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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by gadman on January 16, 2005, at 8:32:05
Hi All...
I have been on Effexor XR for appr. 3 years now with fantastic results. I started at 37.5 mg and moved up to 75 where I stayed up until now.
The side effects I had with effexor were increased Blood Pressure (Which I am taking a med to control) and weight gain. I was/am getting headaches also, but not sure if that is the Effexor or not.
The Doc recently recommended I switch to Cymbalta for the BP and the weight gain. Right now I am in the transition stage and at 30 mg of Cymbalta and 37.5 mg of Effexor.
I am a week into the process and here is what I have noticed.... Mild to extreme depression, Lethargic, and sexual dysfunction... All of these which I did not have on the Effexor alone.
Right now I am not sure if it is the Effexor Withdrawal or the Cymbalta... I am considering going back to the 75 mg of Effexor if this is what I can expect from the Cymbalta.
I know it is early in the process, but I would hate to fight thru this and find out the Cymbalta is not working or causing these side effects (Especially the depression and sex).
Thanks for listening. What are your thoughts?
Posted by awatts on January 16, 2005, at 11:58:51
In reply to Cymbalta vs Effexor, posted by gadman on January 16, 2005, at 8:32:05
> Hi All...
>
> I have been on Effexor XR for appr. 3 years now with fantastic results. I started at 37.5 mg and moved up to 75 where I stayed up until now.
>
> The side effects I had with effexor were increased Blood Pressure (Which I am taking a med to control) and weight gain. I was/am getting headaches also, but not sure if that is the Effexor or not.
>
> The Doc recently recommended I switch to Cymbalta for the BP and the weight gain. Right now I am in the transition stage and at 30 mg of Cymbalta and 37.5 mg of Effexor.
>
> I am a week into the process and here is what I have noticed.... Mild to extreme depression, Lethargic, and sexual dysfunction... All of these which I did not have on the Effexor alone.
>
> Right now I am not sure if it is the Effexor Withdrawal or the Cymbalta... I am considering going back to the 75 mg of Effexor if this is what I can expect from the Cymbalta.
>
> I know it is early in the process, but I would hate to fight thru this and find out the Cymbalta is not working or causing these side effects (Especially the depression and sex).
>
> Thanks for listening. What are your thoughts?For most people, Cymbalta has turned out to be a real disappointment. Go back to Effexor XR ASAP.
Effexor XR was the only AD that has ever worked for me (225 mg), but I discontinued it only because it totally shut me down sexually. I tried Cymbalta (60 mg), and it also ended sex and didn't even help my depression.
I should mention that I also take 0.25 mg of Klonopin twice a day for anxiety.
I might try Provigil for depression and energy/motivation/concentration. Not sure yet.
Posted by gadman on January 16, 2005, at 13:01:56
In reply to Re: Cymbalta vs Effexor, posted by awatts on January 16, 2005, at 11:58:51
Thanks for the info... I am really considering it. When I was at my full dose of Effexor I never had any issues with sexual dysfunction. It was different than without, but I never had any problems. So far with cymbalta things are just shutting down. I don't know if this is an ongoing problem or if it will get better with continued use.
I would hate to wean myself off of something that is mostly working, just to be disappointed in the end.
Anyone else have any suggestions?
>
> For most people, Cymbalta has turned out to be a real disappointment. Go back to Effexor XR ASAP.
>
> Effexor XR was the only AD that has ever worked for me (225 mg), but I discontinued it only because it totally shut me down sexually. I tried Cymbalta (60 mg), and it also ended sex and didn't even help my depression.
>
> I should mention that I also take 0.25 mg of Klonopin twice a day for anxiety.
>
> I might try Provigil for depression and energy/motivation/concentration. Not sure yet.
>
>
Posted by Racer on January 16, 2005, at 14:22:09
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 16, 2005, at 13:01:56
When I first started Cymbalta, I experienced a lot of adjustment phase effects which faded within a short time. Including decreased libido and anorgasmia -- both those are over and done with. (Of course, I'm also on Wellbutrin, which could contribute to that. But the libido changed before the Wellbutrin, and if I recall the anorgasmia passed, too, before starting the WB.)
If Effexor has significant side effects for you, I think it's worth giving the Cymbalta a fair shot. I'm still on it after several months, and no longer experience much of anything in the way of side effects -- despite a not entirely smooth start.
Good luck.
Posted by gadman on January 16, 2005, at 19:10:24
In reply to Re: Cymbalta vs Effexor, posted by Racer on January 16, 2005, at 14:22:09
I actually had a decent day today, so now I am really on the fence. I really am concerned about the sexual dysfuntion though... Can it really be worse than effexor? The same? Like I said, with effexor it was different, but still there... Are you COMPLETELY done with the decreased libido and anorgasmia? If so, that is encouraging...
Effexor really was pretty good to me, that is why I am having the indecision here. My biggest problems were weight gain, hypertension, and a bit of a spacey feeling... But overall not bad. My Doc just thought Cymbalta would be a better fit for my GAD.
> When I first started Cymbalta, I experienced a lot of adjustment phase effects which faded within a short time. Including decreased libido and anorgasmia -- both those are over and done with. (Of course, I'm also on Wellbutrin, which could contribute to that. But the libido changed before the Wellbutrin, and if I recall the anorgasmia passed, too, before starting the WB.)
>
> If Effexor has significant side effects for you, I think it's worth giving the Cymbalta a fair shot. I'm still on it after several months, and no longer experience much of anything in the way of side effects -- despite a not entirely smooth start.
>
> Good luck.
Posted by caleb96 on January 17, 2005, at 9:03:52
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 16, 2005, at 19:10:24
After 3 1/2 years on 300 mg Effexor per day, I complained to my internist that I had been turned into a eunuch! My shrink didn't was to mess with the Effexor because it worked so well, even though I repeatedly complained about the sexual dysfunction. My internist had me cut the Effexor down over 4 weeks, then completely replace it with Cymbalta (60 mg/d). I had no withdrawal problems--NONE--in fact I didn't notice any physical effects. Within a few days, my sexual function returned and now, after 6 months, I don't notice any sexual dysfunction and my libido is very good. Now if I can just get my wife interested in sex again....
Cymbalta has also worked great on my depression, and it doesn't give me the heebie-geebies like the SSRIs do. I would recommend giving it a shot if you're having problems with other drugs.
Sometimes a good internal medicine doc is just as good or better than a psychiatrist (sorry Dr. Bob, I know this doesn't apply to you).
Love and sanity to all,
Caleb
Posted by gadman on January 17, 2005, at 9:48:13
In reply to Re: Cymbalta vs Effexor, posted by caleb96 on January 17, 2005, at 9:03:52
Wow, That's fantastic! To go from 300 Effexor to 60 of Cymbalta is something. That brings up another question. I wonder what the Effexor to Cymbalta equivelancy dosages are?
I would like to here more success stories (or negatives) if possible.
> After 3 1/2 years on 300 mg Effexor per day, I complained to my internist that I had been turned into a eunuch! My shrink didn't was to mess with the Effexor because it worked so well, even though I repeatedly complained about the sexual dysfunction. My internist had me cut the Effexor down over 4 weeks, then completely replace it with Cymbalta (60 mg/d). I had no withdrawal problems--NONE--in fact I didn't notice any physical effects. Within a few days, my sexual function returned and now, after 6 months, I don't notice any sexual dysfunction and my libido is very good. Now if I can just get my wife interested in sex again....
>
> Cymbalta has also worked great on my depression, and it doesn't give me the heebie-geebies like the SSRIs do. I would recommend giving it a shot if you're having problems with other drugs.
>
> Sometimes a good internal medicine doc is just as good or better than a psychiatrist (sorry Dr. Bob, I know this doesn't apply to you).
>
> Love and sanity to all,
>
> Caleb
Posted by NISSYNICOL on January 17, 2005, at 12:16:13
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 17, 2005, at 9:48:13
> Wow, That's fantastic! To go from 300 Effexor to 60 of Cymbalta is something. That brings up another question. I wonder what the Effexor to Cymbalta equivelancy dosages are?
>My pdoc is having me do just this, except I am on 450 Effexor. I just started 2 days ago. He told me that 30 of cymbalta is like the equival. to 150 of Effexor. I have good thoughts on this and I am hoping this switch over will work for me side effects and withdrawl free!
Take care,
NISSYNICOL
Posted by gadman on January 17, 2005, at 13:23:31
In reply to Re: Cymbalta vs Effexor » gadman, posted by NISSYNICOL on January 17, 2005, at 12:16:13
Another WOW! My pdoc told me they were equivelant 60 Cymbalta = 75 Effexor... But I did not believe him. After doing some research on the Net it seems I am correct. Cymbalta is much more potent than Effexor, Am I correct?
If that is the case, can we expect the same kind of withdrawals from Cymbalta? Worse than Effexor?
> My pdoc is having me do just this, except I am on 450 Effexor. I just started 2 days ago. He told me that 30 of cymbalta is like the equival. to 150 of Effexor. I have good thoughts on this and I am hoping this switch over will work for me side effects and withdrawl free!
> Take care,
> NISSYNICOL
Posted by gadman on January 17, 2005, at 15:46:48
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 17, 2005, at 13:23:31
After much reading on these meds it seems that I need to just pick the lesser of two evils.
Posted by NISSYNICOL on January 17, 2005, at 20:50:11
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 17, 2005, at 13:23:31
> If that is the case, can we expect the same kind of withdrawals from Cymbalta? Worse than Effexor?I did a search of Cymbalta on google and I don't remember the exact website that it was on but I did read on one of them that it does have the same withdrawal as effexor. I have a friend who is a pharmacist and she is checking into the information on cymbalta for me. If there is anything worth reporting I will post it for you.
Take care,
NISSY
Posted by gadman on January 18, 2005, at 7:39:39
In reply to Re: Cymbalta vs Effexor, posted by NISSYNICOL on January 17, 2005, at 20:50:11
Yep... I read the same thing. I think they are only supposing at this point though because it functions the same way Effexor does. I searched for actual experiences and really did not come up with any.
> I did a search of Cymbalta on google and I don't remember the exact website that it was on but I did read on one of them that it does have the same withdrawal as effexor. I have a friend who is a pharmacist and she is checking into the information on cymbalta for me. If there is anything worth reporting I will post it for you.
> Take care,
> NISSY
Posted by gadman on January 18, 2005, at 11:58:37
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 18, 2005, at 7:39:39
Well... I have been feeling pretty decent so I think I am going to forge ahead with Cymbalta.
It has been 8 days now since I have been taking 30 mg of Cymbalta and 37.5 or Effexor.
I think I am going to slowly taper the Effexor to nothing over the next four days, and increase my Cymbalta to 40 mg over the weekend.
My only negative I am noticing so far is my decreased sex drive, but everything I am reading says that Cymbalta is better than Effexor in this regard, so hopefully this will pass.
Posted by Gael on February 12, 2005, at 16:18:49
In reply to Re: Cymbalta vs Effexor, posted by gadman on January 18, 2005, at 11:58:37
Hi - Been having an awful winter of depression and lately really bad persistent headaches. So the pdoc thought we'd switch from 37.5 Effexor directly to 60 mg Cymbalta without any tapering etc. I figured what the hey. Headaches gone. Nightmares over the past 3 nights (3 days on Cymbalta) and INCREDIBLY gross acid refluc, especially when having just eaten sugar/candy/cookies. etc. Is this Effexor withdrawal or coming onto Cymbalta? In the night when I wake up from a nightmare I have to breathe deeply and really get my sh*t together in order to feel like I'm not going to crack up.
Thnx.
Gael
Posted by Giraffeguitar on April 21, 2006, at 7:15:22
In reply to switching from Effexor to Cymbalta midstream, posted by Gael on February 12, 2005, at 16:18:49
The nightmares are withdrawl of the Effexor XR. Keep us informed on the Switch to Cymbalta. I am talking it over with my pDoc later today to see if the weight gain / sex problems are less than with Effexor. I am also taking Wellbutrin 150 mg /day AND Strattera 60mg /day (that one is the REAL orgasm killer!). In a previous post somenone mentioned provagil...I'll ask and let you all know what he says about it. It's a Controlled Substance - Stimulant Class - May worsen the insomnia many of us already have.
Posted by fibr on November 10, 2006, at 14:12:54
In reply to Re: Cymbalta vs Effexor, posted by awatts on January 16, 2005, at 11:58:51
I've been on effexor for 4 years initially for depression and now for fibromyalgia. It's helped tremendously. To counter the sexual side effects my doctor put me on wellbutrin as well. I take 75mg extended release eff. and 100 mg sustained release Wellb.They work well together. I am concerned though about the withdrawl problems with effexor. You have to go off very slowly to the point of halving the 37. dose and tapering from there. I would like to try cymbalta as well; it is supposed to help fibromyalgia pain. Good Luck!
Posted by Lexxor on April 2, 2007, at 22:23:14
In reply to Re: Cymbalta vs Effexor, posted by fibr on November 10, 2006, at 14:12:54
honestly there isn't a comparison between effexor xr and cymbalta. in the office i work in, the doc it trying to switch all of the effexor xr patients over to cymbalta. this cymbalta stuff is working on deression, diabetic neuropethy, fibromyalgia, and one of the reps told us today that it is now indicated for anxiety disorder. hardly any of our patients have gained weight on it, and no one that we've seen has had high blood pressure from it, like effexor xr. Some of the patients that the doc has switched,think he is God's gift to mankind. I don't know about that, but cymbalta seems to be helping.
Posted by Tiffi24 on August 15, 2007, at 10:35:36
In reply to Re: Cymbalta vs Effexor » fibr, posted by Lexxor on April 2, 2007, at 22:23:14
I am making the switch to Cymbalta from Effexor XR , I have been on it since 03...so 4 yrs..I am nervous to say the least!
most of the reason is the high BP..my diastolic number is 100..my BP has typically been low...until effexor..it has crept up over the yrs..
I am on 300 of effexor xr (down from 375 a few months ago..) and am supposed to be making a lateral move to cymbalta...60mgs..I am wondering if I should do a small transition period..150 and 30? then mabye 75 and 60? then off the E totally?
I am nervous as hell..effexor has yanked me out of a serious bout of Major Depression..and has done me well over the years..I know how hellish it can be to go off of it, I am hoping that Cymbalta, since it is the same class, will keep some of the worse withdrawal effects away...
I have 2 boys, 10 and 7, and I cannot be down for the count very long!!!
Posted by Clayton on August 15, 2007, at 12:04:56
In reply to Re: Cymbalta vs Effexor, posted by awatts on January 16, 2005, at 11:58:51
Just to let you know that I am on 300 mg of Effexor a day and the doc recently added Provigil. The improvement was immediate and substantial. Elevated mood and much more enery mostly. I definiteltly would give this a try!
Posted by jrbecker76 on August 16, 2007, at 4:43:40
In reply to Re: Cymbalta vs Effexor, posted by Tiffi24 on August 15, 2007, at 10:35:36
hi there,
I was a longtime veteran of effexor for five years or so. I have been on cymbalta since its release and I can definitely say that [for me] Cymbalta has a moderately superior anxiolytic and antidepressant effect profile.
I am very med-sensitive, but the good news is that I have slightly less overall side effects on cymbalta when comparing it to effexor. *However, I do think that in comparing the recommended dosing levels of the two drugs, Cymbalta is more powerful than Effexor. I would highly recommend getting the 20mg pills and stay at 20mg per day for the first week or two. Then, when you feel up to it, try 30mg daily. And then go up conservatively. I know many people who have found that their optimal dosage level is well below the standard of 60mg.
JB
Posted by jhj on August 16, 2007, at 5:46:47
In reply to Re: Cymbalta vs Effexor » Tiffi24, posted by jrbecker76 on August 16, 2007, at 4:43:40
HiI have tried venlafaxine for three years for my depression,GAD & social phobia.I have been on 300 mg dose for quite some time.But,i have not felt any better in addition to side effect like stomach discomfort.Do you thing i should give duloxetine a try despite the failure of Venlafaxine despite the same mechanism of action? By the way,are you the same jrbecker76 who gives list of upcoming list on neurotransmitter.net? if yes,i would like to know which drugs of depression and anxiety are likely heat market by 2008 end? Thanks.
Posted by Tiffi24 on August 16, 2007, at 9:09:57
In reply to Re: Cymbalta vs Effexor » Tiffi24, posted by jrbecker76 on August 16, 2007, at 4:43:40
jrbecker76-
Thanks for the info!
I am hoping to avoid alot of side effects from stopping my effexor..we all know that can be hellish...so I think that was the reason for the 'lateral' move to 60 of cymbalta..I may try working up to 60 tho w/ 30 then 60 in a few days..
my depression is dx'd Major Depression and it is quite a bugger..very persistent..and cycles w/ my hormones too..fun fun fun! LOL!!!
my main concern is taking them at the same time...
Posted by Tiffi24 on August 16, 2007, at 9:12:09
In reply to Re: Cymbalta vs Effexor-jrbecker76, posted by jhj on August 16, 2007, at 5:46:47
I have heard/read that the side effects from cymbalta are less and that it is more effective than effexor!! good luck
Posted by jrbecker76 on August 16, 2007, at 11:41:34
In reply to Re: Cymbalta vs Effexor-jrbecker76, posted by jhj on August 16, 2007, at 5:46:47
>
> Hi
>
> I have tried venlafaxine for three years for my depression,GAD & social phobia.I have been on 300 mg dose for quite some time.But,i have not felt any better in addition to side effect like stomach discomfort.Do you thing i should give duloxetine a try despite the failure of Venlafaxine despite the same mechanism of action? By the way,are you the same jrbecker76 who gives list of upcoming list on neurotransmitter.net? if yes,i would like to know which drugs of depression and anxiety are likely heat market by 2008 end? Thanks.
Yes, even though nausea might be an issue at start-up as well as higher doses, I think it's worth a shot to find out the cost-benefit ratio. I recall reading a study that compared Effexor to Cymbalta's side effects, and that Cymbalta rated slightly higher for nausea issues. However, hopefully, you can find an effective dosage window where this isn't a problem.Subjectively speaking, I'm not a good candidate to evaluate the typical side effects seen at standard dosage levels since I'm a med-sensitive individual. But back in the time when I was still taking higher doses of Effexor, I also recall nausea issues being a problem. I've had no such problems on Cymbalta. But once again, I'm not a typical case to be measured by.
The transition from Effexor to Cymbalta is not really a rough one in terms of the need for cross-titration. You could always give Cymbalta a try for 2-3 wks. If it's not working, you can re-initiate Effexor with very little cross-tolerance issues.
As for new drugs on the horizon... it's tough to prognosticate there. The FDA makes it harder than Vegas to bet on outcomes. However, we are likely to see drugs like Gepirone (a 5-HT1a partial agonist) be possibly approved by end of '07; Pristiq (a metabolite of Effexor, that like Cymbalta, has a slightly more noradrenergic-to-serotonergic balance) will probably be launched in early '08. Possible other candidates are Amibegron (a purely adrenergic [beta-3] drug) might have a chance of approval in late 08/09. More further down the line in '09 are be saredutant, a neurokin-2 antagonist and agomelatine a 5-HT2c antagonist/melatoninergic agonist. These drugs aren't exactly the next big leap in ADs, however, most of them are attractive because they represent newer classes of drugs and/or have more pin-pointed mechanisms of action (thus, perhaps heightening efficacy while limiting side effects). So, yes, some hopeful things on the horizon.
JB
Posted by Tiffi24 on August 16, 2007, at 12:28:00
In reply to Re: Cymbalta vs Effexor-jrbecker76 » jhj, posted by jrbecker76 on August 16, 2007, at 11:41:34
I am very excited to see Pristiq is so close to approval..it seems that I respond better to the SNRI's than the SSRI's..I am just glad there is a broader pool to choose from if one needs to...
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