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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by theo on September 15, 2005, at 22:51:01
I'm currently taking 30mg Cymbalta at bedtime for about 10 days now. No major sides but I am tired all the time. Not sleepy, just worn out feeling. Hard to get work done. I do wake up feeling fresh, but get slumped about 10:00am, then I feel revived again around 6:00pm.
Should I waste my time going to 60mg as it may make this worse? I'm also experiencing delayed ejaculation at 30mg.
What's weird is when I started Cymbalta, I took 15mg for 3 days and actually felt a lift. When I started 30mg, I thought I would feel a lift after a few days but no luck. I just feel like I'm taking a mild sedative.
Posted by Declan on September 16, 2005, at 21:05:45
In reply to Do Cymbalta Side Effects increase with dose?, posted by theo on September 15, 2005, at 22:51:01
Theo, on the alternative board Verne said in passing that he'd had good response from a really small dose of Cymbalta. Could it be more selective for NERI at low doseage?
Declan
Posted by theo on September 16, 2005, at 22:14:45
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by Declan on September 16, 2005, at 21:05:45
> Theo, on the alternative board Verne said in passing that he'd had good response from a really small dose of Cymbalta. Could it be more selective for NERI at low doseage?
> DeclanHow small of a dose?
Posted by verne on September 19, 2005, at 20:44:06
In reply to Re: Do Cymbalta Side Effects increase with dose? » Declan, posted by theo on September 16, 2005, at 22:14:45
I open the capsule and take anywhere from 2mgs to about 10mgs. I'm not very precise about it. Just whatever sticks to the end of my finger.
Besides the anti-depressant effect, at tiny doses it is an aphrodisiac. Anything above 20mgs - especially 30mgs - however, causes total anorgasmia.
I've been taking cymbalta off and on for a year and I get the best results with small doses when I haven't taken any for over a week. I'm almost euphoric at first but this disappears after a few days of regular doses (40mgs per day currently).
When I briefly took 60mgs I slept alot but actually lost weight. It seemed to act as an appettite suppressant and hunger pains were a thing of the past. I felt hot much of the time, as though my metabolism was higher.
Since my atypical depression is worse than ever and I'm sleeping all the time anyway, overeating, and not enjoying anything, I thought I would go back to the highest possible cymbalta dose that the insurance company will allow. Is that 60mg per day? I see the doc next week.
Of course, at that dose, I will have to give up all my "adult" subscriptions, or what I call my sex life, and live like a monk - substituting the ecstatic religious experience for sex I guess.
I will become a purely cymbaltic saint.
Verne
Posted by theo on September 19, 2005, at 22:06:50
In reply to Re: Do Cymbalta Side Effects increase with dose? » theo, posted by verne on September 19, 2005, at 20:44:06
> I open the capsule and take anywhere from 2mgs to about 10mgs. I'm not very precise about it. Just whatever sticks to the end of my finger.
>
> Besides the anti-depressant effect, at tiny doses it is an aphrodisiac. Anything above 20mgs - especially 30mgs - however, causes total anorgasmia.
>
> I've been taking cymbalta off and on for a year and I get the best results with small doses when I haven't taken any for over a week. I'm almost euphoric at first but this disappears after a few days of regular doses (40mgs per day currently).
>
> When I briefly took 60mgs I slept alot but actually lost weight. It seemed to act as an appettite suppressant and hunger pains were a thing of the past. I felt hot much of the time, as though my metabolism was higher.
>
> Since my atypical depression is worse than ever and I'm sleeping all the time anyway, overeating, and not enjoying anything, I thought I would go back to the highest possible cymbalta dose that the insurance company will allow. Is that 60mg per day? I see the doc next week.
>
> Of course, at that dose, I will have to give up all my "adult" subscriptions, or what I call my sex life, and live like a monk - substituting the ecstatic religious experience for sex I guess.
>
> I will become a purely cymbaltic saint.
>
> VerneIf you have best results at small doses, why are you going higher? Did you have any good long term results at 20mg?
Posted by verne on September 19, 2005, at 23:32:57
In reply to Re: Do Cymbalta Side Effects increase with dose? » verne, posted by theo on September 19, 2005, at 22:06:50
The low doses are good once in awhile but in the long run don't work. It's recreational but not therapeutic.
I thought if I give 60mgs per day a long trial, perhaps, there will be a more lasting anti-depressant effect.
I really haven't given cymbalta much of a chance at the higher doses due to the side effects. The higher the dose, the more I notice the following:
sexual dysfunction
almost painful constipation (hard stools)
blurry vision
occasional sharp chest pain
mild low back painMy current quality of life is so poor, I'm willing to accept the side effects for a few months and see what happens. Also waiting for Emsam to come out in December and may give that a try.
I'm really at a point where I have nothing to lose.
Verne
Posted by grammy on September 21, 2005, at 22:17:19
In reply to Re: Do Cymbalta Side Effects increase with dose? » theo, posted by verne on September 19, 2005, at 20:44:06
> I open the capsule and take anywhere from 2mgs to about 10mgs. I'm not very precise about it. Just whatever sticks to the end of my finger.
>
> Besides the anti-depressant effect, at tiny doses it is an aphrodisiac. Anything above 20mgs - especially 30mgs - however, causes total anorgasmia.
>
> I've been taking cymbalta off and on for a year and I get the best results with small doses when I haven't taken any for over a week. I'm almost euphoric at first but this disappears after a few days of regular doses (40mgs per day currently).
>
> When I briefly took 60mgs I slept alot but actually lost weight. It seemed to act as an appettite suppressant and hunger pains were a thing of the past. I felt hot much of the time, as though my metabolism was higher.
>
> Since my atypical depression is worse than ever and I'm sleeping all the time anyway, overeating, and not enjoying anything, I thought I would go back to the highest possible cymbalta dose that the insurance company will allow. Is that 60mg per day? I see the doc next week.
>
> Of course, at that dose, I will have to give up all my "adult" subscriptions, or what I call my sex life, and live like a monk - substituting the ecstatic religious experience for sex I guess.
>
> I will become a purely cymbaltic saint.
>
> VerneVerne, I have been on Cymbalta for 2-1/2 months and it is working so well for me. The sexual side effects went away and I had the best "O" I've ever had. The constipation issue is also much, much better. I think the longer you stay on it the better the side effects get. Carole
Posted by verne on September 21, 2005, at 22:43:38
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 21, 2005, at 22:17:19
Carole,
Thanks for the imput. I think I will go ahead with 60mgs per day for a few months.
When I took 40mgs on a regular basis I noticed occasional chest pain that felt "circulatory" not like heart burn. But then I also experienced sharp pains elsewhere so perhaps it's nothing to worry about. Others have reported strange pains while on cymbalta.
I haven't really given 60mgs a shot so I'm looking forward to it. I've taken every sort of AD, except for MAO Inhibitors, and was very impressed with cymbalta. I always gave up after a few days due to the side effects but I'm willing to put up with them now - even for an extended period.
If I can go months drinking and being sick all the time, and endure all the pain involved with that, I should be able to handle cymbalta's side effects. Thankfully over two months sober so I won't be mixing them.
Verne
Posted by grammy on September 22, 2005, at 2:28:12
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 21, 2005, at 22:43:38
Verne, I am feeling so much better on Cymbalta than I was on Prozac, Lexapro or Paxil that I would hate to have to go off of it.
It's wonderful you are two months sober!
Have you taken Tranxene? My pdoc gave it to me in place of Xanax XR. I take Restoril to sleep. He had me on Trazadone but it made me violently sick at my stomach.
I would give the Cymbalta another try(30 mg. to start and then increase to 60 mg.), and I would stay on it at least 2 months to see if the side effects lessen. They did for me. :) Good luck, Carole
Posted by verne on September 22, 2005, at 9:59:58
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 22, 2005, at 2:28:12
Carole, I haven't heard of Tranxene. I did have a bad experience with trazadone. I can't remember the side effects but I had to quit after a couple days.
I'm already back up to 40mgs of the cymbalta per day and will get an Rx for 60mgs next week. I think I'll take one pill in the morning. It's too easy for me to miss the evening dose.
If I take cymbalta in the morning I will probably log a power nap during the day; if I take it at night I can't sleep.
Since I've been back on 40mgs the last few days I've noticed that I've quit nervously chewing on my lower lip. I picked up this habit out of nowhere this summer and couldn't leave my lip alone, worrying it until it was cracked and bleeding. Anyway, I just realized I haven't been doing it and it's healed.
Verne
Posted by grammy on September 22, 2005, at 22:21:34
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 22, 2005, at 9:59:58
Verne, I hope and pray Cymbalta works for you.
Cymbalta doesn't make me sleepy, but I have a high tolerance for medicine. I had a bad night last night (nightmares). I take Restoril (temazepam) 15 or 30 mg. at night. I had a lot of anxiety today (a lot of family problems going on now), so I took my last Xanax XR. I have been really mellow all day. I don't take the anti-anxiety pills unless I need them. My p-doc wouldn't give me regular Xanax - I told him the XR was too pricey for me so he gave me Tranxene. I'll try it and see how it goes. Do you take anti-anxiety meds and meds to sleep? Carole
Posted by verne on September 23, 2005, at 0:42:02
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 22, 2005, at 22:21:34
I used to take ativan, librium, and xanax at different times but haven't taken a benzo in about 10 years. I had some problems with dependency and had a hard time getting off ativan and then librium.
Around here, if I ask for a benzo, I'm considered "drug seeking"; if I don't ask, they will never prescribe them. I also admit to being an alcoholic and most docs refuse to prescribe a benzo, even though, I would argue, librium helped me stay sober nearly 2 years.
Perhaps it has been a blessing. I've had to look for anxiety cures in alternative medicine. Meditation helped me. I'm hoping to add some simple asanas (yoga) to the routine.
I tend to react strongly or paradoxically to drugs and herbs. If it is sedating, my body seems to fight it and my heart races. If it is stimulating, my body fights that, and wants to sleep. But benzos like xanax were the exception - no nonsense, straight-forward, calming with no strings attached.
I was able to convince the doc to prescribe inderal since my blood pressure was high. I'm taking inderal LA at 60mgs which helps somewhat with the anxiety and makes it more difficult to drink.
It can be very sedating for some people but doesn't seem to bother me. I much prefer the Inderal LA (long acting) to the regular. There's a qualitative difference, much smoother.
Inderal, by the way, causes nightmares. I mean all my dreams are full of dread, worry, and doom unless I counter it with something. Cymbalta at the higher doses returns my dream life to a happier keel.
Recently I've been experimenting with some exotic herbs not readily available in health food stores. I've been making teas out of bark and plants known to have calming, anti-depressant, or vision or dream inducing effects. (I'll post my findings on the alternative board)
Anyway, I'm doing better. Now up to 60mgs with the cymbalta although I hope to get an Rx for the 60mg capsules next week. Right now I'm taking 3 20mgs per day.
I'll look into tranzene and Restoril - but if they are controlled substances my doc will make an accusatory face, causing the inevitable chain reaction of subtle signals, ending with me slinking away in shame for my "drug-seeking" behavior.
Back to my experiments.
Verne
Posted by grammy on September 26, 2005, at 21:48:48
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 23, 2005, at 0:42:02
Verne, are you going to a psychiatrist? My p-doc is the one who suggested Xanax XR, tranxene, restoril, and trazadone. I used to go to a family doctor who wouldn't give me anything, even when I was having monster anxiety attacks. There are some days when I don't need to take anything for anxiety, however, I almost always need a sleeping pill.
I have never had a drug problem, and at 56 years of age, I don't anticipate one. Also,if it helps me to get through life, I'll take my chances and deal with it. Both of my parents are alcoholics, and I think if I had let myself drink, I would've had a problem also. I think alcoholism runs in both sides of my family.
I don't see the difference between herbs and meds. The Cymbalta makes me slightly anxious, but maybe it will do the opposite with you since you react differently than most people. I hope the herbs work for you, Verne. I would like to try meditation - I used to do it long ago along with yoga. Carole
Posted by verne on September 26, 2005, at 22:50:36
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 26, 2005, at 21:48:48
Carole, none of the pdocs in this area will prescribe anything serious like a benzo for anxiety, so I now just see an MD twice a year.
I'm back to the 60 mgs of cymbalta-a-day plan. I could really stand the weight loss and it worked before in that regard. Another side effect I'm rediscovering is low back pain whenever I'm on cymbalta for any length of time.
It's not like my back is out; in fact, I can do the stretching exercises just fine. It's a deep ache that goes away once I discontinue cymbalta.
I'm gonna stick it out this time and really try to keep my back limber with egoscue and some other stretching disciplines. Besides, losing weight is good for the back.
Verne
Posted by KayeBaby on September 28, 2005, at 2:04:00
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 26, 2005, at 22:50:36
Could this be kidney pain? Cymbalta caused urinary retention which I imagine could cause a problem with kidneys to arise. Might mention that to your Dr. Sometimes a kidney infection causes very few symptoms.
Take Care!
Kaye
> I'm back to the 60 mgs of cymbalta-a-day plan. I could really stand the weight loss and it worked before in that regard. Another side effect I'm rediscovering is low back pain whenever I'm on cymbalta for any length of time.
>
> It's not like my back is out; in fact, I can do the stretching exercises just fine. It's a deep ache that goes away once I discontinue cymbalta.
>
> I'm gonna stick it out this time and really try to keep my back limber with egoscue and some other stretching disciplines. Besides, losing weight is good for the back.
>
> Verne
>
>
>
Posted by verne on September 28, 2005, at 2:10:57
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by KayeBaby on September 28, 2005, at 2:04:00
Kaye, I saw the doc this morning and he ordered a bunch of lab work which included testing the kidneys. I go in next week.
I hadn't really mentioned any of the side effects like back pain; in fact, I hinted at wanting a higher dose. I got the impression that he's seen problems in his other patients on cymbalta.
Anyway, he left me at 40mgs per day.
V
Posted by grammy on September 28, 2005, at 23:50:39
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 26, 2005, at 22:50:36
Verne, when I first started the Cymbalta, I had a urinary hesitancy but that has gone away. In fact, every side effect has gone away. It doesn't seem to be working as well for pain now, though, like it did at first. I have back problems anyhow so I don't know if the Cymbalta is affecting my back. Carole P.S. Where do you live? I live in Oklahoma City. Some docs here won't give you benzos and some will but they are very cautious about it.
Posted by verne on September 29, 2005, at 0:18:58
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 28, 2005, at 23:50:39
Carole, I'm in Fairfield, Iowa, home to Maharishi Univerisity of transcendental meditation fame. Big rift here between townfolk and meditators.
Physicians here range from western orthodox to new-age holistic. Fairfield is a mecca for alternative medicine. We even have an all-organic supermarket - even the toilet paper is organic.
Doctors from both camps are against benzos. I don't think they even recognize anxiety as an illness. Same pioneer spirit about pain too. If you can still walk, talk, or blink once for "yes" and twice for "no", you're fine. Just go to church and take an advil.
The regular western MD's grimace if you even suggest something is wrong with your mind. My current MD is prescribing cymbalta although he proclaimed, "you're not depressed!" after our first visit.
I've burned a couple bridges with the only pdocs in town so I'm stuck with MD's, sundry witchdoctors, and my home experiments.
One pdoc, Dr Dale Armstrong, who did prescribe benzos for me, left for Oklahoma City in 1995. Is he still in OK City? I couldn't find him in any directory.
When he left I had a huge benzo habit and went through hell until I found an MD willing to wean me off them. (took a year) Dr. Armstrong was the best pdoc I've ever worked with. I was able to stay off booze for nearly 2 years and made a lot of progress.
72 days sober.
Verne
Posted by KayeBaby on September 29, 2005, at 4:31:46
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 29, 2005, at 0:18:58
Hey Verne,
Hope all those tests come out fine for you.
My Doc is strangely silent about cymbalta. He normally is quite chatty about how folks are faring on what. We both have a facination with pharms and how they work. Course, he's smart and gets paid for his tinkering.Oh! I live near OKC. My Dr. is in the city and he is the best! Caring and a fearless prescriber. He wants to see his patients well!
Peace,
kaye
Posted by theo on September 29, 2005, at 7:42:11
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by grammy on September 28, 2005, at 23:50:39
> Verne, when I first started the Cymbalta, I had a urinary hesitancy but that has gone away. In fact, every side effect has gone away. It doesn't seem to be working as well for pain now, though, like it did at first. I have back problems anyhow so I don't know if the Cymbalta is affecting my back. Carole P.S. Where do you live? I live in Oklahoma City. Some docs here won't give you benzos and some will but they are very cautious about it.
It's a small world, hello from Lawton, OK. By the way, what dose of Cymbalta are you currently taking? I'm med sensitive and 30mg made me feel horrible. I am now taking 20mg and actually getting some relief. Not much but will stay here a few weeks before trying something different.
Who's your doc in OKC?
Posted by theo on September 29, 2005, at 7:45:23
In reply to Re: Do Cymbalta Side Effects increase with dose?, posted by KayeBaby on September 29, 2005, at 4:31:46
> Hey Verne,
> Hope all those tests come out fine for you.
> My Doc is strangely silent about cymbalta. He normally is quite chatty about how folks are faring on what. We both have a facination with pharms and how they work. Course, he's smart and gets paid for his tinkering.
>
> Oh! I live near OKC. My Dr. is in the city and he is the best! Caring and a fearless prescriber. He wants to see his patients well!
>
> Peace,
> kaye
Who your current doc in OKC? I'm from Lawton, OK and needing to get a second opinion from another pdoc. We are limited in Lawton for pdocs.
Posted by KayeBaby on September 29, 2005, at 14:48:31
In reply to Re: Do Cymbalta Side Effects increase with dose? » KayeBaby, posted by theo on September 29, 2005, at 7:45:23
Hi there!
I will see about getting that babblemail thing on and email his info to you.
He is a great doc.
Peace,
Kaye
Posted by grammy on September 30, 2005, at 1:15:18
In reply to Re: Do Cymbalta Side Effects increase with dose? » KayeBaby, posted by theo on September 29, 2005, at 7:45:23
My p-doc is Dr. Chakraburtty in Oklahoma City. I like him very much.
Posted by grammy on September 30, 2005, at 1:31:23
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by verne on September 29, 2005, at 0:18:58
Verne, I looked in the phonebook and I can't find Dr. Armstrong listed. Don't you hate it when you find a good doctor and you lose him/her?
I am glad I don't live where you do - they sound like they're stuck in the dark ages about medication. I doubt that meditation and health food would've solved my problem.
I can see why you might not want to get back on benzos. Have you tried Trazadone (you may have already told me). The p-doc gave them to me to sleep. He also gave me Tranxene but I think it's a benzo, isn't it?
I hope the Cymbalta works for you, Verne - I hope you will give it at least 6-8 weeks. All of my side effects are gone now, and I am not depressed even though my family is having serious problems right now. Carole
Posted by grammy on September 30, 2005, at 1:36:24
In reply to Re: Do Cymbalta Side Effects increase with dose? » grammy, posted by theo on September 29, 2005, at 7:42:11
I am taking 60 mg. and it was rough, but I was determined to stay on the medication through the side effects. They eventually went away. I've been on it for a little less than 3 months, and I am doing well. Dr. Chrakraburtty is my p-doc (in Oklahoma City) He is a professor at OU Medical Center, and he prescribes medication in private practice and goes to hospitals and treats depressed heart transplant patients. He is excellent.
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