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Can You Take Paxil And Cymbalta Together??


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#1 frosk

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Posted 11 October 2008 - 04:04 AM

I am concerned that over the past 6 years I have been prescribed Paxil and Cymbalta together.
All the P-Docs that I have been to prescribed both to me, but I found myself in an addiction and have been depressed and trying to get out for the past 5 years.
Only 1 doctor expressed concern (Addiction Doc). He said that he is surprised that I am being prescribed Paxil and Cymbalta together because they might interact with each other and cause the meds not to work properly because of enzymes or something.
He was in charge of my addiction problem and didnt get involved with the anti-depressants.
So since I have been in a deep depression along with addiction to pain pills, I am wondering if the 2 are in fact interacting with each other and are causing me to feel worse all these years.
I have been to Cymbalta websites and it has a huge list of meds not to take them with, one being of course Paxil.
Now I am living in another country and go to a General Physician for my meds so I dont think they are all that up to speed on the interactions.
I am reading horror stories about stopping Cymbalta whether you taper or not as I am taking 90mgs a day and 50mgs of Paxil.
If you are taking 2 meds like this or know anything about this please respond as I have been in a deep depression for 5 years now and in the beginning everything was fine, but now I am very depressed.

thanks.

#2 X-ray

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Posted 11 October 2008 - 04:16 AM

I am concerned that over the past 6 years I have been prescribed Paxil and Cymbalta together.
All the P-Docs that I have been to prescribed both to me, but I found myself in an addiction and have been depressed and trying to get out for the past 5 years.
Only 1 doctor expressed concern (Addiction Doc). He said that he is surprised that I am being prescribed Paxil and Cymbalta together because they might interact with each other and cause the meds not to work properly because of enzymes or something.
He was in charge of my addiction problem and didnt get involved with the anti-depressants.
So since I have been in a deep depression along with addiction to pain pills, I am wondering if the 2 are in fact interacting with each other and are causing me to feel worse all these years.
I have been to Cymbalta websites and it has a huge list of meds not to take them with, one being of course Paxil.
Now I am living in another country and go to a General Physician for my meds so I dont think they are all that up to speed on the interactions.
I am reading horror stories about stopping Cymbalta whether you taper or not as I am taking 90mgs a day and 50mgs of Paxil.
If you are taking 2 meds like this or know anything about this please respond as I have been in a deep depression for 5 years now and in the beginning everything was fine, but now I am very depressed.

thanks.


Hi,

There is no reason to mix Cymbalta and Paxil.
This combo should be avoided.

Best of Luck,
X-ray

#3 lambvet

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Posted 11 October 2008 - 04:50 AM

Hi frosk,

Well, I guess "how have you been" is out of order. Here's a take on it. First off, it is not unusual for pDox to sometimes combine meds for a desired effect. Duloxetine and paroxetine have different mechanisms of actions although they do share a common enzyme system for their respective metabolisms. In the ePocrates formulary, the use of these two meds comes with a "Caution Advised" recommendation which implies that the two can be taken together with certain issues to be monitored more closely.

The biggest concern would be the resultant condition known as "Serotonin Syndrome" which if you had to deal with it before now, you would certainly know something was up. The very fact that you have been taking it as long as you have suggests that you have been monitored properly throughout your treatment. That is the upside, the downside is that it appears that it has stopped working for you, so.... Probably a med change is in order. It has been my experience that our disorders do progressively get worse regardless of how well they are initially treated. Since in reality our disorder is a matter of defective enzyme systems, there also exists a ton of research suggesting that any enzyme disorder gets worse with age. Even the addict/alcoholic experiences a decreased tolerance of their drug of choice after several years of abstinence. Again, the results of progressive dysfunction of the underlying enzyme system necessary to properly metabolize the ingested chemical.

A good pDoc (preferable to a regular doc unless they are well read or will to read up on your situation prior to taking any action.) Ideally, you should be detoxed from any outside chemical first before any alteration of your pMeds. I can assure you that your pMeds have had little to do with your addiction other than it making it harder for them to work properly. So, deal with the addiction first, then there can be a re-evaluation after a month or two and remember that it is likely that the majority of depression you are currently experiencing is more likely due to your addiction and subsequent detox rather than the other way around. So, please do not let your addiction play you, it will be telling you big lies about your condition directed towards you returning to it with arms wide open. BEWARE, it is the beast within.

Later may require you to have a change in meds and if it is addressed properly should go smoothly with a minimum of discomfort. And please, be up front with your doc with your concerns but make sure they understand that your transition should proceed slowly and with adequate monitoring of your condition. There is really no reason for you to HAVE to experience any real discomfort over the transition period, the biggest mistake is to try and transition too rapidly. I would think that your detoxing from your drug of choice will be much more uncomfortable in the big picture. And remember, when they are adjusting your pMeds, the transition should be ultra careful. If you can't find a doc with this in mind, find another one until you have found someone with the adequate knowledge and experience to monitor it faithfully.

Hope that helps, keep us posted and remember, you are the most important member of your treatment team. Speak up...

Peace and Love.... wayne

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#4 frosk

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Posted 11 October 2008 - 05:35 AM

Thank you for your quick responses.

Yes, I actually have been on Suboxone for my pain med addiction for over a year now and have been off of that med now for 3 weeks - slow taper plan.
It has been pretty difficult and maybe the whole pain med addiction has caused the depression all these years and coming off the suboxone is not an easy task but I am doing it. It is causing major depression, anxiety etc.
I am waiting to feel normal again which I guess will take time, which led me to think of what the addiction doc said in mixing the 2 anti-depressants.
I started thinking that maybe I have been put on 2 of these types of meds and they are interacting with each other negatively. I am also taking 15mgs of valium a day for anxiety.
So basically what you are saying is that people are put on ssri's and snri's to get a desired effect?
And my desired effect is no longer working so I should talk about stopping one which I think should be Cymbalta as Paxil which was my first anti-depressant, I swear worked in a day.
Not sure how long the negative effects of stopping the suboxone will take to re-evaluate me on my Psych Meds as it really messes your head up.
I lost 3 jobs, my home and now live in Norway in the middle of nowhere with no job and I am worrying constantly about how to support my wife and kids.
That could be a major issue.

#5 Ronnie

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Posted 19 October 2008 - 07:37 PM

I feel your pain and concern. I am currently taking Lexapro with Cymbalta and have been for about a year. I too suffer from addiction with all the Anxiety and Depression i've had for most of my life. In the beginning of this combination, things seem to have been fine. But then I started gambling more and eventually using drugs again after almost 8 years of sobriety. I am at the point were I stopped and do not want to use drugs (they had a bad reaction with the meds), but my depression has come back and I cry almost on a daily basis. I don't know if this combination had anything to do with it, or maybe my Lexapro just not working anymore since i've been on that medication for about 6 years.

I am thinking about talking to my doc and switching the SSRI to either Zoloft or Paxil and maybe stopping the Cymbalta. I've had some good results with adding Wellbutrin to an SSRI but end up going off it for some minor side effect after switching to the generic brand. I may try the name brand XL Wellbutrin again....

OR... who knows what the answer is.... but all I know is that when I am in this state.... it is the worst, Depression and Anxiety are horrible and I will try and re-try any med if that's what it takes to feel somewhat normal again. if they don't work as well or it gets worse, I can always go back to what I am taking now and maybe increase it some. Who knows.

Good Luck with your journey through all this and just know that you are not alone when it comes to Addiction, Depression, and figuring out what the heck medications work best.
Nothing real can be threatened.
Nothing unreal exists.
Herein lies the peace of God.
~A Course in Miracles




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