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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 51 to 75 of 89. Go back in thread:
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
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?
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)
Posted by sarytyr on August 25, 2004, at 13:28:16
In reply to Re: Cymbalta Samples-Question, posted by caraher on August 25, 2004, at 12:45:31
I was wondering if any has information yet on anyone switching to Cymbalta from Effexor. I am currently taking 75mg Effexor XR in the evening and 300mg Wellbutrin in the A.M. While this combination in working very well for me, I read on the Lilly Home page states that studies are showing that Cymbalta may be an effective treatment for stress urinary incontinance as well. This is something that would really benefit me. Duloxetine hydrocloride (marketed under the name Yentreve) has already been approved for SUI in Europe. Maybe a switch to this medication could treat my depression and SUI. Any opinions?
Thanks, Sandy
Posted by owensmar on August 25, 2004, at 14:45:53
In reply to Re: Cymbalta Samples-Question, posted by SLS on August 25, 2004, at 7:05:38
Thanks, that makes sense. So you could take 20 bid =40 total or 30bid =60 total or just 60 hs.
Posted by owensmar on August 25, 2004, at 14:57:31
In reply to Question for SLS, posted by Mr. Scott on August 25, 2004, at 10:23:19
Give me somnolence over insomnia.
And give it to me now!
Marsha
Posted by owensmar on August 25, 2004, at 15:02:26
In reply to Any thoughts on moving to Cymbalta from Effexor?, posted by sarytyr on August 25, 2004, at 13:28:16
Sandi,
I'd say the biggest risk you'd be taking is changing a regimen that's working well. I was doing well on Effexor years ago then tried to get off because I thought something else might work better. It didn't. I went back on Effexor but that time did less well. So I tried something else. Even worse. Back to Effexor again. This time it worked even less well (but with the full complement of side effects.) Every time I've gone off and back on it has worked less well.
If Cymbalta turns out to be great for you, you'll win. But if not, getting back to your current good state might not be so easy.
Good luck,
Marsha
Posted by Mr. Scott on August 25, 2004, at 16:43:47
In reply to Re: Cymbalta Samples-Question » Mr. Scott, posted by theo on August 25, 2004, at 11:46:37
He said start at 30mg 1x daily, and move to 2x daily if I can tolerate.
I think the 60mg's are also there for BID dosing despite what the dosing literature suggests. However that is just my opinion... The FDA approval study showed no benefit above 60mg daily, but I'm sure some people will need 60mg BID or at least be prescribed it...
Mr.Scott
Posted by SLS on August 25, 2004, at 21:11:59
In reply to Question for SLS, posted by Mr. Scott on August 25, 2004, at 10:23:19
> Hey Scott,
>
> You mentioned Somnolence as a potential problem... At what dose this appear for you?
>
> Mr.Scott
I have been taking only 30mg. Somnolence appeared Sunday, Monday, and Tuesday. I slept 12 hours at night and another 4 hours during the day. I had no episodes of somnolence today, so it might be a transient startup side effect. I will be increasing to 60mg tonight. I'll report if the somnolence returns.Good luck!!!
- Scott
Posted by theo on August 26, 2004, at 7:24:25
In reply to Re: Question for SLS » Mr. Scott, posted by SLS on August 25, 2004, at 21:11:59
I'm going to see my pdoc today (my general doc was the one that gave me 60mg Cymbalta samples) and get her blessing before I start it.
A couple of questions, can you compare the initial strartup feeling of Cymbalta to any other med you've tried, Prozac, Paxil, Effexor XR etc? Also, do you know what dose of Cymbalta would equal 20mg Prozac, Paxil?
It seems like from past posts you said you are taking 150mg of Lamictal. Are you still at this dose? I've been lucky and have always been able to get effects from minimum doses of meds. My pdoc keeps pushing up my Lamictal but for me, at 150mg (8 days now) I've felt slothy and and extremely unmotivated with know desire to do anything. She wants me to go to 200mg and I'm fearful that will just increase these side effects. I'm mainly only taking it for an antidepressant. Would this be a sign to maybe drop back to 100mg? My pdoc is one that goes by the book and not by how the patient really is being effected by the meds. I wonder about psychiatrists sometimes.
Posted by SLS on August 26, 2004, at 8:39:17
In reply to Re: Question for SLS » SLS, posted by theo on August 26, 2004, at 7:24:25
Hi Theo.
> I'm going to see my pdoc today (my general doc was the one that gave me 60mg Cymbalta samples) and get her blessing before I start it.
That sounds like a good idea. At least you would still be working as a team, and you would feel more comfortable with whichever way the two of you choose to initiate treatment with Cymbalta.
> A couple of questions, can you compare the initial strartup feeling of Cymbalta to any other med you've tried, Prozac, Paxil, Effexor XR etc? Also, do you know what dose of Cymbalta would equal 20mg Prozac, Paxil?
I took 60mg yesteday after being at 30mg for a week. This stuff seems very clean so far. The only thing I notice is a slight bit of sleepiness, but this seems to be a very passing side effect.
> It seems like from past posts you said you are taking 150mg of Lamictal.
I keep bobbing up and down between 150mg and 300mg. I have been trying to stay at the lower dosages because higher dosages produce memory and cognitive impairments. Unfortunately, I need the higher dosages to afford me greater relief from depression. Even so, the improvement is mild at best. I don't know how to counsel you on the dosage of Lamictal you should take. If you raise the dosage of Lamictal while you are beginning treatment with Cymbalta, you might confuse the side effects of one for the other. You can always raise the dosage of Lamictal at a later time if you need to. Still, I wouldn't be afraid to try 200mg. Either do it before adding Cymbalta, or do it after establishing Cymbalta at 60mg.
Please let us know how things go with your doctor, and which direction you decide to go.
- Scott
Posted by theo on August 26, 2004, at 11:08:02
In reply to Re: Question for SLS, posted by SLS on August 26, 2004, at 8:39:17
I forgot one thing, when you went up to 60mg did you split your dose or take it all at once? If you took it 30mg BID, how far apart did you split the doses?
Posted by SLS on August 26, 2004, at 11:21:00
In reply to Re: Question for SLS » SLS, posted by theo on August 26, 2004, at 11:08:02
> I forgot one thing, when you went up to 60mg did you split your dose or take it all at once? If you took it 30mg BID, how far apart did you split the doses?
30mg b.i.d.
7:00am and 10:00pm
This drug feels pretty clean. I don't know if that's good or bad.
- Scott
Posted by theo on August 26, 2004, at 18:06:10
In reply to Re: Question for SLS » theo, posted by SLS on August 26, 2004, at 11:21:00
I saw my pdoc today and she told me to drop the Lamictal down from 150mg to 100mg. The only other med I'm taking is Keppra 250mg 3 times a day for anxiety.
In three weeks if I don't feel better, she wants me to drop the Lamictal completely and then add either Prozac or Cymbalta to the Keppra.
She's a big fan of Keppra for anxiety and I would have to agree it works on anxiety better than Lamictal for me. She also said the only reason she had me try Lamictal was for an antidepressant.
I was surprised at her response to Cymbalta. She said she wasn't to sure about it because meds that usually are well proven have much more positive feedback (psychiatric seminars, etc) before their release, if that makes any sense. She didn't say anything negative but just hasn't seen any overwhelming proven fact it will be superior over other SSRI's, SNRI's.
The good news is, we won't know till we try!
The Lilly rep said that 60mg was the minimum dose and they are just giving 30mg and 60mg samples out, which makes me wonder why they even mention 40mg (20 BID) in the prescribing info. Oh well.
All that being said, I won't add anything for a few weeks which should be enough time to get feedback from you and others at theraputic doses, so keep me posted.
Posted by theo on August 27, 2004, at 9:51:35
In reply to Re: Question for SLS, posted by SLS on August 26, 2004, at 8:39:17
How's the Cymbalta treating you? I have several friends that are doctors and they said even another rep from Lilly has said, start at 30mg ONCE DAILY and then to 60mg ONCE DAILY. The reps aren't even pitching BID dosing and saying 60mg ONCE DAILY is the minimum dose.
If 30mg BID isn't doing anything great, are you going to try 60mg in a single morning dose to see if a larger single dose works better?
Posted by SLS on August 27, 2004, at 9:58:18
In reply to Re: Question for SLS » SLS, posted by theo on August 27, 2004, at 9:51:35
Hi Theo.
> How's the Cymbalta treating you?
Nothing positive to report yet. Perhaps more important at this juncture is that there is nothing negative to report. No side effects after two days at 60mg.
> I have several friends that are doctors and they said even another rep from Lilly has said, start at 30mg ONCE DAILY
For one week?
> and then to 60mg ONCE DAILY. The reps aren't even pitching BID dosing and saying 60mg ONCE DAILY is the minimum dose.
>
> If 30mg BID isn't doing anything great, are you going to try 60mg in a single morning dose to see if a larger single dose works better?Actually, I would be more inclined to go to 80mg; 40mg b.i.d. I should probably give 60mg a full 3 weeks before making any decisions.
- Scott
Posted by theo on August 27, 2004, at 10:04:21
In reply to Re: Question for SLS » theo, posted by SLS on August 27, 2004, at 9:58:18
Yes, 30mg once daily for one week, then to 60mg once daily.
Posted by jparsell82` on August 27, 2004, at 21:05:34
In reply to Re: Question for SLS » SLS, posted by theo on August 27, 2004, at 10:04:21
Hi, could you give me the cost for a one month supply of Cymbalta? thanks
Posted by etoc on August 28, 2004, at 16:11:56
In reply to Re: Cymbalta Samples-Question-SLS, posted by theo on August 25, 2004, at 7:03:29
I am taking the 60mgs capsule. I empty about 1/2 to get somewhere near 30mgs (med sensitive). Like I said in a new post, it sort of feels like Effexor --to early to tell.
For the guys, So far, I didnt have a problem having an orgasm/erection, which is a major selling point. We'll see as I up my dose to 60mgs.
Posted by theo on August 28, 2004, at 16:47:39
In reply to Re: Cymbalta Samples-Question-SLS, posted by etoc on August 28, 2004, at 16:11:56
When you go up to 60mg are you taking it once daily in the AM?
Posted by Cecilia on August 29, 2004, at 0:34:12
In reply to Re: Cymbalta Samples-Question-SLS, posted by etoc on August 28, 2004, at 16:11:56
Cymbalta is enteric coated, so should not be opened up or cut in half. I wish it weren`t as I`m also very med-sensitive. I`m planning to ask my doctor to start me on the 20 mg capsules, but wish it came in smaller doses. I was sick as a dog on less than 25 mg of effexor. Cecilia
Posted by nmk on August 29, 2004, at 16:02:45
In reply to Cymbalta at Walgreens Pharmacies, posted by Mr. Scott on August 17, 2004, at 20:55:31
Hi All,
I just started my first 30mg dose of Cymbalta yesterday and am having a difficult go of it. I have felt dizzy, "spacey", and have noticed an increase in my anxiety and agitation. To top things off, I was only able to sleep 3 hours last night.
I am frightened because these are the same s/e's I was having on Effexor a few years back and had to discontinue after 2 months. The withdrawal, as you all know, was pure hell.
I know it has only been two days but my gut is telling me that this is going to be similar to my effexor experience and I am scared to death. I have a call in to my pdoc but as usual, no return call.
Can anyone offer some insight? Does a NE reuptake inhibitor have a tendency to increase anxiety and agitation in some?
I really want to go back to my zoloft, even though it helps some of the time.
Please help. Thanks so much.
Nicole
Posted by sndg311 on August 29, 2004, at 19:29:10
In reply to Just started cymblata yesterday-PLEASE HELP!!, posted by nmk on August 29, 2004, at 16:02:45
I am on my third day and am thinking of changing the dose to a morning start.2nd day I felt more depressed then the first but today it seems like things are starting to even out. Try and make it the full week and then decide if you need to try something else. A wonder drug for me in the past was .025 of risperdal at bedtime but Im waiting to see if my mood starts to swing before adding it to cymbalta. Hang in there and keep me updated.
Posted by poop'd-out on August 29, 2004, at 23:55:38
In reply to Just started cymblata yesterday-PLEASE HELP!!, posted by nmk on August 29, 2004, at 16:02:45
> Hi All,
>
> I just started my first 30mg dose of Cymbalta yesterday and am having a difficult go of it. I have felt dizzy, "spacey", and have noticed an increase in my anxiety and agitation. To top things off, I was only able to sleep 3 hours last night.
>
> I am frightened because these are the same s/e's I was having on Effexor a few years back and had to discontinue after 2 months. The withdrawal, as you all know, was pure hell.
>
> I know it has only been two days but my gut is telling me that this is going to be similar to my effexor experience and I am scared to death. I have a call in to my pdoc but as usual, no return call.
>
> Can anyone offer some insight? Does a NE reuptake inhibitor have a tendency to increase anxiety and agitation in some?
>
> I really want to go back to my zoloft, even though it helps some of the time.
>
> Please help. Thanks so much.
>
> NicoleNicole,
I took Effexor years ago and only stayed on it for about a week because of the anxiety and agitation. I was hoping Cymbalta might be different. I don't know about the NE factor but I believe it might cause anxiety/irritation in certain individuals. At least that has been my experience. Hopefully, the cymbalta will even itself out after a while. Don't quit just yet! Keep me up to date because it sounds like we have similar reactions to meds.
Hang in there. = )
Beth
Posted by nmk on August 30, 2004, at 11:34:28
In reply to Re: Just started cymblata yesterday-PLEASE HELP!!, posted by sndg311 on August 29, 2004, at 19:29:10
> I am on my third day and am thinking of changing the dose to a morning start.2nd day I felt more depressed then the first but today it seems like things are starting to even out. Try and make it the full week and then decide if you need to try something else. A wonder drug for me in the past was .025 of risperdal at bedtime but Im waiting to see if my mood starts to swing before adding it to cymbalta. Hang in there and keep me updated.
Thanks. I don't know if I can do this another day. It is day 3 and I just don't feel right. The increase in anxiety and agitation has not let up and I am thinking of discontinuing. My pdoc hasn't called me back yet. Please keep me updated and let me know how you are doing on it. I want to see if these s/e's go away completly after time. Also, are you having any sleep disturbances on it?Nicole
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