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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Cruz on November 8, 2004, at 15:13:01
I'm on week 5 with Cymbalta 90 mg morning. Does anyone take it at night? I am thinking of trying it.
Posted by hawkeye on November 8, 2004, at 15:41:46
In reply to Cymbalta, morning or evening?, posted by Cruz on November 8, 2004, at 15:13:01
The Cymbalta PDR says: "There is a 3 hour delay in absorbtion and a one-third increase in apparent clearance of duloxetine after an evening dose as compared to a morning dose."
Posted by phillipa on November 8, 2004, at 16:48:39
In reply to Re: Cymbalta, morning or evening?, posted by hawkeye on November 8, 2004, at 15:41:46
Posted by phillipa on November 8, 2004, at 16:49:13
In reply to Re: Cymbalta, morning or evening?, posted by hawkeye on November 8, 2004, at 15:41:46
Cruz, I am on 60mg in the morning and can't sleep at nite w/o help from meds. It speeds my pulse to 120/min. after taking and takes all day to calm down! Why do you want to take it at nite?
Posted by Cruz on November 8, 2004, at 17:26:01
In reply to Re: Cymbalta, morning or evening?, posted by phillipa on November 8, 2004, at 16:49:13
> Cruz, I am on 60mg in the morning and can't sleep at nite w/o help from meds. It speeds my pulse to 120/min. after taking and takes all day to calm down! Why do you want to take it at nite?
It makes me sleepy for awhile, maybe 6 or 7 hrs..
This probably will not be an effective med for me but I should give it a complete trial. At 90 mgs. now. Maybe if I take it in the evening I will wake up and do ok.
Posted by phillipa on November 8, 2004, at 18:40:57
In reply to Re: Cymbalta, morning or evening?, posted by Cruz on November 8, 2004, at 17:26:01
Cruz, do you take the 90 at one time or do you split it up? Also, do you wake up in the middle of the nite usually?
Posted by Cruz on November 8, 2004, at 22:19:25
In reply to Re: Cymbalta, morning or evening?, posted by phillipa on November 8, 2004, at 18:40:57
> Cruz, do you take the 90 at one time or do you split it up? Also, do you wake up in the middle of the nite usually?
I have been taking 90mg in the morning. I usually wake up in the middle of the night, then I am able to get back to sleep a half hour or so later.
Posted by verne on November 9, 2004, at 0:40:51
In reply to Cymbalta, morning or evening?, posted by Cruz on November 8, 2004, at 15:13:01
I've been on cymbalta 2 months and tried doses from 20mgs to 60mgs per day, all at once or split, in the am and pm, and I've settled on 40mgs in the morning.
For the first 5 weeks I was logging some pretty serious nap time - especially about 4-6 hours after taking it while at the same time being stimulated the rest of the time and unable to sleep at night. Anyway, over the last few weeks, I've noticed less sleepiness and more of a steady calm throughout the day.
I've had alot of trouble with other AD's and was surprised I could take cymbalta at all. The side effects I first noticed - sedation, agitation, and sexual dysfunction - have all improved.
It's been a great anti-depressant but I noticed I have more trouble now with close social contact. I feel better but I have a deep sense of meaninglessness and emptiness that makes socializing difficult.
My daughter came by for a visit and I realized there was nothing I wanted to do - even talk. I didn't give a rip about Christmas, the movie she was talking about, or life. Yet I'm not depressed and have no SI plans. Just feel like it's all been a lie, that I grew up with the lie and, in turn, passed it on to my daughter.
And now that I know it's a lie - everything from Santa to the Meaning of Life - I can't pretend to be interested or feign enjoyment anymore. My heart just isn't in it anymore.
Yet, in spite of a life without purpose or enjoyment, I'm doing better with a combination of cymbalta and inderal. I've even experienced mild euphoria (how isn't that enjoyable one might ask?) yet I'm so detached, empty, and disengaged. Like being all dressed up with nowhere to go.
We have good news and bad news: At times you will feel euphoria, while at the same time, you will realize that life is meaningless and there's nothing worth doing.
Perhaps, I'm still feeling the after effects of a mini binge and I'm just in a crummy mood. I'm not depressed, really. I'm not acute, just chronically numb.
verne
Posted by KaraS on November 9, 2004, at 13:02:04
In reply to Re: Cymbalta, morning or evening?, posted by verne on November 9, 2004, at 0:40:51
> I've been on cymbalta 2 months and tried doses from 20mgs to 60mgs per day, all at once or split, in the am and pm, and I've settled on 40mgs in the morning.
>
> For the first 5 weeks I was logging some pretty serious nap time - especially about 4-6 hours after taking it while at the same time being stimulated the rest of the time and unable to sleep at night. Anyway, over the last few weeks, I've noticed less sleepiness and more of a steady calm throughout the day.
>
> I've had alot of trouble with other AD's and was surprised I could take cymbalta at all. The side effects I first noticed - sedation, agitation, and sexual dysfunction - have all improved.
>
> It's been a great anti-depressant but I noticed I have more trouble now with close social contact. I feel better but I have a deep sense of meaninglessness and emptiness that makes socializing difficult.
>
> My daughter came by for a visit and I realized there was nothing I wanted to do - even talk. I didn't give a rip about Christmas, the movie she was talking about, or life. Yet I'm not depressed and have no SI plans. Just feel like it's all been a lie, that I grew up with the lie and, in turn, passed it on to my daughter.
>
> And now that I know it's a lie - everything from Santa to the Meaning of Life - I can't pretend to be interested or feign enjoyment anymore. My heart just isn't in it anymore.
>
> Yet, in spite of a life without purpose or enjoyment, I'm doing better with a combination of cymbalta and inderal. I've even experienced mild euphoria (how isn't that enjoyable one might ask?) yet I'm so detached, empty, and disengaged. Like being all dressed up with nowhere to go.
>
> We have good news and bad news: At times you will feel euphoria, while at the same time, you will realize that life is meaningless and there's nothing worth doing.
>
> Perhaps, I'm still feeling the after effects of a mini binge and I'm just in a crummy mood. I'm not depressed, really. I'm not acute, just chronically numb.
>
> verne
>
>Verne,
The lack of interest you describe sounds like the typical SSRI apathy effect. It may be that the NE aspect of Cymbalta is what is helping you. Have you ever taken any more strictly noradrenergic medications? The other thought I had, since you tolerate the Cymbalta so well and seem to have a robust AD response, is to possibly augment with a dopaminergic to balance or oppose the serotonergic effect. (If you decide to try to do that, others on this board are more knowledgeable in terms of recommendations of meds to augment with.)Kara
Posted by verne on November 9, 2004, at 13:38:30
In reply to Re: Cymbalta, morning or evening? » verne, posted by KaraS on November 9, 2004, at 13:02:04
"Have you ever taken any more strictly noradrenergic medications? The other thought I had, since you tolerate the Cymbalta so well and seem to have a robust AD response, is to possibly augment with a dopaminergic to balance or oppose the serotonergic effect."
Kara,
I'm not familiar with the terms noradrenergic or dopaminergic. I'll look into. Thanks for the suggestions.
verne
Posted by phillipa on November 9, 2004, at 14:44:24
In reply to Re: Cymbalta, morning or evening?, posted by Cruz on November 8, 2004, at 22:19:25
Cruz, Have you tried taking your meds after supper so that you sleep better and wake up w/o that drugged feeling?
Posted by phillipa on November 9, 2004, at 14:50:19
In reply to Re: Cymbalta, morning or evening?, posted by verne on November 9, 2004, at 0:40:51
verne, you say you were unable to sleep, but it improved. Do you sleep all nite now? I still need Klonapin to slow me down from the AM Cymbalta dose, but wake up at 4AM constiently and don't feel rested.
Posted by KaraS on November 9, 2004, at 14:53:38
In reply to Re: Cymbalta, morning or evening? » KaraS, posted by verne on November 9, 2004, at 13:38:30
> "Have you ever taken any more strictly noradrenergic medications? The other thought I had, since you tolerate the Cymbalta so well and seem to have a robust AD response, is to possibly augment with a dopaminergic to balance or oppose the serotonergic effect."
>
> Kara,
>
> I'm not familiar with the terms noradrenergic or dopaminergic. I'll look into. Thanks for the suggestions.
>
> verne
Noradrenergic means involving norepinephrine and dopaminergic means involving dopamine. I've learned recently, because of my own issues, that dopamine and serotonin are like opposite sides of a see-saw. If you boost serotonin (like the SSRIs do and like Cymbalta does), then you risk a depressing result on dopamine. I think that's the theory behind the apathy that SSRIs are known to often produce.Again, I am fairly new to all of this and I don't know as much about it as others here do so hopefully others can add more here to clarify.
Posted by verne on November 9, 2004, at 15:36:09
In reply to Re: Cymbalta, morning or evening?, posted by phillipa on November 9, 2004, at 14:50:19
I sleep all nite - very solid. But I also take inderal LA along with the cymbalta in the morning.
I find inderal to be the next best thing to benzos for anxiety - especially the LA version. It is smoother and doesn't knock me out the way regular inderal does.
verne
Posted by phillipa on November 9, 2004, at 16:04:52
In reply to Re: Cymbalta, morning or evening? » phillipa, posted by verne on November 9, 2004, at 15:36:09
verne, is Inderal the same as Lopressor except for a longer half-life?
Posted by verne on November 9, 2004, at 19:19:19
In reply to Re: Cymbalta, morning or evening?, posted by phillipa on November 9, 2004, at 16:04:52
> verne, is Inderal the same as Lopressor except for a longer half-life?
I'm not familiar with Lopressor.
Posted by Sleepless in the ATL on November 9, 2004, at 20:57:47
In reply to Re: Cymbalta, morning or evening? » phillipa, posted by verne on November 9, 2004, at 19:19:19
I am finally sleeping ok on this med...jeez last week I couldn't tell you whether I was depressed or not, I was just overwhelmingly tired. Yawning all day and then waking up over and over all night. Yesterday, I felt more rested. I did change the time I take it though. I am still taking 30mg to see how I adjust. I was taking it in the morning but was tired all day, then had a boost of energy late at night and couldnt sleep so now I take it around 9 at night. Seems to help.
Posted by PhoenixGirl on November 12, 2004, at 19:34:57
In reply to Cymbalta - day 12 and sleep, posted by Sleepless in the ATL on November 9, 2004, at 20:57:47
Hey there. I've been taking Cymbalta for a few weeks, and have had the exact same sleep/wake cycle issues as you have had.
Is Cymbalta having an effect on your libido or sexual function?
> I am finally sleeping ok on this med...jeez last week I couldn't tell you whether I was depressed or not, I was just overwhelmingly tired. Yawning all day and then waking up over and over all night. Yesterday, I felt more rested. I did change the time I take it though. I am still taking 30mg to see how I adjust. I was taking it in the morning but was tired all day, then had a boost of energy late at night and couldnt sleep so now I take it around 9 at night. Seems to help.
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