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Dr. Bob is Robert Hsiung, MD,
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Posted by Mildred on July 19, 2005, at 22:36:04
Is that a safe and potentially effective combination? I am currently on Lexapro and Wellbutrin. I have quite a bit of pain from osteoarthritis, and from reading this board, I have learned that Cymbalta relieves pain.
Posted by Racer on July 19, 2005, at 23:23:19
In reply to Cymbalta and Wellbutrin?, posted by Mildred on July 19, 2005, at 22:36:04
That's my cocktail, with a twist of Provigil, and it's doing very well for me. There are problems here and there, it's not perfect, but it's working better, with fewer side effects, than anything else I've taken.
The pain relief is real, but it won't work as well as, say, a painkiller like codeine. It does ease the discomfort enough to notice, though, and helped me through the winter nicely.
Hope that helps.
Posted by med_empowered on July 19, 2005, at 23:26:10
In reply to Cymbalta and Wellbutrin?, posted by Mildred on July 19, 2005, at 22:36:04
hey! Cymbalta and Wellbutrin would be a more stimulating AD combo. This could work for you quite nicely, especially if you tend towards fatigue, oversleeping, and have had problems with SSRIs in the past. On the other hand...Cymbalta raises blood pressure in some people. Usually, the increase is small--I think on average 4 points--but now and then Cymbalta makes blood pressure go crazy. The real problem is that Wellbutrin can also raise blood pressure in some people and, although the combo hasn't really been well studied, I imagine that together it could pack a punch. Again, this might not even happen, and if it does happen it could be minor, but if you have blood pressure problems already, its worth discussing with your doc. As for the pain thing...Cymbalta is kinda sorta Tricyclic-ish in terms of relieving pain...I think that, so far, the FDA has only OK'd it for diabetic neuropathic pain, but I suppose that could change. If cost is an issue, or if the cymbalta doesn't help enough, it might be worth trying a Tricyclic, assuming you can handle the side-effects (this AD RX'ing business is tricky). I think the major TCAs used for pain are Elavil, Doxepin, and Tofranil. Elavil can make a good sleeping pill, and there's an Elavil-Librium combo med (Limbitrol, also available in generic) that's used for anxiety/sedation, but could probably also be good for minor-mild pain (Librax, a librium-containing compound, is used for this purpose). Doxepin is sold under bunches of different brand names and is good for pain, anxiety, odd-ball depressions (psychotic, severe endogenous depression, etc.) is sedating (though not as sedating as Elavil or Limbitrol) and, in addition to the usual pain-relieving effects of the Tricyclics, is apparently good for headaches and dermatological problems. Tofranil is the first tricyclic that hit the market, so its the benchmark. Its also loaded with side effects. Expect sedation, dizziness upon standing, weight gain, and a slight hangover if you take it all at nite (there is a newish Tofranil-PM that doses everything at nite. However, given the half-life and what not, you could probably take generic Tofranil all at nite and get comparable results). Good luck!
Posted by Phillipa on July 20, 2005, at 18:06:38
In reply to Re: Cymbalta and Wellbutrin?, posted by med_empowered on July 19, 2005, at 23:26:10
Wow Med! You sure know a lot! What I know is that when I took cymbalta I didn't have any pain. Didn't realize this until I stopped and my back began to hurt again. I stopped too soon. Fondly, Phillipa
Posted by Mildred on July 20, 2005, at 19:29:28
In reply to Re: Cymbalta and Wellbutrin?, posted by med_empowered on July 19, 2005, at 23:26:10
I think I'll give it a try - my blood pressure is generally quite low, so there's a good chance that that won't be a problem. And I need something to give me a bit of a boost, to help me deal with amotivation. Thanks for all of your input!
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