![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 335. Go back in thread:
Posted by Lest on August 24, 2004, at 16:23:39
In reply to Im gonna try to get cymbalta tomorrow.. if he wont, posted by Lest on August 24, 2004, at 13:20:31
to get an idea of if im going to feel good on a medication when im just starting, i have found that if i drank 2 beers and feel better than i would usually not on the med then it might be helping. ;] saD that i have drank alcohol when trying new ssri's but nothing bads happened.
Posted by owensmar on August 24, 2004, at 20:36:59
In reply to Re: Cymbalta (duloxetine) - report--SLS » alesta, posted by SLS on August 24, 2004, at 14:00:27
Scott,
I am three days on this board and I find myself immediately thinking of you when I have a question. I barely recognize people's names yet but you stand out.
I have those horrible nadir periods too. I will pray for you. (p.s. I'm a spiritual, not a particularly religious pray-er - hope that's okay)
Marsha
Posted by ravenstorm on August 25, 2004, at 11:01:11
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 24, 2004, at 15:04:44
Apparently the drug reps have a nick name for cymbalta: cymbarfa. I probably won't ever want to try it for that reason. Only 1mg of Lexapro made me feel like I was going to puke through my nose!!
Hope this is the one for you. Glad you are having fairly benign start up side effects so far. It could, apparently, be much, much worse.
Posted by SLS on August 25, 2004, at 20:39:24
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 24, 2004, at 15:04:44
Hi Folks.
8/25/2004
Day 6
30mg
No perceptible improvement in depression.
No side effects.
I did not experience nearly as much sleepiness today. Hopefully, somnolence will not be an issue when I increase the dosage tomorrow.
- Scott
Posted by Lest on August 25, 2004, at 21:05:10
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 25, 2004, at 20:39:24
hope right now.. so i go to the dr. and he says he doesnt want me trying it cuz its so "new", so he presribed me, lamictal.. and heres what it does..."Lamictal is prescribed to control partial seizures in people with epilepsy. It is also used to control a serious form of epilepsy known as Lennox-Gastaut syndrome. Lamictal is used in combination with other antiepileptic medications or as a replacement for a medication such as Tegretol, Dilantin, phenobarbital, or Mysoline. "
Keep in mind ive never had a seizure, nor do i want to deal with the side effects which are completely more severe than cymbalta. hes a turd
Posted by SLS on August 26, 2004, at 14:26:17
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 25, 2004, at 20:39:24
8/26/2004
Day 7
60mg
No perceptible improvement in depression.
No side effects except that I experienced some sleepiness today. It was not so much that I would use the word somnolence, though. I have been sleeping well at night and am able to get up at my regular time of 6:30am.
- Scott
Posted by SLS on August 27, 2004, at 15:14:27
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 26, 2004, at 14:26:17
8/27/2004
Day 8
60mg
No perceptible improvement in depression, but this is only my third day at a therapeutic dosage.
No side effects except that for some continued sleepiness. I slept for a few hours this afternoon. I would not consider it hindering to functioning.
- Scott
Posted by Lest on August 27, 2004, at 23:53:22
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 27, 2004, at 15:14:27
sell me 5 60 mg pills so i can take them til i see my dr. next week :P
Posted by jparsell82` on August 28, 2004, at 8:38:24
In reply to scott. wanna make some money?, posted by Lest on August 27, 2004, at 23:53:22
Well, my order of Milnacipran is shipped out and today I am seeing my pdoc to get Cymbalta. I will probably try the Cymbalta first... I'm not sure that there would be much difference between the two. I think I read Milnacipran is just a little bit more preferential for norepinephrine than Cymbalta. We'll see I guess.
Posted by SLS on August 28, 2004, at 9:58:19
In reply to Starting soon..., posted by jparsell82` on August 28, 2004, at 8:38:24
Hi.
> Well, my order of Milnacipran is shipped out and today I am seeing my pdoc to get Cymbalta. I will probably try the Cymbalta first... I'm not sure that there would be much difference between the two.
There is a giant difference between the two drugs if one works and the other one doesn't. Please don't exclude either one based upon your experience with the first of the two. Scientists haven't determined all of the properties of each individual drug to be able to conclude such things as interchangeability. The placement of one atom can make all the difference in the world. One must account for not just what these drugs do, but precisely where in the brain they do them. Just like in real estate, it's "location, location, location".
Good luck with Cymbalta. If for no other reason, it makes sense to try it first because of its availability locally.
- Scott
Posted by theo on August 28, 2004, at 11:01:49
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 27, 2004, at 15:14:27
How's today? I know it's early to give a more in depth comparison, but can you compare the startup of Cymbalta to Prozac, Paxil, Effexor, etc. or is it a completely different feeling?
Posted by SLS on August 28, 2004, at 11:24:40
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on August 28, 2004, at 11:01:49
> How's today? I know it's early to give a more in depth comparison, but can you compare the startup of Cymbalta to Prozac, Paxil, Effexor, etc. or is it a completely different feeling?
Hi Theo.So far, this thing is very clean. Gosh, if this stuff works, it would be incredible.
Today is starting out pretty good so far. I have noticed that food tastes better. That is always a good sign. There are a couple of other things going on that I am happy to see. My finger-tap test is improving and the tips of my fingers are sweaty. Also, I am not feeling cold all of the time. These things have been consistent markers for me in the past that something good is happening. I must add the caveat, however, that I am still in that 2-3 week period after discontinuing imipramine when I often do see a rebound improvement. It confounds any interpretation of these positive phenomena.
- Scott
Posted by owensmar on August 28, 2004, at 16:16:52
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 28, 2004, at 11:24:40
>
>
> Hi Theo.
>
> So far, this thing is very clean. Gosh, if this stuff works, it would be incredible.
>
> Today is starting out pretty good so far. I have noticed that food tastes better. That is always a good sign. There are a couple of other things going on that I am happy to see. My finger-tap test is improving and the tips of my fingers are sweaty. Also, I am not feeling cold all of the time. These things have been consistent markers for me in the past that something good is happening. I must add the caveat, however, that I am still in that 2-3 week period after discontinuing imipramine when I often do see a rebound improvement. It confounds any interpretation of these positive phenomena.
>
>
> - Scott
>
>
Scott,I am wondering how you did on imipramine and the reason for d/cing it. Did it just not work very well or were the side effects bad?
I was on imipramine a long time ago and did well. If Cymbalta doesn't work for me I was thinking of trying imipramine again but I can't remember what side effects I had then (1986-87).
I am hoping so much that Cymbalta works for you.
Marsha
Posted by Nohope on August 28, 2004, at 18:51:18
In reply to Re: Starting soon... » jparsell82`, posted by SLS on August 28, 2004, at 9:58:19
> There is a giant difference between the two drugs if one works and the other one doesn't. Please don't exclude either one based upon your experience with the first of the two. Scientists haven't determined all of the properties of each individual drug to be able to conclude such things as interchangeability. The placement of one atom can make all the difference in the world. One must account for not just what these drugs do, but precisely where in the brain they do them. Just like in real estate, it's "location, location, location".
If you like, do a search for 'milnacipran' and 'structure', then 'parnate' and 'structure'. They are very similar in structure, but feel totally different in effect. No doubt you are absolutely right when you say it's not just what these drugs do but where they do it.
Nohope
Posted by SLS on August 29, 2004, at 7:03:20
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by owensmar on August 28, 2004, at 16:16:52
Hi.
> I am wondering how you did on imipramine and the reason for d/cing it. Did it just not work very well or were the side effects bad?
Combined with Lamictal, I was only getting about a 15% response. I was taking 300mg. Physical side effects became tolerable over time, but it did cause some mild-moderate impairments of memory and cognition that I wasn't happy about.
> I was on imipramine a long time ago and did well. If Cymbalta doesn't work for me I was thinking of trying imipramine again but I can't remember what side effects I had then (1986-87).
Dry mouth, blurred vision, constipation, sweating, orthostatic hypotension, urinary retention, tachycardia, itching, weight gain, and a few others that are on the tip of my tongue. Of course, it is unlikely that you will get all of them.
> I am hoping so much that Cymbalta works for you.
Thanks. :-) Me too...
- Scott
Posted by Dr. Bob on August 29, 2004, at 22:39:33
In reply to scott. wanna make some money?, posted by Lest on August 27, 2004, at 23:53:22
> sell me 5 60 mg pills so i can take them til i see my dr. next week :P
Please do not request medication directly from others here:
http://www.dr-bob.org/babble/faq.html#illegal
Thanks,
Bob
Posted by Lest on August 29, 2004, at 23:09:55
In reply to Re: requesting medication from others » Lest, posted by Dr. Bob on August 29, 2004, at 22:39:33
j/k :]
Posted by theo on August 30, 2004, at 7:09:25
In reply to Re: Cymbalta (duloxetine) - report » owensmar, posted by SLS on August 29, 2004, at 7:03:20
How's Cymbalta treating you?
Also, I posted below a question on increasing and decreasing Lamictal dose after you go above 100mg. You mentioned before you jump aroung between 150-300mg and was wondering in what dosing increments are best when going back and forth, 50mg, 100mg?
Posted by SLS on August 30, 2004, at 8:17:02
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on August 30, 2004, at 7:09:25
> How's Cymbalta treating you?
>
> Also, I posted below a question on increasing and decreasing Lamictal dose after you go above 100mg. You mentioned before you jump aroung between 150-300mg and was wondering in what dosing increments are best when going back and forth, 50mg, 100mg?Hi Theo.
Everything remains the same. I am not experiencing any real improvement, but no side effects. The sleepiness seems to be dissipating.
I saw your post below and responded to it. I think it makes sense to move in 50mg increments. I also think that to really put Lamictal to the test, you should continue to increase the dosage as long as you are tolerating side effects. Many people need more than 200mg to get the full antidepressant effect.
- Scott
Posted by jrbecker on August 30, 2004, at 10:59:27
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 30, 2004, at 8:17:02
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. Some nights, I have experienced a little sleep disruption and initial insomnia on some nights. But I've been able to still make it to the gym, so I can't say that there's been any decrease in my overall enegry level. To my relief, I have not experienced any increase in anxiety or agitation. As Scott mentioned, the drug is rather "clean."
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.
JB
Posted by mxrider on August 30, 2004, at 13:00:57
In reply to Re: Cymbalta (duloxetine) - report » theo, posted by SLS on August 21, 2004, at 12:03:34
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.
Chris
Posted by SLS on August 30, 2004, at 14:41:34
In reply to Re: Cymbalta (duloxetine) - day 7, posted by jrbecker on August 30, 2004, at 10:59:27
> here's my first report...
I hope it's the first of many good ones...
:-)
Good luck with Cymbalta!
- Scott
Posted by Lest on August 30, 2004, at 15:38:12
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on August 23, 2004, at 17:00:49
what seems to be the majority of people experience with this drug from what youve read?
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?
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.