Posted by desolationrower on December 2, 2008, at 20:34:28
In reply to Cymbalta vs. Lyrica, posted by smart.drug on December 2, 2008, at 10:46:57
> Howdy, folks.
>
> As usual, I'm checking in after a long haitus, so an update is in order. To recap, I have Bipolar 2.0 (tm), with possible ADHD and/or a sleep disorder. I have a sleep study coming up, which will hopefully sort things out. First, the list of the happy pills.
>
> Cerefolin NAC, 1 tab with breakfast.
> Lovaza 1 gm, 4 times a day with or without food.
> Lamictal, 200 mg in the morning.
> Provigil, 100-200 mg as needed.
> Seroquel 50-150 mg as needed.
>
> For a while, I thought I had found the perfect combination for me. Then, about a week ago, I started to get mild anxiety which became pretty severe when I saw me p-doc at my last appointment. I also complained of fatigue and an all-over aches. By the way, my p-doc and I both agree that benzos are bad, so we won't touch them until all other options are exhuasted. So anyway, she decided to add Cymbalta to my regimen.
>
> She gave me three reasons for trying it:
> 1, it targets core symptoms, namely depression.
> 2, it helps with pain and fatigue
> 3, it treats GAD
>
> When I brought up Lyrica, she gave me the death glare and asked why I brought it up. I said that it can also help with pain/fatigue (approved for fibromyalgia, like Cymbalta) and with GAD. She raised her eyebrows and said that it's used in Europe for that, but it's not approved in America for that. Furthermore, she did not think there was enough evidence.
>
> Okay, so here's the point I'm trying to get to. Can anyone please help me? I have the following questions.
>
> 1.) Which of the two medications are superior with respect to generalized anxiety disorder, relative to their benefits versus side-effects?
>
> I have tried Lexapro, a seretogenic drug in the past. It did absolutely nothing for my anxiety (which waxes and wanes.) I have reason to believe that Cymbalta won't work for me either. I realize I might psych myself out, but. I will stick to it, grit my teeth through the side-effects, and titrate upwards to the right dose.
>
> 2.) Which of the two is superior with regards to bodily fatigue?
>
> 3.) Which of the two is more likely to impact cognitive function, either positively or negatively?
>
> Please provide solid references, if at all possible and where available. Any other interesting tidbits, please feel free to share. Thank you for your time and attention, and I appreciate your advice.ok, well a couple of things. Neither really seem useful for fatigue, at least where they have strong evidence, not just anecdote or theory. Two, i'd be somewhat concerned with cymbalta since youi're bipolar, i'd prefer taking a non-sri/nri/snri type drug if there is another option. Do you have addiction problems that make you wary of the benzos? Those do not have evidence of causing destabilization. So, lyrica woulud be preferable for anxiety, especially if it comes and goes; it can be taken more on a prn fashion where cymbalta would not have that option.
As for the 'aches/fatigue' - do you ahve fibro or something, or is this a result of the GAD? If just the latter, then i can see the benefit of pregabalin; i don't know to what extent PRN pregabalin would help with a more formal fatigue or pain disorder.
Cognitivly, i'd expect cymbalta to be better than the sri you had; for someone with adhd i'd think the norephinephrine reuptake would be helpful - pure nris like strattera are prescibed for that. It is probably a personal matter whetehr that will outweigh the foggyness i'd expect from the sri part of it. Lyrica is a stronger relative of neurontin - this has been nicknamed 'morontin' for the cognitive effect. But, some people don't experience them. Like a benzo, if it helps reduce anxiety so you can think clearly it could help, but too much or just bad reaction could make you forgetful and confused. Like bleuberry said it can vary person to person. One problem with treating 'fatigue' is that most treatments have some liability to cause mania, its just par for the course. Even something like creatine has had case reports like that. Also for cognitive problems, is that a problem now, or just a concern? It might be treatable with something mild like a nootropic, rather than forcing a different medicine that is less effective for your main symptoms.
-d/r
poster:desolationrower
thread:866260
URL: http://www.dr-bob.org/babble/20081123/msgs/866336.html