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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Tabitha on September 30, 2016, at 12:25:22
I added Cymbalta 60mg six weeks ago. It's great for mood and pain but I'm very frustrated with the effects on sleep. If I take it at night, I wake up around 2am, eventually fall asleep, then have a hard time waking up later. If I take it in the morning, I sleep through the night until 5am, sometimes 7am, but during the day I have a constant urge to lie down and nap. I'll get up, then an hour later (or less) I need to lie down.
Does anyone have experience with this? Any augmentation strategies? Maybe trying divided dose? I really want to tolerate this med because it's so good for mood and pain.
By the way I also take a sleep med (triazolam) which worked really well before adding cymbalta.
Posted by rjlockhart37 on September 30, 2016, at 13:55:19
In reply to Cymbalta-- sedating? activating? both?, posted by Tabitha on September 30, 2016, at 12:25:22
I took cymbalta 30mg twice daily in 2003, it's activating because it works on norepinephrine, and serotonin, it's similar to effexor in stimulating effects but not compeltely......
it may be the serotonin receptiors that's cauing drowsiness, maybe ask your doctor to take 1 in morning and 1 in afternoon, or switch to effexor ... effexor is very effective with depression, very effective, but the only thing is it's withdrawl, i've read bad things about getting off effexor, but still maybe a low dose could help, higher doses such as 225-300mg are the ones that have significant withdrawl effects
maybe ask for something to help you stay alseep, at night, a benzo, what ever that will get you to sleep and stay asleep
cybalta defiently is good for pain, it works with nerve pain, and various others, but some of it's antidepressant effects arent as strong as effexor......
Posted by Christ_empowered on September 30, 2016, at 15:19:13
In reply to Re: Cymbalta-- sedating? activating? both?, posted by rjlockhart37 on September 30, 2016, at 13:55:19
when i took 90mgs in the AM and it was somewhat stimulating. maybe up the dose? I think you can go to 120.
Posted by SLS on September 30, 2016, at 15:33:54
In reply to Cymbalta-- sedating? activating? both?, posted by Tabitha on September 30, 2016, at 12:25:22
When you take Cymbalta at night and wake up at 2:00 AM, how long does it take for you to fall asleep again? Is it possible that your difficulties in waking up in the morning are due to an inadequate amount of sleep?
You could wait until you wake up at 2:00 AM to take triazolam. Triazolam it an extremently potent hypnotic, but it has a very short half-life (1.5-3.0 hours). It should put you back to sleep quickly and allow you to wake up at your normal time. The problem with triazolam is that, because of its very short half life and high potency, people often experience rebound (withdrawal) awakenings that occur early in the morning.
Just a few ideas:
1. You could try RJ's idea and divide your doses. It might work. It would be a simple fix.
2. You could try taking melatonin an hour before going to sleep and allow it to coincide with the normal cyclic peak that occurs at 2:00 AM.
3. You could wait until you wake up at 2:00 AM before taking triazolam.
4. You could use a longer acting hypnotic like lorazapam.
5. You could take a small amount of amitriptyline at night instead of, or in addition to, triazolam. In addition to helping with sleep, it might also help Cymbalta work better for depression and pain.
- Scott
Posted by SLS on September 30, 2016, at 15:35:24
In reply to Re: Cymbalta-- sedating? activating? both?, posted by Christ_empowered on September 30, 2016, at 15:19:13
> when i took 90mgs in the AM and it was somewhat stimulating. maybe up the dose? I think you can go to 120.
That's an interesting idea. It might work.
- Scott
Posted by former poster on November 10, 2016, at 0:19:33
In reply to Re: Cymbalta-- sedating? activating? both? » Christ_empowered, posted by SLS on September 30, 2016, at 15:35:24
I took it about 6 years ago. The sweet spot was 3PM for me. This was the time of day that I had most of my hard physical work done and it was time to start winding down, so a nap could be an option.
This is the end of the thread.
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