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Re: Cymbalta TCAs mixed states ed_uk

Posted by barbaracat on March 24, 2005, at 15:59:23

In reply to Re: Cymbalta barbaracat, posted by ed_uk on March 24, 2005, at 14:01:49

> How did trazodone affect you?

**I liked it at first because it felt so calllmmm. I was bouncing around with moderate mixed-states so it was a nice change from the constant anxiety. It helped me sleep well at higher doses. The major drawback was getting up in the morning, never my strong point. It would take about 2 hours to get the cotton out of my head and I felt lethargic all day. I believe I was taking around 200mg for around 2 years and got tired of fighting off the lethargy. That's when Prozac came on the scene and my pdoc switched me over to it. Lasted about 1 month and then switched to sertraline, as we talked about. I think traz is a decent sleeping med at 50mg or so (still grogginess at that dose in the a.m. and feels like a histamine blockade effect). I now take Ambien for sleep instead. I don't believe many are using it for first-line AD relief but it could be a good adjunct.

>>Which TCAs did you try? Did they induce manic/mixed states?

**In my experience, no. When I first agreed I needed meds it was a big admission since this was the late '70s and I was the quintessential Ms. Natural. Didn't even wash my floors with anything non-organic. So the only things back then were the old standards, Elavil, Tofranil. I HATED the side effects. One did help, however, Surmontil, which I don't think they make anymore. But then, trazadone and then SSRIs came on the scene and most pdocs pretty much abandoned TCAs.

Recently, after my Mom died, I had to do something and went on Nortriptyline for about 6 months. I loved it, absolutely loved how I felt on it. As you can imagine, I was totally wigged out from losing my beloved Mom right around Christmas from a car hitting her while out on a walk. I was losing it, even on lithium and lamictal. So my pdoc, knowing my bad history with SSRIs suggested nortrip. It brought me out of that desperate place in 2 weeks and allowed me to deal with the grief normally. No, it did not induce mania, in fact brought me out of a severe mixed states depression in a gentle, light manner.

I'd be on it today if it weren't for two side effects that were intolerable - constant dry mouth and thirst, and constipation. I felt like it was dehydrating me no matter how much water, electrolytes, whatever I took. So I eased off taking it pretty rapidly. Very easy to stop, none of that nonsense like you get with SSRI discontinuation.
> When did you eventually get diagnosed with bipolar disorder?

**About 2-1/2 years ago, mainly from researching on my own and the help of this board. It had actually been suggested to me years ago by an astute pdoc but I totally rejected the concept of it. I thought it meant 'really crazy' and meant either depressed or grandiose madcap manias and euphoria. Looking back now, I can see that I had more symptoms than I would admit, and many hypomanias which were too much fun, but major symptoms were wretched mixed states bipolar depression which was not classic anything - just scary and weird for everyone. Someone said 'depression on speed'. I'd add 'depression on speed AND bad acid'. Every one of my many docs were baffled by my symptoms and stuck me in the 'treatment resistant major depressive disorder with comorbid anxiety' slot. Mixed states was not recognized as even possible (up and down together?) until recently so I kept getting higher doses of SSRIs as I continued to get worse.

I followed a Babble poster's link to, read about mixed states, and with great relief thought to myself 'I'm not alone! That's me!', suggested this to my pdoc who put me on lithium and the rest is history. But I can't help lamenting how traumatized my receptors were for so many years and wondering how things would be now if this had been caught sooner. I'm just grateful it was.
> Cymbalta for depression and as Yentreve for stress incontinence. I guess they don't want the people with stress incontinence to know they're taking a psych drug!!!

**Or smokers knowing they're taking wellbutrin.
> I was worried about you reducing the lithium because you seem so healthy at the moment :-)

**'Oh, I can reduce my meds!' Isn't this a common misperception we make when we're feeling better? I think I'll stick with my 600mg lithium for now.

Really, Ed, if you're thinking of an AD, consider low dose Cymbalta before settling on sertraline. IMHO, as long as you don't start out too high, there's no comparison. Be well, my friend. - Barbara
> Kind regards,
> Ed.




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