Posted by bleauberry on August 1, 2008, at 20:13:23
In reply to cymbata trial, posted by ricker on August 1, 2008, at 18:30:38
Wow, what a heartfelt story. I have enormous respect for you. I relate strongly to your goals, your battles, and the tinnitus. Similar background with me...many meds, ECT, tinnitus.
Cymbalta. I am no pro at it. I have had multiple brief trials with it. First time was added to ongoing prozac+zyprexa. Ramped up to 60mg in a few days, didn't really feel much from it, but got severe anorgasmia and stopped it.
Post-ECT things changed. I found even tiny doses seemed massively powerful. Benefits for me...quieter tinnitus, better sleep, social anxiety eased greatly, leg cramps gone, leg weakness greatly improved, a small but noticeable boost in motivation, slight anorgasmia along with slightly increased sexual desire. Negatives...less appetite, felt on the edge of crying for no reason, though not really depressed. Keep in mind this was all in a dose range of 5mg to 10mg.
A recent clinical study showed that for people who had not responded to 60mg during the first part of the trial, half of them were in remissioni 4 weeks later at 60mg, and those that were raised to 120mg showed no more benefit than those at 60mg. It was apparently the extra time, not the extra dose, that did the good. Total time was 12 weeks.
If start-up anxiety is a problem, you can customize dose size and ramp up slower. Inside the capsules are enteric coated beads. 10 of them is approximately 1mg. Works good on applesauce or anything soft where you won't chew the beads. This strategy is more common in getting off the med, but I used it getting on.
During my first week I did experience worse sleep, a slight increase in tinnitus, and some flu-like stuff. But even on the first day I could feel some warmth, social confidence, and I even smiled for the first time in a while. It was at maybe day 5 or so that the benefits mentioned above started to show themselves a little.
At askapatient.com or at revolutionhealth you'll see cymbalta is much like anything else...it is a miracle for some and poison to others.
My own personal opinion is that the dose is often too high. I do know of people that do best at half of a 30mg capsule per day. As the clinical trial hinted, I believe lower doses can work better assuming they are given plenty of time. And of course, less side effects at the lower doses. Many doctors will have patients at 30mg, not responding after a few weeks or a month, and raise it to 60mg, where maybe it would have been better to stay at 30mg and wait. Can always go to 60mg later. It just seems to me reviewing ratings and reviews of users that those who got pushed to higher doses quicker were the ones that quit due to side effects.
You need to do something, and if a med can help your life, I believe it should be tried. I guess I'm saying that in my opinion, opinion only, cymbalta trials are usually pushed too aggressively and for too short of a time. I plan on revisiting it with all of this in mind myself.
I could name a few other meds too, but I understand your focus here is cymbalta.
poster:bleauberry
thread:843545
URL: http://www.dr-bob.org/babble/20080727/msgs/843574.html