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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by lemon68 on October 9, 2004, at 20:30:38
Today is the 2nd day I bumped up to 60 mg of Cymbalta, after being on it at 30 mg for 2 weeks. I feel better than I have felt in about 3 months. Not euphoric, but maybe... dare I say... normal. Today was also the first day I took no Effexor, after weaning down 75 mg per week, from 225mg to 0. I know, there's enough prohibitory advice on this board against stopping so abruptly, but I am going to do it this way and see what happens, and also to know whether what I am feeling is Cymbalta and not a Cymb/Effxr hybrid. Believe me, if I start to wig out after dumping Effexor after 4 years, I'll let you guys know.
So if you're taking Cymbalta, or considering taking it, keep your chin up, there might be hope. Everyone's personal experience is valid, even those who have only taken the med for 3 days. However, I am going to try to tune out the negative feedback and concentrate on my own head...
cheers
Posted by newwife on October 9, 2004, at 20:35:48
In reply to Cymbalta might just be workin', posted by lemon68 on October 9, 2004, at 20:30:38
congrats, dont you love feeling normal? i know i do. :)
Posted by verne on October 10, 2004, at 9:21:20
In reply to Cymbalta might just be workin', posted by lemon68 on October 9, 2004, at 20:30:38
Cymbalta is working for me too. I can concentrate better and feel more motivated. Compared to all the other AD's I've tried it is clean - and actually helps with the depression. And best of all, I continue to lose weight. I can go an entire evening without eating or even thinking about food.
verne
Posted by utopizen on October 11, 2004, at 14:21:23
In reply to Re: Cymbalta might just be workin' » lemon68, posted by verne on October 10, 2004, at 9:21:20
> Cymbalta is working for me too. I can concentrate better and feel more motivated. Compared to all the other AD's I've tried it is clean - and actually helps with the depression. And best of all, I continue to lose weight. I can go an entire evening without eating or even thinking about food.
>
> verneThis is incredible to hear! I really am glad that you found some relief with this!
From my brief education of the stuff as of 5 minutes ago, the Lilly site cymbalta.com doctors section makes it clear that only going up to 60mg was clinically efficacious, and that this should be the target dose for patients.
Higher doses should be explored, of course, if you aren't responding, since it's often the case that clinically, docs find higher doses more effective than what the package insert may claim.
Lilly claims that their data shows relief occuring in 1-2 weeks (keep in mind these studies tend to go up to the target dose quite agressively) and full relief in 4 weeks. That's quite a statement! (Lexapro's site claims to "hear" that patients report relief shortly after beginning with it, but this is a little too anecdotal for me).I haven't tried it, but I'm on Lexapro 20mg and haven't found much relief yet. I'll try it for another month, maybe doubling the dose if my doc feels like it, and then trying Cymbalta since I've tried all the SSRIs and Wellbutrin and Effexor and Remeron already.
I've also, as a Plan-B, got some Seligiline I've got on its way in the mail I plan to use along with it.
Posted by jujube on October 11, 2004, at 17:58:59
In reply to Re: Cymbalta might just be workin' » lemon68, posted by verne on October 10, 2004, at 9:21:20
Is Cymbalta effective for anxiety disorders? Also, does anyone know if it is available in Canada yet? Thanks.
Tamara
> Cymbalta is working for me too. I can concentrate better and feel more motivated. Compared to all the other AD's I've tried it is clean - and actually helps with the depression. And best of all, I continue to lose weight. I can go an entire evening without eating or even thinking about food.
>
> verne
Posted by utopizen on October 12, 2004, at 8:43:11
In reply to Re: Cymbalta might just be workin' » verne, posted by jujube on October 11, 2004, at 17:58:59
> Is Cymbalta effective for anxiety disorders? Also, does anyone know if it is available in Canada yet? Thanks.
>My heart goes out to you guys north of the border, it really does.
I advise calling Eli Lilly's U.S. hotline for physicians, 1-800-Lilly-Rx, and asking if there's any laws that allow for importation of drugs not approved for Canada but permitted for compassionate use.
That is, when there is evidence you need the med to survive, like if you suffer sucicidal ideation or have failed other AD's in the past. If they can't get you an answer to you or your doc, ask them to write or fax back to you once they have a chance to do their homework.
Posted by earthgirl on October 16, 2004, at 12:13:30
In reply to Re: Cymbalta might just be workin', posted by utopizen on October 12, 2004, at 8:43:11
Jujube,
My experience is that Cymbalta has been excellent for anxiety relief. I am only on Day 5, but I felt the benefits within first 3 days.
Even if Cymbalta isn't available in Canada yet, can you buy it on the internet? Also, would your pdoc be supportive of this?
Earthgirl
Posted by jujube on October 16, 2004, at 14:10:24
In reply to Re: Cymbalta might just be workin' » utopizen, posted by earthgirl on October 16, 2004, at 12:13:30
Thanks for the response. I could raise Cymbalta with my pdoc, but I don't think he'd go for buying it on the interet - he's a bit conservative.
> Jujube,
>
> My experience is that Cymbalta has been excellent for anxiety relief. I am only on Day 5, but I felt the benefits within first 3 days.
>
> Even if Cymbalta isn't available in Canada yet, can you buy it on the internet? Also, would your pdoc be supportive of this?
>
> Earthgirl
Posted by banga on October 19, 2004, at 15:06:10
In reply to Re: Cymbalta might just be workin' » earthgirl, posted by jujube on October 16, 2004, at 14:10:24
Those of you who are experiencing relief with Cymbalta...what about sexual side effects? Drowsiness?
Posted by verne on October 19, 2004, at 15:28:30
In reply to Re: Cymbalta -sexual side effects?, posted by banga on October 19, 2004, at 15:06:10
I've been on cymbalta a month at doses from 20mgs to 60mgs per day. I recently went from 40mgs to 20mgs because of the sexual side effects - anorgasmic for the most part.
I find cymbalta to be both stimulating and sedating so I never know when I'll need a power nap - I'm talking pedal-to-the-metal zzz's.
Otherwise it has helped me with the depression and I've lost some weight.
verne
Posted by yznhymer on October 19, 2004, at 15:28:34
In reply to Re: Cymbalta -sexual side effects?, posted by banga on October 19, 2004, at 15:06:10
> Those of you who are experiencing relief with Cymbalta...what about sexual side effects? Drowsiness?
I stopped taking Cymbalta 3 days ago because the side effects were so uncomfortable, particularly the increased anxiety, but also dry mouth, anorgasmia, hot flashes, some constipation, and sleepiness.
Granted, 2 weeks was not a fair trial. I was initally committed to trying it out for at least 6 weeks with the hopes the side effects would abate. But I couldn't stand the anxiety any longer and decided to take a break and possibly restart Cymbalta after a day or two.
Three days later, the anorgasmia is as intractable as ever, and I'm reluctant to reintroduce the physical and other symptoms of anxiety. The only welcome result of the med for me so far has been weight loss. I lost almost 10 pounds in two weeks. I'm even considering sticking it out one or two more week to lose a few more pounds but don't know if I can take it.
At this point I don't know what to do. I'm a little afraid to call my new pdoc and tell him I've given up after 2 weeks. I don't know what would be a good next step for me either. I have disability insurance issues that have me worried about making sure I have my treatment covered.
Posted by yznhymer on October 19, 2004, at 15:30:47
In reply to Re: Cymbalta -sexual side effects? » banga, posted by verne on October 19, 2004, at 15:28:30
Posted by jujube on October 19, 2004, at 15:46:02
In reply to Re: Cymbalta -sexual side effects?, posted by yznhymer on October 19, 2004, at 15:28:34
> > Those of you who are experiencing relief with Cymbalta...what about sexual side effects? Drowsiness?
>
> I stopped taking Cymbalta 3 days ago because the side effects were so uncomfortable, particularly the increased anxiety, but also dry mouth, anorgasmia, hot flashes, some constipation, and sleepiness.
>
> Granted, 2 weeks was not a fair trial. I was initally committed to trying it out for at least 6 weeks with the hopes the side effects would abate. But I couldn't stand the anxiety any longer and decided to take a break and possibly restart Cymbalta after a day or two.
>
> Three days later, the anorgasmia is as intractable as ever, and I'm reluctant to reintroduce the physical and other symptoms of anxiety. The only welcome result of the med for me so far has been weight loss. I lost almost 10 pounds in two weeks. I'm even considering sticking it out one or two more week to lose a few more pounds but don't know if I can take it.
>
> At this point I don't know what to do. I'm a little afraid to call my new pdoc and tell him I've given up after 2 weeks. I don't know what would be a good next step for me either. I have disability insurance issues that have me worried about making sure I have my treatment covered.Couldn't your pdoc give you something for the anxiety while you go through the start-up side effects and your body adjusts to the med? I don't thing two weeks really isn't enough time to say whether the med will work for you or not. But, it's obvious you need something to help you with the increased anxiety. Maybe you can give your pdoc a call and see what he/she says.
Tamara
Posted by verne on October 19, 2004, at 16:09:48
In reply to did dropping to 20mgs help? (nm) » verne, posted by yznhymer on October 19, 2004, at 15:30:47
There's slight improvement in sexual side effects after a couple days at 20mgs per day. I'm hoping that after a few weeks at the lower dose I'll notice even more improvement. Otherwise it's off to the monastary for me.
verne
Posted by yznhymer on October 19, 2004, at 16:26:56
In reply to Re: Cymbalta -sexual side effects? » yznhymer, posted by jujube on October 19, 2004, at 15:46:02
> > > Those of you who are experiencing relief with Cymbalta...what about sexual side effects? Drowsiness?
> >
> > I stopped taking Cymbalta 3 days ago because the side effects were so uncomfortable, particularly the increased anxiety, but also dry mouth, anorgasmia, hot flashes, some constipation, and sleepiness.
> >
> > Granted, 2 weeks was not a fair trial. I was initally committed to trying it out for at least 6 weeks with the hopes the side effects would abate. But I couldn't stand the anxiety any longer and decided to take a break and possibly restart Cymbalta after a day or two.
> >
> > Three days later, the anorgasmia is as intractable as ever, and I'm reluctant to reintroduce the physical and other symptoms of anxiety. The only welcome result of the med for me so far has been weight loss. I lost almost 10 pounds in two weeks. I'm even considering sticking it out one or two more week to lose a few more pounds but don't know if I can take it.
> >
> > At this point I don't know what to do. I'm a little afraid to call my new pdoc and tell him I've given up after 2 weeks. I don't know what would be a good next step for me either. I have disability insurance issues that have me worried about making sure I have my treatment covered.
>
> Couldn't your pdoc give you something for the anxiety while you go through the start-up side effects and your body adjusts to the med? I don't thing two weeks really isn't enough time to say whether the med will work for you or not. But, it's obvious you need something to help you with the increased anxiety. Maybe you can give your pdoc a call and see what he/she says.
>
> Tamara
>
>
>Yes, that's a reasonable suggestion. I still may call him about it. At this point I haven't for 4 reasons:
First, he recently decided he wanted me off a very low dose of ativan (.5 to 1 mg) that I've been taking as needed, mostly for sleep. His reasoning was that it could add to my depression. Frankly, this didn't make much sense to me. I've been on the same low dose of either klonopin or atiivan, as needed, for about a decade with no problems.
Second, I tried taking 1mg ativan and it didn't put a dent in the anxiety but added to the sleepiness I was already feeling from the Cymbalta. I don't know how I'd manage to stay awake at doses that did help, though for a short time this might be tolerable.
Third, even if the anxiety were controlled, I'm still left with the anorgasmia. The fact that it hasn't gotten better 3 days off the meds, as well as my own experience with other ADs, leads me to think that this particular side effect is not gonna go away with time. Does anorgasmia usually abate over time?
Fourth, I'm not really comfortable with my pdoc. I started with him after moving here from across country. I often "feel" he doesn't believe my depression issues, though he's never said as much. So my generalized anxiety and avoidant personality get in the way of calling him under these circumstances.
Still, your suggestion is a good one and it might be worthwhile to see what happens. Thanks for making it. At the very least its helping me sort through the issues here. I'd like to have some idea about where I want to go with this before calling him. :-)
Mark
Posted by jujube on October 19, 2004, at 16:49:50
In reply to Re: Cymbalta -sexual side effects? » jujube, posted by yznhymer on October 19, 2004, at 16:26:56
> > > > Those of you who are experiencing relief with Cymbalta...what about sexual side effects? Drowsiness?
> > >
> > > I stopped taking Cymbalta 3 days ago because the side effects were so uncomfortable, particularly the increased anxiety, but also dry mouth, anorgasmia, hot flashes, some constipation, and sleepiness.
> > >
> > > Granted, 2 weeks was not a fair trial. I was initally committed to trying it out for at least 6 weeks with the hopes the side effects would abate. But I couldn't stand the anxiety any longer and decided to take a break and possibly restart Cymbalta after a day or two.
> > >
> > > Three days later, the anorgasmia is as intractable as ever, and I'm reluctant to reintroduce the physical and other symptoms of anxiety. The only welcome result of the med for me so far has been weight loss. I lost almost 10 pounds in two weeks. I'm even considering sticking it out one or two more week to lose a few more pounds but don't know if I can take it.
> > >
> > > At this point I don't know what to do. I'm a little afraid to call my new pdoc and tell him I've given up after 2 weeks. I don't know what would be a good next step for me either. I have disability insurance issues that have me worried about making sure I have my treatment covered.
> >
> > Couldn't your pdoc give you something for the anxiety while you go through the start-up side effects and your body adjusts to the med? I don't thing two weeks really isn't enough time to say whether the med will work for you or not. But, it's obvious you need something to help you with the increased anxiety. Maybe you can give your pdoc a call and see what he/she says.
> >
> > Tamara
> >
> >
> >
>
> Yes, that's a reasonable suggestion. I still may call him about it. At this point I haven't for 4 reasons:
>
> First, he recently decided he wanted me off a very low dose of ativan (.5 to 1 mg) that I've been taking as needed, mostly for sleep. His reasoning was that it could add to my depression. Frankly, this didn't make much sense to me. I've been on the same low dose of either klonopin or atiivan, as needed, for about a decade with no problems.
>
> Second, I tried taking 1mg ativan and it didn't put a dent in the anxiety but added to the sleepiness I was already feeling from the Cymbalta. I don't know how I'd manage to stay awake at doses that did help, though for a short time this might be tolerable.
>
> Third, even if the anxiety were controlled, I'm still left with the anorgasmia. The fact that it hasn't gotten better 3 days off the meds, as well as my own experience with other ADs, leads me to think that this particular side effect is not gonna go away with time. Does anorgasmia usually abate over time?
>
> Fourth, I'm not really comfortable with my pdoc. I started with him after moving here from across country. I often "feel" he doesn't believe my depression issues, though he's never said as much. So my generalized anxiety and avoidant personality get in the way of calling him under these circumstances.
>
> Still, your suggestion is a good one and it might be worthwhile to see what happens. Thanks for making it. At the very least its helping me sort through the issues here. I'd like to have some idea about where I want to go with this before calling him. :-)
>
> Mark
>Mark,
I've said this before to others. So, for what it is worth, you need to keep in mind that your pdoc works for you! You should not allow him to put you off, or dismiss your depression and anxiety issues. These are serious issues. One thing I have done lately to help in my appointments, mostly with my family doctor who is good but tends to be rushed and impatient, is to write down the issues I want to discuss beforehand. Then, when I get to the appointment, I tell the doctor I have a number of issues to discuss and pull out my list. It helps me focus and it seems to make her more attentive. With respect to the anti-anxiety meds, perhaps you could suggest short-term use of Xanax (short-term to avoid dependency) while you get your anxiety under control. For me, Xanax (taken only when needed or for short periods), relaxes me, but does not make me sleepy. It actually helps me focus, and didn't make me depressed at all. Finally, with respect to the sexual side effects, some have experienced some relief by taking Gingko and perhaps some Ginseng. Be careful with the Ginseng though, I have heard that Panax Ginseng can actually increase anxiety. I believe Siberian Ginseng tends to be better for people with anxiety. And, not to sound trite, but heightened anxiety and worry can cause problems in this area as well.
Good luck to you Mark, and don't let your pdoc put you off or try to minimize your suffering.
Tamara
Posted by banga on October 19, 2004, at 20:35:02
In reply to Re: Cymbalta -sexual side effects?, posted by banga on October 19, 2004, at 15:06:10
I asked because Î'm considering switching from Lexapro with hope that there will be less sexual side effects, and some antianxiety effect-others had reported help with anxiety. Guess this isn't the one for me then. Bummer. Currently on Lexapro 15mg, Geodon 40 mg, amantadine 200 mg. Geodon helped with anxiety for a while, now has worn off...
Posted by awatts on October 20, 2004, at 6:42:10
In reply to Re: Cymbalta -sexual side effects? » jujube, posted by yznhymer on October 19, 2004, at 16:26:56
> Yes, that's a reasonable suggestion. I still may call him about it. At this point I haven't for 4 reasons:
>
> First, he recently decided he wanted me off a very low dose of ativan (.5 to 1 mg) that I've been taking as needed, mostly for sleep. His reasoning was that it could add to my depression. Frankly, this didn't make much sense to me. I've been on the same low dose of either klonopin or atiivan, as needed, for about a decade with no problems.
>
> Second, I tried taking 1mg ativan and it didn't put a dent in the anxiety but added to the sleepiness I was already feeling from the Cymbalta. I don't know how I'd manage to stay awake at doses that did help, though for a short time this might be tolerable.
>
> Third, even if the anxiety were controlled, I'm still left with the anorgasmia. The fact that it hasn't gotten better 3 days off the meds, as well as my own experience with other ADs, leads me to think that this particular side effect is not gonna go away with time. Does anorgasmia usually abate over time?
>
> Fourth, I'm not really comfortable with my pdoc. I started with him after moving here from across country. I often "feel" he doesn't believe my depression issues, though he's never said as much. So my generalized anxiety and avoidant personality get in the way of calling him under these circumstances.
>
> Still, your suggestion is a good one and it might be worthwhile to see what happens. Thanks for making it. At the very least its helping me sort through the issues here. I'd like to have some idea about where I want to go with this before calling him. :-)
>
> Mark
>
Two things:Ativan has not worked well for me. I take Klonopin 0.5 mg x 2 now.
Anorgasmia from ADs almost NEVER goes away with time or augmentation with other drugs. You get it - you keep it, until you reduce or discontinue the drug.
Posted by yznhymer on October 20, 2004, at 16:03:18
In reply to Re: Cymbalta -sexual side effects?, posted by awatts on October 20, 2004, at 6:42:10
> > Yes, that's a reasonable suggestion. I still may call him about it. At this point I haven't for 4 reasons:
> >
> > First, he recently decided he wanted me off a very low dose of ativan (.5 to 1 mg) that I've been taking as needed, mostly for sleep. His reasoning was that it could add to my depression. Frankly, this didn't make much sense to me. I've been on the same low dose of either klonopin or atiivan, as needed, for about a decade with no problems.
> >
> > Second, I tried taking 1mg ativan and it didn't put a dent in the anxiety but added to the sleepiness I was already feeling from the Cymbalta. I don't know how I'd manage to stay awake at doses that did help, though for a short time this might be tolerable.
> >
> > Third, even if the anxiety were controlled, I'm still left with the anorgasmia. The fact that it hasn't gotten better 3 days off the meds, as well as my own experience with other ADs, leads me to think that this particular side effect is not gonna go away with time. Does anorgasmia usually abate over time?
> >
> > Fourth, I'm not really comfortable with my pdoc. I started with him after moving here from across country. I often "feel" he doesn't believe my depression issues, though he's never said as much. So my generalized anxiety and avoidant personality get in the way of calling him under these circumstances.
> >
> > Still, your suggestion is a good one and it might be worthwhile to see what happens. Thanks for making it. At the very least its helping me sort through the issues here. I'd like to have some idea about where I want to go with this before calling him. :-)
> >
> > Mark
> >
> Two things:
>
> Ativan has not worked well for me. I take Klonopin 0.5 mg x 2 now.
>
> Anorgasmia from ADs almost NEVER goes away with time or augmentation with other drugs. You get it - you keep it, until you reduce or discontinue the drug.
>Thanks for the feedback, awatts, and others. I was on klonopin before (to stay asleep)but switched to ativan cuz the klonopin left me drowsy into the day. Otherwise it worked well and there were no dependency issues for me. I'd have no problem going back to it if I were gonna stay on Cymbalta and my pdoc went along with it.
However, the anorgasmia is a deal killer... at least for a long-term solution. Its never gone away on other ADs for me so I suspect the same here. My pdoc says it can go away in some cases but I don't think it will from what I'm experiencing. He also says augmentation to counteract anorgasmia doesn't work, though for erection issues viagra helps. My previous pdoc said the same thing.
Given that, lemme ask you this: would you throw in the towel now on Cymbalta in my case? I'm thinking why mess with the anxiety and other side effects if I know I won't stay on it with permanent anorgasmia? i.e., why put up with 6 more weeks of nastiness if I'm gonna end up ditching it anyway?
I guess I need some objective input since I don't trust the clarity of my own thinking so much these days. Thanks again,
Mark
Posted by Mind on October 24, 2004, at 0:06:18
In reply to Re: Cymbalta -sexual side effects? » awatts, posted by yznhymer on October 20, 2004, at 16:03:18
Yohimbine by presciption (don't get Yohimbe Bark, IMO). Just one 5.4 mg taken about 1/2 an hour before sexual activity should take care of the anorgasmia. Whether this would have negative impact on your anxiety or not, I don't know. I don't have what I'd call anxiety.
I have found Yohimbine to be very effective, but your orgasm will still not feel like one w/o the drug.
It's very cheap, too.
Mind
> Thanks for the feedback, awatts, and others. I was on klonopin before (to stay asleep)but switched to ativan cuz the klonopin left me drowsy into the day. Otherwise it worked well and there were no dependency issues for me. I'd have no problem going back to it if I were gonna stay on Cymbalta and my pdoc went along with it.
>
> However, the anorgasmia is a deal killer... at least for a long-term solution. Its never gone away on other ADs for me so I suspect the same here. My pdoc says it can go away in some cases but I don't think it will from what I'm experiencing. He also says augmentation to counteract anorgasmia doesn't work, though for erection issues viagra helps. My previous pdoc said the same thing.
>
> Given that, lemme ask you this: would you throw in the towel now on Cymbalta in my case? I'm thinking why mess with the anxiety and other side effects if I know I won't stay on it with permanent anorgasmia? i.e., why put up with 6 more weeks of nastiness if I'm gonna end up ditching it anyway?
>
> I guess I need some objective input since I don't trust the clarity of my own thinking so much these days. Thanks again,
>
> Mark
This is the end of the thread.
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