Savella, also sold under the name Milnacipran (generic), is a serotonin-norepinephrine reuptake inhibitor (SNRI) prescribed for the treatment of fibromyalgia [and major depressive disorder in countries outside the United States]. Although many Savella users find that the medication is effective in reducing symptoms of fibromyalgia and depression, other individuals may report tolerability difficulties or lack of efficacy. If you are a person who doesn’t respond well to Savella, it may be necessary to discontinue treatment and face Savella withdrawal symptoms.
What causes Savella withdrawal symptoms?
Savella withdrawal symptoms are suspected to result from neurotransmitter imbalances that emerge after treatment is discontinued. When an individual first begins using Savella to treat fibromyalgia or major depressive disorder, the brain usually needs a bit of time (e.g. several weeks) to fully adapt to the neurochemical modulation exerted by Savella. That said, once the brain fully adapts to Savella, it eventually learns to rely on the presence of Savella to stabilize neurotransmitter levels.
How Savella affects brain activity
- Serotonin transporter (SERT) inhibition
- Norepinephrine transporter (NET) inhibition
In the event that a person discontinues Savella usage after an extended duration of administration, neurotransmitters will no longer be regulated by the medication. Additionally, because the medication will have altered various internal workings of the brain (neurotransmitter activity, connectivity, etc.) throughout treatment, the brain may have a difficult time readapting to functioning without being under the influence of the medication. The neurotransmitter fluctuations that occur while the brain is reverting to homeostasis, particularly in serotonin and dopamine systems, are probably responsible for most Savella withdrawal symptoms.
Savella Withdrawal Symptoms (Extensive List)
Any person who stops taking Savella after regular long-term use is at risk of experiencing withdrawal symptoms. Nonetheless, the specific withdrawal symptoms that a person experiences after quitting Savella will be individualized. Furthermore, the severities of Savella withdrawal symptoms and amount of time it takes to recover from symptoms will also be individualized.
This considered, you should understand that your Savella withdrawal might be different from that experienced by someone else. Listed below are some of the most common Savella withdrawal symptoms documented by former users and/or in medical literature. Realize that most people who discontinue Savella will not experience every single symptom below.
- Agitation & restlessness: You may find yourself feeling agitated or restless when you withdraw from Savella. Agitation and restlessness can occur as a result of irregularities in both serotonin and norepinephrine signaling during withdrawal. If you feel agitated and are overcome by inner restlessness, you may benefit from mental relaxation exercises (e.g. meditation) or physical exercise (e.g. jogging).
- Anxiety & panic attacks: After quitting Savella, you might experience high anxiety. The high anxiety is usually related to overactivation of the sympathetic nervous system caused by neurotransmitter imbalances (e.g. serotonin irregularities) and elevated stress hormones. In some cases, high anxiety could trigger panic attacks or unpredictable bouts of crippling fear in which an individual may end up with shortness of breath, palpitations, trembling and/or crying spells. If you experience high anxiety or end up with panic attacks after quitting Savella, you should inform your doctor and consider utilizing relaxation exercises to reduce activation of the sympathetic nervous system.
- Appetite & weight changes: Savella isn’t associated with appetite or weight changes (loss or gain). That said, some individuals may experience changes in appetite or weight during withdrawal. Usually appetite changes are caused by other withdrawal symptoms such as nausea, upset stomach, anxiety, and/or depression. Body weight changes could be directly related to appetite fluctuations or metabolic shifts during withdrawal.
- Brain fog, confusion, cognitive deficits: Once you’ve discontinued Savella, it may seem as though your brain isn’t functioning properly. You might experience foggy thinking or “brain fog,” along with confusion, and possibly cognitive deficits. Some individuals may find it difficult to store/retrieve memories, focus/concentrate on important tasks, plan ahead, or engage in critical thinking.
- Brain zaps: Some people may experience “brain zaps” in which it feels like their head is being shocked by electricity after discontinuing Savella. The brain zaps are thought to be caused by changes in serotonin signaling throughout withdrawal. It is believed that high stress, poor sleep, and various eye movements might trigger these zaps in susceptible individuals. If you experience brain zaps during withdrawal, report them to your doctor and realize that they usually subside over time.
- Chills, hot flashes, sweating: After withdrawing from an antidepressant like Savella, you may experience chills, hot flashes, and/or sweating. While most people don’t experience chills and hot flashes, certain individuals could end up with both during their withdrawal. It is believed that neurochemical and hormonal changes can affect body temperature regulation, which in turn may induce chills and/or hot flashes. Usually these body temperature changes are accompanied by increased sweating or “sweats.”
- Depressed mood: Because many people take Savella to treat major depressive disorder, when the medication is stopped, depression may return. Additionally, the depression experienced during Savella withdrawal may be worse than ever before due to elevated stress, poor sleep, and neurotransmitter imbalances that emerge in withdrawal. If you’re experiencing severe depression during Savella withdrawal, it is recommended to inform your doctor and try to manage it as best you can with medication, psychotherapy, and exercise.
- Dizziness: After stopping Savella, you might find yourself feeling dizzier than usual. Some people claim to experience such extreme dizziness that balance is impaired. In any regard, the dizziness could be related to shifts in neurotransmitter levels, cerebral blood flow, or vestibular processing. Dizziness can also be exacerbated by high stress levels throughout withdrawal. If you feel dizzy in your Savella withdrawal, it’s probably best to lie low, avoid strenuous activities, and engage in relaxing activities.
- Headaches: It is thought that changes in blood flow, neurotransmitters, and connectivity may trigger headaches during Savella withdrawal. To cope with the headaches, you may want to ask your doctor about trying an over-the-counter headache medication. Furthermore, because stress and poor sleep can exacerbate headaches – do whatever you can to lower stress and adhere to a healthy sleep schedule.
- Increased heart rate & palpitations: Withdrawal symptoms that may be very disturbing include: increased heart rate and heart palpitations. Increased heart rate and palpitations are usually caused by anxiety, high stress, and overactivation of the sympathetic nervous system. If you notice changes in your heartbeat (e.g. fluttering, rapid beating, etc.) – have your doctor rule out serious cardiac conditions. If there are no issues with your heart function, you may need to practice relaxation (e.g. deep breathing) to decrease sympathetic nervous system activation.
- Insomnia & disturbed sleep: Following Savella discontinuation, you might experience insomnia or notice that your sleep is disturbed. Common sleep disturbances in Savella withdrawal include: excessive nighttime sweating, tossing-and-turning, waking up in the middle of the night, and emotionally-charged dreams. Because getting quality sleep may help you recover from Savella withdrawal symptoms at a quicker pace, it is recommended to ask your doctor about sleep aids if your sleep is compromised.
- Irritability and anger: When you’ve stopped taking Savella, there’s a chance that you might experience irritability or anger. If you’re highly stressed during withdrawal, the irritability and anger may be triggered by the release of stress hormones. Getting your stress under control with deep breathing, meditation, and regular physical exercise might improve these symptoms.
- Joint & muscle aches: Some individuals will experience aches and pains throughout their joints and muscles after withdrawing from Savella. These aches and pains could be related to a return of fibromyalgia symptoms (if that’s what you were using the drug to treat). However, joint and muscle aches in withdrawal could also be related to increased production of stress hormones, alterations in blood flow throughout the body, and/or withdrawal-related systemic inflammation.
- Lethargy & fatigue: During Savella withdrawal, you may feel really tired, sleepy, lethargic, or fatigued such that it’s difficult to stay mentally alert and/or physically active. In some cases, the lethargy and fatigue may be due to high stress and poor sleep throughout withdrawal. However, lethargy and fatigue might also indicate the return of an untreated medical condition such as: fibromyalgia or major depression. If the fatigue persists for more than several weeks, you may find that forcing yourself to exercise (even if you’re tired) helps to increase your energy.
- Nausea & vomiting: Nausea can sometimes occur in the first few days after discontinuing Savella. If the nausea is severe, there’s a chance that it might cause vomiting. To manage the nausea and vomiting during Savella withdrawal, you may want to ask your doctor about using antiemetic agents.
- Sensory disturbances: Many people will experience sensory disturbances when they discontinue Savella. Among those that experience sensory disturbances as a withdrawal symptom, the most common disturbances include heightened sensitivity to noise and lights. Specifically, it may seem as though average sounds have become ear-piercingly loud or that certain lights are so bright that they’re giving you a headache. Others might experience tactile sensations such as tingles or numbness across the skin.
- Suicidal thoughts: Some individuals may experience suicidal thoughts while withdrawing from Savella. If you experience suicidal thoughts, immediate psychiatric attention is needed. Suicidal thoughts can be dangerous if unmanaged during withdrawal. With proper psychiatric treatment and adequate time off of Savella, suicidal thoughts should subside.
Note: The list of Savella withdrawal symptoms provided above may be partial or incomplete. If you know of additional Savella withdrawal symptoms that weren’t reported, share them in the comments section.
What determines the severity of Savella withdrawal symptoms?
The severity of Savella withdrawal symptoms will vary depending on the specific person. Certain individuals will claim that withdrawals are easy to endure, whereas others might report that withdrawals are very difficult. It is suspected that several variables might influence Savella withdrawal severity, such as: duration of Savella use; Savella dosage; rate of Savella discontinuation; the former user’s lifestyle; and the former user’s genetics.
- Length of Savella treatment: The total duration over which you took Savella might affect withdrawal symptom severity. Long-term users are thought to have more challenging withdrawals (on average) than short-term users.
- Savella dose: Dose of Savella utilized during treatment could influence withdrawal symptom severity. It is thought that high-dose Savella users may experience more severe withdrawal symptoms than low-dose users.
- Rate of Savella discontinuation: How quickly you discontinue Savella could influence the severity of Savella withdrawal. Those who slowly taper off of the medication tend to have easier withdrawals (on average) than those who quit “cold turkey” or rapidly.
- Other substance use: Using other substances (medications and/or supplements) during Savella withdrawal generally reduces the severity of a person’s withdrawal symptoms. Those who aren’t using other substances tend to have more severe withdrawal symptoms.
- Lifestyle: Lifestyle of the individual who quits Savella could impact how severe their withdrawal symptoms end up. Living a healthy lifestyle may decrease the severity of Savella withdrawal symptoms, whereas living an unhealthy one may make withdrawal more difficult.
- Genetics: It’s possible that genetics may influence how severe your withdrawal symptoms end up. Expressing certain genes might make withdrawal from Savella more or less difficult compared to expressing others.
Best supplements for Savella withdrawal symptoms
Using supplements might help minimize the severity of Savella withdrawal symptoms, or possibly help you recover from your symptoms at a quicker rate. Listed below are supplements that may prove therapeutic while withdrawing from Savella. That said, you should know that not all individuals will benefit from using supplements during Savella withdrawal.
Disclaimer: Never take supplements without consulting a medical doctor to confirm that the supplements are safe based on your current medical status.
Affiliate disclosure: The supplements listed below contain affiliate links which help this site earn money. That said, the links are to products that we think are high quality, reasonably-priced, and potentially beneficial during Savella withdrawal.
- Magnesium: A supplement that may address a variety of Savella withdrawal symptoms is magnesium. Many report that it helps with anxiety, depression, palpitations, insomnia, and muscle pain.
- Electrolytes: Due to high anxiety and stress in withdrawal, some people might end up with electrolyte imbalances. Supplementing with an electrolyte formula may alleviate certain withdrawal symptoms.
- Vitamin B complex: Using a vitamin B complex may help relax your muscles, decrease anxiety, and boost your energy as you withdraw from Savella.
- Lemon balm: If you’re feeling extremely anxious or notice panic attacks after discontinuing Savella, you might want to consider lemon balm supplementation.
- L-Tryptophan: L-Tryptophan is a supplement that the body can use to manufacture serotonin during Savella withdrawal.
- Krill oil: A supplement that may help reverse brain fog and cognitive deficits during Savella withdrawal is krill oil.
- Melatonin: If you have severe insomnia or are experiencing sleep issues after quitting Savella, consider trying melatonin.
- Multivitamin: A multivitamin will decrease likelihood that you’ll end up with a vitamin deficiency during withdrawal (not something you want).
- Probiotics: Probiotic supplementation can help stabilize gut bacteria after Savella is discontinued.
- Curcumin: If you feel achy or sense significant inflammation throughout your body during Savella withdrawal, you may want to use curcumin.
- Rhodiola rosea: Anyone with high stress and/or fatigue during Savella withdrawal may benefit from supplementing with Rhodiola.
- L-Tyrosine: L-Tyrosine helps the body synthesize dopamine and may increase dopamine levels in the brain after Savella is discontinued.
- NAC: This supplement is a robust antioxidant that helps offset high oxidative stress that may be present during Savella withdrawal.
How to withdraw from Savella safely (Recommendations)
For most, there’s never going to be a perfect time or perfect way to withdraw from Savella. Nevertheless, there are some recommendations that can be made to increase your safety during withdrawal. If you’re thinking about discontinuing Savella or are already experiencing withdrawal, read through the recommendations below.
- Psychiatric support: Always work with a psychiatrist (or medical doctor) when withdrawing from Savella. A psychiatrist will be able to help come up with a tapering plan for discontinuing Savella and will know how to treat debilitating withdrawal symptoms. If you don’t work with a psychiatrist or medical doctor, you could be putting your health at risk during withdrawal.
- Gradually taper off of Savella: Savella is not a medication that you should ever quit “cold turkey” or suddenly. Instead, it is recommended that you gradually taper off of Savella over a period of weeks or months. Some sources recommend tapering very slowly such as by decreasing the dosage 10% per month.
- Healthy lifestyle: It is imperative that you try to keep yourself as healthy as possible after discontinuing Savella. A healthy lifestyle will likely help you cope with withdrawal symptoms and/or overcome withdrawal symptoms quicker than an unhealthy one.
- Use other substances: Talk to your doctor about medications and/or supplements that may be helpful during Savella withdrawal. Most people find that utilizing medications and/or supplements can expedite recovery from Savella withdrawal symptoms.
How long does Savella withdrawal last? (Duration)
The amount of time that it’ll take for you to overcome Savella withdrawal symptoms will be individualized (or unique to you). In other words, not everyone will recover from Savella withdrawal symptoms at the same pace. One person might find that Savella withdrawal only lasts for 1-2 weeks, whereas another individual might claim that Savella withdrawal is protracted and lasts for months.
Most suspect that variables such as: duration of Savella use; Savella dosage; and rate of Savella discontinuation could influence the time it takes to completely overcome withdrawal symptoms. That said, most people who work with a psychiatrist or medical professional to discontinue Savella should experience marked improvement in Savella withdrawal symptoms within 2 to 12 weeks of their final dose. Keep in mind that marked improvement in symptoms does not always imply complete recovery from symptoms.
Have you experienced Savella withdrawal symptoms?
If you stopped taking Savella and have experienced withdrawal, be sure to share a comment reflecting upon your experience. Sharing a comment may help others feel less alone who are also withdrawing from Savella. If you don’t know what to say in your comment, below are some questions that you could consider answering.
- How long did you use Savella before discontinuation?
- What dose of Savella did you take throughout treatment?
- Why did you decide to withdraw from Savella?
- How fast did you taper off of Savella?
- Did you replace Savella with another medication?
- In your experience, what were the most noticeable Savella withdrawal symptoms?