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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Phillipa on December 27, 2005, at 13:23:30
Even crazy meds said to start cymbalta at 20mg. My new pdoc says 30mmg ,60mg, 90mg, 120mg. Each a week apart. What side effects should I expect. I am an anxious as you know person so I am scared to start. Need some help! Fondly, Phillipa
Posted by ed_uk on December 27, 2005, at 13:33:52
In reply to Afraid to Start Cymbalta, posted by Phillipa on December 27, 2005, at 13:23:30
Hi PJ
What dose did you start at when you tried Cymbalta before? Did you have any side effects when you started it?
Ed xx
Posted by spriggy on December 27, 2005, at 14:10:19
In reply to Re: Afraid to Start Cymbalta » Phillipa, posted by ed_uk on December 27, 2005, at 13:33:52
I think I'm going to try Cymbalta as well soon; for both fibromyalgia and depression/anxiety.
I've heard you can take out little pellets and go up slowly on it.. instead of swallowing the whole capsule.
Posted by flmm on December 27, 2005, at 14:38:09
In reply to Re: Afraid to Start Cymbalta, posted by spriggy on December 27, 2005, at 14:10:19
It does work well for pain, but caused a lot of anxiety! Not good if you have panic disorder! Started out smooth, then anxiety got worse and worse. Like effexor but with more anxiety, but it fools you into thinking it is not bad! Gave up after second try around. No more ssnri meds for me! It feels good to be back on Lexapro and calm.
Posted by Phillipa on December 27, 2005, at 15:57:34
In reply to Re: Afraid to Start Cymbalta, posted by flmm on December 27, 2005, at 14:38:09
Lexapro at 5mg flipped me out. Twitching legs and higher anxiety. So after five days I stopped it. Fondly,Phillipa
Posted by Phillipa on December 27, 2005, at 15:59:55
In reply to Re: Afraid to Start Cymbalta » Phillipa, posted by ed_uk on December 27, 2005, at 13:33:52
Ed I thought I just posted my response to you but I don't see it. Sorry if it's a repeat. I started at 30mg and had no side effects but that was the time I found this website so I didn't know about how strong it is. Love PJ O
Posted by blueberry on December 27, 2005, at 18:33:50
In reply to Afraid to Start Cymbalta, posted by Phillipa on December 27, 2005, at 13:23:30
Try the bead trick. Do like maybe 4 beads the first day, double it the next, maybe shoot for 20 beads in a few days and stay there for a week. You might be surprised. You can always go higher if you want. I know you are prone to anxiety, so starting super low with just a few beads might be a good strategy.
Don't let those little tiny beads fool you. They are very powerful. At least to me anyway.
Posted by spriggy on December 27, 2005, at 18:39:54
In reply to Re: Afraid to Start Cymbalta, posted by blueberry on December 27, 2005, at 18:33:50
how many pellets do you take?Did you notice any anxiety in the beginning, even with using the small pellet trick? LOL
I need some relief from my fibro and something for depression but am prone to anxiety/panic attacks.
I DO NOT do well on SSRi's- Lexapro landed in me in the hospital with akathasia. I was suicidal on that stuff.
I've been scared to try anything since.
Thanks!
Posted by Glydin on December 27, 2005, at 19:18:55
In reply to Afraid to Start Cymbalta, posted by Phillipa on December 27, 2005, at 13:23:30
PJ,
Why did you stop Cymbalta the first time you were on it?
Posted by Phillipa on December 27, 2005, at 20:44:32
In reply to Re: Afraid to Start Cymbalta » Phillipa, posted by Glydin on December 27, 2005, at 19:18:55
Can I E-mail you that? I'll do it now. Fondly, Phillipa
Posted by Cairo on December 27, 2005, at 22:08:41
In reply to Afraid to Start Cymbalta, posted by Phillipa on December 27, 2005, at 13:23:30
I also could not tolerate Lexapro (or any SSRI, for that matter), so I'd start the Cymbalta even LOWER than 20mg. I'm sensitive to meds and my doctor started me on Cymbalta at 60mg, claiming that the "balanced" SSRI/NERI effect would not cause problems. WRONG! Was an absolute basket case at that dose with panic attacks, akithisia, etc., but I titrated myself down to 5mg and found I had much increased energy, without most of the horrible side effects. There are other posters on Babble that are taking low doses like 5-10mg.
I found no problem opening up the capsule and counting out pellets. I'd simply put them in a small paper cup, crease one side and toss them back into my mouth and take a big gulp of water so I wouldn't crush the pellets.
I don't see why docs start doses higher in people that they know to be sensitive to meds, then taper them back. Start low, and go slow is my motto, especially if you have a history of problems with dosing and side effects.
You won't know until you try Cymbalta. The 5mg of Cymbalta gave me lots of energy, but I still had some problems with neck stiffness and at that dose it didn't do a thing for mood, so I quit it. But that's me. You may do well on it, but if you are prone to panic attacks and very anxious, I'd be cautious. Have you had problems with caffeine, Wellbutrin or any other stimulating type med?
Cairo
> Even crazy meds said to start cymbalta at 20mg. My new pdoc says 30mmg ,60mg, 90mg, 120mg. Each a week apart. What side effects should I expect. I am an anxious as you know person so I am scared to start. Need some help! Fondly, Phillipa
Posted by yxibow on December 27, 2005, at 23:21:21
In reply to Afraid to Start Cymbalta, posted by Phillipa on December 27, 2005, at 13:23:30
> Even crazy meds said to start cymbalta at 20mg. My new pdoc says 30mmg ,60mg, 90mg, 120mg. Each a week apart. What side effects should I expect. I am an anxious as you know person so I am scared to start. Need some help! Fondly, Phillipa
Well, first thing as one who takes Cymbalta in two sizes is I dont understand this pellet extraction business -- it sounds like an awful lot of work and at a few pellets, 2 or 3mg, it really is just a placebo. But hey, placebos work 33% of the time :) Also just judging from individual colour differences in the outside of the 20mg pills, I'd place a fair bet that the capsules vary in pellets and the pellets vary in strength. They were meant to be taken at once -- I'm not sure if they're extended release or not.
I do understand your concerns over dosing though -- and I don't think a week, at least my doctor anyway, is enough of a time to give the medication its full trial or work through side effects. I would say 2 weeks to a month.
As for high dosage -- some people respond to it; it is noted for changes in somatic (pain, internalization) parts of depression at doses beyond 60mg. Personally I don't find it at all like Effexor which is like 12 cups of coffee mixed with amphetamines. All jokes aside, everyone tolerates different dosing, but I would think the minimum realistic and psychiatrically relevant dose is 20 or 30mg.
hope that helps
Posted by Racer on December 28, 2005, at 0:31:17
In reply to Re: Afraid to Start Cymbalta » ed_uk, posted by Phillipa on December 27, 2005, at 15:59:55
> Ed I thought I just posted my response to you but I don't see it. Sorry if it's a repeat. I started at 30mg and had no side effects but that was the time I found this website so I didn't know about how strong it is. Love PJ O
If you started at 30mg before with no problems -- and that was the dose I started on, too, by the way -- then there's really no reason you'd have trouble now. Except if you work yourself into a frenzy about it. It's no stronger when you know a bit more about it than it was when you didn't -- you've already learned that you can start at 30mg without problems, and that's what your doctor prescribed for a starting dose for you.Every so often, I think it's good practice to follow doctors' instructions. (Hard as that is at times.)
Phillipa, am I getting the feeling that you really don't like or trust this doctor? If so, there's really only one thing you can do to get help: find a doctor you trust. If there are no doctors out there that you can trust at this point -- something I'm experiencing, so I do understand -- then maybe you really need some sort of counseling to get you through the adjustment phase. Maybe even going into the hospital for a week or two to adjust upwards.
But seriously, Phillipa: I don't think you're doing yourself any favors at all to break up the capsules and take the individual pellets. All you'll really do by that is prolong your agony, and it will take that much more time before you know if Cymbalta will help. How long have you been suffering now, PJ? Long enough, right? Why extend that suffering, when you know that you've taken it before without problems? Why not just start at the dose your doctor ordered, and see if it is once again a good, easy transition.
Good luck
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