, namely adderall, caffeine, and nicotine, so it seems fairly plausible that the medication route is promising for me.
Hurray, I have looked through your history and think our POIS cases are almost identical, which is one reason I am so interested in trying this medication. I too have predominantly cognitive symptoms - my sole physical symptom is hives during sex/masturbation (and possibly slight muscle weakness) - and struggle with social situations during POIS. My social issues were what led to me identifying my POIS, and would probably be my most debilitating symptoms if I wasn't in a particularly intellectually demanding job.
I find it interesting that the effects of milnacipran on your POIS are acute - most antidepressants take weeks to months to take effect. Milnacipran, from my research seems to be faster-acting (on the order of one week). This is still a far cry from most drugs taken for acute effects, like adderall. Pharmacology is weird though, and we barely understand how any of these drugs work. So maybe we shoudn't overthink things
. I wonder if daily milnacipran use would nullify the effects on POIS? I still have moderate brain fog some of the time outside of POIS, so I may have to try this.
