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Dr. Bob is Robert Hsiung, MD,
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Posted by Tony P on August 29, 2008, at 19:05:59
I've been gaining weight alarmingly since going on to a combination of Remeron and Cymbalta (Remeron alone was bad enough). When I started getting what I'm pretty sure were liver pains after taking my Remeron I really panicked and stopped the Cymbalta cold turkey. Not a good idea, I wasn't thinking too clearly.
I'm between pdocs and even my GP is hard to get in to see. My liver is boderline as it is -- all it takes is being around fresh alkyd paint to give me a pain -- so I think I was right to panic at least a little. I assumed the Cymbalta was the main offender because of its rep. of causing liver dysfunction, and that the Remeron was interacting in some way to make it worse; I had a similar liver reaction a few years ago between Celexa and Trazadone. I could have stopped the Remeron easier maybe but I believe it's doing my depression more good than the Cymbalta (apart from the durned weight gain).
Anyway, a day or two after stopping the Cymbalta cold, I was up all night (and day) 48 hours in a row, hypomanic, getting some interesting stuff done (writing music), but severely wired and not thinking clearly. I didn't experience "brain zaps", but I was having mild auditory hallucinations (e.g. sounds like there's a radio playing quietly but always in the NEXT room). By day 3 I was really weird. I felt totally stoned (and not in a pleasant way); my tongue felt about 6 inches thick, my speech waa slurred, my concentration & thinking were severely impaired -- kind of the opposite to what I'd expected. I was also forgetting to eat or drink, which probably contributed to my condition. Unfortunately, I was also impaired enough not to remember that Thursday was the one morning a week my GP does the walk-in clinic, so I missed him.
Happily my pharmacist was willing to dispense me some 30-mg Cymbalta caps (I was on 60's), and within a couple of hours of taking 30 mg I felt almost normal. So it wasn't just sleep deprivation. And today, despite only a few hours sleep, I feel OK. It certainly was strange to feel -- I can only call it stoned -- as a withdrawal symptom. Maybe it was some interaction with the other meds I'm on (clonazepam Buspar & Requip). So I'm going to taper the Cymbalta (as best I can since you're not supposed to split the time-release caps), and maybe cut back on the Remeron too until I can see my MD next Wednesday.
It was a strange and unpleasant experience and I would welcome suggestions as to how to proceed for the next few days. I'm worried enough about my liver that I want to get off the Cymbalta PDQ, but I don't want to be a manic zombie either! So I take 30 mg caps for a couple of days -- but then what? every other day? Break open & divide the caps even though they say not to?
BTW, has anyone else had liver problems with this combo of meds?
And then the question is, what next? I was doing fairly well a couple of months on Remeron plus low dose Selegeline (10 mg/day) but quite shaky & inclined to late night hypomania.
The Remeron by itself doesn't seem to be quite enough. Anyone had experience with Reboxetine + Remeron? I'll post again when I get a chance, on the main board.
Tony
This is the end of the thread.
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