Posted by Racer on February 20, 2008, at 13:13:13
In reply to Cymbalta - pdoc wants me to start at 60 mg, posted by kezia on February 20, 2008, at 10:38:33
> When I questioned it, he said that 60mg was a good starting dose.
It's usually good practice to question what your doctors tell you if you're not sure about it. The best doctors actually appreciate that their patients are paying attention, and even the good doctors usually understand that it's not meant as criticism.
As far as starting at 60mg, there are two schools of thought on that -- one says to start low and go slow; the other says that starting higher minimizes the duration of adjustment issues and shortens the time spent waiting for it to work. So, there's an argument to be made either way. If you trust your doctor -- and it sounds as though you do -- it's worth giving it a shot at 60mg. If you have trouble, give him a call and let him know you're having difficulties and want to step down to a lower dose. That should cover your bases, and you might find starting at 60mg works a treat for you.
>
> I am so sick of ADs that leave you feeling flat and apathetic, which is part of the reason I am nervous (and somewhat reluctant) to start Cymbalta at 60mg. I mentioned this to my family doctor and she basically said that that is what ADs are supposed to do.I had to laugh when I read this. My pdoc said basically the same thing to me, but in very, very different words -- it made such a difference. I can't remember his exact wording, but the gist of it was that psychiatrists often use the flattening from SSRIs to their patients' advantage. That is, for people with problems like anxiety or negative ruminations, the apathy SSRIs can cause is often helpful. It's the same basic message, but put so much more effectively, in my opinion. (As evidence, I'd like to point out that you were dismayed by your doctor's comment, while I was encouraged by mine.)
You, I, and most here know that "feeling flat and apathetic" is *not* what antidepressants are "supposed" to do. In the best of all possible worlds, we'd have an antidepressant which curbed anxiety, increased emotional resilience, controlled depression, didn't poop out, and turned us all into intellectual fashion models driving sports cars. In this world, there are trade offs with any medication -- apathy from some, increased agitation from others, weight gain from many, insomnia from a few, etc. Cymbalta, for me, was amongst the friendliest -- it had by far the fewest and least annoying side effects of any antidepressant I've tried. (And I have tried more than a few.) I stayed on it for about a year and a half, and am not sure the problems I *did* have with it weren't more to do with my erstwhile pdoc. My experience, overall, inclines me to recommend it as a very helpful medication which is very well worth trying.
Good luck with it.
poster:Racer
thread:813738
URL: http://www.dr-bob.org/babble/20080207/msgs/813748.html