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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 tonyz on May 18, 2010, at 19:31:30
Positive responses only please, unless there is a real problem.
I've been on clonazepam for 4 months down to 1.25mg at bedtime, been through a bunch of different meds and have gone through major depression more times than I care to remember.
Currently 1.25mg clonazepam, 125mg amitryptyline and 300 LI. The Lithium is taken in the afternoon the other two are taken at bedtime.
Doc suggested taking cymbalta, he wants me to drop the amitriptyline by 25mg for 2 days tonight and tomorrow night and then start adding the cymbalta at 20mg, and continue this strategy.
The amitriptyline would be reduced 25mg every 2 days
By day 5 the bedtime dose of amitriptyline would be 50mg and the cymbalta would be increased by 40mg.
After another 4 days the cymbalta would be increased to 60 mg. By then the amitriptyline would be at 0.
Symptoms are major depression, apathy and anxiety, and memory problems, trouble concentrating,etc.
Posted by chujoe on May 19, 2010, at 5:08:22
In reply to Another change in medication, posted by tonyz on May 18, 2010, at 19:31:30
I've had a good response to Cymbalta. Completely stopped my anxiety / depression, though I had to work up to 90mg. I'm also sleeping well for the first time in years. Other people have had different responses, but for me it has worked wonders. The only other drug I'm taking with it is Ritalin, though, so I don't know how it would interact with your other meds.
Posted by tonyz on May 19, 2010, at 11:31:58
In reply to Re: Another change in medication » tonyz, posted by chujoe on May 19, 2010, at 5:08:22
Thanks that's encouraging; hopefully I will have some luck, and I hope things continue to work well for you.
Posted by Polarbear206 on May 19, 2010, at 15:05:57
In reply to Another change in medication, posted by tonyz on May 18, 2010, at 19:31:30
> Positive responses only please, unless there is a real problem.
>
> I've been on clonazepam for 4 months down to 1.25mg at bedtime, been through a bunch of different meds and have gone through major depression more times than I care to remember.
>
> Currently 1.25mg clonazepam, 125mg amitryptyline and 300 LI. The Lithium is taken in the afternoon the other two are taken at bedtime.
>
> Doc suggested taking cymbalta, he wants me to drop the amitriptyline by 25mg for 2 days tonight and tomorrow night and then start adding the cymbalta at 20mg, and continue this strategy.
>
> The amitriptyline would be reduced 25mg every 2 days
>
> By day 5 the bedtime dose of amitriptyline would be 50mg and the cymbalta would be increased by 40mg.
>
> After another 4 days the cymbalta would be increased to 60 mg. By then the amitriptyline would be at 0.
>
> Symptoms are major depression, apathy and anxiety, and memory problems, trouble concentrating,etc.Tony, what have your sleep patterns been like?
Posted by tonyz on May 19, 2010, at 15:44:27
In reply to Re: Another change in medication, posted by Polarbear206 on May 19, 2010, at 15:05:57
They were really bad before, lately I would say 6+ hours per night, but memory and concentration has been worsening. I think it is the amitriptyline and clonazepam. Just stared the cymbalta today.
Posted by chujoe on May 19, 2010, at 16:30:14
In reply to Re: Another change in medication, posted by tonyz on May 19, 2010, at 15:44:27
You may need to be patient with the cymbalta -- it took a while to kick in for me, but once it did & once I got the dose right (90mg) it's been very effective.
Posted by tonyz on May 19, 2010, at 17:47:35
In reply to Re: Another change in medication, posted by chujoe on May 19, 2010, at 16:30:14
Thanks chujoe. How did you arrive at the correct dosage? My doc has me tapering one med while increasing the cymbalta; basically every 4 days I increase by 20mg while decreasing the amitriptyline.
I was a little nervous taking it today with the other meds still in my system, but within a few minutes after taking 20mg I felt a little tired which was a relief for me. Thought I would be able to take a nap but it didn't work out that way. In a little over a week I should be at 60mg.Did you experience any side effects?
Thanks again for your postings.
Posted by chujoe on May 19, 2010, at 21:04:46
In reply to Re: Another change in medication, posted by tonyz on May 19, 2010, at 17:47:35
Tonyz -- I had been taking Zoloft & my pdoc had me reduce one while adding the other over ten days or so. I forget the exact sequence, but it went smoothly, though when I stopped at 60mg for two or three weeks I felt the effect was kind of patchy, on & off, so my pdoc upped the dose to 90, which is where I am now. The minimum maintenance dose is 60, which may work for you, but don't be surprised if you need to go to 90.
I haven't had any significant side effects. On Zoloft I had a pronounced tremor in my hands and that is virtually gone now, even with the addition of Ritalin. For my system, this is a very clean drug.
Posted by Phillipa on May 20, 2010, at 12:50:01
In reply to Re: Another change in medication » tonyz, posted by chujoe on May 19, 2010, at 21:04:46
Congrats on cymbalta. So now the original high dose of 60mg is a maintanence dose and the doses are higher now? Phillipa
Posted by chujoe on May 20, 2010, at 14:57:58
In reply to Re: Another change in medication » chujoe, posted by Phillipa on May 20, 2010, at 12:50:01
Yes, that's what my pdoc told me.
Posted by Polarbear206 on May 20, 2010, at 14:59:08
In reply to Re: Another change in medication, posted by tonyz on May 19, 2010, at 15:44:27
> They were really bad before, lately I would say 6+ hours per night, but memory and concentration has been worsening. I think it is the amitriptyline and clonazepam. Just stared the cymbalta today.
AD's can exacerbate underlying mood disorders if not used in adjunct with a mood stablizer. Wish you well in the future.
Posted by tonyz on May 20, 2010, at 16:34:09
In reply to Re: Another change in medication, posted by Polarbear206 on May 20, 2010, at 14:59:08
Thanks for your reply.
Sleep has collapsed again. I called my pdoc and told him I had to get some sleep this morning. I took 30mg of restoril - nothing. I called him back he said try taking 50mg or trazodone and another 50mg in an hour if nothing happens. Well still no sleep and memory problems getting worse.
He started me on cymbalta a few days ago.
I am not sure at this point if I should check into a hospital. Short term memory is so bad now I can't remember if I ate lunch or not -- how much worse can it get.
I also took 300 Li and 20 of cymbalta per doctor's orders.
Tonight I am supposed to take
100 of amitriptyline
1.25mg clonazepam
150mg of trazadone
and if not asleep in an hour then take 50mg seroquelShould I go check in to a hospital?
Posted by Phillipa on May 20, 2010, at 22:02:13
In reply to Thanks and Help - Getting desperate, posted by tonyz on May 20, 2010, at 16:34:09
Oh you poor man call that Pdoc back now!!!!! Phillipa
This is the end of the thread.
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