Posted by NutellaBear on January 21, 2013, at 2:46:53
In reply to Re: Cymbalta withdrawal HELL! » PhoenixGirl, posted by SLS on January 14, 2013, at 0:40:03
I thought Cymbalta was an awful med. Actually the worse one I've ever taken. Still have tinnitus from taking it and I think it is a permanent side effect.
Getting off of it was hell no matter how slowly I tapered. Though it seems like the OP is on a similar path that I just recently took. Never used Adderall, but was using both Cymbalta and Wellbutrin. I kept the Lamictal and went on Emsam. Started with 6mg Emsam but went to 9mg then 12mg over the course of three months. Very happy with this regimen so far.
While Emsam has only been studied at 6mg for dietary conflicts, that was primarily because the main market for Emsam is Parkinson's patients who only use a low dose. Everything I've read seems to indicate that the high dose patches are also safe, but the margin of safety starts to go down on the higher dosages.
On the 6mg patch you'd have to eat more than a pound of cheddar within 30 minutes on an empty stomach to get a reaction. On 12 mg I think it went down to 6 ounces on an empty stomach. But if you eat other food and that 6 ounces of cheddar is part of a meal, the limit is tripled by the fact that you haven't fasted prior to exposure. So with a meal you might be able to eat a lot of cheddar again.
There was a fairly detailed study that I found on this and can dig it out if anyone wants to read the full report. The other aspect of it is the reaction is proportional to the exposure. So as you approach the limit you might feel something like palpitations and start getting a headache but only a mild rise in blood pressure at the beginning. The point of this being that this isn't like a "tipping point" where once you hit it you'll immediately end up flat on your back.
None of this is to say that you shouldn't exercise care with your diet. But it is also nothing that you need to freak out about either. And freak out is exactly what a lot of people do! One last example. Soy sauce has tyramine in it. So most lists tell you not to eat it. Soy sauce does indeed have tyramine -- specifically measured samples contained 300 - 500 mg of tyramine which would be enough to probably land you in a hospital if not dead. But that 300 - 500 mg of Tyramine was in a LITER of soy sauce. How many people would be tempted to use that much soy sauce in any dish? A teaspoon on your noodles would be perfectly safe.
I think something to be more careful of are the medication conflicts. Definitely stay away from ephedrine derivatives, Dextromethorphan, SSRI's, and Demerol in any amount. One other thing is what I said applies to 99% of the people out there taking an MAOI. But there are a small number of people who can't process tyramine properly in the first place. While you can say that if they avoid all tyramine they'd be safe taking an MAOI, in actuality it is probably not a good choice of medication for those people.
....wrote too much but oh well!
poster:NutellaBear
thread:1035407
URL: http://www.dr-bob.org/babble/20130112/msgs/1035934.html