Posted by 4WD on September 4, 2004, at 15:58:30
First, "brief" hx.
Was on Effexor 37.5mg/day. I wanted to switch because while Effexor keeps me out of the black pit, I am still lethargic and anhedonic. Also, I have (relatively) mild side effects from Effexor that I'd rather do without (anorgasmia, tinnitus, dry mouth, inability to cry, general lack of emotion). In the past I've been on imipramine, Prozac, Celexa, Zoloft, Paxil and Wellbutrin. These all worked for depression but caused bad side effects even at half dosages, notably insomnia, severe muscle tension in my neck and shoulders, anxiety and anorgasmia. Not all side effects with each drug, but some combination.
10 weeks ago, I went off Effexor and on St. Johns' wort. Still felt very tired and apathetic but not severely depressed. On July 1, my father died and there was a lot of ugly family stuff to deal with (my mom has Alzheimer's and I am responsible for her as well as for my dad - both in assisted living and my sister stole half their money and is mad at me for trying legally to get it back for them). Managed the death stuff okay and three weeks later finally quit the SJW since it didn't seem to be helping. A week later, I lapsed into severe depression and crippling anxiety. (The anxiety was exacerbated by the progesterone in my new HRT, I think, but can't yet prove. I'm off HRT now but when stabilized will give it another try to see for sure.)
Resumed EFfexor XR and within a week I was no longer severely depressed but still having horrible anxiety. On Klonopin for a while while waiting for anxiety to subside. Then off Klonopin but having some rebound insomnia. (Insomnia has been a lifelong problem for me.)
Had an appointment with new pdoc on Thursday, Sept 2. He prescribed Cymbalta 30mg/day. Instructions were to continue Effexor, start Cymbalta for 3-4 days then taper Effexor. I went ahead and quit the Effexor, though, and started the Cymbalta on Friday yesterday. No withdrawal effects from the Effexor at all.
Friday 9-3-04 Day 1:
Took first Cymbalta at 2:30 pm (I didn't get out of bed til then - insomnia kept me awake til 4 the night before). After about three hours, I started to feel tired. Not sleepy, just tired, unmotivated. (However, I have been unmotivated for years so I can't blame that on the Cym.) Also, no anxiety. I noticed some increase in dry mouth but no other side effects. Went to bed at 1pm (my usual time) and immediately fell asleep. No insomnia!
No improvement in depression, motivation, energy or anhedonia.
Day 2 - Saturday 9-4-04Woke up to alarm at 11a.m. and was able to wake up without turning alarm off and going back to sleep. Didn't feel groggy or medicated. Took Cymbalta at 11. By about 2pm I started to feel tired again, yawning. (This from someone who does *not* get sleepy, ever.) Two cups of green tea later, I can't tell I've taken anything. No side effects other than mild dry mouth and a bit of irritability. Still no Effexor withdrawal effects.
I feel depression-wise exactly like I felt while taking 37.5mg/day Effexor.
No improvement in depression, motivation, energy, anhedonia. No decline, either, though.
Re sexual side effects: Normally after being completely off Effexor for three days, I would be experiencing a rebound effect of much quicker, easier orgasm. That isn't happening but neither is there anything more than a very mild delay so far.
One positive side effect: I can go longer without having to pee. I drink a lot of liquids and I'm normally in the bathroom every hour or so. That has decreased. And - I didn't have to get up during the night last night at all.
Next post won't be so long. Sorry about all the hx but I figured some of it was relevant.
Marsha
P.S. Does anyone know why the 30mg Cymbalta is in capsules and the 60mg is apparently in enteric coated tablets? My doc tried to give me samples of Cymbalta but only had the 60 mg. I had to tell him they couldn't be broken in half. My cynical surmise is that Lilly doesn't *want* people breaking the 60's in half in order to save on costs (if they're taking 30mg per day).
poster:4WD
thread:386422
URL: http://www.dr-bob.org/babble/20040904/msgs/386422.html