![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by TrishP on April 28, 2006, at 7:25:09
I've been on Cymbalta 30 mg a week now and while it does seem to help anxiety, I think it is making me depressed. I felt so depressed last night and all I wanted to do was escape, so I took some Trazodone and got a good night's sleep.
This is the second time I have tried Cymbalta, and the first time I thought it made me depressed, but I wasn't sure because I had recently switched meds so I chalked it up to that.
I have never had a med cause depression before.
I really need a med that will help with depression and anxiety. SSRIs seem to make me more anxious. I liked Effexor, but couldn't miss taking my next dose by even a few hours ( I am a fast metabolizer and feel results pretty quick).
I need a long acting Effexor like drug.
Any suggestions?
Posted by SLS on April 28, 2006, at 7:54:56
In reply to I think Cymbalta is making me depressed, posted by TrishP on April 28, 2006, at 7:25:09
> I've been on Cymbalta 30 mg a week now and while it does seem to help anxiety, I think it is making me depressed. I felt so depressed last night and all I wanted to do was escape, so I took some Trazodone and got a good night's sleep.
>
> This is the second time I have tried Cymbalta, and the first time I thought it made me depressed, but I wasn't sure because I had recently switched meds so I chalked it up to that.
>
> I have never had a med cause depression before.
>
> I really need a med that will help with depression and anxiety. SSRIs seem to make me more anxious. I liked Effexor, but couldn't miss taking my next dose by even a few hours ( I am a fast metabolizer and feel results pretty quick).
>
> I need a long acting Effexor like drug.
>
> Any suggestions?
With the advent of SSRIs and SNRIs, doctors seem to have forgotten about the tricyclics. Nortriptyine might be worth looking into. The side effects are relatively mild and tend to lessen with time. Most people respond to 75-100mg.
- Scott
Posted by yxibow on April 28, 2006, at 14:01:40
In reply to I think Cymbalta is making me depressed, posted by TrishP on April 28, 2006, at 7:25:09
> I've been on Cymbalta 30 mg a week now and while it does seem to help anxiety, I think it is making me depressed. I felt so depressed last night and all I wanted to do was escape, so I took some Trazodone and got a good night's sleep.
I understand your feelings, but a week is a short time on Cymbalta... its a subtle drug that takes a while to build up and then at least for me you suddenly feel some effect from it.
> This is the second time I have tried Cymbalta, and the first time I thought it made me depressed, but I wasn't sure because I had recently switched meds so I chalked it up to that.
>
> I have never had a med cause depression before.
>
> I really need a med that will help with depression and anxiety. SSRIs seem to make me more anxious. I liked Effexor, but couldn't miss taking my next dose by even a few hours ( I am a fast metabolizer and feel results pretty quick).I am a fast metabolizer too. Lilly never recommended it but people have dosed up to 120mg. Depends on how cranky your insurance is. Mine plays BS with me sometimes but I can get the 90mg that I take with me (they normally only rx 60) at least part of the time.
> I need a long acting Effexor like drug.
>
> Any suggestions?Cymbalta is a long acting Effexor like drug with none of the caffeinating effects that would make someone with anxiety climb the walls like I did, you just might certainly need at least 60mg.
Tricyclics are, yes an option, but they have their side effects, even the mildest. I hardly feel Cymbalta but some cannot stand it (well I get wierd shock sensations if I'm really going at it hard in the gym but other than that).
I would stick with the Cymbalta and augment it with a small dose of a less depressant prone benzodiazepine (such as Valium instead of Klonopin if that happens to work with you) for anxiety.Just my 2c
Hope you feel betterCheers
-- Jay
Posted by blueberry on April 28, 2006, at 19:10:32
In reply to I think Cymbalta is making me depressed, posted by TrishP on April 28, 2006, at 7:25:09
Just about any antidepressant can cause depression. That's why they have to put the black box warning of suicide on them. People actually do get much worse on a particular med for whatever reason. It has happened to me several times. I don't like it and I don't understand it.
You would think the thousands of brilliant scientists and tons of dollars could figure stuff out a little better.
I don't know much about effexor, but I thought they had an extended release version of it? No? Or am I mistaken.
Posted by Phillipa on April 28, 2006, at 21:11:05
In reply to Re: I think Cymbalta is making me depressed » TrishP, posted by blueberry on April 28, 2006, at 19:10:32
Blueberry i never thought of it like that but it's true. Don't they say a severely depressed person doesn't have the energy for suicide but as they gain a little energy they do? As far as cymabalta is concerned first time no side effects no nothing. Second time I went out of my sking with anxiety. I don't think I like any of these meds. Love Phillipa
Posted by yxibow on April 29, 2006, at 0:33:58
In reply to Re: I think Cymbalta is making me depressed » TrishP, posted by blueberry on April 28, 2006, at 19:10:32
> Just about any antidepressant can cause depression. That's why they have to put the black box warning of suicide on them. People actually do get much worse on a particular med for whatever reason. It has happened to me several times. I don't like it and I don't understand it.
>
> You would think the thousands of brilliant scientists and tons of dollars could figure stuff out a little better.
>
> I don't know much about effexor, but I thought they had an extended release version of it? No? Or am I mistaken.
>
>
They put the black box on it to protect their *sses, pardon the expression, not that I speak for the drug company. Yes, it is conceivable that not every antidepressant is best for the same person, certainly Wellbutrin put my head on fire.
However, the black boxes are more there because of bad press and endless media-ese exposure of teenagers jumping out of windows (or adults), when if you really examined some of these cases, they would have done so anyhow. Severe depression is severe depression. No pill on the planet is going to hold someone back who is intent on doing self harm beyond its capabilities.
Its the same thing that I see paraded on CNN (which is the worst of repetitive networks, especially Nancy Grace, I get entertained while watching in the gym [humour]) about MySpace or blogs -- people not really thinking through that before we had one method of communication, there was the lockerroom and the cliques in the schoolyard, and the deranged people who would snatch kids off campus because "mommy told me to drive you home."
There is no "liberal media", its a misnomer. We now have one from Fox speaking for our great leader in the latest shuffle. (This is for the US audience). Anyhow, I've gone far off the topic, but there are no guarantees in medicine. We have advanced far from the 1950s and far from the 1970s that my very brilliant but undermedicated aunt with what we would now call BPII I never met committed suicide.
Some day there will be the better "happy pill". And there are thousands of briliant scientists. Some of them are your doctors, I hope. And it doesn't even take an antidepressant or genetic depression to cause depression. The very thing we call life can lead to depression, births, deaths, and all inbetween.
But I admit there is always that twinge of feeling that you are born too early. Some day if we figure out our energy future, which is really the future of the planet, lots of things can become possible.Ah, I wax.
Just my 2c. Maybe 4. :)
Tidings and cheers
-- Jay
Posted by blueberry on April 29, 2006, at 10:41:47
In reply to Re: I think Cymbalta is making me depressed » blueberry, posted by yxibow on April 29, 2006, at 0:33:58
Interesting observations. I agree with you about the drug companies covering their butts.
What I don't agree about is the currently accepted explanation that suicide is from a depressed patient getting just enough energy and recovery from a drug to actually carry it out.
They say it is all about chemical imbalance. But not everyone has the same chemical imbalance. Someone who has good serotonin but low dopamine and they start a serotonin med that further squashes out dopamine could feel real bad real fast. And vica versa. It's my own opinion and not scientifically based at all, but I think if a drug affects someone's chemistry in the opposite way that their chemistry needs, then getting more depressed on the drug is not a surprise.
Another theory is that the increased levels of neurotransmitters from a reuptake inhibitor stop the release and firing of presynaptic receptors, which can feel like increased depression to some people, like me. After a few weeks those receptors readjust to the higher levels of neuros and they resume firing at their normal rate. Again though, just an opinion.
Posted by addinbc on April 29, 2006, at 15:18:34
In reply to Re: I think Cymbalta is making me depressed » yxibow, posted by blueberry on April 29, 2006, at 10:41:47
With regard to the increased suicidality on these antidepressants...
I actually used to work with a psychiatrist who was one of the leaders in bringing this phenomenon to light. She read and re-read many of the articles outlining the results of pediatric/adolescent antidepressant drug trials. She consulted statisticians etc... and had them look at the data over and over again.
What she discovered was that time after time, there was evidence of statistically significant differences between suicidality (especially sudden, acute and/or ego dystonic) in the drug groups versus the placebo groups. Once really looked into, the difference was very evident.
I think it's good that the drug companies have made this risk as widely known as possible.
Posted by patrickhh on April 29, 2006, at 20:10:17
In reply to Re: I think Cymbalta is making me depressed, posted by addinbc on April 29, 2006, at 15:18:34
I believe the increased suicidality is being caused by the agitated stated that the drug can induce, also called akathisia.
Posted by linkadge on April 29, 2006, at 22:44:36
In reply to Re: I think Cymbalta is making me depressed, posted by patrickhh on April 29, 2006, at 20:10:17
Its an interesting topic. The dumb thing is that we are narrowminded enough to suggesst that the problem is only restricted to children who take the drugs.
I too, don't agree with the idea that the drugs increase suicidialty simply by giving the patient more energy. That is unsubstantiated, and theres no way to test the claim. Plus, some of the SSRI's don't cause psychomotor activation.
Personally, I just think it is another example of psychiatry trying to take the focus off of themseleves and their treatments and put it back on to the patient. Ie. if a patient doesn't respond properly to the drug, it must be "the patient's" fault. Psychiatry always assumes that the drugs are flawless, and if somebody responds strangely to them, they must have latent bipolar, or that the drugs just caused psychomotor activation.
In order for psychiatry to survive, they must squash out all doubt, and any hint of weakness.
The psychiatric patient group is very suspicious to begin with. The proposed theories have to seem flawless in order for the system to thrive.
There have been many times, that taking antidepressant made me much worse. Just like blueberry said, they can supress dopamine function, and untill your brain adapts to that its really a freeforall as to how it will make you feel. We know that antipsychotics can cause acute dysphoria by interupting dopamine function.I remember when I was first put on citalopram 20mg. About 2 hours after the first morning dose, I just sat down and stared at the wall till 7:00pm, that went on for about 2 weeks, till I decided to cut the dose in half. Before starting I was depressed, but was still a lot more active than that.
I actually became more suicidal, simply because it caused significant initial dysphoria.
Linkadge
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.