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Cymbalta


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#41 Jkm

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Posted 06 October 2004 - 09:04 PM

i think the cymbalta is either upsetting my gut or I have a stomach virus, so I didn't take it tiday, and was too caught up in between working and running kids to lessons to go to the docs or call.  Lightbeing...  I'm wondering if we have some kind of sensitiviey to this med.  I bought some zantac, and took it so get the PAIN down.  I thought I had gastritis Saturday, and instead of the pain going away, it was worse.  I hope this is something in passing, but I can't deal with this pain.  I really like cymbalta, but need to get my stomach back in shape.  I can't afford to loose any weight.  I'm going to take 1/2 lexapro if I start to get the zaps.  I hope this is a virus.......    :hearts:

I also read that stomach pain happens for some when they go off Lexapro.....  I'm just going to do what I think is best, at this point.

Remission,  Sorry that this didn't work out for you.  I have that sinking feeling at this point, too.  I can understand your disappointment.  Keep hanging around with us, and see how it goes.  We're still interested in how you do with you next new treatment.  I understand it's kind of new.  Any information is appreciated!
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#42 Chatman

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Posted 17 November 2004 - 11:11 PM

mindless13,

What blood enzymes do Effexor and Cymbalta alter and what, if any, is the significance or potential harm in the alterations?

Thanks!
Chatman

#43 Hope

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Posted 27 October 2004 - 09:16 AM

Well guys I woke up this morning after taking my first 60mgs and my anxiety isn't increased at all.  I feel the same.  So that is good news.  I am though a little irritable.  Not sure why, but hopefully that goes away.  I had to take a xanax to calm me down abit.  But this has happened to me on the other meds I have taken as a start up side effect.  Hopefully it goes away.
Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#44 Jkm

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Posted 05 October 2004 - 06:37 AM

We have quite a group going here!  I have to give us all the 'Hat's Off!' for trying a new med.

I'm sleeping much better and dreaming away, which is normal with a new med, but the dreams are interesting and not of the nightmare variety, which has been my experience with start-up from past 'new' ad's.  I feel refreshed, and this is much better than how I was feeling with my previous ad.   Maybe that was not as effective for me after 15mo?  I like the idea that I'm not having to take other meds for anxiety, like I did when I went on Lexapro.  This is covering my anxiety, too!

I think there are so many things we don't know about this med.  The first reason I got on it was because it's supposed to deal with the intensified pain that some people feel when dealing with a pain disorder and depression.  I have arthritis, and having to take doses of Motrin every day would set my stomach in an uproar.  I was on the med they pulled off the market the other day, too.  I quit it after 3mo., as I got no relief from it. I'm still taking 2 Motrin before I go to bed, but haven't had a 'flare'  that people get with the type of pain disorder that I have.  I'll have to wait till the weather gets damp to see what happens...

I'm on day 11. Still taking 60 in the am.  I case anyone is interested, I weigh 100lbs., which is very petite, so the milligrams seem to have little to do with weight, but more with the amount of depression one is dealing with.  I don't have the 'spaced-out feeling', either, but more of the tiredness that comes with depression.  I'm waiting to see if this is a start-up feeling, and am hopeful that it is....

:hearts: Mindless and Jumping Frog.  I hope that your pharmacy can get the 20mg. for you soon!

So far the start-ups seem to be an upset stomach for some.  I haven't had this experience.  It also seems to make some more sensitive to caffine, which can easily be substituted by switching over to 'caffine free' or  50/50, which I did for the coffee affection I have!   :bump:  Some find this too stimulating to take at bedtime, so people have moved that dose down to early evening.  I'm taking mine in the early am.  How are the rest of the group doing?

Remission, are you still out there?                        Jackie   :shocked:
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#45 lightbeing

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Posted 30 September 2004 - 08:54 AM

It seems that the dead tiredness in the middle of the day has already passed. That was quick! I am really sold on this switching straight over from Effexor. I think that I have had fewer start up symptoms because of it and no discontinuation symptoms. What a gift!
light

#46 Jkm

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Posted 26 October 2004 - 06:00 PM

Gee Hope,

Sorry to hear that you're having such a difficult time with this med.  I tried to take it at night, and couldn't sleep due to the exergizing effect, but never had all the anxiety you're dealing with.  Maybe a call to the doc is in order.  This med is so new, who knows what kind of side-effects it has.

I know when I went on Lexapro, it did nothing for the anxiety for months, and I took Ativan to get me back on my feet and back to work.  It took a long, long time for the anti-anxiety effect to kick in.  The nice thing about Ativan is that I could break a two mg. pill in halfs or quarters, and could control the amt. I was putting in my system so if the anxiety was the panic-producing type, I could take the whole thing, and if it was the kind that just gets your mind reeling, I could do a half or less.    :hearts:
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#47 Jkm

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Posted 29 September 2004 - 05:13 AM

I slept last night like a log, so I know my poor body was beat.  I don't know about this med.  I initially was dx.'d with panic disorder, and I'm afraid that it won't cover that.  There's no indication that this med covers anxiety, just depression, pain from depression, and  incontinence problems, from what I've read.  I feel clearer, as far as my thought processes.  I think the Lexapro was producing lots of fog, LOL!  I seem to have more energy...but I'm wondering if this  energizing effect goes down with time.  Wish we had contact with someone from the clinical trials...... :hearts:

As far as my anxiety, I had one episode of this while tapering off Lexapro, so I know it's still there.   :confused:  My issue is that with this in mind, the energizing effects, lack of sleep, and lack of knowledge about the longterm effects of this med, am I going to have the anxiety coming back full force, or will these side-effects abate with time?  I hate to be setting my self up.  

I'm beginning to think we're running our own clinical study, here!  :oh:
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I have GAD. I worry about everything, lol!

#48 taffycat

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Posted 07 October 2004 - 05:20 AM

Went for my blood pressure test yesterday - it was back to normal, for the first time on ADs, so I was happy with that.  It definitely seems to help with cravings - altho I find that it takes about 2 hours after taking before I notice that benefit.  I'm still playing with when to take it, will talk to pdoc tomorrow when I see him.  I'm still sleeping better.  The fatigue seems to be building - I went to bed around 7:30 last night, and still over slept this morning.  I was up 3 or 4 times during that time, but that was still an improvement.  The nausea is still there - seems to be worse if I do eat.  That's okay, because I need to lose some weight.  I am still really sad, but it's easier to pretend that I'm fine.

Remission, how did everything go? Will you be staying on the med for a while longer?

How's everyone else?               deb   :hearts:
...in a time lacking in truth and certainty and filled with anguish and despair, no woman should be shamefaced in attempting to give back to the world, through her work, a portion of its lost heart.
-Louise Bogan

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#49 Hope

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Posted 24 October 2004 - 08:57 AM

Thanks guys I did try to take it in the morning but the lightheadedness was so bad it was horrible.  So I thought maybe taking it at night would help.  Oh I am lost.  I did toss and turn alot last night.  So I may have to play around with the time I take it.

Remission thanks for the info on the ect.  No I havent tried a MAOI.  But to be honest, I dont want to.  IT is to scary for me, being the diet thing and all.  I know that they do alot of research with Case.  My brother went to that college.  He says that he has heard many people talk highly of the ECT.  That is a shame that they wont even consider it unless you have tried MAOI's.  What does it take.   :hearts:  And yeah for the surroundings, you are right when you say that the surroundings arent that pretty.

Remission I rememember you saying that the drug made you feel lightheaded.  HHow long till that went away for you.  If you remember.  OH I  dont know how much time I should give it for that feeling to go away.  It constatnly makes me feel like I am going to pass out.

thanks guys for helping me out!!!!!!!!!!!!!

Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#50 Hope

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Posted 26 October 2004 - 05:48 PM

Wow, the anxiety is knocking me on my butt.  I cant stand it at all.  The only plus to it is that mood seems just slightly better.  But I dont want to jinkx myself.  My mood does vary throughout the day.  I am suppose to up my dose tonight to 60 but I am scared to death the anxiety will get worse.

Oh yeah and the lightheadedness is still here.  NOt constant all day but happens several times a day.  And the blurred vision too.  Not sure what to do. :hearts:

Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#51 Jaded

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Posted 05 October 2004 - 09:16 AM

Well, I too am joining the ranks of the Cymbalta group.
My first try was Wellbutrin. 9 weeks of hell. Next was zoloft. I've been on that for 7 weeks now. Don't like the s/e's but I could tolerate them if I was getting good results otherwise. But it's just not working for me.

Went to the doc yesterday. He recommended Paxil CR to try next and I asked him about Cymbalta. He said he hasn't precribed it yet but did attend a conference on it and I could try it if I wanted. So, I have an Rx to start on 20mg. 1x day for 2 weeks. Then up to 20mg twice a day. He said if i'm feeling pretty good in a week I can call the office and start the 2 tabs sooner.

He said I could make the switch from zoloft straight to Cymbalta because the Cymbalta works on serotonin too. I'll pick my up my Rx this affternoon and take my first tab tomorrow morning. I'm praying this will work for me. I don't know what is was with the wellbutrin that I could not tolerate but I hope it wasn't the norephinephrine....

Thanks to everyone for sharing your experiences with this new drug. I'll be checking back and adding my own experience as well.    :hearts:

#52 jumpinfrog

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Posted 29 September 2004 - 12:27 AM

Any opinions about how Cymbalta has affected your anxiety levels since you guys have started taking it?  I've been reading about a revved up feeling, but is that throwing anyone into an anxiety state?  I know it's not approved yet for anxiety, but just wondering...

jf


#53 Hope

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Posted 04 November 2004 - 06:54 PM

Hey Jackie, I am taking xanax to try to calm me down.  I evan was so excited becasue when the emptiness went I felt awesome.  I could actually sit on the floor and play with my son and interact with him.  I just felt so peacful.  Then Like i said the irritablilty hit.  I am hoping it is just anxiety.  Maybe the irritablitly will settle down or if I just lower my dose to 50 would work.  I just really want to feel happy.  And actually tuesday, wednesday and this morning I was happy.  NOt that awful dreadful emptiness feeling.  Just the irritablity at night.  I am due for the monthly thing but not for 5 more days.  And this would have started 10 days before.  I dont think pms would start that soon.
Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#54 Jkm

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Posted 08 November 2004 - 07:17 AM

It's to quiet in here,  What happened to everyone.  Let us know how you are doing on Cymbalta!    :hearts:
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I have GAD. I worry about everything, lol!

#55 Hope

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Posted 28 October 2004 - 09:08 AM

Oh yeah the blurry vision.  i hated that.  It went away for me after a week.  My anxiety is climbing high again.  Not sure if because last night was my second night on the 60mgs.  The depression was really bad last night.  And of course it is lingering still.  All I want to do is cry. Crosssing my fingers still though.
Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#56 Jaded

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Posted 27 October 2004 - 09:38 AM

This is dosing info I got from Medscape - hope it helps clear up some of the confusion over the differing dosages.

Adult Min/Max Dose: 40.0mg/60.0mg

Common Dosages by Indication:

Diabetic Peripheral Neuropathy
take 2 capsules (60mg) by oral route once daily
take 1 capsule (60mg) by oral route once daily

Major Depressive Disorder
take 1 capsule (20mg) by oral route 2 times per day
take 1 capsule (30mg) by oral route 2 times per day
take 2 capsules (60mg) by oral route once daily
take 1 capsule (60mg) by oral route once daily

#57 Remission

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Posted 29 September 2004 - 03:34 PM

Don't worry, Lilly will be doing clinical trials to get Cymbalta approved for everything under the kitchen sink.  You know, the typical one pill fits all - Depression, Pain, PMS, Social Anxiety, GAD, panic, incontinence, etc.

In the 1800's, didn't they do the same think with snake oil and the active ingredient was alcohol?  Gets ride of the blues, calms the nerves, and lifts the spirits.   :D

I have had a few doctors™ appts since starting Cymbalta.  The doctors have told me that other patients are doing well and tolerating this med pretty well.  We maybe at the ground floor of a blockbuster drug.

#58 lightbeing

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Posted 03 October 2004 - 11:16 AM

taffycat - I have been sleeping the sleep of the dead since starting Cymbalta. It has been wonderful as I was the same way as you. As for the nausea...if I were you I would try to take your dose with food to see if that helps.

Remission - I am sorry that you are having a bad time of it. Fatigue has been one of the most brutal start up side effects for me. It seems to be improving everyday though. Hang in there. Maybe you are coming down with something.

JKM - I have been having some bowel issues that last few days. I haven't decided yet whether it is just a fluke or the Cymbalta. I have actually been losing weight since I started Cymbalta. I am already down three or four pounds. I hope that you don't start losing as well, although I know that Effexor was causing me to gain so it may just be the change. I honestly hope so and I hope that I keep losing as Effexor caused me to gain 30lbs in less than three months.

VelvetElvis - I am glad that you are doing well. Me too!!

Effexor had some pain in the butt sexual side effects for me. It made it super hard to orgasm. Well, I have to report that last night I had two orgasms in the space of five minutes. Can it be true? Please let it be true! So, I am doing GREAT on all fronts!
light

#59 taffycat

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Posted 01 October 2004 - 02:36 PM

Just got home from the pdoc appointment with 2 sample packs of 30 mg Cymbalta, so thought that I'd pop in to say hi.  I'll try to read thru this thread in the next day or so to acquaint myself with how you all are doing.            
             deb                  :hearts:

I've breezed thru kind of fast - and may have missed this, so please excuse me if this has been asked before, but, barry, my pdoc, was adamant that I had to go see my gp in the next two weeks to have my blood pressure checked.  He kept down playing the number who have had a spike, and I don't suffer from high blood pressure, but really really stressed that I had to promise to do this.  Has anyone else had this experience?
...in a time lacking in truth and certainty and filled with anguish and despair, no woman should be shamefaced in attempting to give back to the world, through her work, a portion of its lost heart.
-Louise Bogan

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#60 max

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Posted 08 November 2004 - 11:13 AM

Hi all,
I went up to 60mg a little over 2 weeks ago.  After my initial good response when I started at 30mg, I went down somewhat, and still don't feel like I did then.  My depression isn't as bad as before starting Cymbalta, but not great either.  I'm seeing my pdoc today and will see what he has to say.

#61 VelvetElvis

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Posted 02 October 2004 - 06:14 AM

TC: I've learned to always take in the morning, even it means setting my alarm to get up early, taking it, and then going back to bed.
Autumn wins you best by this its mute
Appeal to sympathy for its decay.

-Robert Browning

#62 taffycat

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Posted 02 October 2004 - 06:07 AM

I took my first pill last night around 6, after dinner.  (Usually barry just hands me the meds and a few weeks later, asks when and how I take them.  This time he gave me explicit instructions)

Woke up at midnight with extreme nausea which lasted until about 2:30.  An upset stomach is not uncommon for me, but this was clearly more than that.  I'm wondering if it's because I have been med free for 6 - 8 weeks, so the chemicals have to start from square 1.

Thanks for the welcome, Jackie.                     deb :hearts:
...in a time lacking in truth and certainty and filled with anguish and despair, no woman should be shamefaced in attempting to give back to the world, through her work, a portion of its lost heart.
-Louise Bogan

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#63 VelvetElvis

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Posted 02 October 2004 - 06:13 AM

Note to self:

Cymbalta + 2 oil cans Fosters = up at 6am with blinding headace.

Second not to self: That was stupid.  Don't do it again.

*moan*
Autumn wins you best by this its mute
Appeal to sympathy for its decay.

-Robert Browning

#64 Jkm

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Posted 02 October 2004 - 06:44 AM

Good morning!  I think this is one of those meds that needs to be taken in the am, unless you're working the midnight shift....  LOL!

Sorry you were up late, but that happened to me too, Deb.  I was on another med and did a quick taper and switch over, so I didn't get many side-effects, except for the energizing thing when I took it a night.  Won't be trying that again, either.....  I'm thinking it's a start-up effect, as the nausea.  I think remission had that, too.

Velvet,  I guess the alcohol tolerance is different, too.  I found out last weekend that it intensifies alcohol, and a couple of drinks, and you're   :hearts:  People come over to celebrate  our wedding anniversary, and I went to bed while they were still here.) Two drinks, I was very tired. I'm usually very active when company comes around, so they were like where is she going?    

Yesterday I was suppossed to go to 60, but was afraid that I'd have some kind of side-effect at work, so I opened one up, and dumped half of it out.  Those little balls in there are some powerful stuff!  I put half of it on a spoon, and chucked it down.  About 7 hrs. later, I had terrible stomach pain.  I know there are many viruses going around that manifest themselves like this, but I don't think I'll be doing that again!  I'm still chicken to try 60 all at once, and have to go to the mall today with my kids.  I better take one, before I chicken out.  ( I took it,  It looks just like a thirty, only bigger.)  Anyone else doing the 60mg., yet?

I'll keep you posted......    :wave:
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I have GAD. I worry about everything, lol!

#65 Jkm

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Posted 28 October 2004 - 08:15 AM

The jury is out about the anxiety.  It's more for depression and pain disorders, and they are also saying this can help with urinary incontenence.   :bump:  My doc said they were using it for lots of things, but I didn't ask her to clarify this.

My biggest fear is that my anxiety will come back, and after hearing this complaint, I'm waiting for my body to break down, LOL!  So far, I'm out of pain as far as the fibro, and haven't had a flare since I started it, and others who have this have. I'm sleeping much better.   :shocked:  As far as the depression, I have more motivation to take care of things, that I ignored on Lexapro.  We'll see!    :hearts:
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I have GAD. I worry about everything, lol!

#66 lightbeing

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Posted 29 September 2004 - 04:14 PM

JKM - I am having the opposite effect as far as sleep goes. Man, it is kinda freaky actually. When I sleep it is the sleep of the dead. Two days in a row I have fallen asleep for a nap only to miss the doorbell one day and my kids coming in with their sitter the next. I slept through the after school hubbub and I WAS ON THE COUCH! Kids yammering all around me and I didn't wake up. It is not like me at all. FREAKY! Although I have to admit it is kind of nice because I was sleeping so horribly before. Right now I am fighting the drowsies so that I don't sleep through the time I need to pick my kiddos up. LOL!

jumpinfrog - No anxiety here! Also I started straight away at 60mg. I actually transferred straight over from Effexor XR with NO PROBLEMS. I am shocked, amazed and incredibly relieved.

My mood is already improving. It is harder for me to get down in the dumps. I think that this may be starting to work. Woohoo!
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#67 mindless13

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Posted 05 October 2004 - 09:33 AM

:D Dear Cymbalta group,
I started my 20mg bid yesterday and I feel great, but I always feel that way at the beginning, hope it lasts.  I too gained about 30 lb when on lexapro, and Im hoping I can lose some of that.  Lex made me really tired and then I eat to get energy that never comes.   I feel more focused also, I work in a hospital lab and that is kinda important!!  thanks all
                                                                Lisa
HELP

#68 VelvetElvis

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Posted 29 September 2004 - 06:24 AM

According to my pdoc it was developed with agitated depression in mind.  It should work about as well as effexor for anxiety.
Autumn wins you best by this its mute
Appeal to sympathy for its decay.

-Robert Browning

#69 Remission

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Posted 06 January 2005 - 10:47 PM

YES, even with my elevated liver enzymes being associated with Cymbalta, I have tapered it, NOT discontinued it.  I am letting my pdoc guide me on the next steps.  

Here is some more info I found today on the subject. ----->

DO NOT USE Duloxetine (CYMBALTA) for Major Depressive Disorder - Nothing Special and Possible Liver Toxicity
    Worst Pills Best Pills Newsletter article January, 2005
   


Do Not Discontinue Cymbalta Treatment Abruptly ”
Gradual Discontinuation Of This Drug Must Take Place Under Medical Supervision.


Duloxetine (CYMBALTA) was approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD) in adults in August 2004. It has also been approved for a nerve condition seen in diabetics known as diabetic peripheral neuropathy. This article focuses on the use of duloxetine in depression.

Duloxetine is marketed by Eli Lilly and Company of Indianapolis.

MDD is a depressed mood accompanied by several of the following problems that have been present for at least several weeks. If a careful history, physical examination, and lab tests have ruled out specific causes of depression, then MDD is probably the diagnosis. The problems are sadness that impairs normal functioning, difficulty concentrating, low self-esteem, guilt, suicidal thoughts, extreme fatigue, low energy level or agitation, sleep disturbances (increased or decreased), or appetite disturbance (increased or decreased) with associated weight change.

Some drugs can also cause depression.

Duloxetine is classified as a serotonin and norepinephrine reuptake inhibitor (SNRI) or dual reuptake inhibitor. As one physician observer of drugs used to treat serious mental illness has noted, duloxetine has œdual the reuptake, triple the hype.? The other SNRI inhibitor on the market is venlafaxine (EFFEXOR).

Our major safety concern with duloxetine is the possibility of liver toxicity. The FDA medical officer that reviewed the drug found a small but statistically significant excess of discontinuations of treatment due to liver-related adverse events in patients treated with duloxetine compared to those given a placebo in clinical trials conducted before the drug was approved.

In his conclusions and recommendations regarding duloxetine™s liver toxicity, the medical officer wrote:

In the event that unconfounded cases of severe liver injury or acute liver failure related to duloxetine treatment are identified and submitted early in the postmarketing period, the division will use the threshold of three œclean? cases to initiate additional regulatory action that could range from a more prominent warning to the withdrawal of the drug product.

This is a remarkable statement. The FDA obviously has serious concerns about the safety of duloxetine, yet they still allowed it on the market. By approving duloxetine, the FDA has made the American public guinea pigs in a large uncontrolled safety experiment. Because duloxetine is nothing special and there are numerous options to treat major depressive disorder in adults, the proper course of action for the FDA should have been to require the manufacturer to conduct more studies to clarify the liver toxicity issue before approving the drug.

The FDA-approved professional product labeling, or package insert, for duloxetine does warn pharmacists and physicians about an increased risk of elevations in blood levels of liver enzymes. Elevations in liver enzyme levels are an early signal of possible liver toxicity. However, there is no requirement in the professional product labeling that physicians monitor liver enzymes. Physicians are cautioned not to prescribe duloxetine to patients who regularly use alcohol because of the possibility of liver toxicity.

Blood pressure elevation is another area of concern with duloxetine. The FDA medical officer recommended that:

Patients taking duloxetine should be monitored regularly for hypertension (high blood pressure). There is evidence for a dose dependent increase in the incidence of elevated blood pressure with duloxetine treatment. These increases do not appear to pose an acute risk; however, given that the treatment of Major Depressive Disorder (MDD) is chronic in nature, patients™ blood pressures could easily drift into ranges that are associated with increased risk of heart disease and stroke. 24% of patients taking duloxetine 120-mg/day (milligrams per day) experienced elevated blood pressures versus 9% of placebo patients.

The FDA-approved professional labeling for duloxetine advises that blood pressure be measured prior to starting treatment and periodically measured throughout treatment.

Duloxetine and all of the other antidepressants marketed in the U.S. now carry warnings in their professional product labeling about worsening of depression and an increased risk of suicide. Patients being treated with antidepressants should be observed closely for worsening of their depression and suicidal ideation and behavior, especially at the beginning of a course of drug therapy, or at the time of either increases or decreases in dose changes.

Duloxetine is not approved for use in children or adolescents with major depressive disorder. The drug™s professional product labeling contains the following uninformative statement about the use of duloxetine in children and adolescents œSafety and efficacy in pediatric patients have not been established.? This could mean that the drug failed in clinical trials in this age group but the manufacturer decided not to make the results public. The bottom line is that duloxetine has not been shown to be of therapeutic benefit in younger patients.

Abruptly stopping duloxetine treatment can result in a withdrawal syndrome that consists of the following symptoms: dizziness; nausea; headache; a sensation of P**king, tingling, or creeping on the skin (paresthesia); vomiting; irritability; and nightmare. Discontinuation of duloxetine should only be done under medical supervision.

Duloxetine was approved by the FDA on the basis that it was more effective than a placebo, in other words, better than nothing. One of the games that pharmaceutical manufacturers play when their new drug is only better than nothing is to create an image that the new drug has unique effects compared to other similar drugs in its family. In the case of duloxetine, Eli Lilly is trying to claim that the drug has special value in managing the painful symptoms of major depressive disorder.

At this time, any claim that duloxetine is useful for managing pain is groundless.

The Medical Letter on Drugs and Therapeutics a source we frequently cite because of its independence from drug company influence, found that duloxetine was œnothing special? and concluded their October 11, 2004 report by saying:

Whether duloxetine offers any advantage over venlafaxine (EFFEXOR) or an SSRI [selective serotonin reuptake inhibitor] such as fluoxetine (PROZAC, and others) remains to be established. The manufacturer™s claim that duloxetine is the antidepressant for painful physical symptoms associated with depression is unsupported; no comparative trials are available.

What You Can Do

There is no medical reason why you should be taking duloxetine when safer antidepressants are available on the market.


DO NOT DISCONTINUE CYMBALTA TREATMENT ABRUPTLY ” GRADUAL DISCONTINUATION OF THIS DRUG MUST TAKE PLACE UNDER MEDICAL SUPERVISION.

#70 Jkm

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Posted 29 September 2004 - 06:38 AM

That's interesting.  My doc said they were touting it for everything.  LOL!  I'm thinking if I can't sleep with it, I might get agitated...LOL!

How are you feeling with it?  I guess that's the biggest thing.....as she takes her next dose...     :oh:
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I have GAD. I worry about everything, lol!

#71 mindless13

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Posted 07 October 2004 - 01:21 PM

To the Cymbalta gang,
                      I thought cymbalta was a 2x a day med, and those of you on it twice a day, what time are you taking it?  I usually get up at 5 am and take it and then and around 2-3 pm.  I also feel ill if I eat anytime near taking my med. lisa :hearts:
HELP

#72 Remission

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Posted 24 October 2004 - 11:44 AM

Hope - The lightheadedness went along with tiredness for about 2 hours after I took my morning dose.  Then later in the afternoon, it would turn into restlessness and anxiety (chest pressure too).  This lasted at least 2 weeks, and seemed to get better 2-3 days after I went up to 30 mg twice a day.

Presently, I really don't notice anything when I take my AM dose.  It took almost a month to get to this point.  However, if I don't take the afternoon dose by a certain time, I will know it.   It is not a problem for me to remember if I took the second pill or not, I will know it with time.

I hear you about MAOI's.  I am not about to argue which is safer or better, ECT or a MAOI.  Both have significant risks and it is impossible to forecast which would be best for you.  Giving Cymbalta at least 30 days seems like a logical step in lieu of these other options, as long as you can be safe during the wait.  My biggest complaint about ECT is although it works almost 90% of the time, they are 99% sure that it does not last and you have to get on a med anyhow to prevent relapse.  ECT seems like an emergency short-term solution, but finding a med seems like the better long-term solution.

On the bright side, the FDA did give EMSAM (transdermal MAOI) approvable status, and it should be launched in the next few months.  EMSAM is a MAOI that might not need the dietary restrictions.  There is also reversible MAOI's (Manerix) available in Canada and Europe, that do not have the dietary restrictions.  For fun, I ordered some over the Internet, and it was easy to do, even without a doctor prescription.  If Cymbalta does not do the trick for me, Manerix is my next step. It is also probable that EMSAM will be out by this time too.

Hang In!!!

#73 Remission

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Posted 23 October 2004 - 07:27 PM

Hope - I know that it is really hard (been there, over and over) to hang in there.  I had pretty much given up on the drugs too.  Starting Cymbalta was no pleasure trip, but it did sporadically start to give me relief 3 weeks into it at the 60-mg dose.  BTW, going from 30 mg to 60 mg was no sweat for me.  I did not experience a repeat of the initial start up effects.

I have been going to University Hospital too (along with University of Mich., John Hopkins and the Cleveland Clinic).  The surroundings at University Hospital are not that pretty, but if you can get through to the docs; they seem to be very smart.  The ECT doc (Mcglaughlin) is very nice.  They are very well known for research with Case Western Reserve.  Everyone says that ECT works 90% of the time.  Have you tried a MAOI?  Just to prepare you, they usually don't recommend ECT till you have had a complete trial with a MAOI.  Unless you are suicidal, catatonic, can't take car of yourself and need ECT because you can't wait for meds to work.  Good Luck!

JKM - I still take mine in the morning and evening.   Maybe once a day (in the AM) might help my sleep.  When you take it all in the AM, does it give you any rebound in the evening?

#74 Remission

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Posted 13 November 2004 - 09:43 PM

This kind of talk is getting contagious.  I hit a bump in the road too.

#75 Jkm

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Posted 22 January 2005 - 06:56 PM

Call to all on Cymbalta who haven't responded in awhile.  How is everyone doing?  Mine is still working at 60mg., but if I take it during the afternoon instead of in the am, I get the zaps.
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#76 Jkm

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Posted 23 October 2004 - 07:09 PM

Have you ever taken it during the daytime?  I couldn't sleep with it at night.  I wonder what the difference would be.  I don't have any problems after I take it.  I know I sure get tired at night,  and sleep well.  When I tried to take it at night, I tossed and turned, and felt like I was on the moon the next day.  I have to sleep.  If not, I'm yawning all day long.
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#77 Hope

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Posted 23 October 2004 - 07:02 PM

JKM, I am taking my dose at night.  I had to, to see if it helped with the lightheadedness.  It only affected my sleep once.  I think the second night.  But I did have anxiety before the med, but I think the lightheadedness is bring more on.  If you know what I mean.  When everything is blurring and hard to focus , it reminds me of the derealisation I use to have.  And I had that constant for over 12 months.  I dont want to go back there. :hearts:  But I do have some xanax.  I just hate taking it because it makes me so tired.  And I have a two year old so it is hard to function.  Plus needless to say I drive around for work.  But I am going stay on 30 mgs a little longer to see if things get better.  I hope the lightheadedness goes away soon.

Remission glad to hear that you are doing okay.  ECT is still in the plan for me.  I am just afraid that wont work either.  I think my doc is going to get me an appointment to speak with someone at University Hospital.  I rather talk to them and see what they think.  I will keep you all posted.

Hope



Someday I will be able to live life again.  Hope is the only thing I have left.

#78 ados

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Posted 13 November 2004 - 09:26 PM

Good for you, Hope, that you did some cleaning!  Depression makes it so very hard for us to motivate ourselves, often.  And having a young child only adds to that.

Of course, you need to work closely with your doctor about the meds and dosages.  Probably there are some meds that just don't work for you - maybe the side effects are too unbearable or something.  In that case, you might not be able to give certain meds a full trial.  But that could also be a good reason for you to start at a very low dose.  Occasionally (for example, check out SoulSearching's posts in the zoloft room) some people do best on very low doses.  I have worked with people who happen to have a certain window of effectiveness for some meds, and if they take too high a dose that won't work for them either.

But each person is unique, and you may or may not find that these factors effect you.  I would just suggest you do lots of reading (here and at other informative sites) and talk to your doctor about it.  Hopefully you can find something that is perfect for you.

Keep us informed, okay?

Karen
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#79 Remission

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Posted 27 October 2004 - 11:44 AM

This is dosing info I got from Medscape - hope it helps clear up some of the confusion over the differing dosages.

Adult Min/Max Dose: 40.0mg/60.0mg

Common Dosages by Indication:

Diabetic Peripheral Neuropathy
take 2 capsules (60mg) by oral route once daily
take 1 capsule (60mg) by oral route once daily

Major Depressive Disorder
take 1 capsule (20mg) by oral route 2 times per day
take 1 capsule (30mg) by oral route 2 times per day
take 2 capsules (60mg) by oral route once daily
take 1 capsule (60mg) by oral route once daily

I am confused, if the min dose is 40 and the max is 60 mg; how can they say take 2 capsules 60 mg daily for Diabetic Peripheral or Major Depressive Disorder?

#80 ados

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Posted 27 October 2004 - 11:39 AM

Jaded,

Is this Medscape info meaning that any of these dosages could be appropriate?  So someone could benefit from anywhere between 40 and 120 mgs per day?  Thanks for sharing this.

Karen
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