Milnacipran - completely stopping my brain fog

[hurray]

Well, I'm not the person you were replying to, I was just browsing the forum and came across this, but I just wanted to say that I also think you should be very cautious when taking a psychiatric medication like Milnacipran. It's great that it helps you, but many things have helped people with POIS, which means they are probably just masking different symptoms and not attacking the cause, since said cause is still unknown. I suppose many medications that affect brain function and mood could make people with POIS feel better, that's what they're supposed to do in general, but they could have serious effects in the long run. Just saying you should maybe be cautious. I hope you won't be offended by this, it's your choice after all, but I personally think sex isn't that important as to take random psychiatric medications so we can have it, no matter what doctors think or say (we all know how effortlessly some of them prescribe meds, and none of them knows the slightest thing for sure about POIS yet). Best of luck to you, take care!

Thank you for your thoughtful contribution, IronFeather.

At this point, it seems likely that there are many different types of POIS, as Quantum's comprehensive thread below discusses:
https://poiscenter.com/forums/index.php?topic=2338.0

It's entirely possible that there are many different "causes" of POIS, with O being the initial trigger which links all the different causes/symptoms. So I'd say that you CAN in theory directly address the cause of 1 or more types of POIS. And most common diseases have treatments that work for some patients and not for others, you would expect the same to be true for POIS.

I'm not encouraging anyone to take risks with their health. Quantum's earlier reply to you describes the issues involved with risk very well, I can't think of anything to add to that.

Best of luck to you too 

[taurusthree]

hurray, once again, congrats on your treatment!

"There are several drugs which boost norepinephrine, so why is milnacipran any different?"

Well, I have already tried several NRIs:

atomoxetine (Strattera) - uncomfortable feeling during O, brain fog remained
buproprion - made me feel jittery, brain fog remained
ritalin - gave me energy and focus before quickly building up tolerance, did not stop the brain fog
duloxetine - felt like bad flu, could not drive or work, withdrawal symptoms, too sick to accurately gauge brain fog
venlafaxine - felt like bad flu, could not drive or work, bad withdrawal symptoms, too sick to accurately gauge brain fog

The effects of duloxetine and venlafaxine (both SNRIs) were interesting. They made me feel terrible - there was no way that I could take them every day. But my POIS felt a bit different while I was on both drugs.

I read that duloxetine and venlafaxine don't have a powerful effect on norepinephrine at low doses. There was only a substantial norepinephrine reuptake inhibition effect at high doses.

Venlafaxine has potency at serotonin transporters which is about 30-fold greater than that at norepinephrine transporters while milnacipran has a similar potency at each transporter. Thus, at low doses, venlafaxine acts essentially as a SSRI, with significant noradrenergic activity only occurring at higher doses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819762/

Trying milnacipran, I was surprised  to find that a low one-off dose was sufficient to completely stop the POIS brain fog that I have been accustomed to for so many years. I attributed this to the powerful effect that milnacipran has on norepinephrine reuptake inhibition.

Milnacipran also has multiple reports that it cured the brain fog of fibromyalgia sufferers.

I was planning to get Atomoxetine for my ADD. I'm curious - why didn't Atomoxetine help you. After all it is considered a pure NRI.

[hurray]

hurray, once again, congrats on your treatment!

"There are several drugs which boost norepinephrine, so why is milnacipran any different?"

Well, I have already tried several NRIs:

atomoxetine (Strattera) - uncomfortable feeling during O, brain fog remained
buproprion - made me feel jittery, brain fog remained
ritalin - gave me energy and focus before quickly building up tolerance, did not stop the brain fog
duloxetine - felt like bad flu, could not drive or work, withdrawal symptoms, too sick to accurately gauge brain fog
venlafaxine - felt like bad flu, could not drive or work, bad withdrawal symptoms, too sick to accurately gauge brain fog

The effects of duloxetine and venlafaxine (both SNRIs) were interesting. They made me feel terrible - there was no way that I could take them every day. But my POIS felt a bit different while I was on both drugs.

I read that duloxetine and venlafaxine don't have a powerful effect on norepinephrine at low doses. There was only a substantial norepinephrine reuptake inhibition effect at high doses.

Venlafaxine has potency at serotonin transporters which is about 30-fold greater than that at norepinephrine transporters while milnacipran has a similar potency at each transporter. Thus, at low doses, venlafaxine acts essentially as a SSRI, with significant noradrenergic activity only occurring at higher doses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819762/

Trying milnacipran, I was surprised  to find that a low one-off dose was sufficient to completely stop the POIS brain fog that I have been accustomed to for so many years. I attributed this to the powerful effect that milnacipran has on norepinephrine reuptake inhibition.

Milnacipran also has multiple reports that it cured the brain fog of fibromyalgia sufferers.

I was planning to get Atomoxetine for my ADD. I'm curious - why didn't Atomoxetine help you. After all it is considered a pure NRI.

That's a great question taurusthree. I try not to use pharmalogical jargon in my posts here, but my gut feeling is that is that milnacipran's NRI mechanism is somehow different from the other NRI/SNRI drugs that I have tried in the past.

I would not be surprised if in the future, another poiscenter.com member discovered an NRI/SNRI drug that worked for them as milnacipran works for me. I have found something that works for me, so I'm not really motivated to keep looking for new solutions. I'm not willing to deliberately ruin 3-4 days of my life to check to see if a new POIS drug candidate is effective

[demografx]

I'm not willing to deliberately ruin 3-4 days of my life to check to see if a new POIS drug candidate is effective

Hi hurray,

That’s exactly how I feel when a new, attractive possibility comes up!

[not_enot]

is milnacipran still helping you?  For all symptoms?

[hurray]

is milnacipran still helping you?  For all symptoms?

Yes, it is still as effective as ever 

[demografx]

is milnacipran still helping you?  For all symptoms?

Yes, it is still as effective as ever 

Great to hear!

[hurray]

is milnacipran still helping you?  For all symptoms?

Yes, it is still as effective as ever 

Great to hear!

Thanks Demo 

[demografx]

is milnacipran still helping you?  For all symptoms?

Yes, it is still as effective as ever 

Great to hear!

Thanks Demo 

My pleasure!

[followthrough91]

Hurray, it is wonderful that Milnacipran has had a positive effect on your P.O.I.S. symptoms. I started taking Ritalin 10 MG twice a day after having an "O". I switched away from Adderall. It helps with concentration, but extreme fatigue and discomfort remain for a day or two. Do you take Milnacipran daily? Do you suffer from fatigue, and if so, does it improve the symptoms? Thanks!

[hurray]

Hi followthrough!

I generally take milnacipran "on demand", 1.25 hours before the event, for maximum effect. POIS doesn't give me physical fatigue, but it certainly gives me mental fatigue, and milnacipran eradicates that.

[famas40]

Guys just to inform you, after using Milnacipran 50mg for 1 month, it start's working for me 🎉 🎉 🎉  So my conclusion Milnacipran need time to fixes things.

[hurray]

Guys just to inform you, after using Milnacipran 50mg for 1 month, it start's working for me ? ? ?  So my conclusion Milnacipran need time to fixes things.

That's good news, I'm glad milnacipran was able to help you. I've sometimes needed to take milnacipran several days in a row, and its effects do seem to accumulate over time.

[famas40]

Could you please explain more how you take Milnacipran for mant days ? At what time exactly, untel you feel good ?

[Egyptian ahmad]

Guys just to inform you, after using Milnacipran 50mg for 1 month, it start's working for me 🎉 🎉 🎉  So my conclusion Milnacipran need time to fixes things.

Hi fatmas, Is the effect still on?

[gzbking]

Interesting. If I take anti-histamines with pseudoephedrine they are more effective than anti-histamines alone (ie Allegra-D). Pseudoephedrine is a norepinephrine releasing agent.

"Pseudoephedrine acts on ?- and ?2-adrenergic receptors" Ref

Activation of ?2-adrenergic receptors on mast cells is the primary pathway for adrenergic agents to inhibit mast cells.

Table 1 and chapter 5: Neuroendocrinology of mast cells: Challenges and controversies

Milnacipran is used for fibromyalgia and fibromyalgia is associated/comorbid with mast cell activation disease.

what does this mean androgenic agent, is it means androgenic hormones like testosterone, its a molecule without bonds required to analyze a protein so it wont be interacting with a mast cell receptor, unless something went very wrong

[Muon]

Men versus women on sexual brain function: Prominent differences during tactile genital stimulation, but not during orgasm

"The only prominent gender difference during orgasm was male-biased activation of the periaqueductal gray matter."

Periaqueductal Gray

The neurobiology of central sensitization

We have similarly shown that decreased connectivity to antinociceptive brain regions, such as the periaqueductal gray (PAG - a critical locus of descending analgesic pathways), predicts responsiveness to milnacipran, a serotonin norepinephrine reuptake inhibitor. https://poiscenter.com/forums/index.php?topic=3312.0

Perhaps the most consistent finding noted to date is a mild elevation in IL-8, which is a cytokine associated with sympathetic function

I wonder if these milnacipran responders have mild elevations of this cytokine.

[hurray]

Could you please explain more how you take Milnacipran for mant days ? At what time exactly, untel you feel good ?

Hi famas! I was still taking it 75 minutes before O as normal, but since I was having several Os a week, I could feel it having a cumulative effect. Very interesting that it worked better for you when you took it daily - I wonder if other people could potentially benefit from a daily dose of milnacipran?

I try not to take it too often as my blood pressure is higher than average, something to bear in mind for anyone considering trying it.

[hurray]

POIS doesn't give me physical fatigue, but it certainly gives me mental fatigue, and milnacipran eradicates that.

Above & below, very common complaints I’ve heard here for 16 years! Bold emphases mine.

…I find every aspect of [POIS] manageable/livable - except extreme fatigue, that can trail after O*, for days and weeks.
And fatigue, after extensive mental work…

I’m going to ask my POIS doctors about trying Milnacipran, hurray. Thank you.

50 years of POIS fatigue, and now I’m…exhausted!

This week I found faster relief (in addition to my recent POIS-symptom improvements via regular TRT injections and other meds - - see my “Testosterone” thread) by sleeping for a huge chunk of the first 24 hours post-POIS-onset. Aided by Trazadone.

I’m very fortunate in that I’m retired and can “get away with that”!

Hi Demo, it would be interesting to hear what your POIS doctors thought about using milnacipran to treat POIS. I've posted before that I believe its strong NRI (norepinephrine reuptake inhibitor) qualities are what makes it work for me - I believe that it's stopping my norepinephrine levels from dropping too much following an O.

If your doctors give you the go-ahead and you decide to try it, I wish you the very best of luck

Sleeping is an underrated tool in the fight against POIS - for all the years I've had POIS, late night Os have resulted in better outcomes than daytime Os, and sleep is probably the reason for that.

[demografx]

This week I found faster relief (in addition to my recent POIS-symptom improvements via regular TRT injections and other meds - - see my “Testosterone” thread) by sleeping for a huge chunk of the first 24 hours post-POIS-onset. Aided by Trazadone.

I’m very fortunate in that I’m retired and can “get away with that”!

Sleeping is an underrated tool in the fight against POIS - for all the years I've had POIS, late night Os have resulted in better outcomes than daytime Os, and sleep is probably the reason for that.

This week, hurray, I’m abandoning my “POIS SLEEP” strategy! It’s making me excessively groggy and I think it’s prolonging my POIS symptoms.

I’m now trying a “POIS AWAKE” strategy, with lots of caffeine and an increased dose of daily Cialis. The combined stimulant effect along with NO DAYTIME SLEEPING (with the exception of a nap-but-not-sleep-med-aided) I hope will speed up the sluggish refractory period, which I believe is at the heart of my POIS problem.