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Dr. Bob is Robert Hsiung, MD,
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Posted by Paul_d_234 on September 8, 2004, at 20:22:17
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Thanks for reporting.
Are you on anything else? Where you on anything else?
I noticed most people starting at 30 for a week or two. Any reason why your doc recommended 60?
Posted by 4WD on September 8, 2004, at 22:27:17
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
> Went to p-doc who initially proposed upping Effexor, but was willing to go with Cymbalta. The p-doc was skeptical of duloxetine because his first patient bailed day 1. My prior regimen was Effexor 75mg / 1mg Klonopin. I've taken Cymbalta 60mg around 9 this morning and this first thing I noticed is less social anxiety, and more motivation, which is what I'm looking for. Of course, this could be a placebo effect, but nonetheless, duloxetine doesn't have the rough edge that Effexor XR has. I'll continue to report.
Did your doctor recommend you to taper the Effexor while starting the Cymbalta? I am having some bad anxiety (day 6 on Cymbalta after Effexor 37.5 mg for several years). I didn't taper like I was supposed to because I thought they were both snri's and there shouldn't be a problem but I'm now scared to death and crying. I would think it was fropm the cymbalta except that I get like this every time I try to go off effexor.marsha
Posted by pseudonym on September 9, 2004, at 2:38:05
In reply to Re: Pseudonym's Cymbalta Journal: Day1, posted by Paul_d_234 on September 8, 2004, at 20:22:17
Yes, I take 1 mg of Klonopin in the morning, which is quite effective at removing anxiety. Klonopin, at least for me, is not mood-brightening, motivational, or pro-social, which is why I requested Cymbalta. And yes, I was on Effexor 150 mg. As for the 60 mg, I believe that was the dose used in many of the clincal trials during which their was no evidenced need of titration.
Posted by pseudonym on September 9, 2004, at 2:47:08
In reply to Re: Pseudonym's Cymbalta Journal: Day1 » pseudonym, posted by 4WD on September 8, 2004, at 22:27:17
Hmm, that's a good question. Yes, the doctor did suggest that I take 75 mg Effexor for one week, then 37.5 Effexor for a second week, while on Cymbalta. And I intend to do just that. So, since you get scared and anxious when going off Effexor, it would seem that cross-tapering would be a wise choice. I would suggest perhaps two weeks with both before sticking with Cymbalta, that is, if its working for you. Do note though, that this is only day 1 for me so I could well experience Effexor withdrawal within a week, or for that matter, Cymbalta anxiety.
Posted by theo on September 9, 2004, at 6:57:14
In reply to Re: Pseudonym's Cymbalta Journal: Day1 » pseudonym, posted by 4WD on September 8, 2004, at 22:27:17
My guess would definitly be the Effexor. I don't know that many drugs to cause that in the startup phase, mainly withdrawal phase.
Posted by pseudonym on September 9, 2004, at 17:43:44
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Second day on Cymbalta 60mg , Klonopin 1 mg (been taking K for some time). I feel a calmness, almost to the point of being tired, that I did not feel on Effexor. I have noted that SLS mentioned he felt somewhat weary during the initial days on Cymbalta. Relaxed is where I'm at, so I'm not complaining at all. I will continue the Effexor taper for the next two weeks. Best wishes to all of you.
Posted by pseudonym on September 10, 2004, at 17:43:37
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Day 3 on Cymbalta 60mg in the morning.
Woke up today without a sense of negativity, which is extremely unusual. As others have noted, Cymbalta seems to bring a good deal of energy to the table, which enables me to stick with the task at hand. I even invited a girl out on a date, which I hadn't done it some time, and we'll be doing something fun next week. I haven't noticed much sexual side effects, or inability to sleep, or dry mouth, or for that matter, anything. We'll see how it goes. I'm quite pleased thusfar.
Posted by pseudonym on September 12, 2004, at 0:00:11
In reply to Re: Pseudonym's Cymbalta Journal: Day1, posted by theo on September 9, 2004, at 6:57:14
60 mg Cymbalta @ 9am
Cymbalta is definitely better for me, at least thusfar, then Effexor ever was. In particular, it has provided more energy and motivation, althrough it doesn't seem to touch anhedonia. Perhaps that will come with time.
Posted by SLS on September 12, 2004, at 7:40:58
In reply to Re: Pseudonym's Cymbalta Journal: Day4, posted by pseudonym on September 12, 2004, at 0:00:11
> 60 mg Cymbalta @ 9am
>
> Cymbalta is definitely better for me, at least thusfar, then Effexor ever was. In particular, it has provided more energy and motivation, althrough it doesn't seem to touch anhedonia. Perhaps that will come with time.As I mentioned in another thread, energy comes first and anhedonia comes last. It sounds like you are on the right track!
Good luck and get well.
- Scott
Posted by Paul_d_234 on September 12, 2004, at 8:40:39
In reply to Re: Pseudonym's Cymbalta Journal: Day4, posted by pseudonym on September 12, 2004, at 0:00:11
Had you gained any extra weight on Effexxor?
Posted by pseudonym on September 12, 2004, at 15:23:30
In reply to Re: Pseudonym's Cymbalta Journal: Day4, posted by Paul_d_234 on September 12, 2004, at 8:40:39
No weight gain on Effexor. For me, all antidepressants have been weight neutral. Then again, I have only tried the SSRIs, and SNRIs, no tricyclics, no MAOIs.
Posted by pseudonym on September 12, 2004, at 23:14:37
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Good day again today. Took 30 mg Cymbalta in them\ morning and then again in the evening to compare it to 60mg once. Can't say I noticed much difference, except that with the 30mg, I went for a solid nap, while the 60mg is only mildly tiring. So, I'll stick with the 60 mg once daily. No side effects noted, as I continue to taper the Effexor at 37.5.
Posted by pseudonym on September 13, 2004, at 18:58:53
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60 mg once a day (37.5 mg Effexor taper)
1 mg KlonopinBest day on Cymbalta thusfar. I'm nearly a week into the Cymbalta and am feeling very positive about where this regimen is headed. I find myself speaking more with others, as well as more motivated on projects (work or personal). The Cymbalta + Klonopin + small amount of Effexor is helping my social anxiety in both its aspects: fear of interaction and seeking interaction. Let's say I'm pleased with what Lilly has come up with, whether or not its a "me-too" substance, which I don't think it entirely is.
Posted by 4WD on September 13, 2004, at 20:31:06
In reply to Re: Pseudonym's Cymbalta Journal: Day 6, posted by pseudonym on September 13, 2004, at 18:58:53
> 60 mg once a day (37.5 mg Effexor taper)
> 1 mg Klonopin
>
> Best day on Cymbalta thusfar. I'm nearly a week into the Cymbalta and am feeling very positive about where this regimen is headed. I find myself speaking more with others, as well as more motivated on projects (work or personal). The Cymbalta + Klonopin + small amount of Effexor is helping my social anxiety in both its aspects: fear of interaction and seeking interaction. Let's say I'm pleased with what Lilly has come up with, whether or not its a "me-too" substance, which I don't think it entirely is.Can you tell me how you are tapering your Effexor? I was on 37.5 mg Effexor before the switch to Cymbalta as well. I didn't need to be on Klonopin before lowering the Effexor but I"m needing it now. WEre you on 37.5 all along?
Marsha
Posted by pseudonym on September 13, 2004, at 22:58:51
In reply to Re: Pseudonym's Cymbalta Journal: Day 6 » pseudonym, posted by 4WD on September 13, 2004, at 20:31:06
As far as the Effexor taper, having switched to Cymbalta, I was on a dose of 150mg Effexor for about 3 months. In anticipation of Cymbalta, I tapered down to 75mg for two weeks.
Once on Cymbalta at 60mg, my intention and current regimen, is to take Effexor to 37.5 for 10 days, then attempt to drop it altogether. If that fails, I'll resume the Effexor at 37.5 and taper it more slowly.
Posted by 4WD on September 14, 2004, at 13:52:11
In reply to Re: Pseudonym's Cymbalta Journal: Day 6 » 4WD, posted by pseudonym on September 13, 2004, at 22:58:51
> As far as the Effexor taper, having switched to Cymbalta, I was on a dose of 150mg Effexor for about 3 months. In anticipation of Cymbalta, I tapered down to 75mg for two weeks.
>
> Once on Cymbalta at 60mg, my intention and current regimen, is to take Effexor to 37.5 for 10 days, then attempt to drop it altogether. If that fails, I'll resume the Effexor at 37.5 and taper it more slowly.
I've heard a lot of people say the hardest part is going from 37.5 to nothing. You might want to do half of 37.5 for a week, then a quarter for a week before stopping. I've made a 150mg capsule last 10 days now and I"m still having withdrawal.Marsha
Posted by pseudonym on September 15, 2004, at 20:13:59
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60mg Cymbalta ( 0 mg Effexor)
2 mg Klonopin (normally I take only 1)Felt a more nervous today, and yes 4WD, I read your message regarding the lasat 37.5 mg of an Effexor taper attempt. I imagine the anxiety may in part be due to the lessened sertonergic effect from no Effexor and particularly Cymbalta's half life. However, while my mood is definitely improved over Effexor, my anhedonia has not drastically. Overall, I feel good.
Posted by theo on September 16, 2004, at 10:37:28
In reply to Re: Pseudonym's Cymbalta Journal: Day 8, posted by pseudonym on September 15, 2004, at 20:13:59
With your Cymbalta, are you taking 60mg once daily or 30mg twice daily?
Posted by pseudonym on September 16, 2004, at 20:40:42
In reply to Re: Pseudonym's Cymbalta Journal: Day 8 » pseudonym, posted by theo on September 16, 2004, at 10:37:28
I'm taking 60mg once a day.
Posted by pseudonym on September 16, 2004, at 20:49:02
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60 mg Cymbalta (no effexor for second day)
1.5 mg KAnother excellent day today. Cymbalta's definitely does have an attention improving aspect, which I attribute to the noradrenergic reuptake inhibition. Also for 4WD, I notice no particular withdrawal effects from Effexor, having been off 37.5 mg for two days now. Furthermore, Cymbalta certainly seems to do an away with whatever depression I may be feeeling. I will say that it has lessened my desire to exercise, only because I feel happier and exercise is something I do because I know its the right thing I do, not because its fun. Of course, when skiing season comes around, that changes.
Posted by pseudonym on September 19, 2004, at 22:54:03
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60 mg Cymbalta in the morning
1 mg KlonopinAnother good weekend. I actually went to a party, albeit a LAN-party, which I wouldn't normally go to. Furthermore, my mood was generally better, and more specifically, so was my drive and concentration. I think the key aspect of Cymbalta thusfar has been its ability to allow me to concentrate. As for sex drive, I would say its not significantly decreased, but since my mood is better, it balances out for the better. No real side effects noted, gastronomic, sleep or otherwise.
Posted by Allan on September 20, 2004, at 17:20:55
In reply to Re: Pseudonym's Cymbalta Journal: Day 12, posted by pseudonym on September 19, 2004, at 22:54:03
Hi,
I think someone asked you this earlier in the thread but I'm not sure what the answer was ...
When you switched from Effexor to Cymbalta, did you cross taper? Or just switch?
I'm on regular effexor 100 twice a day which is giving me some chest tension and agitation at this point ... I want to give cymbalta a try but don't know how to go about doing it and my pdoc isn't really sure either ...
Thanks ...
Posted by pseudonym on September 20, 2004, at 18:33:54
In reply to Re: Pseudonym's Cymbalta Journal: Day 12, posted by Allan on September 20, 2004, at 17:20:55
There is no roadmap for this per se, but my pdoc and I made one up, and I haven't experienced any withdrawal. Here was the plan
Starting out 150mg Effexor
1. Go to 75 mg Effexor for one weeks
2. Switch to Cymbalta 30 & Effexor 75 for one week
3. Cymbalta 60 & Effexor 37.5 for one week
4. Cymbalta 60 there on out (this is where I'm at)
Posted by Allan on September 20, 2004, at 20:21:34
In reply to Re: Pseudonym's Cymbalta Journal: Day 12, posted by pseudonym on September 20, 2004, at 18:33:54
Thanks. How is day 13 faring?
> There is no roadmap for this per se, but my pdoc and I made one up, and I haven't experienced any withdrawal. Here was the plan
>
> Starting out 150mg Effexor
> 1. Go to 75 mg Effexor for one weeks
> 2. Switch to Cymbalta 30 & Effexor 75 for one week
> 3. Cymbalta 60 & Effexor 37.5 for one week
> 4. Cymbalta 60 there on out (this is where I'm at)
Posted by karaS on September 20, 2004, at 23:25:23
In reply to Re: Pseudonym's Cymbalta Journal: Day 12, posted by Allan on September 20, 2004, at 20:21:34
> Thanks. How is day 13 faring?
Actually I think that the critical time period is when you've been below 37.5 mg for 3 days. I've been decreasing Effexor gradually but didn't really have any problems until going under 37.5 mg. and esp. now that I've gone from 19 mg. to 9 mg. and been there for 3 days. The extra anxiety that kicked in was unbelievable (for such a small decline in the medication). I hadn't expected that at all since I've had relatively few problems so far.I am also thinking of starting Cymbalta. I think I may do so sooner rather than later so that I can minimize the rest of the Effexor withdrawal. I am curious to see how both of your withdrawal/switching over goes.
-K
>
> > There is no roadmap for this per se, but my pdoc and I made one up, and I haven't experienced any withdrawal. Here was the plan
> >
> > Starting out 150mg Effexor
> > 1. Go to 75 mg Effexor for one weeks
> > 2. Switch to Cymbalta 30 & Effexor 75 for one week
> > 3. Cymbalta 60 & Effexor 37.5 for one week
> > 4. Cymbalta 60 there on out (this is where I'm at)
>
>
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