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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by jessers11581 on February 28, 2006, at 19:37:30
Hi! I've been on 30 mg. Cymbalta (along with 600 mg. SAM-e and high EPA fish oil) for 6 or 7 months now. This combination worked great for a while, but lately, I've been feeling extremely obsessive-compulsive and depressed. I've been compulsively eating sugar and carbohydrates, and my motivation is completely sapped. I'm so preoccupied with myself and my health (both mental and physical) that I have no sex life and am being very unproductive in my life. Is this an indication that I'm not getting enough serotonin from this dosage? I hate to increase, as I know that Cymbalta is an extremely difficult drug to wean off of. And I don't to get increased side effects from it, either.
What are your experiences with this medication, and at what dosages? What does it sound like I need to do?
Posted by med_empowered on February 28, 2006, at 19:50:39
In reply to cymbalta: do I need to increase?, posted by jessers11581 on February 28, 2006, at 19:37:30
the standard dose for cymbalta is 60mgs/day, although some people apparently do OK on less, and some people get a better result with more--I myself took 90, and some people take 120. So..if you think it might help, talk w/ your doc about upping the dose to 60mgs or so.
Good luck!
Posted by Phillipa on February 28, 2006, at 20:46:14
In reply to Re: cymbalta: do I need to increase?, posted by med_empowered on February 28, 2006, at 19:50:39
Med I agree. That's what my pdoc said too. Fondly, Phillipa
Posted by Racer on February 28, 2006, at 21:13:17
In reply to cymbalta: do I need to increase?, posted by jessers11581 on February 28, 2006, at 19:37:30
I can't tell you whether or not to increase, but I can tell you that I discontinued it after about fifteen months at 60mg with no trouble. I tapered from 60, to 40, to 20, and stopped -- short taper, really, and stopping was no problem.
For what it's worth, I did taper off Effexor after about two years, and it was rotten. It's not that I don't have trouble discontinuing meds -- it's just that Cymbalta doesn't seem to be nearly as wicked in that regard as its cousin, Effexor.
Hope that helps you gain confidence about raising your dose.
Posted by yxibow on March 1, 2006, at 1:11:38
In reply to cymbalta: do I need to increase?, posted by jessers11581 on February 28, 2006, at 19:37:30
> Hi! I've been on 30 mg. Cymbalta (along with 600 mg. SAM-e and high EPA fish oil) for 6 or 7 months now. This combination worked great for a while, but lately, I've been feeling extremely obsessive-compulsive and depressed. I've been compulsively eating sugar and carbohydrates, and my motivation is completely sapped. I'm so preoccupied with myself and my health (both mental and physical) that I have no sex life and am being very unproductive in my life. Is this an indication that I'm not getting enough serotonin from this dosage? I hate to increase, as I know that Cymbalta is an extremely difficult drug to wean off of. And I don't to get increased side effects from it, either.
>
> What are your experiences with this medication, and at what dosages? What does it sound like I need to do?
I take 90mgs, the dosage increase was excellent for my secondary depression. It is not the best drug for my body, for random obsessive "mind garbarge" thinking. But, one compromises I guess. Luvox was most best for that. I dont know that you can combine a SSNRI and a SSRI -- you might get Serotonin Syndrome.While I believe in better living through chemistry as they say, some of what you express sounds like something that could be worked through psychotherapy as an adjuct to your medicine regime. The preoccupation with a lack of sex life and a feeling of unproductivity are things that "inside therapy" or psychotherapy can touch on a lot. While this is the medicine board, I would suggest looking into some psychotherapy -- I think some of that would help and make you feel better.
Just a thoughtBest wishes
-- Jay
Posted by jessers11581 on March 1, 2006, at 19:51:49
In reply to cymbalta: do I need to increase?, posted by jessers11581 on February 28, 2006, at 19:37:30
Well, I saw my doctor today and he stongly suggested upping the dose, preferably to 60 mg. So I'm going to give this a go, but I have a few questions.
1) What are the main side effects that you have encountered with Cymbalta? Do any of them go away over time?
2) Is it best to take it all at once in the morning, or in two 30 mg. doses (once in a.m., once in p.m.)?
3) I have pretty bad anxiety and obsessive-compulsive tendencies. Will Cymbalta help, or potentially make these things worse?
4) What should I expect??
Thanks for any info that you can give me. I'd really like to hear what your experiences are. :)
Posted by Phillipa on March 1, 2006, at 20:09:58
In reply to I'm increasing: what to expect and other questions, posted by jessers11581 on March 1, 2006, at 19:51:49
Definitely take it all in the morning. And if you have anxiety issues make sure you have a benzo or a sleeper til you get used to it. Fondly, Phillipa
Posted by jessers11581 on March 1, 2006, at 20:21:12
**I posted this message above as a response to a previous post. I'm just posting it again here so as to (hopefully) get more responses. :)
Well, I saw my doctor today and he stongly suggested upping the dose, preferably to 60 mg. So I'm going to give this a go, but I have a few questions.
1) What are the main side effects that you have encountered with Cymbalta? Do any of them go away over time?
2) Is it best to take it all at once in the morning, or in two 30 mg. doses (once in a.m., once in p.m.)?
3) I have pretty bad anxiety and obsessive-compulsive tendencies. Will Cymbalta help, or potentially make these things worse?
4) What should I expect??
Thanks for any info that you can give me. I'd really like to hear what your experiences are.
Posted by Phillipa on March 1, 2006, at 20:33:43
In reply to Increasing Cymbalta...what to expect, posted by jessers11581 on March 1, 2006, at 20:21:12
I answered your post above. But take in the am and it is stimulating. And go slow. Fondly, Phillipa
Posted by antigua on March 3, 2006, at 8:45:09
In reply to I'm increasing: what to expect and other questions, posted by jessers11581 on March 1, 2006, at 19:51:49
I take .25mg of klonopin when I take my 60 mg of Cymbalta; otherwise, my anxiety is all over the place.
best,
antigua
Posted by jessers11581 on March 3, 2006, at 9:51:11
In reply to Re: I'm increasing: what to expect and other questions » jessers11581, posted by antigua on March 3, 2006, at 8:45:09
> I take .25mg of klonopin when I take my 60 mg of Cymbalta; otherwise, my anxiety is all over the place.
> best,
> antiguaAntigua: does klonopin cause drowsiness, or trouble thinking clearly?
Posted by Racer on March 3, 2006, at 12:11:45
In reply to Increasing Cymbalta...what to expect, posted by jessers11581 on March 1, 2006, at 20:21:12
>
> 1) What are the main side effects that you have encountered with Cymbalta? Do any of them go away over time?The only side effect I got that bothered me was amotivation. Otherwise, all the side effects were good things, for me. Mostly digestive -- amazingly it did not cause constipation, which is something all other ADs have done to me. The other side effect that I noticed was a lessening of intrusive (anxiety based) thoughts, and better sleeping.
>
> 2) Is it best to take it all at once in the morning, or in two 30 mg. doses (once in a.m., once in p.m.)?I've heard both, but took mine in the morning. At night, which my doctor suggested I try, I couldn't sleep very well. In the morning worked fine, though.
And, statistically, most side effects that you get in the first weeks will go away over time.
>
> 3) I have pretty bad anxiety and obsessive-compulsive tendencies. Will Cymbalta help, or potentially make these things worse?Potentially? Potentially it could do anything, because we all react differently. I see that Phillipa had increased anxiety -- keep in mind that she only took it for about a week, so we don't know if that would have gone away -- and Antigua also experienced it. (Dunno how long Antigua has been on it, so can't say if that's a long term reaction.) In my case, it reduced anxiety a huge amount.
>
> 4) What should I expect??Probably an increase in everything you've experienced to date. If it's been kind to you so far, it's likely to continue to be kind to you.
My strongest advice to you is to approach it with an open mind. Try not to be afraid of it, and try not to jump at the first sign of any problem. Chances are, any problem you get within the first month will go away, but if it doesn't, it can probably be mitigated. If the increased dose of Cymbalta works for you, then you can start looking at whether or not it's causing problems.
Good luck. While Cymbalta was not an overwhelming success for me, it was the least problematic AD I'd ever taken, fewest side effects by far. I hope it's as kind to you, while working a bit better.
Posted by jessers11581 on March 3, 2006, at 14:44:04
In reply to Re: Increasing Cymbalta...what to expect » jessers11581, posted by Racer on March 3, 2006, at 12:11:45
I just want to thank everyone for your responses so far. :)
Posted by antigua on March 3, 2006, at 15:54:31
In reply to Re: I'm increasing: what to expect and other questions, posted by jessers11581 on March 3, 2006, at 9:51:11
My head is clear, very sharp really, but the drowsiness was making me sleep in the afternoon, so the pdoc added another 20mg in the afternoon w/o the klonopin. It's only been a few days so I don't know if it's working yet.
antigua
Posted by jessers11581 on March 3, 2006, at 18:09:46
In reply to Re: I'm increasing: what to expect and other questions » jessers11581, posted by antigua on March 3, 2006, at 15:54:31
A strange thing happened this afternoon--I got super trembly and weak after walking for 45 minutes on my treadmill, like I could just collapse. It felt similar to coming down off a caffeine buzz. Is this something that might be attributed to the increased Cymbalta? Other possibilties are: 1) an antihistamine nasal spray that I took just before working out, or 2) taking 120 mg. ginkgo biloba just before working out. It's very odd...I've had the same thing happen before, but it's been a long time. I don't think my blood sugar was low because I'd had a snack about 2 hours beforehand...but I guess that's possibility, too. Any ideas?
Posted by Racer on March 3, 2006, at 20:35:49
In reply to Odd symptom..., posted by jessers11581 on March 3, 2006, at 18:09:46
I'd vote for the antihistimine, personally... Mostly because I don't know anything about ginko biloba.
Posted by yxibow on March 4, 2006, at 1:19:36
In reply to Odd symptom..., posted by jessers11581 on March 3, 2006, at 18:09:46
> A strange thing happened this afternoon--I got super trembly and weak after walking for 45 minutes on my treadmill, like I could just collapse. It felt similar to coming down off a caffeine buzz. Is this something that might be attributed to the increased Cymbalta? Other possibilties are: 1) an antihistamine nasal spray that I took just before working out, or 2) taking 120 mg. ginkgo biloba just before working out. It's very odd...I've had the same thing happen before, but it's been a long time. I don't think my blood sugar was low because I'd had a snack about 2 hours beforehand...but I guess that's possibility, too. Any ideas?
I'd also vote for the nasal spray and the ginko mixing in with your medication. Sounds like your blood sugar was fine. If I haven't had anything to eat in a while before I go to the gym I down a bit of honey -- its pretty much instant glucose.
A symptom I would attribute to Cymbalta if you ever experience it on a treadmill (I do) -- is if you move your head from left to right while running, and get electric shocks. That's more a Cymbalta situation, with seritonergic reactions.
This is the end of the thread.
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