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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 335. This is the beginning of the thread.
Posted by SLS on August 21, 2004, at 8:13:25
Cymbalta (duloxetine)
8/10/2004I began to taper my dosage of imipramine from 300mg
--
8/17/2004
I took my last 50mg dose of imipramine
I am experiencing a mild rebound improvement of depression that is the direct result of discontinuing imipramine so quickly. This is normal for me.
--
8/20/2004
Begin Cymbalta...
First dose - 30mg
I experienced a brief significant improvement in depressive symptoms beginning 1 hour after this first dose. It lasted for 3 hours. No side effects.
--
8/21/2004
Second dose - 30mg
I did not experience any improvement. No side effects.
--
* The manufacturer's label describes initiating treatment with Cymbalta using the desired target dosage. People are to begin by taking 40-60mg per day. Dosing is probably best split as twice a day. The half-life of Cymbalta is approximately 12 hours.
* My doctor asked that I take 30mg for the first week before moving up to 60mg in the second week. I am impatient, of course, but this is probably prudent, especially after having so recently discontinued imipramine.
* Smiling
- Scott
Posted by jparsell82` on August 21, 2004, at 9:19:59
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
Let me know how it effects your energy and pain levels if it makes any difference. I'm about to give Ixel(milnacipran) a try in a week or so. If it works I'll probably talk to my doctor about Cymbalta. Also, in a study I ready comparing Ixel to SSRIs the study showed SSRI's caused more anxiety. I wonder how that is with Cymbalta. Good luck and keep us updated!
Posted by theo on August 21, 2004, at 11:20:17
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
This is a thread to a current study (August 2004) on Cymbalta which sounds positive. What surprised me is that the comparison is between Cymbalta and Paxil. Most studies are considering Cymbalta's comparator to be Paxil. I always assumed it would be Effexor.
Posted by SLS on August 21, 2004, at 12:03:34
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on August 21, 2004, at 11:20:17
> This is a thread to a current study (August 2004) on Cymbalta which sounds positive. What surprised me is that the comparison is between Cymbalta and Paxil. Most studies are considering Cymbalta's comparator to be Paxil. I always assumed it would be Effexor.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15232330
Paxil was probably chosen as the comparator because there was a better chance that Cymbalta would be shown superior. Effexor has already been found to be superior to Paxil, so it would not be in their best interest to take on such a formidable foe.
- Scott
Posted by theo on August 21, 2004, at 16:14:51
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 21, 2004, at 12:03:34
I guess things work better for some then others. Paxil was the best med I ever took (1 year) but had to stop it because I started a relationship and could not have sex while on it.
Although it's an SSRI, I've seen many studies where Paxil was shown to hit norepinephrine pretty strong.
Effexor XR for me went like this, high anxiety at 37.5mg and felt like a flat emotionless pit when I went to 75mg.
For me I hope Cymbalta is effective for anxiety and depression as was Paxil or it may not be for me.
Posted by KaraS on August 21, 2004, at 16:48:17
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
> Cymbalta (duloxetine)
>
>
> 8/10/2004
>
> I began to taper my dosage of imipramine from 300mg
>
> --
>
> 8/17/2004
>
> I took my last 50mg dose of imipramine
>
> I am experiencing a mild rebound improvement of depression that is the direct result of discontinuing imipramine so quickly. This is normal for me.
>
> --
>
> 8/20/2004
>
> Begin Cymbalta...
>
> First dose - 30mg
>
> I experienced a brief significant improvement in depressive symptoms beginning 1 hour after this first dose. It lasted for 3 hours. No side effects.
>
> --
>
> 8/21/2004
>
> Second dose - 30mg
>
> I did not experience any improvement. No side effects.
>
> --
>
>
>
> * The manufacturer's label describes initiating treatment with Cymbalta using the desired target dosage. People are to begin by taking 40-60mg per day. Dosing is probably best split as twice a day. The half-life of Cymbalta is approximately 12 hours.
>
> * My doctor asked that I take 30mg for the first week before moving up to 60mg in the second week. I am impatient, of course, but this is probably prudent, especially after having so recently discontinued imipramine.
>
> * Smiling
>
>
> - Scott
>
I'm so glad it's going well so far. My thoughts are with you...-Kara
Posted by theo on August 22, 2004, at 10:16:37
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
Sorry to keep hounding you , but the initial side effects (1st-3rd days) worry me the most with a new med. I see one of my docs tomorrow about adding an antidepressant to my 150mg Lamictal. Of course, being new, I'll push for Cymbalta.
I thought I would see many more threads on this site by now about Cymbalta. Maybe that's because I'm so impatient!
Posted by SLS on August 22, 2004, at 10:37:02
In reply to How's day 3? » SLS, posted by theo on August 22, 2004, at 10:16:37
> Sorry to keep hounding you , but the initial side effects (1st-3rd days) worry me the most with a new med. I see one of my docs tomorrow about adding an antidepressant to my 150mg Lamictal. Of course, being new, I'll push for Cymbalta.
>
> I thought I would see many more threads on this site by now about Cymbalta. Maybe that's because I'm so impatient!
I don't mind being hounded. You might need to "motivate" me every now and again. :-)8/22/2004
Day 3
Dosage 30mg
No improvement.
No side effects. No anxiety. No foggy-brain.
Good orgasm this morning 1 1/2 hours after dosing.
:-)
I don't think we should conclude too much regarding side effects until I have been at 60mg for two weeks.
Feel free to ask any questions.
- Scott
Posted by theo on August 22, 2004, at 12:28:38
In reply to Re: How's day 3?, posted by SLS on August 22, 2004, at 10:37:02
I agree on not drawing any premature conclusions after only three days. My anxiety triples whenever I swallow an SSRI, SNRI I've never tried because of the horrible feelings I had when I took my first dose of Zoloft and also with Lexapro, made me totally jumpy and uncomfortable.
So at least Cymbalta sounds promising on initial startup.
Posted by Phil on August 23, 2004, at 10:00:42
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
I was allergic to Effexor. Two hours of intense itching every night at around 8 p.m. No rash, just itching like crazy.
I've been waiting for Cymbalta. It's nice to have another option.
I do hope it works well for you.
Posted by pseudonym on August 23, 2004, at 14:55:41
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
I thought Cymbalta did not need titration. In fact, I recollect reading various press releases stating that a patient could initate at 60mg. Another note from the prescribing info states that at least for one trial, no benefit beyond 60 mg was noted.
Posted by SLS on August 23, 2004, at 17:00:49
In reply to Re: Cymbalta (duloxetine) - report, posted by pseudonym on August 23, 2004, at 14:55:41
8/23/2004
Day 4
30mg
No real improvement.
No side effects.
As I have mentioned in previous posts, I recently discontinued imipramine. More often than not, I actually experience a small improvement in my mood and functioning afterwards that lasts for about two or three weeks. I am in that period now, so it might be difficult for me to assertain if Cymbalta is responsible for any slight brightening of mood that may occur over the first two weeks. Some people do experience such a brightening during the second week of antidepressant therapy that often goes unnoticed.
- Scott
Posted by Lest on August 24, 2004, at 2:50:03
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 23, 2004, at 17:00:49
Youre going to have to anyway, just dont die, ill feel bad
Posted by SLS on August 24, 2004, at 6:10:29
In reply to take an extra 30 to get quick results :], posted by Lest on August 24, 2004, at 2:50:03
> Youre going to have to anyway, just dont die, ill feel bad
I'm trying to be compliant with the doctor's orders. :-) I'm not real happy to be moving up so slowly, but I think I can be patient for one more day.
Thanks for the concern!
- Scott
Posted by Lest on August 24, 2004, at 9:44:30
In reply to Re: take an extra 30 to get quick results :], posted by SLS on August 24, 2004, at 6:10:29
take it.. Ive tried almost everything else, all the ssri's plus some antipsychs.. couldnt tolerate them. effexor worked the best for me, but had chest pain, so im havin hopes for cymbalta...
Posted by Lest on August 24, 2004, at 9:45:49
In reply to Re: take an extra 30 to get quick results :], posted by SLS on August 24, 2004, at 6:10:29
j/w
Posted by SLS on August 24, 2004, at 10:23:53
In reply to is it making you more sleepy at all?, posted by Lest on August 24, 2004, at 9:45:49
> j/w
Yes.
At first, I didn't know how to interpret the increased sleepiness I have experienced, but I have been suspecting as much over the last two days. I was hoping it wasn't a side effect. Looks like it is. Maybe it's good I started out so slowly. Still, I'd like to move up to 60mg tomorrow. We'll see. I have a feeling the sleepiness will pass eventually.
- Scott
Posted by SLS on August 24, 2004, at 10:26:58
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 23, 2004, at 17:00:49
8/24/2004
Day 5.
30mg
No improvement in depression.
I am beginning to experience some sleepiness as a side effect. I'm going to take a nap now.
- Scott
Posted by iris2 on August 24, 2004, at 11:15:48
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
Sorry Scott. I did not read the newer posts before I sent a message to you about Cymalta updates. Please ignore my request.
I should have known that of course you would update people on the board. Stupid me!
irene
Posted by alesta on August 24, 2004, at 13:09:54
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by iris2 on August 24, 2004, at 11:15:48
hi, scott, :)
hope you're doing okay. you seem a little bummed in your posts lately (or maybe i'm just reading too much into them). don't lose the optimism...and i still can't figure out what it is about you that draws people to you..:)..an unusual charisma...that's something to smile about.:) there will be an end to this misery soon....i just know it.
take it easy,
amy :)
Posted by Lest on August 24, 2004, at 13:20:31
In reply to Re: Cymbalta (duloxetine) - report--SLS, posted by alesta on August 24, 2004, at 13:09:54
prescribe it for me , what else should i do to try it. k thx
Posted by SLS on August 24, 2004, at 14:00:27
In reply to Re: Cymbalta (duloxetine) - report--SLS, posted by alesta on August 24, 2004, at 13:09:54
Hi Amy.
You are so sweet.
> hope you're doing okay. you seem a little bummed in your posts lately (or maybe i'm just reading too much into them).
No, you were reading them exactly right. I reached a nadir of spririt that comes over me from time to time. It is very hard.
I am trying to remain objective about Cymbalta and not to get too optimistic about it. On the surface, it is not terribly different from the things that have failed to represent an answer to me in the past. However, it is similar enough to things that I have had partial responses to that I have reserved a certain amount of hope. When it comes to the brain, you never know what surprises these drugs have waiting for us.
> don't lose the optimism...
OK. If you say so, I won't. :-)
> and i still can't figure out what it is about you that draws people to you..:)
I had no idea that anyone was. I often thought that I may have come off as being to clinical or something. I haven't always recieved the responses I seem to be getting lately. It feels good.
> ..an unusual charisma...that's something to smile about.:)
I think I'll savor this comment for awhile. You know, it's funny about how people's personalities can come out or not come out when interacting on the Internet.
> there will be an end to this misery soon....i just know it.
I could really use a break sooner than later. I'll ride awhile on your positive spirit...
> take it easy,
Thanks. I'll try.
> amy :)
scott :)
Posted by pseudonym on August 24, 2004, at 14:51:35
In reply to Cymbalta (duloxetine) - report, posted by SLS on August 21, 2004, at 8:13:25
I want to try Cymbalta almost as badly as yourself. However, I was never expecting much at 30mg from what I read regarding both the double blind and open trials. Here's the quote about the open label trial: "Patients were administered duloxetine 80 to 120 mg/day as two equal doses of 40 mg or 60 mg." So despite the fact that the label states no additional benefit beyond 60, I wonder.
Posted by SLS on August 24, 2004, at 15:04:44
In reply to Re: Cymbalta (duloxetine) - report, posted by pseudonym on August 24, 2004, at 14:51:35
Hi.
> I want to try Cymbalta almost as badly as yourself. However, I was never expecting much at 30mg from what I read regarding both the double blind and open trials. Here's the quote about the open label trial: "Patients were administered duloxetine 80 to 120 mg/day as two equal doses of 40 mg or 60 mg." So despite the fact that the label states no additional benefit beyond 60, I wonder.
They always say crap like that. Inevitably, there are always people who do better at higher dosages. I wouldn't want to stop until 120mg.
I'm kind of glad that my doctor asked that I remain at 30mg for a week. I am finding that somnolence is emerging as a side effect. I plan to go up to 60mg tomorrow or Thursday.
- Scott
Posted by alesta on August 24, 2004, at 15:10:54
In reply to Re: Cymbalta (duloxetine) - report--SLS » alesta, posted by SLS on August 24, 2004, at 14:00:27
> Hi Amy.
>
> You are so sweet.awwww, thanks, scott:)...your reply made me feel good, too. and i meant every word of what i said in my post...
take care you :),
amy
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