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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
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)
>
>
Posted by SLS on September 21, 2004, at 1:31:48
In reply to Re: Pseudonym's Cymbalta Journal: Day 12 » Allan, posted by karaS on September 20, 2004, at 23:25:23
> 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.
Good luck, Kara.
:-)
- Scott
Posted by iris2 on September 22, 2004, at 9:37:13
In reply to Re: Pseudonym's Cymbalta Journal: Day 12, posted by pseudonym on September 19, 2004, at 22:54:03
Thanks for posting your journal about Cymalta. I had previosly missed it. I am thinking of trying this sonn, so I am very interest.
Glad it seems to be working for you:)
irene
Posted by pseudonym on September 23, 2004, at 12:38:59
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60 mg Cymbalta one a day
1 mg KlonopinStill going strong on the Cymbalta. My diagnosis has been social anxiety for some time and it certainly helps in the anxiety department. However, it helps in other ways as well. I have been painting my condo, and building a dresser, things I would generally postpone ad infinitum. Also, I noticed it helped my concentration level as well, in both reading and listening to others. So far, so good.
Posted by pseudonym on September 28, 2004, at 10:38:43
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
60 mg Cymbalta
1.5 clonazepam mgI would say any depression I have is in remission. I enjoy doing the things I always have, enjoy my job, and enjoy most relationships. However, I must say that my diagnosis was always social anxiety, and for that, clonazepam is a more essential ingredient than Cymbalta. Since I still wish to improve in the area of anhedonia and prosociability, I will experiment with the additional of Provigil, failing that, with selegiline+amino acid. We'll see how that goes. Otherwise, with Cymbalta, no complaints. Its side effect profile seems rather benign.
Posted by sunshine211 on September 29, 2004, at 4:40:14
In reply to Re: Pseudonym's Cymbalta Journal: Day 21, posted by pseudonym on September 28, 2004, at 10:38:43
Glad to see that things are going good for you! I had post-poned my start of Cymbalta and took longer to decrease my paxil (had some anxiety about it, imagine that, lol). How is your sleep and sexual side-effects. you said benign, but how benign?
Posted by pseudonym on September 29, 2004, at 14:46:20
In reply to Re: Pseudonym's Cymbalta Journal: Day 21, posted by sunshine211 on September 29, 2004, at 4:40:14
Well, I will be switching to taking Cymbalta at night, considering that as far as sleep is concerned, it does seem to be marginally sleep inducing, so why not take it at night? As far as sex drive is concerned, it does have marginal effect on desire, but for me at least, it doesn't lessen it that much. By diagnosis is social anxiety however, so while Cymbalta is great, I'm also probably going to try Emsam (the selegiline patch) if and when it becomes FDA approved.
Posted by yznhymer on September 29, 2004, at 15:29:55
In reply to Re: Pseudonym's Cymbalta Journal: Day 21, posted by pseudonym on September 29, 2004, at 14:46:20
I'm going to be starting on Cymbalta this Monday but have also been interested in EMSAM. Its always a crapshoot but given my response to Nardil I thought selegiline might be a better bet. Don't want to wait for it, however. Last I heard it might be available early 2005. Have you seen anything else about its projected marketing date?
Mark
> Well, I will be switching to taking Cymbalta at night, considering that as far as sleep is concerned, it does seem to be marginally sleep inducing, so why not take it at night? As far as sex drive is concerned, it does have marginal effect on desire, but for me at least, it doesn't lessen it that much. By diagnosis is social anxiety however, so while Cymbalta is great, I'm also probably going to try Emsam (the selegiline patch) if and when it becomes FDA approved.
Posted by pseudonym on October 1, 2004, at 3:26:40
In reply to Re: Pseudonym's Cymbalta Journal: Day 21 » pseudonym, posted by yznhymer on September 29, 2004, at 15:29:55
No, I'm not sure when marketing approval will be given. The FDA has given the approvable letter, but I'm unsure if there is an additional FDA action date. I surmise that the current negotation will be over the labeling, in particular, what tyramine dietary restrictions may or may not be required. Now, out of an abundance of caution, the FDA may mandate dietary restrictions despite the selegiline patch totally bypassing the gut.
In any case, Cymbalta and selegiline are two different weapons in the anti-depressant arsenal, and they definitely have different mechanisms of action. It's highly possible that EMSAM alone, or EMSAM + DLPA could be what you'll ultimately decide upon.
Posted by pseudonym on October 1, 2004, at 3:36:13
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Cymbalta 60 mg
1.5 mg KlonopinWell, I took Cymbalta 60 mg at night and while sleeping ok, I was rather tired during the day, so much so that I left work 2 hours early and came home to sleep it off, which is unheard of. My pdoc suggested taking it at night, but I've given that a one day trial and I prefer taking it during the day.
Another thing I noted was that during the one year open label study, the participants were taking 40 to 60 mg twice a day, for a total of 80 or 120. I wonder if that isn't the route to take for many of you, since a large percentage had depression in remission by week 6. I'm halfway to week 6, and while the depression is wiped out, the social anxiety is not. I'm convinced that social anxiety, as a number of studies have shown, has a dopaminergic element, which Cymbalta does not attempt to touch.
Posted by iris2 on October 1, 2004, at 10:02:39
In reply to Re: Pseudonym's Cymbalta Journal: Day 21, posted by pseudonym on September 29, 2004, at 14:46:20
Do you think that the Emsam (the selegiline patch) might not bother my bladder because it does not go through the gut? I do not know if it will be filtered out by the kidneys anyway?
irene
Posted by martha stone on October 6, 2004, at 14:23:54
In reply to Re: Pseudonym's Cymbalta Journal: Day 21 » pseudonym, posted by iris2 on October 1, 2004, at 10:02:39
I've been following this thread with great interest as my doc wants me to switch from lexapro to cymbalta because of the lack of sexual side effects in females shown by cymbalta. i am somewhat sceptical because the drug companies always start out saying these drugs don't have or much sexual side effects and then they do. cymbalta is supposed to have no sexual side effects on females, minimal on males. any females out there taking this that can talk about it. not so much desire as difficulty with orgasm. thanks. ms
Posted by pseudonym on October 8, 2004, at 11:12:38
In reply to Pseudonym's Cymbalta Journal: Day1, posted by pseudonym on September 8, 2004, at 18:11:37
Current regimen
10mg selegiline + DLPA
1 mg klonopinI am no longer taking Cymbalta or any S(S|N)RI at the moment. Of those serotonergic drugs that I've been prescribed Cymbalta is the best ... if you're depressed. Taking Cymbalta, my depression is gone and my concentration most definitely improved. However, there are two issues. One, my diagnosis is not depression per se, it is social anxiety, like others on this board, Michael Bell, Ritch, and btnd come to mind. With that being the case, Cymbalta removes depression it would seem by wiping out emotion. You win, you lose, doesn't matter. You succeed, you fail, doesn't mater. You see a pretty girl, doesn't matter quite as much as you're used to. So, with the success of nemesis and ASV, I've decided to try segiline with DLPA.
Again, I'm not ripping Cymbalta per se, it just does not seem to fit my dx, beyond the concentration aspect.
This is the end of the thread.
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