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Dr. Bob is Robert Hsiung, MD,
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Posted by 4WD on September 8, 2004, at 22:39:37
In reply to Re: Help, I'm panicky » 4WD, posted by iris2 on September 8, 2004, at 22:27:38
> It is going to be okay. Is your family coming home soon? The Zyprexa should help a lot. Probably is better than the klonopin would have been so maybe it is a good thing they were out of it. You already know that you have been through this before so remember that and you'll know that it always goes away. Really for panicy stuff I always think Zyprexa or perphenazine or one of the major tranquilizers does the trick in a pinch. I'll be up for a while so I'll check in later to see if you're okay. I hope you just fall asleep though.
>
> ireneThank you Irene. My husband will be home fromn work in about half an hours but I don't want him to come home and find me crying and terrified. He has had to pull me through these attaack so many times befoe\re he must be sick of it by now. God lknows I am sick of it myself. I will wait for the zyprexa to kick in and maybe I will feel better. In the meantime I will just pace and wring my hands and i can't stop crying. i guess it's partly that i feel so sorry for myself right now.
marsha
Posted by iris2 on September 8, 2004, at 23:09:05
In reply to Re: Help, I'm panicky » iris2, posted by 4WD on September 8, 2004, at 22:39:37
Marsha,
Strange I was going to suggest to you to respond to that particular post a few minutes ago.
The Zyprexa should have a fairly quick onset of action so you should start to feel better within the hour. I know the perphenazine I take when I get like that takes about 1/2 hour to start to work. So hopefully you will feel calmer before your husband gets in. Does it make you tired or sleepy? It does for me. Just writng so you'll know that you're not alone. I am usually awake until at least 2pm or later.irene
Posted by 4WD on September 9, 2004, at 20:09:02
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Cymbalta Day 7 - 9-9-04
Whew. Last night was bad. The Zyprexa helped.
Thanks for all the support (Irene).
Today I feel much better. I've got a few days of a small dose Effexor back in me and will now taper properly.
Efficacy: I still have a lot more energy. I am more talkative, less withdrawn. I feel a little bit of motivation to use the energy only as of today. I have managed to get myself to the gym four times in the last week which definitely did not happen on Effexor.Side effects: The tone in my head is still very bothersome especially if I am somewhere quiet. I don't notice it as much with the AC, computer, refrigerator etc. running but if I am in a quiet place, it is really loud. My head feels like there is too much pressure inside it - this is part of the ear-ringing thing. I complained to my PCP today about it and I am having an MRI done on Monday since I also have another problem which could indicate a pituitary gland tumor. The ear-ringing could be related.
Don't know if the orgasm delay has gotten any better or worse - haven't tried to find out in the last couple days.
My anxiety level has gone back down in general since restarting a small dose of Effexor three days ago. I still have quite a bit of anxiety and have had a couple of bad spells but now that I know it's from the Effexor withdrawal I'm feeling better about it.
I'm still having some dry mouth.
Other than that, no side effects.
Small improvement in motivation.No improvement in anhedonia.
Posted by hope4best on September 9, 2004, at 20:20:57
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Marsha,
Hang in there, we're pulling for you and there with you in spirit. Thanks for sharing your experiences. I don't want to sound cliche, but for me, the saying "This too shall pass" is always helpful when I feel low, since both good times and bad times shall pass.
Wishing you good times!
Posted by SLS on September 10, 2004, at 7:21:19
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
> Efficacy: I still have a lot more energy
> Small improvement in motivation.
> No improvement in anhedonia.You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
- Scott
Posted by 4WD on September 10, 2004, at 18:39:29
In reply to Re: Cymbalta Journal, posted by SLS on September 10, 2004, at 7:21:19
> > Efficacy: I still have a lot more energy
>
> > Small improvement in motivation.
>
> > No improvement in anhedonia.
>
> You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
>Thanks, Scott. I was wondering about that but had never heard one way or the other. You know, when my PCP told me she wanted me to have a brain MRI because I have some symptoms that would hint at a pituitary gland tumor my first thought was "oh I hope so! That could explain my depression and they could remove it and then I'd be okay!" Kind of twisted. I guess only another depressed person would understand.
Marsha
>
Posted by 4WD on September 10, 2004, at 19:48:25
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Cymbalta 20mg
Effexor 15 mg(to mitigate withdrawal)Day 8 9-10-04
I lowered the dose of Cymbalta today to see if the ringing in my ears might lessen on a lower dose. Just an experiment; I'm going back up to 30mg tomorrow. I've added back about 15-20 mg Effexor to help with the withdrawal symptoms I've been having (anxiety). I'll slowly taper the Effexor over the next few weeks.
I can't really give an accurate report today. I took some prescription pain meds yesterday and so today I feel kind of groggy and out of sorts. (This always happens.)
Taking the pain pills has showed me one new side effect, though. When I take those pain meds, I get a lot of energy and motivation and enjoy doing constructive things. So I went out and worked on my little garden area in the back yard yesterday after I took the meds. I discovered that I sweat a lot more with exertion now that I'm on Cymbalta. Admittedly it was about 85 degrees and I was digging with a shovel but I usually don't perspire much even when I'm hot. Luckily it only seems to happen with pretty heavy activity. I haven't noticed any sweating at all during normal activities.
I'll be able to report better tomorrow. I should be about back to "normal" by then.
Marsha
Posted by 4WD on September 10, 2004, at 21:09:22
In reply to Re: Cymbalta Journal, posted by SLS on September 10, 2004, at 7:21:19
> > Efficacy: I still have a lot more energy
>
> > Small improvement in motivation.
>
> > No improvement in anhedonia.
>
> You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
>
>
> - Scott
P.S. It's really nice of you to be supportive, Scott, since the Cymbalta doesn't seem to be working so well for you. I truly do appreciate it.Marsha
Posted by iris2 on September 11, 2004, at 0:09:11
In reply to Re: Cymbalta Journal - Day 8, posted by 4WD on September 10, 2004, at 19:48:25
> I lowered the dose of Cymbalta today to see if the ringing in my ears might lessen on a lower dose. Just an experiment; I'm going back up to 30mg tomorrow.
Marsha,
Just a thought. Do not knwop the half life of Cymbalta but do you think that one day of lowered Cymbalta is long enough to observe an accurate change in the ringing in your ears?
irene
Posted by 4WD on September 12, 2004, at 16:28:27
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Days 9 and 10 (Saturday & Sunday, Sept. 11 &12)
Cymbalta 30mg
Effexor 15 mgDay 9 (yesterday) was pretty bad. It was partly from still feeling groggy and tired from taking too many pain pills (hydrocodone) on Thursday so that was my fault. I had just been so tired of feeling so bad for so long that I desperately wanted to feel GOOD for a little while. Now I'm paying for it.
It was also from the pressure in my head and the ringing tone in my head. This is much worse than it was on 37.5 mg of Effexor and with Effexor I never had the pressurized feeling. Last night about 10 o'clock it got really bad. My neck and shoulders got real tense and started to draw up. My head felt like it was overstuffed with heavy wet cotton- my brain felt like it was swollen. When I'd turn my head from side to side it felt like my sore brain was banging against the inside of my skull. Then it turned into an actual painful headache starting at the base of my skull and moving over the whole top of my head. I took some ibuprofen and went to bed.
Day 10 Sunday didn't start out so great either. I felt okay (though still tired from pain pills) but a little scared when I got up. Within a hour I was very anxious and in another hour got panicky. I took 1/8 mg of Klonopin and the panic subsided into fear. I waited about an hour then took another 1/8 mg K. Now I feel okay but my head still feels pressurized. It's like I'm in an airplane but my ears won't pop x five and my brain is vaguely sore. ANd the tone in my head is driving me nuts.
It's hard for me to tell how I'd be feeling if I weren't having the tone in my head and if I weren't having to take Klonopin. The K makes me feel a bit down.
I don't know if the anxiety is completely from Effexor withdrawal or not. I tend to think it is since my anxiety has increased every time I switch from Effexor to another drug.
Today I do not feel energetic, motivated or hedonic. I think yucky/nervous might describe it. I am sleeping great, though.
Marsha
Posted by iris2 on September 13, 2004, at 9:14:05
In reply to Re: Cymbalta Journal, posted by 4WD on September 12, 2004, at 16:28:27
Marsha,
Sorry to hear that things are not so well the last couple of days. Hope most of it is from the Effexor withdrawel. That will be over soon enough so keep you chin up. I'll be thinking of you of course.
irene
Posted by 4WD on September 13, 2004, at 21:03:07
In reply to Re: Cymbalta Journal » 4WD, posted by iris2 on September 13, 2004, at 9:14:05
> Marsha,
>
> Sorry to hear that things are not so well the last couple of days. Hope most of it is from the Effexor withdrawel. That will be over soon enough so keep you chin up. I'll be thinking of you of course.
>
> irene
Thank you Irene. I am much better today. It was partly from the pain pills, partly from the Effexor withdrawal. The pain pill part is over but I'm still having panic attacks from the Effexor withdrawal.Marsha
Posted by 4WD on September 13, 2004, at 21:37:02
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Day Eleven, Monday, 9-13-04
Cymbalta 30mg (15mg a.m., 15mg p.m.)
Effexor XR 10mg
Klonopin .25 mg as needed, mostly in the morningsNOTE: I may not be posting after today or tomorrow for a while. Hurricane Ivan is headed straight for where I live (between Mobile, AL & Pensacola, FL)
I'm doing much, much better today.
The bad feeling from the pain pills has worn off. I'm still experiencing anxiety and some panic attacks presumably from the Effexor withdrawal.
Efficacy: I have so much energy. I am bouncy. Part of this is nerves from the hurricane, however. I am sleeping better than I have in years. I go to bed and am asleep within 20 minutes. This is miraculous for me. (this is without klonopin) I am feeling maybe a bit more motivation but not a lot. Still can't say there's any improvement in anhedonia.
Side effects: Absolutely no sleepiness after dosing, either at 30mg in the morning or when I divide the doses. I am dividing the doses because I have found myself waking up after fewer hours sleep than I want to get. I thought maybe the Cymbalta was wearing off too soon and anxiety was waking me up too early.
The buzz/hum/roar in my head is still there. I am trying to ignore it. It's not too hard except when I'm in a quiet place; then it's maddening. The pressurized feeling is less though.
Mild delay in orgasm. Libido seems okay, not much opportunity lately.
Dry mouth is less.
I can't decide whether it would be better to taper the Effexor rapidly and get it over with while I'm taking Klonopin or to drag it out and have to take the Klonopin longer. It doesn't seem to matter how slowly I taper, I'm going to have anxiety regardless and as soon as I quit it completely, it's going to get worse. I'm afraid the ringing in my ears is worse because I'm taking Effexor + Cymbalta - they both cause it.
In general I'm very happy with Cymbalta - if the dratted ringing in my ears would go away, I'd be thrilled.
Marsha
Posted by boomarang on September 13, 2004, at 22:20:08
In reply to Re: Cymbalta Journal Day 11, posted by 4WD on September 13, 2004, at 21:37:02
hi marsha,
i am also experiencing panic attacks. i think it has more to do with the lamictal i'm taking than the cymbalta. i've been on cymbalta four days and the panic attacks started a week before that. i think my lamictal dose was too high, causing way too much anxiety and now i'm probably still having them because i'm reducing the lamictal fairly quickly.
Posted by Allie Blue on September 14, 2004, at 11:30:38
In reply to Re: Cymbalta Journal Day 11, posted by 4WD on September 13, 2004, at 21:37:02
> Day Eleven, Monday, 9-13-04
>
> Cymbalta 30mg (15mg a.m., 15mg p.m.)
> Effexor XR 10mg
> Klonopin .25 mg as needed, mostly in the mornings
>
> NOTE: I may not be posting after today or tomorrow for a while. Hurricane Ivan is headed straight for where I live (between Mobile, AL & Pensacola, FL)
>
> I'm doing much, much better today.
>
> The bad feeling from the pain pills has worn off. I'm still experiencing anxiety and some panic attacks presumably from the Effexor withdrawal.
>
> Efficacy: I have so much energy. I am bouncy. Part of this is nerves from the hurricane, however. I am sleeping better than I have in years. I go to bed and am asleep within 20 minutes. This is miraculous for me. (this is without klonopin) I am feeling maybe a bit more motivation but not a lot. Still can't say there's any improvement in anhedonia.
>
> Side effects: Absolutely no sleepiness after dosing, either at 30mg in the morning or when I divide the doses. I am dividing the doses because I have found myself waking up after fewer hours sleep than I want to get. I thought maybe the Cymbalta was wearing off too soon and anxiety was waking me up too early.
>
> The buzz/hum/roar in my head is still there. I am trying to ignore it. It's not too hard except when I'm in a quiet place; then it's maddening. The pressurized feeling is less though.
>
> Mild delay in orgasm. Libido seems okay, not much opportunity lately.
>
> Dry mouth is less.
>
> I can't decide whether it would be better to taper the Effexor rapidly and get it over with while I'm taking Klonopin or to drag it out and have to take the Klonopin longer. It doesn't seem to matter how slowly I taper, I'm going to have anxiety regardless and as soon as I quit it completely, it's going to get worse. I'm afraid the ringing in my ears is worse because I'm taking Effexor + Cymbalta - they both cause it.
>
> In general I'm very happy with Cymbalta - if the dratted ringing in my ears would go away, I'd be thrilled.
>
> Marsha
>
>
> Marsha,Are you splitting the 30mg cymbalta capsules? Are there any problems with splitting and how do you split them? I'm thinking about doing that too but the manufacturers insert says not to split?
ALLIE
Posted by iris2 on September 14, 2004, at 12:46:45
In reply to Re: Cymbalta Journal » iris2, posted by 4WD on September 13, 2004, at 21:03:07
Marsha,
I goggled Effexor withdrawal. There is a lot of stuff. A lot related to anxiety and depression from it if you are interested in reading a little about other people’s experiences here is a link:
http://www.pandamedicine.com/rt_health/123.html
Please do not read this stuff if it will only contribute to how you are feeling. Some people find it easier if they are aware of others experiencing similar side effects.I was in hospital in the first group of patients there to take Effexor. I had side effects that were not in the initial studies. They (the pdocs) used to make me feel like a hypochondriac. Every side effect I had was either already known, observed after they were on the market or a symptom of my I.C. not yet diagnosed. First I had migraines. I did not want to discontinue the Effexor because I thought it was starting to help. Finally a pdoc on the weekend shift believed me and prescribed pain meds. I only had to take them about three times to break the cycle of pain and it stopped. Then I started with frequency and retention. Again they did not believe me. Finally they decided I must have an infection (of course it could not be the med as it was not sighted as a side effect in the trials). The pdocs sent me in a cab about three miles away to my urologist who promptly stretched my urethra as usual to no avail. Then again I got lucky and a new resident came to see me and had compassion and believed me. He prescribed (cannot remember exactly) something for retention. It worked great. But as we increased the Effexor we had to increase that and the stuff for retention finally gave me too many side effects so I finally went off everything. Then they all came in (the big wig pdocs) and tried to talk me into ECT again. I already had had it twice with no positive result. What for? These pdocs have a screw loose themselves. At least a lot of them. Do you not agree?
Long story but I thought you might enjoy the debauchery.
I wanted to convince my Mother to ask her doctor to try Effexor. She is on Prozac and I do not think it is working for her anymore. I know these tend not to poop out but I think it is that her depression became worse. She has not tried other SSRI's and since initially this did work maybe another is the way to go. I just thought that since Effexor acts as an SNRI it might be better to try next. What do you think she should try?
She is 73 with three mild strokes, high blood pressure, and diabetes and tends to be a hypochondriac. She is an anxious person. She is becoming very forgetful. Part is from the stroke I know but I cannot determine since it is a lot worse how much is anxiety, depression or some dementia.Thanks,
Irene
Posted by 4WD on September 14, 2004, at 13:06:41
In reply to Re: Cymbalta Journal » 4WD, posted by iris2 on September 14, 2004, at 12:46:45
Irene,
Probably not Effxor for your Mom since she already has high blood pressure. Maybe Lexapro? It's supposed to have fewer side effects and is supposed to be good for anxiety too.
I think a lot of doctors are just making a stab in the dark with diagnoses and with prescriptions. I've avoided going to hospitals even at my worst because I figured I'd get dosed with stuff I *knew* was bad for me. I'm glad you told me about the ECT. It scared me before but not more.
Marsha
Posted by 4WD on September 14, 2004, at 13:08:26
In reply to Re: Cymbalta Journal Day 11 » 4WD, posted by boomarang on September 13, 2004, at 22:20:08
> hi marsha,
> i am also experiencing panic attacks. i think it has more to do with the lamictal i'm taking than the cymbalta. i've been on cymbalta four days and the panic attacks started a week before that. i think my lamictal dose was too high, causing way too much anxiety and now i'm probably still having them because i'm reducing the lamictal fairly quickly.Yeah, I was having the panic attacks before I started the Cymbalta, too. I think I've reduced the Effexor too quickly but I'm taking Klonopin now anyway so I might as well get it over with while I'm taking the Klonopin instead of draggin it out and having to K longer.
Marsha
Posted by 4WD on September 14, 2004, at 13:11:58
In reply to Re: Cymbalta Journal Day 11 » 4WD, posted by Allie Blue on September 14, 2004, at 11:30:38
I split the pills by opening the capsule, pouring out half the little granules, swallowing them and keeping the rest of the capsule. I pinch the end of it so I know I've taken half of that one. I read that each granule is enteric coated so I can't imagine what the problem would be with splitting them. I figure the capsule itself is just gelatin and dissolves right away. I've been splitting Effexor that way for a long time.
I think the reason they don't want you to split them is because they want to sell more pills.
Marsha
Posted by iris2 on September 14, 2004, at 13:42:46
In reply to Re: Cymbalta Journal » iris2, posted by 4WD on September 14, 2004, at 13:06:41
Marsha,
I was concerned about the blood pressure thing too jsut was not sure if it was a big deal. I'll check Lexapro but waht I hav read is that the efficacy of most of the SSRI's is about the same. But if it is better for anxiety perhaps.
> I think a lot of doctors are just making a stab in the dark with diagnoses and with prescriptions.My large experience in hospitals is that with little exception everyone gets put on the newest antidepressant out regardless of the persons particular problems. Other pdocs usually have a favorite diagnosis and /or a favorite med that everyone gets put on.
Irene
Posted by 4WD on September 14, 2004, at 14:10:20
In reply to Re: Cymbalta Journal » 4WD, posted by iris2 on September 14, 2004, at 13:42:46
> Marsha,
>
> I was concerned about the blood pressure thing too jsut was not sure if it was a big deal. I'll check Lexapro but waht I hav read is that the efficacy of most of the SSRI's is about the same. But if it is better for anxiety perhaps.
>
>
> > I think a lot of doctors are just making a stab in the dark with diagnoses and with prescriptions.
>
> My large experience in hospitals is that with little exception everyone gets put on the newest antidepressant out regardless of the persons particular problems. Other pdocs usually have a favorite diagnosis and /or a favorite med that everyone gets put on.
>
> Irene
I think the efficacy may be the same but if one has pooped out, switching to another one can often fix that. She could also try augmenting the Prozac with something else.Marsha
Posted by 4WD on September 14, 2004, at 21:09:40
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Day 12 Tuesday September 14, '04
Cymbalta 30mg a.m.
Effexor 10mg a.m.Klonopin as needed
I hate taking Klonopin. If I take enough to ease a panic attack it makes me tired and sleepy and depressed. But if I don't take it I can't handle the panic attacks. I wish there was something lighter that would only last a while - as long as an anxiety attack, a few hours, and not make me so dragged out feeling.
Anyway...
I've been pretty energetic today, considering the Klonopin effects. I've had to be because of the hurricane preparations.
Efficacy: No particular additional improvement today that I could notice. I feel kind of sluggish.
I have completely stopped having suicidal thoughts - even during the panic/anxiety attacks I just feel terrified and cry but I don't want to die anymore.
Side effects: Dry mouth is less (until I take the Klonopin). I'm yawning a lot but again, I think that's the Klonopin. I've had a mild headache today and I'm still having some heartburn (which is extremely unusual for me). It could be from the Cymbalta or from the anxiety. STill having the tone/roaring in my head. I think it's from too much norepinephrine.
STill no improvement in anhedonia.
Posted by iris2 on September 14, 2004, at 22:47:44
In reply to Re: Cymbalta Journal Day 12, posted by 4WD on September 14, 2004, at 21:09:40
Marsha,
Do you think the Klonopin works better than the Zyprexia for the anxiety/panic? Especially since the Klonopin has longer acting side effects? I take either perphenazine or Klonopin for about the same thing as you. It is really a subjective decision each time I think I need one of them, which would be the best to take. For times I am very panicky or extreme anxiety, like when I cannot stop crying or want to pound my head into a wall, literally, I find perphenazine (in your case Zyprexia) to be fast acting and short lived. For when I am anxious in a general way, a feeling that was not sudden and fierce I take Klonopin because it calms me down and lasts longer which is what I need when the anxiety is something that I am living with as opposed to going through. Not sure if this scenario would work for you. How do you decide which one to take for what?
Irene
Posted by SLS on September 15, 2004, at 5:02:35
In reply to Re: Cymbalta Journal Day 12, posted by 4WD on September 14, 2004, at 21:09:40
Hi.
> I hate taking Klonopin. If I take enough to ease a panic attack it makes me tired and sleepy and depressed. But if I don't take it I can't handle the panic attacks. I wish there was something lighter that would only last a while - as long as an anxiety attack, a few hours, and not make me so dragged out feeling.
Xanax or Xanax XR sound like they would be ideal for your situation. Is there some reason why you have not considered them?
- Scott
Posted by raindrop on September 16, 2004, at 16:17:38
In reply to Re: Cymbalta Journal Day 11 » 4WD, posted by Allie Blue on September 14, 2004, at 11:30:38
Hi Marsha,
I have been following your Cymbalta/Effexor/Klonopin journal and want to put in my 2 cents about the background noise you hear in your head.
It may be Klonopin withdrawal. I tried to withdraw from K about 3 years ago and experienced a really funny feeling in my head and ears; it was like there was a humming or fuzziness in my head. It was very odd so I went to my doc (I thought I had an ear infection), but she said it was a classic Klonopin withdrawal symptom.
This may not apply to you, but I wanted to mention it.
I am currently on 60 Prozac/300 Wellbutrin/1mg Klonopin, and I am weaning off of Prozac so I can try Cymbalta (my psychiatrist wants me to come down off Prozac very slowly, and won't prescribe Cymbalta for me until I am down to 20 Prozac:-( So, I am living vicariously through you lucky people already on Cymbalta, and am hanging on every word you report. Thank you for sharing your experience!
Sara
(new. my first time posting.)
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