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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by steve12 on September 8, 2004, at 19:07:20
I'd appreciate feedback from people who have been on Cymbalta for more than 20 days. I posted this elsewhere, but think it may have gotten lost:
I've been on Cymbalta for 25 days now (18 days at 60 mgs) this is what I've observed:
1. I felt better about 10 days after I began taking it;
2. I have lost weight -- my appetite is suppressed (good thing ;)
3. Anxiety is under controlBUT:
4. Definately has sexual side effects -- the same as all the other SSRI/SNRI's
5. I sweat a lot -- I mean a lot!I think I'll ask my doc to lower the does to 40 mgs. The research litature has Cymbalta used for MDD between 20-160 mgs! AND, if you look at the offical prescribing info, Lilly has a table which seems to imply that Cymbalta is low in sexual side effects, but it does not mention the dose used!
Have others experienced these effects? Initially, there were few sexual side effects, but within the past week they have returned. The sweating is problematic and I'm wondering if others have experiencd this. Thanks!
Posted by Bob on September 8, 2004, at 21:38:25
In reply to Cymbalta folks who have been on it 20 days, posted by steve12 on September 8, 2004, at 19:07:20
I have not tried Cymbalta, but your report of sexual side effects does not suprise me in the least. I would also not be suprised if people on Cymbalta gain weight in the long term. You've gotta remember that the drug companies do everything in their power to make their drug look good so that it will get approval. They keep studies short, and only publicize favorable results. That is why there is movements underway to develop a federally sponsored registry which would keep track of all studies. In that way, all info would be published, good or bad. Until then, it is the way it is.
There is no reason to expect profound new developments with this drug, as the basic chemistry is not novel. It uses, as one of it's mechanisms of action, SRI action. This has always, without exception, caused sexual side effects.
The fact that the Cymbalta compound is not identical to others in its class offers at least the hope that one would respond slightly differently to it. In the end, freedom will not be found until new avenues are explored.
I am sorry to hear about the side effects you are having. I am very, very familiar with the sweating and sexual side effects, as I've gotten them on most drugs I've taken. Hopefully they will diminish for you in time. It seems to me like the anticholinergic effects of Cymbalta may be somewhat high.
Posted by steve12 on September 9, 2004, at 15:18:30
In reply to Re: Cymbalta folks who have been on it 20 days » steve12, posted by Bob on September 8, 2004, at 21:38:25
Well yes and no. Cymbalta has a 1:1 ratio for 5HT and NE whereas venlafaxine doesn't. However, it seems that most re-uptake inhibtors of 5HT will produce sexual side-effects. The problem with the national registery is that it does nothing to solve the problem that the drug companies sponsor most of the studies and given huge incentives to docs and medical centers to find "good correlations" All research in psychiatry, in my opinion, is untrustworthy since all of the journals are heavily supported with drug money, as well as the docs and the medical centers. If Lilly sponsored all of the studies, paid honorarims for MD's to "educate" themselves about Cymbalta and gives out free samples -- then how do we know that anyone has an objective viewpoint in eval this drug (the FDA? Ha!) It's a disgrace.
> I have not tried Cymbalta, but your report of sexual side effects does not suprise me in the least. I would also not be suprised if people on Cymbalta gain weight in the long term. You've gotta remember that the drug companies do everything in their power to make their drug look good so that it will get approval. They keep studies short, and only publicize favorable results. That is why there is movements underway to develop a federally sponsored registry which would keep track of all studies. In that way, all info would be published, good or bad. Until then, it is the way it is.
>
> There is no reason to expect profound new developments with this drug, as the basic chemistry is not novel. It uses, as one of it's mechanisms of action, SRI action. This has always, without exception, caused sexual side effects.
>
> The fact that the Cymbalta compound is not identical to others in its class offers at least the hope that one would respond slightly differently to it. In the end, freedom will not be found until new avenues are explored.
>
> I am sorry to hear about the side effects you are having. I am very, very familiar with the sweating and sexual side effects, as I've gotten them on most drugs I've taken. Hopefully they will diminish for you in time. It seems to me like the anticholinergic effects of Cymbalta may be somewhat high.
>
>
>
>
Posted by Racer on September 9, 2004, at 16:06:50
In reply to Cymbalta folks who have been on it 20 days, posted by steve12 on September 8, 2004, at 19:07:20
I'm not at 20 days yet, and have had no interest or energy to check on the sexual side effects, but the sweating was really horrendous for the first week or so! It seems to be fading now, for me, though. We're in the middle of a pretty significant heat wave here, in California (Silicon Valley), and I'm a bit sweaty at times, but the soaking, chilly sweats are gone.
I've been having night sweats, still, but again: we've got western exposure on our HUGE windows, we're having a heat wave, and someone who doesn't always think about these things turns the A/C to 80 at night. And, even with that, the night sweats aren't nearly as bad as they were.
I guess I'll have to check the sexual side effects. On Effexor, I found cyproheptidine to work just fine for mitigating them, by the way. Have you tried it? I know it doesn't help for everyone, but it was a BLAST for me.
Posted by Racer on September 9, 2004, at 17:12:22
In reply to Cymbalta folks who have been on it 20 days, posted by steve12 on September 8, 2004, at 19:07:20
Yep. Sexual side effects here, too. (No doubt in combination with lack of motivation and interest and energy...)
{{sigh}} Not quite worth asking for cyproheptidine yet, since the drug isn't helping much otherwise yet, and since I don't feel any real interest in the activity for which it would be used...
Posted by steve12 on September 9, 2004, at 17:27:34
In reply to Re: Cymbalta folks who have been on it 20 days, posted by Racer on September 9, 2004, at 16:06:50
cyproheptidine? never heard of it. More info please!
> I'm not at 20 days yet, and have had no interest or energy to check on the sexual side effects, but the sweating was really horrendous for the first week or so! It seems to be fading now, for me, though. We're in the middle of a pretty significant heat wave here, in California (Silicon Valley), and I'm a bit sweaty at times, but the soaking, chilly sweats are gone.
>
> I've been having night sweats, still, but again: we've got western exposure on our HUGE windows, we're having a heat wave, and someone who doesn't always think about these things turns the A/C to 80 at night. And, even with that, the night sweats aren't nearly as bad as they were.
>
> I guess I'll have to check the sexual side effects. On Effexor, I found cyproheptidine to work just fine for mitigating them, by the way. Have you tried it? I know it doesn't help for everyone, but it was a BLAST for me.
Posted by Racer on September 9, 2004, at 17:42:08
In reply to Re: Cymbalta folks who have been on it 20 days, posted by steve12 on September 9, 2004, at 17:27:34
It's an old anti-histimine that isn't used for that anymore. The usual AH effects, but it does help with being able to sleep after an exciting event. For me, the cool effects lasted just long enough before it made me sleepy.
It's one of the drugs suggested to mitigate SSRI sexual side effects, although it doesn't work for everyone. The biggest benefits for me were the cost -- since I was uninsured, and it's way long off patent -- and the fact that it's a pretty clean mitigating agent. Since it's been around forever, and been used for a million things, there aren't a lot of surprises with it.
Aside from all that, one additional factor interested me: it's been studied as a treatment for Cushing's Disease in animals. Since there's so much literature now about the HPA axis and depression, and the HPA axis is what's out of whack in Cushing's, it made sense that it might be a useful augmenting agent. (In fact, I've come across references to it being used as an anti-depressant on its own, although that was back when dirt was new.)
Hope that helps. (Oh, and the brand name I know is Periactin.)
Posted by steve12 on September 9, 2004, at 18:25:52
In reply to Cyproheptidine » steve12, posted by Racer on September 9, 2004, at 17:42:08
Thanks -- but I looked it up and noticed that it causes weight gain! I do think, however, that future treatments of depression will focus on the HPA -- but that's still 10 years away.
> It's an old anti-histimine that isn't used for that anymore. The usual AH effects, but it does help with being able to sleep after an exciting event. For me, the cool effects lasted just long enough before it made me sleepy.
>
> It's one of the drugs suggested to mitigate SSRI sexual side effects, although it doesn't work for everyone. The biggest benefits for me were the cost -- since I was uninsured, and it's way long off patent -- and the fact that it's a pretty clean mitigating agent. Since it's been around forever, and been used for a million things, there aren't a lot of surprises with it.
>
> Aside from all that, one additional factor interested me: it's been studied as a treatment for Cushing's Disease in animals. Since there's so much literature now about the HPA axis and depression, and the HPA axis is what's out of whack in Cushing's, it made sense that it might be a useful augmenting agent. (In fact, I've come across references to it being used as an anti-depressant on its own, although that was back when dirt was new.)
>
> Hope that helps. (Oh, and the brand name I know is Periactin.)
Posted by 4WD on September 9, 2004, at 20:39:33
In reply to Cyproheptidine » steve12, posted by Racer on September 9, 2004, at 17:42:08
Racer
Is Periatin OTC or do you have to have a prescription? You said it isn't used anymore?
Posted by Racer on September 9, 2004, at 20:59:47
In reply to Re: Cyproheptidine, posted by steve12 on September 9, 2004, at 18:25:52
Yes, it can cause weight gain -- if you take it regularly. (That's often one of its uses, as it happens. Increasing appetite is a side effect.)
The thing about cyproheptidine and the sexual side effects is that you only take it when you want to -- you know. If it's going to work for you, it'll work in about 20 to 30 minutes, and the effects will be gone in the morning. (Or after a number of hours, if you take it at other times of the day.) It's like viagra, in that you won't have the same level of sponteneity, but it's also like viagra in that it's PRN.
There are other things I've heard of to help, but they're all more expensive or more bothersome. Some citations are: wellbutrin to counteract it, "medication holidays" so that you can plan a couple of days during which you can -- you know, viagra -- although, how that would help I can't imagine, and I believe I recently read about another, but I can't remember.
Hope that helps.
Posted by Racer on September 9, 2004, at 21:03:35
In reply to Re: Cyproheptidine » Racer, posted by 4WD on September 9, 2004, at 20:39:33
I said it isn't used as an anti-histimine anymore. That's because the newer drugs are more popular, especially those that don't cause drowsiness. Periactin is used for a number of other things, like mitigating the sexual side effects of SSRIs, increasing appetite for patients with cancer or AIDS, and in a lot of veterinary situations.
It's prescription only, not OTC. But, since it's a pretty benign drug, most doctors will go ahead and give it a try if you ask for it. (Although, I'd expect that they'd try to steer you to another choice if you actually wanted it as an anti-histimine.)
Posted by 4WD on September 9, 2004, at 21:08:32
In reply to Re: Cyproheptidine » 4WD, posted by Racer on September 9, 2004, at 21:03:35
Posted by Sad Panda on September 10, 2004, at 11:22:36
In reply to Cyproheptidine » steve12, posted by Racer on September 9, 2004, at 17:42:08
Cyproheptadine stops night sweats caused by SRI's too.
Cheers,
Paul.
Posted by Racer on September 10, 2004, at 19:49:48
In reply to Re: Cyproheptidine » Racer, posted by Sad Panda on September 10, 2004, at 11:22:36
This is the end of the thread.
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