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Dr. Bob is Robert Hsiung, MD,
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Posted by theo on August 30, 2004, at 16:31:28
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 30, 2004, at 8:17:02
I have another question posted below under "Lamictal increase-decrease" and wanted your input if you get a chance.
Thanks,
Theo
Posted by jrbecker on August 30, 2004, at 16:40:18
In reply to Re: Cymbalta (duloxetine) - report for SLS JB, posted by mxrider on August 30, 2004, at 13:00:57
> Hello Scott and JB,
>
> I have a quick question for either or both of you. I have not responded well to SSRI's as of yet. I experience pronounced agitation, irritability, and insomnia. The exception being a low dose of Paxil CR (12.5) day for 2 years. I also take Klonopin 1mg/day b.i.d. for depression and SP. I think I may have soft BP but no dx yet. My question is you have reported no anxiety or other side effects with duoloxetine. How have you reacted to SSRI's in the past? Did you experience anxiety or agitation to those meds? Any input would be helpful.
>
> Chrisyes, that's typically been my response to SSRIs as well. And yes, I have a dx that falls in line with atypical depression and soft BP II symptoms too.
I did experience some of the same side effects while on Effexor, but to a lesser degree than those experienced with most of the SSRIs. Actually, I'm quite certain that my anxiety is much better on Effexor than with SSRIs. Agitation is less, but not considerably. Insomnia was not a problem on effexor since I kept it so low (i took it at night and it actually helped me doze off), however, I can imagine that for many, effexor might be worse than SSRIs for some people.
My current approach is to always keep the dosage low and to augment with exercise - my best weapon for counteracting these side effects.
As for Cymbalta thus far, I'm happy to report that I'm having LESS of these issues (agitation, anxiety) than I did on Effexor.
Besides induced apathy, agitation has always been my biggest complaint about antidepressants. The side effect itself might come from a variety of causes (e.g., 1) 5HT2A agonism, 2) decrease in prefronal dopamine activity, 3) P450 liver metabolism).
see:
http://www.dr-bob.org/babble/20040608/msgs/354870.html
klonopin did help my agitation, and my anxiety to a lesser extent, but in the end I found it was too emotionally-blunting.have you tried effexor before? If so, what was your reaction?
Posted by mxrider on August 30, 2004, at 17:22:32
In reply to Re: Cymbalta (duloxetine) - report for SLS JB » mxrider, posted by jrbecker on August 30, 2004, at 16:40:18
Hi JB,
I haven't given Effexor a trial yet, I assumed it would cause similar SE's as it acts like a SSRI at the low dosages to my understanding. As for the aggitation thing, I couldn't eat enough Klonopin to make it go away, not fun! I am currently in my first week on a Wellbutrin trial on my Pdoc's advise, (it seems contraindicated when you consider my strong social anxiety, but hey, what the heck, at least I can drop it easily). Anyway, thanks for the reply, I hope the duloxetine does the trick for you!
Chris
Posted by owensmar on August 30, 2004, at 19:12:42
In reply to Re: Cymbalta (duloxetine) - day 7, posted by jrbecker on August 30, 2004, at 10:59:27
> here's my first report...
>
> taking 30mg once daily in the morning. only side effects are some mild somnolence about 3-6 hours after dosing.If somnolence seems to be a problem (for you & SLS) why is everyone taking it in the am? Would it be better to take it at night?
> So far, I must admit that this is a welcomed improvement over my prior regimen of Effexor 37.5mg.
>
> I plan to stick with 30mg for a couple more weeks.
>
> I haven't ruled out upping to 40mg (20mg BID) or even decreasing to 20mg. As you might guess, I'm fairly med sensitive.
>
Thanks for your report - I'm another Effexor 37.5 mg/day person (also med sensitive) and expect to try Cymbalta soon.Good luck...
Marsha
>
Posted by Lest on August 31, 2004, at 0:37:32
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on August 30, 2004, at 16:31:28
death..
jk... i took one 60 mg. and umm 3 beers , ill let u know how i feel tomorrow :D And yes i am insane
Posted by jessie77 on August 31, 2004, at 6:57:09
In reply to Re: Cymbalta (duloxetine) - day 1, posted by Lest on August 31, 2004, at 0:37:32
Hi,
I have been trying to follow the threads on Cymbalta; sorry if this question has already been posted. I am starting Cymbalta today as a last ditch effort for severe depression and anxiety. Im still on adderrall and slowly coming off topamax, which I think has really made me depression a lot worse. A LOT worse.I gained 20 pounds on paxil which made me flip
out considering I have a history of eating disorders. I know they are saying that Cymbalta is "weight neutral" but I feel like Ive heard that before with Lexapro, which made me gain 6 pounds in like 30 seconds.I know it hasnt been around long, but how have you guys on Cymbalta been doing in regard to weight and appetite? Gaining weight seriously increases my depression. (not like anyone gets excited about it:)
Thanks,
Jess
Posted by SLS on August 31, 2004, at 7:50:04
In reply to Re: Cymbalta (duloxetine) - report » owensmar, posted by SLS on August 29, 2004, at 7:03:20
8/31/2004
Day 12 (6 days at 30mg; 6 days at 60mg)
60mg (30mg b.i.d.)
I wish I could say that I was feeling an improvement. I'm not. Of course, it is still relatively early in the trial.
Mild sleepiness remains as a side effect. No other side effects have emerged. Weight gain and sexual side effects don't seem to be issues at this time.
- Scott
Posted by theo on August 31, 2004, at 9:42:33
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 31, 2004, at 7:50:04
Do you feel at all that Cymbata will be good for anxiety?
Can you roughly compare how you are currently feeling on Cymbalta to any other SSRI's you have taken in the past?
Posted by nmk on August 31, 2004, at 10:17:45
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 31, 2004, at 7:50:04
> 8/31/2004
>
> Day 12 (6 days at 30mg; 6 days at 60mg)
>
> 60mg (30mg b.i.d.)
>
> I wish I could say that I was feeling an improvement. I'm not. Of course, it is still relatively early in the trial.
>
> Mild sleepiness remains as a side effect. No other side effects have emerged. Weight gain and sexual side effects don't seem to be issues at this time.
>
>
> - ScottHi Scott,
Thanks for the updates. I am on day 4 30mg and can't stand it. I have not noticed any improvement and feel very dizzy and more anxious on it. Are you having any of these symptoms? Also, have you ever tried Effexor? I am finding the s/e's to be almost identical and was wondering if you thought the same?
Thanks again for keeping us all in the loop, I do appreciate it.
Nicole
Posted by pseudonym on August 31, 2004, at 11:45:21
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 31, 2004, at 7:50:04
Scott,
So I understand, you were taking imipramine, lamictal and a benzo, and have swapped the imipramine with Cymbalta, correct?
Posted by SLS on August 31, 2004, at 12:00:07
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by nmk on August 31, 2004, at 10:17:45
Hi Nicole.
> I am on day 4 30mg and can't stand it.
:-(
Gosh, that is such a short period of time. I know how frustrating and infuriating side effects can be, especially if you've had them before with other drugs. Sometimes it is best to take things one day at a time. Despite how significant the side effects are, at the end of today, can you commit to taking Cymbalta for just one more day? Ask yourself the same question at the end of tomorrow. I have had to do this before.
> I have not noticed any improvement
Of course, not. You can't expect to see any until you are on 60mg for 2-3 weeks. I have to remind myself of this.
> and feel very dizzy and more anxious on it. Are you having any of these symptoms?
No. But neither did I have those effects with Effexor either, although it did make me feel "spacy".
With Effexor, how long did these side effects last for? If they were temporary, I would look forward to them being temporary again with Cymbalta.
* Just because the startup side effects of two drugs are similar doesn't mean the the outcome will be the same! Cymbalta could very well work where Effexor failed.
Did you respond at all to Effexor?
I wish you the best.
- Scott
Posted by SLS on August 31, 2004, at 12:03:36
In reply to Re: Cymbalta (duloxetine) - report, posted by pseudonym on August 31, 2004, at 11:45:21
Hi Pseudonym.
> So I understand, you were taking imipramine, lamictal and a benzo, and have swapped the imipramine with Cymbalta, correct?
I had been taking:imipramine 300mg
Lamictal 150mg
Namenda 20mg
Abilify 10mgNo benzo.
I discontinued imipramine for one week before starting Cymbalta.
- Scott
Posted by SLS on August 31, 2004, at 12:11:22
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on August 31, 2004, at 9:42:33
Hi Theo.
> Do you feel at all that Cymbata will be good for anxiety?
So far, two people have reported a reduction in their anxiety after only one day. This is nice to hear, but only time will tell. Be aware that several SSRIs can produce anxiety as a startup side effect that eventually disappears and yields to a reduction in anxiety and depression.
> Can you roughly compare how you are currently feeling on Cymbalta to any other SSRI's you have taken in the past?
So far, I find it to be cleaner than the SSRIs or Effexor. I can detect no effects on cognition. No fogginess or spaciness. No anxiety. No sexual side effects. These are things that have occurred with me with these drugs in the past.
I hope this helps. I know you want all of the answers right away. I'm afraid there are no guarantees that Cymbalta will act similarly or differently from other drugs based upon the drug category it is loosely placed in or the side effects that appear early in treatment. I think we are all in this discovery stage together.
- Scott
Posted by pseudonym on August 31, 2004, at 12:27:29
In reply to Re: Cymbalta (duloxetine) - day 7, posted by jrbecker on August 30, 2004, at 10:59:27
I'm going to ask for Cymbalta this week as well. Please keep the group aprised of your status jr.
Posted by hope4best on August 31, 2004, at 20:16:36
In reply to Re: Cymbalta (duloxetine) - report » nmk, posted by SLS on August 31, 2004, at 12:00:07
Hi, just wanted to say thank you for taking the time to share your experience with Cymbalta--and for all the positive support you give to others. My doctor is refusing to give me a rx for Cymbalta--I'm bummed but will try tomorrow to find a new doctor who will be willing to let me try it. Thanks again, and wishing you all the best.
Posted by theo on September 1, 2004, at 7:05:18
In reply to Thanks SLS, posted by hope4best on August 31, 2004, at 20:16:36
Posted by hope4best on September 1, 2004, at 8:18:22
In reply to Why is your doctor refusing Cymbalta? (nm) » hope4best, posted by theo on September 1, 2004, at 7:05:18
Believe it or not, I feel like he is refusing to write me an Rx for it simply because it was my idea to go on it. When he finally returned my calls (after 3 days) he was like, "you think you can go online and learn all about a medication and then tell me what to prescribe...it doesn't work that way." I reminded him that I have already tried a lot of medications--Lexapro, Zoloft, Paxil, Remeron, Serzone, Wellbutrin, Prozac...he said, "That's not really that many medications..." I don't understand him, I was so sad when he said he wouldn't prescribe it for me--Cymbalta sounds like it might work for me and I feel hopeful about it. Now I am making phonecalls trying to find a new dr, but u know how it can be, the doctor isn't taking new patients at this time...etc.
Posted by Denise1904 on September 1, 2004, at 11:25:13
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 31, 2004, at 12:11:22
Hi Scott,
How long are you going to stay on 60mg, do you intend going up to the max dose of 80mg and if so for how long?
Denise
Posted by ravenstorm on September 1, 2004, at 12:34:58
In reply to Re: Why is your doctor refusing Cymbalta? » theo, posted by hope4best on September 1, 2004, at 8:18:22
Hope4best: I hope you find another doctor, that is just sooo ridiculous. And for him to make light of how many drug trials you have had is just mean spirited.
For everybody starting or in the middle of yet another trial (Thats me too) just try to remember that expecting results in two to three weeks is often way too optimistic. PLEASE don't stop a drug trial at six weeks. A lot of people don't respond until eight, ten or twelve weeks. The only drug I responded to in three weeks was paxil. My last drug trial I got anti'anxiety in four weeks and AD effect (well, what there was of it) in ten weeks(only partial response so on I go). I just wonder how many people don't find the drug that works because they stop at the recommended four to six weeks. I just think for some people that isn't enough time.
I know it sucks to invest so much time, but it might be worth a big pay off in the end.
Posted by owensmar on September 1, 2004, at 15:03:00
In reply to Re: Why is your doctor refusing Cymbalta? » theo, posted by hope4best on September 1, 2004, at 8:18:22
I've seen this advice posted elsewhere on this board. If you don't have other problems and other meds to have to balance, maybe you could try asking for a trial of Cymbalta from a GP while you look for another pdoc. Most GP's I've been to are less likely to get their feathers ruffled by patient suggestions. Not as much ego, perhaps?
I've also discovered that if there is something in particular you want the doctor to recognize, you can't go at it directly. You have to work it so that they think they thought of it themselves.
For example, if you think you have fibromyalgia, don't go in and say "I think I have fibromyalgia." Go in and describe the symptoms you are having and let the doc come up with the dx.
Good luck
Marsha
Posted by SLS on September 1, 2004, at 20:03:20
In reply to Re: Cymbalta (duloxetine) - report -To Scott (SLS), posted by Denise1904 on September 1, 2004, at 11:25:13
Hi Denise.
> How long are you going to stay on 60mg,Probably for three weeks if there is no improvement.
> do you intend going up to the max dose of 80mg and if so for how long?
I think my doctor and I are looking at 120mg as a maximum. Many of the studies used this as one of the dosages tested. It probably makes sense to go to 80mg (40mg b.i.d.) for three weeks before going to 120mg. I guess it will depend upon the degree of antidepressant response and my tolerance of side effects.
- Scott
Posted by Lest on September 2, 2004, at 0:02:46
In reply to Re: Cymbalta (duloxetine) - report -To Scott (SLS) » Denise1904, posted by SLS on September 1, 2004, at 20:03:20
im havin trouble breathing on it, but thats just me, i reacted the same to zoloft, ill let ya know how it goes. peace
Posted by SLS on September 2, 2004, at 8:05:40
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 31, 2004, at 7:50:04
9/2/2004
Day 14 (6 days at 30mg; 8 days at 60mg)
60mg (30mg b.i.d.)
I felt some signs of improvement in my depression yesterday. It was slight, but perceptible. I'm not so sure about today. It's still early, though. It is so hard to be patient.
The sleepineness that I had been experiencing was not evident yesterday. No other side effects have emerged.
- Scott
Posted by KaraS on September 2, 2004, at 8:47:23
In reply to Re: Cymbalta (duloxetine) - report -To Scott (SLS), posted by Lest on September 2, 2004, at 0:02:46
> im havin trouble breathing on it, but thats just me, i reacted the same to zoloft, ill let ya know how it goes. peace
That's the way I reacted to Wellbutrin. I've never heard anyone else say that about a medication. It's an awful feeling, isn't it?
Posted by jessie77 on September 2, 2004, at 9:49:55
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 2, 2004, at 8:05:40
> 9/2/2004
>
> Day 14 (6 days at 30mg; 8 days at 60mg)
>
> 60mg (30mg b.i.d.)
>
> I felt some signs of improvement in my depression yesterday. It was slight, but perceptible. I'm not so sure about today. It's still early, though. It is so hard to be patient.
>
> The sleepineness that I had been experiencing was not evident yesterday. No other side effects have emerged.
>
>
> - ScottI have been on Cymbalta for 3 days. The sleepiness is killing me. I feel like I am talking to people and my eyes are literally closing.
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