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Re: What is stronger Amitriptyline or Cymbalta? » fido

Posted by ed_uk2010 on January 25, 2015, at 4:36:16

In reply to Re: What is stronger Amitriptyline or Cymbalta?, posted by fido on January 23, 2015, at 17:48:31

Hi,

>multiple Lipomas

I doubt that's connected to your depression.

>frequent pains in multiple joints (rheumatologist found nothing)

Widepread pain without an identifiable cause is often associated with chronic fatigue states and depression. The pain may respond to Cymbalta, so it's probably a good medication to be trying.

>visual disorders (visual snow, floaters, seeing white blood cells in the vision field which is totally annoying)

I doubt this is related to your depression.

>seborrheic eczema

This is often associated with the presence of a microscopic yeast on the skin, malassezia. Do you use a cream with a combination of an antifungal and a mild antiinflammatory steroid?

Less commonly, a seborrheic eczema-like condition has been reported to occur in vitamin B deficiency states. I do not know whether you have any risk factors for these deficiencies... they tend to be seen in people with a poor diet who drink too much alcohol. Other symptoms may include a sore tongue, irritation around the corners of the mouth, anemia, fatigue and depressive/psychiatric problems. Deficiencies of more than one B vitamin may occur together. Doctors often assess levels of vitamin B12 and folic acid if anemia is found on a complete blood count. Other B vitamins are not usually measured. If you are concerned that you may be at risk due to your diet or alcohol intake, you may wish to take a vitamin B complex, if you don't already. There is some evidence that folic acid helps SSRIs and related antidepressants to work more effectively. It's probably a good idea to choose a B complex which contains some folic acid as well as all the other B vitamins.

> hypothyroidism (i take T3 + T4)
> hypogonadism (TRT with T injections)

Do you have a pituitary disorder? This is sometimes the cause when hypothyroidism and hypogonadism occur together. Do you have your latest thyroid blood results? eg. TSH level, free T4 etc. Inadequate thyroid hormone replacement may render depression poorly responsive to treatment and widespread aches and pains may be a problem. I'm not saying your thyroid hormone dose is too low, just that it would be useful to see your lab results complete with reference ranges for the lab which performed them. Are you taking levothyroxine? If so, how much?

>I have been on Lexapro 20mg for at least 3 months. I really couldn't tell a difference.

More than enough time for it to work, or not.... Glad you're trying something else.

>But does it even make sense to think about add ons when I haven't even found an antidepressant which works?

Give Cymbalta a chance first. You mentioned Lamictal as an option. It's used more in bipolar disorder than unipolar depression but might still have utility for you.

 

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