Psycho-Babble Medication Thread 401671

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Cymbalta- to linkadge

Posted by utopizen on October 11, 2004, at 15:07:21

Linkadge,

Have you tried Cymbalta yet? The clinical trials showed that at 60mg, the recommended target dose, patients found signifigant relief from their depressive symptoms in just 1-2 weeks, with full relief in 4 weeks (cymbalta.com, doctor's section).

LOL, I know I sound like a drug rep saying that, but it's incredible-- I'm on Lexapro 20mg right now, and want to give it another month, maybe even go to 40mg of it, before giving up and going on Cymbalta.

The thing about Cymbalta is that when posters on this board say it's working for them, they talk of how much energy and concentration and drive they've gotten. And the fast-acting nature of it could be something you could use. (Don't expect miracles, you could not notice changes for weeks regardless).

Just keep in mind doses below 60mg weren't shown to be effective, and the therapeutic range goes up to 120mg. I suspect, given your troubles, your doc will be aggressive in getting you to 60mg in a matter of days.

It's something to consider. Zoloft really fails below 200mg in so many, so I'm worried about you, even though you're also taking a low dose of Risperdal. I would really stick with the Risperdal, maybe even the Zoloft, and talk with your doc about the Cymbalta. He'll probably take you off Zoloft, but Cymbalta+Risperdal sounds like a potent combo you could find some hope in.

But come prepared to your meeting. Bring abstracts on the drug's use in depression from medline, head-to-head comparisons of other drugs, etc. Maybe even try calling Lilly and seeing if they can have a rep drop by your doc's office and talk about how to prescribe Cymbalta (and you'd benefit, getting the free samples!) (I'm not sure if drug co.'s do this, but it's worth calling them over). And also call your doc before your next appt. if you're interested in a new treatment option, so he can research it before you come in to see him!

That, and of course keep up with your doc in-between appointments- even if you get an answering machine- to tell him your progress (or lack thereof), your concerns with any side effects you might be experiencing (which he may be able to relieve for you with another prescription), etc.

Calling your doc in-between appts. can help you enermously. I do it with mine, and often I've uped my Lexapro dose (now at 20mg) and that helps to speed up my treatment by not waiting until the next month to do something so simple as that.

I advise anyone who doesn't notice any progress between visits to especially make sure to leave messages with their docs. They can help you out a lot, since waiting for the next appt. just to like bump up a dose slows down your treatment too much.

Take care!

 

Re: Cymbalta- to linkadge

Posted by linkadge on October 11, 2004, at 17:34:34

In reply to Cymbalta- to linkadge, posted by utopizen on October 11, 2004, at 15:07:21

I would like to give cymbalta a try, the only problem is that its not avaliable here in canada (anger)

Things take *forever* before they are approved in canada. We still havn't got lexapro yet.

I don't know why this is, and hope I can get a trial of something novel soon. I think the doctors want to try me on lamictal, but to tell you the truth, even though the SSRI's aren't working, they're also not not working. Ie withdrawl is hellish.


Linkadge

 

Re: Cymbalta- to linkadge

Posted by utopizen on October 11, 2004, at 18:13:00

In reply to Re: Cymbalta- to linkadge, posted by linkadge on October 11, 2004, at 17:34:34

> I would like to give cymbalta a try, the only problem is that its not avaliable here in canada (anger)
>

For depression: Lamictal is generally, at least here in the states, ADDed to an antidepressant to increase the AD's effectiveness, not as a substitute. I tried it, but got some benign rash, so had to come off.

Isn't there some sort of thing your docs can do, like file some paperwork to get special permission for you to get a U.S. med imported?

I'm surprised if they don't allow that, especially since you report suicidal ideation at times (I'm confident, since you went to the hospital, you were brave enough about confessing to suicidal ideation).

Have you tried high (300-450mg) of Effexor? Lexapro is what I'm on at 20mg, but it's not that great. Forest Labs claims it's superior to Effexor, but I'm assuming they just used a low dose of Effexor.

Effexor is kinda like Cymbalta, in a less refined way. I took it for 6 months for social anxiety. I was so happy and motived and loved life, but I also never dealth with depression in my life before at the time, I don't know of what antidepressant qualities it would give me now if I tried it.

Seriously, do make an effort to leave progress updates with your doc at least weekly, especially if you aren't noticing improvement- don't wait for appointments. And hopefully you are seeing him every 2-3 weeks.

I saw mine weekly when my depression was really bad, and I think everyone should in extreme cases.

Lithium is often added to an antidepressant in non-bipolars to maximize the effect of the antidepressant as well.

But if your doc isn't going to med change you, for the love of god, at LEAST go up to 200mg, as fast as possible, with the Zoloft!!! My starting dose was 100, and my doc called that extremely low. And keep uping the Risperdal routinely, and if you experience depression or fatigue on it, ask if you can have some Provigil or Adderall.

 

Re: Cymbalta- to linkadge

Posted by Rayray on October 11, 2004, at 18:50:26

In reply to Re: Cymbalta- to linkadge, posted by linkadge on October 11, 2004, at 17:34:34

Utopizen has an excellent point. Are there any laws in Canada that would prohibit you from importing Cymbalta? Although I should mention that is quite expensive. I would have been charged $265 for (60) 30mg. tabs were it not for insurance.

Ray

 

Re: Cymbalta- to linkadge

Posted by utopizen on October 11, 2004, at 19:36:14

In reply to Re: Cymbalta- to linkadge, posted by Rayray on October 11, 2004, at 18:50:26

> Utopizen has an excellent point. Are there any laws in Canada that would prohibit you from importing Cymbalta? Although I should mention that is quite expensive. I would have been charged $265 for (60) 30mg. tabs were it not for insurance.
>
> Ray

yup. Don't know how Canada insurance works, but perhaps they have some options for you under the extreme circumstances (having failed meds available in your country, having suicidal ideation, etc) and talking with Eli Lilly in Canada might help as well.

 

Re: Cymbalta- to linkadge

Posted by linkadge on October 11, 2004, at 20:03:03

In reply to Re: Cymbalta- to linkadge, posted by utopizen on October 11, 2004, at 19:36:14

The insurance I am working with won't pay for
medications that are not approved in canada.

If a one months supply is over $250 american, then I would be paying over $300 a month for this. This would be well out of my reach.

We could try high doses of effexor, but this amost increased my suicidiality. Zoloft is working so, so. Its not quite as bright a feeling as celexa, but it leaves me more whole. Still moods are dark at times. Will go back to the doctor soon.

Linkadge

 

Re: Cymbalta- to linkadge linkadge

Posted by zeugma on October 11, 2004, at 20:19:43

In reply to Re: Cymbalta- to linkadge, posted by linkadge on October 11, 2004, at 20:03:03

why don't you try imipramine or other TCA, Cymbalta is just a new version of these.

 

Re: Cymbalta- to linkadge

Posted by linkadge on October 11, 2004, at 20:41:42

In reply to Re: Cymbalta- to linkadge linkadge, posted by zeugma on October 11, 2004, at 20:19:43

I tried sinequan (close to amitryptaline). It had some effects but gave me significant tachycardia.
I have a history of a heart murmor and some EEG abnormalities so we kind of want to avoid the tryciclics if possible.

I *know* that if I used my rTMS machine I would feel significantly better, but I can't go back to that. I have a bad mood disorder and using something so unregulated is not helpful.

Perhaps a trial of regulated rTMS would be beneficial.


Linkadge

 

Re: Cymbalta- to linkadge

Posted by utopizen on October 11, 2004, at 21:35:29

In reply to Re: Cymbalta- to linkadge linkadge, posted by zeugma on October 11, 2004, at 20:19:43

> why don't you try imipramine or other TCA, Cymbalta is just a new version of these.
>

It's much more complicated than that. Chocolate influences serotonin-- is that a reason to use it as a model for a synthetic antidepressant? Psychopharmacology is more complicated than we want to think it is.

 

Re: Cymbalta- to linkadge

Posted by utopizen on October 11, 2004, at 21:42:21

In reply to Re: Cymbalta- to linkadge, posted by linkadge on October 11, 2004, at 20:03:03

> The insurance I am working with won't pay for
> medications that are not approved in canada.
>
> If a one months supply is over $250 american, then I would be paying over $300 a month for this. This would be well out of my reach.
>

With my insurance, virtually anything can be appealed, if someone's willing to attempt it and it appears like an exception to the rule to the docs at the insurance co.

I doubt your insurance would favor having to pay for repeat hospitalizations and multiple ECT treatments if Cymbalta might help you. A lot of these policies are made for the typical case, and the last thing you want to believe is that your case is typical. Letter writing is worth the effort, especially with a doc's note explaining the circumstances.

You really should up the dose of Zoloft, and I'm not trying to play doctor, but I would say call your doc tomorrow morning if you're not seeing him in the next few days. You should be at 200mg ASAP, my doc would make it increased over a week's time if it were up to him. It lets your doc focus on other concerns at the appointment, too.

And Lithium added to an antidepressant is really helpful.


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