Here is my report about my first trial of Milnacipran.
I took 25 mg and waited 2 hours before O. I have 50mg gel caps so I just opened one and took approximately half the powder. I think this is okay since it's not a time release capsule. I'm glad I didn't take all 50 mg because I did experience some nausea that peaked about an hour after ingestion and quickly dissipated. Not pleasant but not terrible either. My O was through masturbation to an erotic non-nude video.
My normal masturbation involves my body temperature dropping significantly and shivering when viewing highly stimulating erotic material. I don't know if anyone else with POIS experiences this. I get so cold feeling that even under my blankets I will experience shivering, shaking, and teeth chattering. I'm not sure what causes this but it may be due to viewing erotic material and perhaps linked to my POIS, but I'm not sure. Then, right after O, I normally experience a great increase in body temperature. So much so that I am usually sweating and have a difficult time falling asleep because I'm so hot.
With Milnacipran I still felt very cold and shaky before O but unusually I didn't get hot afterwards. I just kind of slowly returned to normal body temperature. This made falling asleep after O very easy.
I did experience a bit of ED at the beginning which is unusual for me normally but not unusual when I take serotonin enhancing substances before O such as Niacin, Niacinamide, 5-HTP, or Tryptophan. So I suspect the extra serotonin from Milnacipran made it a little harder (heh) to obtain an erection.
The mechanics of my orgasm seemed significantly different. As others have mentioned the intensity of the orgasm was higher. I expected that to mean more pleasurable feelings but in my case it just meant much stronger contractions of the muscles involved in ejaculation. It wasn't painful really but it was uncomfortable a little. Usually after I ejaculate my penis loses erection sort of slowly and semen continues to leak out a little for some time after. With Milnacipran I lost my erection almost immediately after the intense ejaculation and to my surprise there was little to no semen leakage afterwards. The muscles in my pelvic floor felt a bit sore afterwards from such contractions.
I slept normally for around 8 hours with my regular highly vivid and unusual dreams. When I woke I felt fine. That's not that unusual since onset of the worst of POIS for me usually takes about 12 hours or so. The test is always after I eat breakfast since that seems to bring out POIS symptoms in me. This time I did feel some anxiety begin after I finished eating a meal of eggs and potatoes. I chalked it up to perhaps the histamine releasing properties of the egg whites. I took some Vitamin C to try and counteract this.
The rest of the day I maintained that low level of anxiety and brain fog which peaked after lunch. I didn't get a ton of brain fog but I definitely did have a little. My normal post orgasm depression was there but not as pronounced, and my irritability seemed much lower than normal. I took some Ashwanganda to try to improve my anxiety and mood and that seemed to work a little. My normal POIS aches and pains seemed almost completely absent. Later I took some curcumin to combat any inflammation that may have been happening. After the curcumin and a quick trip to the tanning salon for some Vitamin D at 5:30pm I felt POIS was almost completely over. I had a surge in energy and went for a long bike ride and a short body weight workout.
Overall I'd rate Milnacipran an 8/10. Very few side effects and very effective. I will use at as my go to treatment from now on. Next time I might try combining it with one, or more, of my other treatments such as anti-histamines, anti-inflammatories, or GABA enhancing substances.
Thanks to hurray for bringing it to our attention!