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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by kezia on February 20, 2008, at 10:38:33
Don't ask me why, but he gave me enough 60mg samples for a month. When I questioned it, he said that 60mg was a good starting dose. It's new in Canada, so he doesn't have much experience with it, but he has switched a number of his patients over to Cymbalta and, from what he said, he started them at 60mg and they haven't had any significant side effects.
Well, I'm nervous about starting it, especially at 60mg. I asked if he would give me a script for 30mg, but he said I would be fine with 60mg. He is a great pdoc and I don't want to question him, but . . .
I am so sick of ADs that leave you feeling flat and apathetic, which is part of the reason I am nervous (and somewhat reluctant) to start Cymbalta at 60mg. I mentioned this to my family doctor and she basically said that that is what ADs are supposed to do. Wow! So, a person is depressed (loss of interest, no motivation, apathetic . . . ), so let's give them a pill that keeps them that way but makes them not care that they are that way?!?!?!
I don't know what to do anymore. I really just give up and think I will just learn to live without the joy and enthusiasm that I used to experience. It sucks, but I know there are others who are worse off, so I should just suck it up and get on with things.
Oh well, sorry for the rant and the pity party.
Posted by Racer on February 20, 2008, at 13:13:13
In reply to Cymbalta - pdoc wants me to start at 60 mg, posted by kezia on February 20, 2008, at 10:38:33
> When I questioned it, he said that 60mg was a good starting dose.
It's usually good practice to question what your doctors tell you if you're not sure about it. The best doctors actually appreciate that their patients are paying attention, and even the good doctors usually understand that it's not meant as criticism.
As far as starting at 60mg, there are two schools of thought on that -- one says to start low and go slow; the other says that starting higher minimizes the duration of adjustment issues and shortens the time spent waiting for it to work. So, there's an argument to be made either way. If you trust your doctor -- and it sounds as though you do -- it's worth giving it a shot at 60mg. If you have trouble, give him a call and let him know you're having difficulties and want to step down to a lower dose. That should cover your bases, and you might find starting at 60mg works a treat for you.
>
> I am so sick of ADs that leave you feeling flat and apathetic, which is part of the reason I am nervous (and somewhat reluctant) to start Cymbalta at 60mg. I mentioned this to my family doctor and she basically said that that is what ADs are supposed to do.I had to laugh when I read this. My pdoc said basically the same thing to me, but in very, very different words -- it made such a difference. I can't remember his exact wording, but the gist of it was that psychiatrists often use the flattening from SSRIs to their patients' advantage. That is, for people with problems like anxiety or negative ruminations, the apathy SSRIs can cause is often helpful. It's the same basic message, but put so much more effectively, in my opinion. (As evidence, I'd like to point out that you were dismayed by your doctor's comment, while I was encouraged by mine.)
You, I, and most here know that "feeling flat and apathetic" is *not* what antidepressants are "supposed" to do. In the best of all possible worlds, we'd have an antidepressant which curbed anxiety, increased emotional resilience, controlled depression, didn't poop out, and turned us all into intellectual fashion models driving sports cars. In this world, there are trade offs with any medication -- apathy from some, increased agitation from others, weight gain from many, insomnia from a few, etc. Cymbalta, for me, was amongst the friendliest -- it had by far the fewest and least annoying side effects of any antidepressant I've tried. (And I have tried more than a few.) I stayed on it for about a year and a half, and am not sure the problems I *did* have with it weren't more to do with my erstwhile pdoc. My experience, overall, inclines me to recommend it as a very helpful medication which is very well worth trying.
Good luck with it.
Posted by SLS on February 20, 2008, at 13:47:53
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » kezia, posted by Racer on February 20, 2008, at 13:13:13
Hi Racer.
Did you experience tiredness and fatigue while taking Cymbalta? If so, did it dissipate? If so, how long did it take to dissipate?
If you check the label, I believe it suggests that Cymbalta treatment be initiated at 60mg. Of course, there are some people who would do well to start at 30mg.
I admire your academic achievements. Psycho-Babble has profited greatly from your presence here.
- Scott
Posted by Phillipa on February 20, 2008, at 22:57:42
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » Racer, posted by SLS on February 20, 2008, at 13:47:53
Scott did they change the monogram of cymbalta as used to start at 20mg or 30mg. For me it helped with back pain that was it on 60mg for about three months. Phillipa
Posted by 49er on February 22, 2008, at 14:16:31
In reply to Cymbalta - pdoc wants me to start at 60 mg, posted by kezia on February 20, 2008, at 10:38:33
> Don't ask me why, but he gave me enough 60mg samples for a month. When I questioned it, he said that 60mg was a good starting dose. It's new in Canada, so he doesn't have much experience with it, but he has switched a number of his patients over to Cymbalta and, from what he said, he started them at 60mg and they haven't had any significant side effects.
>
> Well, I'm nervous about starting it, especially at 60mg. I asked if he would give me a script for 30mg, but he said I would be fine with 60mg. He is a great pdoc and I don't want to question him, but . . .
>
> I am so sick of ADs that leave you feeling flat and apathetic, which is part of the reason I am nervous (and somewhat reluctant) to start Cymbalta at 60mg. I mentioned this to my family doctor and she basically said that that is what ADs are supposed to do. Wow! So, a person is depressed (loss of interest, no motivation, apathetic . . . ), so let's give them a pill that keeps them that way but makes them not care that they are that way?!?!?!
>
> I don't know what to do anymore. I really just give up and think I will just learn to live without the joy and enthusiasm that I used to experience. It sucks, but I know there are others who are worse off, so I should just suck it up and get on with things.
>
> Oh well, sorry for the rant and the pity party.Kezia,
What is your med sensitivity history? If you have a history of being unusually sensitive, personally, I would start as low as possible. You might be interested in this site by Jay Cohen, a psychiatrist who feels that alot of SSRI side effects are due to high starting doses. He is not antimeds:
49er
Posted by Cecilia on February 23, 2008, at 2:36:05
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg, posted by 49er on February 22, 2008, at 14:16:31
I agree with 49er-don't start Cymbalta at 60 mg if you're at all sensitive to meds. I had terrible side effects at just 5 mg and can't imagine what 60 would have done to me. You can count out the beads in a capsule and put a small number in an empty gel cap (use tweezers). Everyone is different, but to me it rarely makes sense to start anything out on a large dose. You're the one who will feel the side effects, not your doctor. Cecilia
Posted by yxibow on February 26, 2008, at 13:58:41
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg, posted by Cecilia on February 23, 2008, at 2:36:05
> I agree with 49er-don't start Cymbalta at 60 mg if you're at all sensitive to meds. I had terrible side effects at just 5 mg and can't imagine what 60 would have done to me. You can count out the beads in a capsule and put a small number in an empty gel cap (use tweezers). Everyone is different, but to me it rarely makes sense to start anything out on a large dose. You're the one who will feel the side effects, not your doctor. Cecilia
Its really difficult to count the beads in a capsule -- they're also non uniform (and so are the capsules, I noticed slightly different color variations) and one runs the serious risk of breaking the beads, which are time released. Its not a good idea. Cymbalta is available in 20mg capsules which is enough for most sensitive people to start with. If one continues to be sensitive at a dose as low as 5mg, it probably isn't the best agent for them. Sometimes you have to stick through the side effect for benefits. It is a slow acting agent but can be a pretty potent antidepressant after a number of weeks titrating to 60 (and above).
Posted by Jamal Spelling on February 26, 2008, at 14:54:45
In reply to Cymbalta - pdoc wants me to start at 60 mg, posted by kezia on February 20, 2008, at 10:38:33
I saw my pdoc today. She wants me to start Cymbalta at 60 mg/day as well.
Posted by Jamal Spelling on February 26, 2008, at 14:57:18
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » kezia, posted by Racer on February 20, 2008, at 13:13:13
> Cymbalta, for me, was amongst the friendliest -- it had by far the fewest and least annoying side effects of any antidepressant I've tried. (And I have tried more than a few.) I stayed on it for about a year and a half, and am not sure the problems I *did* have with it weren't more to do with my erstwhile pdoc. My experience, overall, inclines me to recommend it as a very helpful medication which is very well worth trying.
I'm sorry if I missed it, but why did you stop taking Cymbalta, if I may ask?
Posted by Phillipa on February 26, 2008, at 21:19:10
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » kezia, posted by Jamal Spelling on February 26, 2008, at 14:54:45
Jamal not in the best physical shaped right now but what meds are you currently on? Can't sit at the computer. I took 60mg of cymbalta when first out noticed notice but when stopped I had back pain so should have stayed on it longer????? Love Phillipa
Posted by Jamal Spelling on February 27, 2008, at 4:20:27
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » Jamal Spelling, posted by Phillipa on February 26, 2008, at 21:19:10
> Jamal not in the best physical shaped right now but what meds are you currently on?
I am not taking any medication at the moment.
> I took 60mg of cymbalta when first out noticed notice but when stopped I had back pain so should have stayed on it longer????? Love Phillipa
No, Phillipa, I don't think back pain alone justifies taking Cymbalta.
I hope you get better soon.
Posted by Jamal Spelling on March 2, 2008, at 13:33:04
In reply to Re: Cymbalta - pdoc wants me to start at 60 mg » Racer, posted by Jamal Spelling on February 26, 2008, at 14:57:18
This is the end of the thread.
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