Posted by jms600 on June 13, 2011, at 16:23:34
In reply to need advice ASAP!, posted by manduh on June 12, 2011, at 23:29:09
> It's been awhile since I've posted anything on here. I started cymbalta back in January. By all accounts it seemed like to be the drug for me.
> Things were working out good for awhile. Things at work started getting better, people started saying things like "the old manda is back".
> After this period, I would be pretty good except the week around my menstrual period.
> Then the good days started getting fewer and far between.
> Just in this past week I was sent home from work because I couldn't control my crying. I was okay again for a few days, but friday I went to work feeling really anxious, and dissociated from myself. I took a half a klonopin that day before work. Around my lunchtime I started to break down badly. I called the on-call doctor at my gp's office. He told me to go home and try to relax.
> I came home shortly later, and spent the next 3 hours just generally breaking down.
> My mom was home at the time. She sees things in a very black and white way. She was doing nothing but sending me deeper into my freak out.
> I finally made the decision to get into the ER to see someone immediately. The doctors there pretty much told me that they were pretty confident I wouldn't kill myself, so I was given a prescription for ativan and sent home.
> I spent saturday in a some-what haze from being exhausted from all the crying, and the ativan.
> Tonight it seems as though I'm back to where I was, or quite possibly worse.
> I tried to talk to my parents about taking a short leave of absence from work. My mom decided that this was a bad idea, because according to her "all I'd do was sit around or sleep". Also that I was "using depression as a crutch, since I just didn't want to go to work".
> Trust me, nobody likes work....sometimes I have a great time there, sometimes it sucks and I feel like having a good cry when I get home.
> It's really hard to explain to a parent who has no history of mental illness exactly what I'm talking about.
> So that's where you guys come in. I'm really having a tough time. I feel as though I'm barely hanging on, and I'm going to totally lose it any moment. I just want to cry, and I'm physically uncomfortable. I find myself pacing a lot.
> Finally, I had a cutting problem for quite a few years. Which I was able to stop doing for quite some time now. But the urge to do so again has been back lately, and at the moment it is SO strong.
>
>
Firstly, how often are you taking the Klonopin? I tried Klonopin some time back (1mg twice per day) and had a terrible time with it. It really increased my depression to the point where I was crying and feeling so low. Some people do really well on it. However, following my experiences with it I really wouldn't recommend it if you're suffering from depression along with the anxiety. I did far better on Valium (albeit at a high dose). It's a longer acting benzo than Ativan, but there again if Ativan is working for you then stick with it.I'm wondering if Cymbalta is really right for you?? If you're taking it and still suffering from depression then you either need to get your doc to change the med or add something to it. It could be that the drug is simply no longer working for you - the dreaded 'poop out'.
If you decide to stick with the Cymbalta you could try augmenting it with another med(s). I don't know what you have tried before or what other meds you're on now, but you could consider adding an atypical antipsychotic such as Seroquel or Zyprexa to the Cymbalta. Not only can they help with anxiety but they also have an antidepressant effect. Some people say that their usage is controversial due to tardive dyskinesia, but if the drug works for you (and you keep an eye out for TD) then they are definitely worth considering in my opinion. They don't work for everyone (me being an example) and they both tend to cause weight gain - especially Zyprexa - so be mindful.
You could also consider adding low-dose lithium to your med regime to augment your antidepressant. You could even take an antidepressant, atypical antipsychotic and low dose lithium - but to start with just try one or the other and then build up if no response.
Finally, I read on here time and time again about people's dramatic responses to MAOIs. People seem to do just so well on Nardil or Parnate. Nardil would be the drug of choice where anxiety is present, however, you must weigh up the benefits with the unpleasant side effects and dietary restrictions. Also some doctors don't like prescribing them (mine included).
Hope you're feeling better soon.
poster:jms600
thread:987907
URL: http://www.dr-bob.org/babble/20110610/msgs/987959.html