Psycho-Babble Medication Thread 378908

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Re: Sooshi! How are you doing? » sooshi

Posted by chemist on August 21, 2004, at 10:51:16

In reply to Re: Sooshi! How are you doing? » sb417, posted by sooshi on August 21, 2004, at 9:21:25

hello sooshi, chemist here....i thank sb417 for resurrecting your post, as i was on vacation (blocked) during your in and out of the hospital.....heartened to hear that things went well, and perhaps the recent discomfort will pass: maybe related to the rain, who knows, hopefully fleeting in nature and harmless.....again, best wishes for a speedy and healthy recovery, chemist


> Hi sb,
>
> I gave a follow-up to my surgery on my "Anesthesia..." post, but it got bumped into the archives! I did really well, and have had no depression following surgery! However, as of the past 4 days or so, I've been experiencing what feels like Effexor withdrawals, even though I'm NOT withdrawing...you know, "brain whooshes, zaps", etc. Maybe my metabolism is all sped up post-surgery and this is affecting the way I'm processing my meds?? I don't know. I will probably do a post about it, see if I can get any input from others.
>
> Thanks for thinking of me!
> Sooshi

 

Re: Sooshi! How are you doing? » chemist

Posted by sooshi on August 21, 2004, at 15:00:33

In reply to Re: Sooshi! How are you doing? » sooshi, posted by chemist on August 21, 2004, at 10:51:16

Hi Chemist,

You? Blocked? I can't imagine why?! Sorry I wasn't around to defend you! I'm actually feeling a few less "whooshes" and "zaps" today, so maybe it is just the rain (or the lack of it - we needed it badly!). Thanks for your concern!

Sooshi

 

Re: Sooshi! How are you doing? » sooshi

Posted by chemist on August 21, 2004, at 15:04:09

In reply to Re: Sooshi! How are you doing? » chemist, posted by sooshi on August 21, 2004, at 15:00:33

> Hi Chemist,
>
> You? Blocked? I can't imagine why?! Sorry I wasn't around to defend you! I'm actually feeling a few less "whooshes" and "zaps" today, so maybe it is just the rain (or the lack of it - we needed it badly!). Thanks for your concern!
>
> Sooshi

hi sooshi, yes, blocked (again)....glad you are feeling better....be well, chemist

 

Re: I wouldn't mind a post every day from you, Scott.

Posted by mxrider on August 22, 2004, at 18:22:07

In reply to Re: I wouldn't mind a post every day from you, Scott., posted by SLS on August 20, 2004, at 12:06:34

Hello...you are on the wonder drug we all have been waiting for...what the f*&k???? How about a status report???? Check in please...

 

Re: I wouldn't mind a post every day from you, Scott. » mxrider

Posted by SLS on August 23, 2004, at 2:06:25

In reply to Re: I wouldn't mind a post every day from you, Scott., posted by mxrider on August 22, 2004, at 18:22:07

> Hello...you are on the wonder drug we all have been waiting for...what the f*&k???? How about a status report???? Check in please...

Please see:

http://www.dr-bob.org/babble/20040821/msgs/380308.html

Thanks.


- Scott

 

Hi - Just joined and just took my first dose...

Posted by struggles on August 23, 2004, at 16:20:45

In reply to Re: YOU TOOK FIRST DOSE OF CYMBALTA AND NO FOLLOW UP?? » SLS, posted by theo on August 21, 2004, at 8:44:39

Hi. I hope I am not intruding. I was doing some research and found you guys. I thought I would join in, since I too have tried many different meds in search of relief. The latest and greatest seems to be Cymbalta. I hope so!

Anyway, hi from Struggles. I look forward to comparing notes with anyone else taking this, and providing anyone interested with feedback.

Cheers.

 

Cymbalta

Posted by sac on August 23, 2004, at 21:11:29

In reply to Hi - Just joined and just took my first dose..., posted by struggles on August 23, 2004, at 16:20:45

Anyone know how much it costs?? I have no insurance so this would be a major issue for me. Very interested in trying it but cost is a factor. Thanks.

 

Re: Cymbalta

Posted by caraher on August 24, 2004, at 8:43:44

In reply to Cymbalta, posted by sac on August 23, 2004, at 21:11:29

A newspaper story a few weeks ago said it was supposed to wholesale for $2.85 per 60 mg

 

Re: Cymbalta at Walgreens Pharmacies

Posted by vikala on August 24, 2004, at 11:34:02

In reply to Cymbalta at Walgreens Pharmacies, posted by Mr. Scott on August 17, 2004, at 20:55:31

I called my Walgreens here in IL last night.. they have Cymbalta too. Put the call in to my psychiatrist requesting a prescription. I have *maybe* 5 other meds left to try before I run out of options. I have hope this will work. Effexor helped me before.. hoping Cymbalta does the same. Luckily I was only on Effexor XR 300mg a day for 9 months - I weaned off slowly and hardly felt a thing. Stopping Zoloft was nearly a disabling experience for me.

I'm not expecting magic, just some relief.
Best wishes to you all,

Vikala

 

Re: Cymbalta at Walgreens Pharmacies » SLS

Posted by owensmar on August 24, 2004, at 12:37:50

In reply to Re: Cymbalta at Walgreens Pharmacies » Nohope, posted by SLS on August 19, 2004, at 6:11:29

Me too, Scott, me too!!!!!!!!!!!!!!!!!!!!!!

 

Re: Cymbalta at Walgreens Pharmacies

Posted by SLS on August 24, 2004, at 13:46:34

In reply to Re: Cymbalta at Walgreens Pharmacies » SLS, posted by owensmar on August 24, 2004, at 12:37:50

> Me too, Scott, me too!!!!!!!!!!!!!!!!!!!!!!

Thanks guys!!!!!!!!!!!!!!!!!!!

I have a good feeling about this drug. I like what I felt after my first dose - a sort of "blip" improvement that lasted for a portion of the day. I think that demonstrates its potency at important pharmacological sites. Even if it doesn't represent an answer for me, I think it will for many others.

By the way, at the low dosage of 30mg, somnolence is beginning to emerge as a side effect. One other person has reported this. I expect that it will be a startup side effect that will eventually pass. I'll try to keep up with the log I'm keeping as "Cymbalta (duloxetine) - report"


- Scott

 

Re: Cymbalta Samples-Question » SLS

Posted by theo on August 24, 2004, at 17:02:44

In reply to Re: Cymbalta at Walgreens Pharmacies, posted by SLS on August 24, 2004, at 13:46:34

My doc left some samples at the front desk so I couldn't ask any questions, but he gave me Cymbalta samples and they are 60mg pills.

When you go to 60mg are you going to take it b.i.d. or once daily? What did your doc suggest?

I'm kinda of freaked out to try 60mg first dose, but those are the only samples I got.

 

Re: Cymbalta Samples-Question

Posted by SLS on August 24, 2004, at 17:27:11

In reply to Re: Cymbalta Samples-Question » SLS, posted by theo on August 24, 2004, at 17:02:44

> My doc left some samples at the front desk so I couldn't ask any questions, but he gave me Cymbalta samples and they are 60mg pills.
>
> When you go to 60mg are you going to take it b.i.d. or once daily? What did your doc suggest?
>
> I'm kinda of freaked out to try 60mg first dose, but those are the only samples I got.


When I go up to 60mg tomorrow, I'll go 30mg b.i.d. just on principle. I think my doctor started me low because there was still some tricyclic in my system.

Your doctor is doing exactly what the manufacturer says to do. Except for some added sleepiness, I feel no effects at all. Lexapro gave me anxiety and made me feel uncomfortable and fatigued. There isn't a hint of anxiety or fatigue so far.

You'll be fine.


- Scott

 

Re: Cymbalta Samples-Question » SLS

Posted by theo on August 24, 2004, at 18:23:14

In reply to Re: Cymbalta Samples-Question, posted by SLS on August 24, 2004, at 17:27:11

I was reading the insert in my samples and it says: Take a total dose of 40 mg/day (given as 20mg BID) to 60 mg/day (given either once a day or 30 mg BID).

A little confusing on what the Lilly thinks the dose range should be and if the half life is long enough for once a day dosing.

Also, are they assuming at 60mg means it's a high enough dose to extend the half life and take it once a day? At 40mg/day it says MUST be taken BID but at 60mg you can take it once daily, I'm so confused.

 

Re: Cymbalta Samples-Question

Posted by owensmar on August 24, 2004, at 19:59:15

In reply to Re: Cymbalta Samples-Question, posted by SLS on August 24, 2004, at 17:27:11

Scott, what dosage formulations does it come in? 20mg? 40mg & 60mg?

From what I've read, it's enteric coated so you aren't supposed to break tablets in half. It's designed to be absorbed after leaving the acidic environment of the stomach. So how can people take 30mg bid and/or take 40mg bid?

Marsha

 

Re: Cymbalta Samples-Question-SLS

Posted by theo on August 25, 2004, at 7:03:29

In reply to Re: Cymbalta Samples-Question » SLS, posted by theo on August 24, 2004, at 18:23:14

> I was reading the insert in my samples and it says: Take a total dose of 40 mg/day (given as 20mg BID) to 60 mg/day (given either once a day or 30 mg BID).
>
> A little confusing on what the Lilly thinks the dose range should be and if the half life is long enough for once a day dosing.
>
> Also, are they assuming at 60mg means it's a high enough dose to extend the half life and take it once a day? At 40mg/day it says MUST be taken BID but at 60mg you can take it once daily, I'm so confused.

WHAT DO YOU THINK ABOUT THE ABOVE POST??

 

Re: Cymbalta Samples-Question

Posted by SLS on August 25, 2004, at 7:05:38

In reply to Re: Cymbalta Samples-Question, posted by owensmar on August 24, 2004, at 19:59:15

Here's the information that one would find in the PDR:

http://www.rxlist.com/cgi/generic/cymbalta_ids.htm

DOSAGE AND ADMINISTRATION
Initial Treatment

Cymbalta should be administered at a total dose of 40 mg/day (given as 20 mg BID) to 60 mg/day (given either once a day or as 30 mg BID) without regard to meals.

There is no evidence that doses greater than 60 mg/day confer any additional benefits.


HOW SUPPLIED
Cymbaltaź (duloxetine hydrochloride) capsules are available in 20, 30, and 60 mg strengths.

- Scott

 

Re: Cymbalta Samples-Question » SLS

Posted by theo on August 25, 2004, at 7:28:59

In reply to Re: Cymbalta Samples-Question, posted by SLS on August 25, 2004, at 7:05:38

I guess my question would be, in the past 4-5 days you've been taking 30mg, do you think it can be taken once daily? Any peaks and valleys? How far are you planning to split your doses apart while taking 30mg BID to avoid the 2nd dose causing "possible" insomnia?

My doctor will prescribe Cymbalta however I want to and all the studies I've read, even at high doses, show Cymbalta taken BID. I've never seen anything about taking 60mg once daily, except in Lilly's prescribing info. Do you think Cymbalta can realistically be taken as once daily dosing after your experiance taking 30mg once daily?

Did your doctor have any input on dosing?

 

Re: Cymbalta Samples-Question » theo

Posted by SLS on August 25, 2004, at 7:53:22

In reply to Re: Cymbalta Samples-Question » SLS, posted by theo on August 25, 2004, at 7:28:59

> I guess my question would be, in the past 4-5 days you've been taking 30mg, do you think it can be taken once daily? Any peaks and valleys? How far are you planning to split your doses apart while taking 30mg BID to avoid the 2nd dose causing "possible" insomnia?
>
> My doctor will prescribe Cymbalta however I want to and all the studies I've read, even at high doses, show Cymbalta taken BID. I've never seen anything about taking 60mg once daily, except in Lilly's prescribing info. Do you think Cymbalta can realistically be taken as once daily dosing after your experiance taking 30mg once daily?
>
> Did your doctor have any input on dosing?


I didn't speak to him at length regarding the dosing of Cymbalta because I basically had him write me a script over the phone as soon as I heard it was approved. He has been speaking to the drug reps for quite a few months regarding Cymbalta, so I assume he knew what he was doing when he prescribed it. I'll know more when I see him next week.

I would rather take Cymbalta b.i.d. only because it seems to make sense intuitively. However, if cost is an issue, purchasing the 60mg must surely be more economical than using twice as many 30mg.

I know how urgently you require definitive information. I really can't provide you with anything more at the moment. If you are a litte bit bashful about taking 60mg as your first dose, perhaps you can open the capsule and dump half of it for a couple of days. Otherwise, I would go ahead and try the 60mg once a day and see what happens. With the short half-life, you can always skip a dose to relieve you of any adverse effects that emerge.

I'll be increasing from 30mg to 60mg b.i.d. today. I generally dose at 7:00am and 10:00pm. I doubt I will know much about side effects for a few days. Right now, somnolence is becoming an issue.

Good luck.


- Scott

 

Re: Cymbalta, low-dosing - for med-sensitive types

Posted by jrbecker on August 25, 2004, at 10:00:53

In reply to Re: Cymbalta Samples-Question » theo, posted by SLS on August 25, 2004, at 7:53:22

This strategy will probably only work for a very small minority of people since most will definitely have to push the dose up to 40-60mg to see beneficial results...but for those that want to be conservative and start low and go slow, here's some reassuring news.


Int Clin Psychopharmacol. 1997 May;12(3):137-40.

An open-label study of duloxetine hydrochloride, a mixed serotonin and noradrenaline reuptake inhibitor, in patients with DSM-III-R major depressive disorder. Lilly Duloxetine Depression Study Group.

Berk M, du Plessis AD, Birkett M, Richardt D.

Department of Psychiatry, University of the Witwatersrand, Johannesburg, South Africa.

Duloxetine hydrochloride, a mixed reuptake inhibitor of serotonin and noradrenaline, was studied in a 6 week open-label uncontrolled multicentre design at a dose of 20 mg daily both in in- and outpatients meeting DSM-III-R criteria for unipolar major depressive disorder. Seventy-nine patients took part in the study. The mean score on the 17-item Hamilton Depression Rating Scale at baseline was 24.9 (SD 4.4), decreasing to 8.5 (SD 7.8) after 6 weeks using a last observation carried forward analysis. Clinical response, defined as a 50% reduction in 17-item Hamilton Depression Rating Scale scores, occurred in 78.2% of patients, whereas remission, defined as a 17-item Hamilton Depression Rating Scale score of < or = 6, occurred in 60.3% of patients. Duloxetine hydrochloride was safe and well tolerated in this patient population.

PMID: 9248869 [PubMed - indexed for MEDLINE]


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9248869

 

Re: Cymbalta Samples-Question

Posted by Mr. Scott on August 25, 2004, at 10:09:47

In reply to Re: Cymbalta Samples-Question » SLS, posted by theo on August 25, 2004, at 7:28:59

I just started Cymbalta today. 30mg capsules 1x daily. Apparently reps are not even detailing the 20mg size. Some anyways are telling docs the 20mg are only for the a taper process which will involve withdrawal. Who cares I just want to get out of bed without so much a struggle.

Basically...The dosing situation is akin to prozac's where 20mg was used for Everybody. It's the same with Cymbalta apparently at except at 30mg BID. My doc says Lilly want's everybody to take 60mg right off the bat.

My greatest hope is that I don't develop the now well known and often experienced cluster of neurologic/serotonin/hypomanic symptoms that I always get on standard doses of ssri/snri antidepressants. I just want to get feeling okay without too many damn side effects or a switch into hypomania/mixed land.

Be well everyone.
Mr.Scott

 

Re: Cymbalta Samples-Question » owensmar

Posted by Mr. Scott on August 25, 2004, at 10:15:18

In reply to Re: Cymbalta Samples-Question, posted by owensmar on August 24, 2004, at 19:59:15

The samples anyway of the 30mg size are old fashion looking gelatin capsules with little balls inside. I haven't looked to see if they are individually coated. There is no splitting these up however.

Mr.Scott

 

Question for SLS

Posted by Mr. Scott on August 25, 2004, at 10:23:19

In reply to Re: Cymbalta Samples-Question » SLS, posted by theo on August 24, 2004, at 18:23:14

Hey Scott,

You mentioned Somnolence as a potential problem... At what dose this appear for you?

Mr.Scott

 

Re: Cymbalta Samples-Question » Mr. Scott

Posted by theo on August 25, 2004, at 11:46:37

In reply to Re: Cymbalta Samples-Question, posted by Mr. Scott on August 25, 2004, at 10:09:47

When you said the reps are pushing 60mg, did your doc suggest taking 30mg twice daily or one 60mg capsule once daily?

 

Re: Cymbalta Samples-Question

Posted by caraher on August 25, 2004, at 12:45:31

In reply to Re: Cymbalta Samples-Question » Mr. Scott, posted by theo on August 25, 2004, at 11:46:37

FYI, in the study I'm in the instructions are such that if you got duloxetine the dose would be 60 mg every morning (they specifically ask that you NOT split the dose morning/evening even though the capsules are 30 mg)


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