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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by qbsbrown on September 18, 2006, at 18:17:44
It seems with effexor, u need to get to 150mgs to hit the norepinephrine. From what i've heard, cymbalta work on both at much lower doses.
Is this correct. I am highly med sensitive, and i doubt i'll be albe to reach or tolerate 150mg of effexor.
Thanks,
Brian
Posted by Jost on September 18, 2006, at 19:32:10
In reply to Cymbalta works on Norepinephrine at low dose right, posted by qbsbrown on September 18, 2006, at 18:17:44
Definitely that's what I've been told.
Much higher effect on norepinephrine at low dose with cymbalta than effexor.
Jost
Posted by Phillipa on September 18, 2006, at 21:22:10
In reply to Re: Cymbalta works on Norepinephrine at low dose r » qbsbrown, posted by Jost on September 18, 2006, at 19:32:10
It also helps with pain. Love Phillipa
Posted by qbsbrown on September 18, 2006, at 21:50:30
In reply to Re: Cymbalta works on Norepinephrine at low dose r, posted by Phillipa on September 18, 2006, at 21:22:10
I'm so damn med sensitive, i can't even tolerate 75mg effexor, so no norepinephrine for me. I guess it's 40 mgs cymbalta, right?
Posted by yxibow on September 18, 2006, at 22:53:17
In reply to Re: Cymbalta works on Norepinephrine at low dose r, posted by qbsbrown on September 18, 2006, at 21:50:30
> I'm so damn med sensitive, i can't even tolerate 75mg effexor, so no norepinephrine for me. I guess it's 40 mgs cymbalta, right?
Well I certainly couldn't stand effexor, so if you can't stand something that is that hyperactive of a medication (for some -- others who seem to need stimulants actually are made sleepy by it) Cymbalta in my opinion is much better. I'm at 120. But 40mg is a fairly okay dose. You can start off at 20mg to try, I'm sure your doctor would anyhow.
Posted by Phillipa on September 18, 2006, at 22:57:59
In reply to Re: Cymbalta works on Norepinephrine at low dose r » qbsbrown, posted by yxibow on September 18, 2006, at 22:53:17
Even start lower break open the capsules don't bite them and start low. Love Phillipa ps I got up to 60mg the first time second time couldn't tolerate 30mg.
Posted by qbsbrown on September 18, 2006, at 22:58:05
In reply to Re: Cymbalta works on Norepinephrine at low dose r » qbsbrown, posted by yxibow on September 18, 2006, at 22:53:17
How can you start off on 20mgs Cymbalta? I thought that it had to be twice a day BID, and lowest capsual pill is 20mgs.
Please advise,
Brian
Posted by Phillipa on September 18, 2006, at 23:00:55
In reply to Re: Cymbalta works on Norepinephrine at low dose r, posted by qbsbrown on September 18, 2006, at 22:58:05
They always prescirbed once a day for me. I think there are 20mg capsules. Goggle on Bob cymbalta and see all the clever ways people dosed. Love Phillipa
Posted by yxibow on September 18, 2006, at 23:44:40
In reply to Re: Cymbalta works on Norepinephrine at low dose r, posted by qbsbrown on September 18, 2006, at 22:58:05
> How can you start off on 20mgs Cymbalta? I thought that it had to be twice a day BID, and lowest capsual pill is 20mgs.
>
> Please advise,
>
> Brian20mg is a test dose to make sure it works for you. The half life length is sufficient that you will probably have enough in you to see if you have side effects and can tolerate. Then it would be dosed 20mg b.i.d.
Be careful about breaking open caplets, I've been through several discussions on this: 1) the individual pellets are not uniform in size, the capsules are by weight, and 2) if you accidentally chew any of them you'll get a NE rush.
Posted by Racer on September 19, 2006, at 1:42:13
In reply to Re: Cymbalta works on Norepinephrine at low dose r, posted by qbsbrown on September 18, 2006, at 22:58:05
> How can you start off on 20mgs Cymbalta? I thought that it had to be twice a day BID, and lowest capsual pill is 20mgs.
>
> Please advise,
>
> BrianI always took it once a day. I've never heard of it requiring twice a day dosing. Are you sure you're not thinking about regular Effexor? That does need to be taken twice a day.
Also, I know you say you're "med sensitive," but remember -- you have to be sensitive to them for them to work. Being "med sensitive" is a Good Thing, in that sense, right?
Whatever you do, Brian? Even if it's not great at first, try to stick it out at least four weeks. I know it sounds like a long time, but you know what? If it turns out that, at four weeks, you find it's working for you with minimal side effects, isn't it worth those adjustment phase effects? I've had a lot of trouble with that in the past, so I know it's hard. If you need support to get through it, you can babblemail me. Or, of course, post here. Lots of support for you here.
Good luck with it. Cymbalta was a pretty friendly drug, for me. First few days felt like drifting on a cloud, which was uncomfortable for me. Then I had some tummy trouble, which went away after I started taking it AFTER eating. And those first few days, I had trouble sleeping -- which I think was more anxiety than the drug. The cloud and sleeping problems were gone by day four or five, as I recall, and the tummy trouble went when I ate first.
And after that, I had no trouble with it. No trouble tapering off, either.
Good luck, Brian.
Posted by Racer on September 19, 2006, at 1:43:40
In reply to Re: Cymbalta works on Norepinephrine at low dose r » qbsbrown, posted by yxibow on September 18, 2006, at 23:44:40
> >
>
> Be careful about breaking open caplets, I've been through several discussions on this: 1) the individual pellets are not uniform in size, the capsules are by weight, and 2) if you accidentally chew any of them you'll get a NE rush.
>
>I agree -- I know a lot of people do it, but I think it's often an unwise idea. You've said it better than I can, so I'll stick with saying, "What he said!"
Posted by qbsbrown on September 19, 2006, at 10:24:58
In reply to I agree... » yxibow, posted by Racer on September 19, 2006, at 1:43:40
I agree, i would never consider opening up a capsual.
As far as being med sensitive, i'm speaking of things that i know will not go away w/ in months time. As was the case while i was just on lexapro and celexa 4 months, and paxil before that.
When certain symptoms rear their ugly heads, i typically know that they aren't going away w/in any ammount of time.
Brian
Posted by qbsbrown on September 19, 2006, at 10:33:20
In reply to Re: Cymbalta works on Norepinephrine at low dose r » qbsbrown, posted by Racer on September 19, 2006, at 1:42:13
Yes, cymbalta has a short half lif 10-15 hrs, so it is many times used BID.
Brian
Posted by Racer on September 19, 2006, at 10:41:39
In reply to Re: I agree..., posted by qbsbrown on September 19, 2006, at 10:24:58
>
>
> As far as being med sensitive, i'm speaking of things that i know will not go away w/ in months time. As was the case while i was just on lexapro and celexa 4 months, and paxil before that.
>
> When certain symptoms rear their ugly heads, i typically know that they aren't going away w/in any ammount of time.
>
> BrianOK, how do you know? It's one thing if something has stuck around for four months without improvement. That's something that probably won't improve on its own. If the medication is working, though, most adverse effects can be mitigated.
What I'm afraid of, Brian, and the reason I'm pushing at you about this, is that you'll stop a medication because you're positive that an adverse effect won't go away -- and thus miss out on a medication that could improve the quality of your life. I think that would be a shame.
Honestly -- Brian? I've had adverse effects that didn't go away, that got worse, that impaired the quality of my life in one way or another. Guess what? I stayed on the medications that worked anyway, because the benefits outweighed them. These days, I wouldn't be nearly as tolerant of those effects -- largely because I could tell myself in the past that the drugs were temporary, that I could stop taking them :-( -- but I wouldn't give up on a medication that helped. I'd talk to my doctor about treating the problems.
I wish you the best, Brian.
Posted by qbsbrown on September 19, 2006, at 11:11:09
In reply to Re: I agree... » qbsbrown, posted by Racer on September 19, 2006, at 10:41:39
That is what i DID for years, through my 5 years of refusing to take an AD, because of the immediate crap that i got from it.
But these days i've finally been talked in to taking them for longer ammounts of time. So i think you have the right intention, and i see what you're saying, but it's not what you think it is.
It's like celexa, and the newly introduced effexor (although doc wants me on cymbalta), there's the loss of appetite, not just from 2 weeks, but the whole duration. Now very unhealthy weight loss isn't worth it to me.
So i'll move on. These things have what, a 20 percent chance of working anyway right?
Brian
Posted by qbsbrown on September 21, 2006, at 17:20:38
In reply to Re: I agree..., posted by qbsbrown on September 19, 2006, at 11:11:09
Not easy, and had help from ativan. 150 should be able to touch the NE right? How much time am i look at, because right now it's making anxiety/depression worse.
I know i know, racer, stick it through, lol
Brian
This is the end of the thread.
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