Posted by barbaracat on March 25, 2005, at 14:17:05
In reply to cymbalta, posted by concerned partner on February 14, 2005, at 10:25:51
Hi, I'm not able to post to Newbie so hopefully you'll get this. Your poor guy - I hope my experience will help a little. You might run across my other posts about Cymbalta on this board. I had and am having a particularly unusual and interesting experience with it. First of all, I cannot believe that any informed psychiatrist would give Cymbalta to a bipolar at such a high dose. Perhaps for unipolar vegetative depression, but Cymbalta is extremely activating and destabling for bipolars, even starting at 1mg. It has a potent norepinephrine component that goes to work almost immediately, unlike any other SNRIs. The full effect takes a few weeks to kick in, but oh my, that stuff is like rocket fuel. Bipolars simply don't need that. But... it can be a wonderful drug all the same.
I am bipolar and was given a starting dose of 30mg. I was having psychedelic effects on it, anxiety, gastric upset, muscle cramps and insomnia. It pushed me into an agitated mixed state. But I did notice an antidepressant quality worth pursuing anyway and wondered what a small dose would do. Over a week I dropped down to 3 pellets out of the capsule and experienced a profound lift in my severe depression with no side effects.
I'm now at 6 weeks on 13 pellets and doing great along with 600mg lithium. A few others on this board are having similar good response on a dozen pellets or so. Time will tell if this response lasts, but I'm convinced that for right now it is a great med. At high doses, it is hell. I can't speak for everyone, but I suspect this is true for bipolars. At tiny doses it is a different med altogther, especially for bipolars.
My words of experience on this med is this: it is very potent, far too potent for bipolars on the standard dose and it's good you recognized this. In the meantime, coming off any SSRI type med is hell. I'd suggest some strong benzo therapy to calm the agitation he surely must be feeling. Ambien works great for sleep but not if I'm highly agitated. On those occasions, I'll take Restoril or Valium or something to help unwind the muscles along with it. Sometimes Seroquel is given with good results but I didn't like it.
Trazodone can be helpful, but it's strongly serotonergic and you've got to be careful when adding it to another serotonin med. It also makes you feel permanently groggy.
My choice would be Ambien with a muscle relaxing benzo taken throughout the day and at bedtime.
He could try taking a few pellets of Cymbalta to see if he has a similar response to mine. I promise you, he will get a response and it may be more healthy than continuing to taper off a high dose. Right now he needs soothing meds and a good talking to his pdoc and Lilly drug reps who ought to know better. - BarbaraCat
> My husband was diagnosed with Bipolar disorder. He was put on Trileptal and Cymbalta. He is having problems with the Cymbalta, especially severe insomnia. He has been on the Cymbalta since December. The insomnia just started a couple of weeks ago. The doctors want to give him Halcion or Ambien to help, but we don't see that as a solution. Also, the Ambien didn't work. We are considering requesting the psychiatrist to let him go off of the Cymbalta. Has anyone else had problems with insomnia from Cymbalta? Also, what are the side effects of going off of the Cymbalta (withdrawal symptoms)? I would appreciate any advice, as we are very frustrated and don't know what to do.
poster:barbaracat
thread:475449
URL: http://www.dr-bob.org/babble/20050322/msgs/475449.html