Highlighting uses, dosage, how to take & discontinue, side effects, pros & cons, and more

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Brand & Generic Names; Drug Classes

US brand name: Savella
Generic name: milnacipran

Drug Class(es)

Primary drug class: Migraine/NeuropathicPain
Additional drug class(es): Antidepressants, Serotonin and Norepinephrine Reuptake Inhibitors

Approved & Off-Label Uses (Indications)

Savella’s US FDA Approved Treatment(s)

Management of fibromyalgia. Approved 14 January 2009.

Uses Approved Overseas but not in the US

  • Most places in the world Ixel/Dalcipran is only an antidepressant.
  • In France Ixel / Dalcipran is approved to treat both MDD and fibromyalgia.
  • In Japan Toledomin is approved to treat acute (short-term) and chronic (long-term) MDD as well as fibromyalgia.

Off-Label Uses of Savella

  • Major Depressive Disorder (MDD)
  • Bipolar Depression
  • Anxiety Spectrum Disorders, such as

When & If Savella Will Work

Savella’s Usual Onset of Action (when it starts working)

Like any SNRI, expect Savella / Ixel to start working in 2 to 4 weeks. Return to Table of Contents

Likelihood of Working

Fibromyalgia

Not all that great. But in all fairness, nothing works all that great when it comes to fibro. In the clinical trials and other double-blind studies around 35% of the people (mostly, if not entirely women) did experience greater than a 50% reduction in pain. Often much greater. So when Savella / Ixel works it can really work. However there was a significant drop-out rate in the people taking the drug. Usually twice as high as the placebo. And not always for side effects. So factoring in the drop-out rate, you have about a 1-in-4 chance that Savella / Ixel will work for you.

I don’t know if this is fibromyalgia-specific, but if you’re still puking your guts out or dealing with other side effects that usually go away for SNRIs at week 4, just give up on Savella / Ixel. I think Stahl was on autopilot when he typed “Wait. Wait. Wait.” in how to deal with milnacipran’s side effects. Unless your doctor has you at 200 mg a day already. But lowering the dosage doesn’t help with the side effects that much and it still isn’t working, just move on.

One thing I’m noticing in reports from consumers: doctors are switching their patients from Cymbalta to Savella and the people are reporting SSRI/SNRI discontinuation syndrome. My money is on the doctors being idiots and having their patients go from 60 mg a day of Cymbalta to 25 mg a day of Savella with no cross-taper/titration (where you simultaneously decrease the amount of one drug and increase the amount of another). No wonder they feel like shit. Savella is taking the blame for their brain zaps and other discontinuation symptoms.

Off-label Applications

There aren’t enough data. I guess all the other SNRIs had the market cornered. I’m surprised Savella wasn’t used more often for depression prior to Fetzima’s approval.

Return to Table of Contents

Taking and Discontinuing

How to Take Savella

Manufacturer’s Recommendations

Forest Laboratories recommends:

2. Dosage and Administration Savella is given orally with or without food.
Taking Savella with food may improve the tolerability of the drug.

2.1 Recommended Dosing The recommended dose of Savella is 100 mg/day (50 mg twice daily).
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 )

Based on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily)

--the Savella PI sheet

Crazymeds’ Suggestions

I don’t think so, Forest.

  • I could take Savella without food and without a problem, but my stomach has yet to meet a med it didn’t like. Based upon reality, people should start taking it with food and figure out later if they need to keep doing so.
  • Have I told you how much I dislike target dosages? Sometimes they’re a good idea, sometimes they’re not. With this type of drug (an SNRI) and these applications (fibromyalgia and depression), the Crazymeds rules are:
    • Start low
    • Increase slowly
    • Stay at the dosage where your symptoms stop.
  • Given the ridiculously short half-lives and other PK factors, taking a single 12.5 mg tablet on day one then two of them the next day makes perfect sense.
    • If you want to do that for another day or two to acclimate to side effects, sure. Just don’t start waiting for it to take effect until you’re taking it twice a day.
    • Just make damn sure you take it at the same time every day. ± one hour at the most.
  • After that, I’d double the length of time involved.
    • I’d just round it up to a week to make it easier to remember.
    • So that would be 25 mg a day the first weeks, 50 mg a day the second and 100 mg a day the third.
      • Depending on your history with meds, you may want to make that 75 mg a day for the third week and 100 mg a day the fourth.
      • That could be expensive, as it would require taking two 25 mg and two 12.5 mg tablets a day.
    • Unless your symptoms stopped. At whatever dosage your symptoms stopped, that’s the dosage you want to be at.

If you’re currently taking Cymbalta, another SNRI or an SSRI and your doctor tells you to stop taking your current medication all at once the same day you take that first 12.5 mg of Savella, find another doctor!!! You need to either lower the dosage of the med you’re now taking as you increase the dosage of Savella, or slowly discontinue whatever you’re taking now prior to starting Savella. There are pros and cons to each method. A good doctor would work with you to figure out the better option. Return to Table of Contents

How to Stop Taking Savella (discontinuation / withdrawal)

Manufacturer’s Recommendations

Oh, this is rich.

2.4 Discontinuing Savella
Withdrawal symptoms have been observed in clinical trials following discontinuation of milnacipran, as with other serotonin and norepinephrine re-uptake inhibitors (SNRIs) and selective serotonin re-uptake inhibitors (SSRIs). Patients should be monitored for these symptoms when discontinuing treatment. Savella should be tapered and not abruptly discontinued after extended use [see Warnings and Precautions (5.7)].

5.7 Discontinuation of Treatment with Savella
Withdrawal symptoms have been observed in clinical trials following discontinuation of milnacipran, as with other SNRIs and SSRIs.

During marketing of milnacipran, and other SNRIs and SSRIs, there have been spontaneous reports of adverse events indicative of withdrawal and physical dependence occurring upon discontinuation of these drugs, particularly when discontinuation is abrupt. The adverse events include the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have been reported to be severe.

Patients should be monitored for these symptoms when discontinuing treatment with Savella. Savella should be tapered and not abruptly discontinued after extended use. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.4)]. --the Savella PI sheet

Thank you, Captain Obvious!

Crazymeds’ Suggestions

Our rule of thumb is to discontinue a med at either the same rate you titrated (the schedule of dosage increases), or by reducing the dosage by whatever the typical dosage increase amount is every however long the clearance is (usually half-life times five). If you followed the recommended schedule for Savella you DO NOT want to decrease what you’re taking at the same rate. Even though that approximates the half-life times five model.

What you want to do is decrease your dosage by 25 mg a day per week. You’ll need 12.5 mg tablets to do this. So if you’re at 100 mg a day that’s 75 mg a day week one, 50 mg a day week two, 25 mg a day week three, and you may need a day or two where you take a single 12.5 mg.

If you’re experiencing really bad discontinuation syndrome symptoms, then get a prescription for 12.5 mg tablets and decrease your dosage by 12.5 mg a day per week.

Savella tablets are film-coated and they aren’t scored, so it’s not a good idea to split them. Return to Table of Contents

Savella’s Pros and Cons

Pros

  • Savella / Ixel affects norepinephrine much more than serotonin, which is important for people whose problems are addressed by tweaking norepinephrine more than serotonin.
  • When it works, it really works.

Return to Table of Contents

Cons

Return to Table of Contents

Interesting Stuff your Doctor Probably didn’t Tell You about Savella

  • Your doctor had damn well better tell you about getting regular blood tests to make sure your liver isn’t imploding. What makes it interesting is there doesn’t seem to be a good reason why. Your liver barely does anything with milnacipran.
  • Savella / Ixel and its sister drug Fetzima (levomilnacipran) are the only SNRIs that are like most TCAs, in that they work on norepinephrine significantly more than serotonin.
  • In June 2000 Toledomin was the first SNRI to be approved in Japan. Which is probably interesting only to me and the 2 or 3 other people in the overlapping sets of pharmacology nerds and Nipponophiles.

Return to Table of Contents

Best Known for

The med whose side effects suck more than fibromyalgia. That’s a neat trick. Return to Table of Contents




These will stick around longer than most side effects. More ways to be stuck-up at Straitjacket T-shirts. All stickers $5 each. Available in packs of 10 and 50.
Medicine Is The Best Medicine stickers at Straitjacket T-shirts
Medicine Is The Best Medicine
Vaccines Cause Immunity stickers at Straitjacket T-shirts
Vaccines Cause Immunity
Mental Illness is NOT Contagious stickers at Straitjacket T-shirts
Mental Illness is NOT Contagious
Medicated For Your Protection stickers at Straitjacket T-shirts
Medicated For Your Protection

Savella’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.2
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.

Typical Potential Side Effects

The usual for SNRIs: headache, nausea, dry mouth, sweating, urinary hesitancy, constipation, dizziness, and insomnia . Because Savella / Ixel works on norepinephrine much more than serotonin, popular TCA side effects are much more common than with other SNRIs. These include flushing / hot flashes, high blood pressure (hypertension), heart palpitations / irregular heartbeat (tachycardia), and increased heartbeat. And like every crazy med on the planet, Savella / Ixel will affect your dreams. Return to Table of Contents

Uncommon Potential Side Effects

Weight loss (not all side effects are bad, unless you can’t afford to lose weight), itchy skin with no rash (pruritus), migraine, making symptoms worse . Return to Table of Contents

Freaky Rare Side Effects

Savella has The. Best. Freakiest. Rarest. Side Effect. EVER!!! That should be Toledomin has it, because this happened in Japan and the guy was taking it as an antidepressant. Nothing comes close to this one:

Ejaculation After Defecation Without Orgasm Induced by Milnacipran

One of the things that makes this the best freaky rare side effect in the history of medication is the way the report is written. It’s not entirely clear what changed and what problem the guy had with it. Did he normally have anorgasmia and Toledomin made him need to take a dump? Did he normally jack-off when the was on the toilet and Toledomin caused anorgasmia? Whatever it was, it sucked less than depression, because this went on for over a year and he refused to stop taking the milnacipran.

Since it happened in Japan, I wouldn’t be surprised if there’s now some kind of anorgasmic scat fetish underground.

Return to Table of Contents


What You Really Need to be Careful About

Your liver could implode. It’s unlikely to happen if you’re taking only Savella / Ixel, you don’t drink and you don’t smoke. You should still get regular blood tests.

Return to Table of Contents

Pregnancy Category

C-Use with caution Return to Table of Contents

Pharmacology

Savella’s Half-Life & How Long Until It Clears Your System

Parent drug: 6–8 hours; active enantiomer (d-milnacipran): 8–10 hours. Clearance 2 days.

Steady State

1.5 to 2 days

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream3, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what4, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.

Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.

Return to Table of Contents

How milnacipran Works

the current best guess at any rate
Based upon our Communications Interference Hypothesis of psychiatric and neurological conditions (or brain cooties as we often call them), Savella treats fibromyalgia and depression by effectively raising norepinephrine and serotonin levels in your brain. It does so by letting your synapses soak in those brain juices for longer than usual by slowing (inhibiting) the mechanism of serotonin transmission deeper into the neurons (reuptake).

When it comes to dealing with pain, SSRIs and SRNIs work in both your spinal cord and the interface between your spinal cord and the brain to suppress the transmission of pain signals from your body to your prefrontal cortex. As more people have more of an issue with norepinephrine than serotonin where their bio-electrochemical signaling system is out of whack, TCAs and SNRIs that do more on norepinephrine (e.g. Cymbalta vs. Effexor) tend to be more effective than SSRIs where clinical trials are concerned. The serotonin receptors most concerned with pain are 5HT1B and 5HT1D, which are the two the triptans, which are popular migraine abortives (meds used to stop migraines after they start), work on. Return to Table of Contents

Active Ingredient

milnacipran hydrochloride


The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.

Return to Table of Contents

Shelf Life

3 years. Return to Table of Contents

Savella’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

Don’t drink alcohol when you take Savella / Ixel. This has nothing to do with operating heavy machinery, but has everything to do with your liver. Unless you have the same pull as David Crosby5 with the organ donor registry, you’ll want to avoid alcohol, nicotine, and charbroiled meat (no, really) as much as you can. You sure as hell don’t want to be taking Savella / Ixel and Depakote together. NSAIDs, including Tylenol (acetaminophen), were used along with Savella in some of the clinical trials. I’d be leery of mixing acetaminophen with milnacipran.

Return to Table of Contents

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions Savella may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.



Name, Address, Serial Number (Generic and Overseas Availability)

Available in the US as a generic? No

Other Trade Names and Overseas Availability

Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).
  • Ixel - France (where it was developed), Austria, Czech Republic, Estonia, Finland, Israel, Latvia, Luxembourg, Poland, Portugal, Slovakia
  • Иксел (Iksel ) - Russia
  • Dalcipran - Argentina, Czech Republic, Finland, France, Luxembourg, Poland, Portugal
  • Milnace - India
  • Tivanyl - Mexico
  • トレドミン (Toledomin ) - Japan
  • midalcipran - original generic name
  • милнаципран - Russian transliteration of milnacipran
  • milnacipranum - Latin INN

Return to Table of Contents

Shapes & Sizes (How Supplied)

  • 12.5 mg round blue tablets
  • 25 mg round white tablets
  • 50 mg oval white tablets
  • 100 mg oval pink tablets

12.5 mg tabs have an F on one side and an L on the other. The rest have their dosage on one side and FL on the other. Return to Table of Contents

Comments, PI Sheet, Ratings, Reviews and More

Comments

Fetzima (levomilnacipran ) is the long-acting version of Savella that is approved in the US for use as an antidepressant. Not that very many people wanted to use Savella as an antidepressant in the first place.

Return to Table of Contents

Rate Savella

Give your overall impression of Savella on a scale of 0 to 5.

Get all critical about Savella

2.5 stars Rating 2.2 out of 5 from 6 criticisms.
Vote Distribution: 2 – 1 – 0 – 1 – 1 – 1


Rate this article

If you’re still feeling judgmental as well as just mental6, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Savella (milnacipran) Synopsis

5 stars Rates 5.0 out of 5 from 2 value judgments.
Vote Distribution: 0 – 0 – 0 – 0 – 0 – 2


Return to Table of Contents

Pages and Forum Topics Google Thinks are Relevant to Your Mental Health

Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, and Other Sites that may be of Interest

Savella’s Full US Prescribing Information / PI Sheet

Global PI Sheets

Consumer Review Sites

Other Sites of Interest

Return to Table of Contents

Discussion board

If you have any questions not answered here, please see the Crazymeds Savella discussion board. Return to Table of Contents


Enable Crazymeds to keep spreading our knowledge. Donate some spare e-currency you have floating around The Cloud.


References

  1. Savella Full US Prescribing Information
  2. Israeli Ixel SPC
  3. Stahl, Stephen M. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition Cambridge University Press 2008. ISBN:978–0521673761
  4. Stahl, Stephen M. The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition Cambridge University Press 2009. ISBN:978–0521743990
  5. Ormseth, Michelle J., Anne E. Eyler, Cara L. Hammonds, and Chad S. Boomershine. “Milnacipran for the management of fibromyalgia syndrome.” Journal of Pain Research 3 (2010): 15. Published online 1 March, 2010
  6. Gendreau, R. Michael, Michael D. Thorn, Judy F. Gendreau, Jay D. Kranzler, Saulo Ribeiro, Richard H. Gracely, David A. Williams, Philip J. Mease, Samuel A. McLean, and Daniel J. Clauw. “Efficacy of milnacipran in patients with fibromyalgia.” The Journal of Rheumatology 32, no. 10 (2005): 1975-1985.
  7. Vitton, Olivier, Michael Gendreau, Judy Gendreau, Jay Kranzler, and Srinivas G. Rao. “A double-blind placebo-controlled trial of milnacipran in the treatment of fibromyalgia.” Human Psychopharmacol Clinical Exp 19 (2004): S27-S35.
  8. Mease, Philip J., Daniel J. Clauw, R. Michael Gendreau, Srinivas G. Rao, Jay Kranzler, Wei Chen, and Robert H. Palmer. “The efficacy and safety of milnacipran for treatment of fibromyalgia. A randomized, double-blind, placebo-controlled trial.” The Journal of Rheumatology 36, no. 2 (2009): 398-409.
  9. Arnold, Lesley M., R. Michael Gendreau, Robert H. Palmer, Judy F. Gendreau, and Yong Wang. “Efficacy and safety of milnacipran 100 mg/day in patients with fibromyalgia: Results of a randomized, double‐blind, placebo‐controlled trial.” Arthritis & Rheumatism 62, no. 9 (2010): 2745-2756. Article first published online: 21 May 2010
  10. Vaishnavi, S. Neil, Charles B. Nemeroff, Susan J. Plott, Srinivas G. Rao, Jay Kranzler, and Michael J. Owens. “Milnacipran: a comparative analysis of human monoamine uptake and transporter binding affinity.” Biological Psychiatry 55, no. 3 (2004): 320-322.
  11. Li, Fanying, Christina Chin, Julie Wangsa, and John Ho. “Excretion and metabolism of milnacipran in humans after oral administration of milnacipran hydrochloride.” Drug Metabolism and Disposition 40, no. 9 (2012): 1723-1735.

Return to Table of Contents


1 The full study is in Japanese and uses animals. But I really like it because it is a huge cagematch between a shitload of meds of different classes, it's testing a drug that has been so dead in the water for 30 years that it still doesn't even have a clinical trial designation, let alone a name, and I learned there is an animal model for OCD: marble-burying. Which seems simultaneously adorable and horrendous.

2 As well as being an indication of half of said conditions.

3 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.

4 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

5 He drank his liver into a rock-solid mass of uselessness, got a transplant for being a self-medicating, raging alcoholic asshole, did the same thing in a shorter period of time, then got another transplant! What do you call someone with bipolar disorder who took their Depakote as directed, didn't self-medicate, and ended up needing a transplant because their doctor never ordered a liver function test? Dead, that's what you call them, because we get sent to the bottom of the list for being suicide risks. No matter how badly we want to stay alive.

6 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!


If you have any questions not answered here, please see the Crazymeds Savella discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)


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Savella, and all other drug names on this page and used throughout the site, are a trademark of someone else. Savella’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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