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Dr. Bob is Robert Hsiung, MD,
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Posted by jerrympls on September 22, 2004, at 17:43:21
In reply to Re: Dr. Ivan Goldberg » iris2, posted by SLS on September 20, 2004, at 7:32:56
> Hi Irene.
>
> > I saw you mentioned this doctors name. I had called his office for an appointment once and left a message. I have had difficulty finding a new pdoc in Pittsburgh. What do you think of going to him as my pdoc? I have not inquired as to the cost yet. Do you have any idea?
>
> I can't remember exactly how much he charges for an initial visit or consultation, but I know it is at least $500. He is particularly interested in treatment-resistant bipolar disorder. I really can't comment on the quality of his administration since I have never seen him. He seems to be a very compassionate man.
>
> Isn't Western Psychiatric (University of Pittsburg) out there? I can't imagine that you couldn't at least get a referral from them. Dr. Kupfer is one of the best out there.
>
>
> - ScottI've emailed Dr. Goldberg many times and he has always replied. He's a very compassionate man and is very committed to his work and to helping people. However, I don't know anyting about how much it costs to get an appointment with him.
Jerry
Posted by theo on September 22, 2004, at 18:02:39
In reply to Re: Cymbalta (duloxetine) - report, posted by Pristine on September 22, 2004, at 12:55:16
After stopping Cymbalta did you have any discontinuation side effects?
Posted by SLS on September 22, 2004, at 18:04:29
In reply to Re: Cymbalta (duloxetine) - report, posted by quarterwit on September 22, 2004, at 16:45:07
Hi.
> BTW, was Parnate your last AD before Cymbalta? If so, how long did you wait after flushing Parnate to start the new one? I know the guideline is 2 weeks, as always. Thanks
The last antidepressant that I was taking before Cymbalta was imipramine. I pretty much crossed-over immediately. I'm sure you know that the traditional waiting period between discontinuing an MAOI and beginning a SRI (serotonin reuptake inhibitor) drug like Cymbalta is two weeks. It takes time for the body to manufacture enough MAO enzymes to replace what has been irreversibly disabled by Parnate. I have heard of some doctors allowing their patients to begin a new drug after waiting only 7-10 days from the last dose of an MAOI. I personally have alway respected the two week recommendation. I guess I'm just a prude.
- Scott
Posted by SLS on September 23, 2004, at 6:51:09
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 20, 2004, at 9:44:43
9/23/2004
Day 35
6 days at 30mg
29 days at 60mg60mg (30mg b.i.d.)
I am not feeling the same "magic" I did a few days ago, but I remain improved. I am not discouraged in the least. Recovery is rarely uniform. Two steps forward and one step back. I can't wait to feel the magic again. It was great.
I remain virtually without side effects. I think my libido is somewhat better than it has been over the last two weeks. I still attribute the ebb to Cymbalta. It's return might be a consequence of an improvement in depression.
- Scott
Posted by theo on September 23, 2004, at 6:58:38
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 23, 2004, at 6:51:09
What is the "ebb"?
Posted by SLS on September 23, 2004, at 8:16:34
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by theo on September 23, 2004, at 6:58:38
> What is the "ebb"?
By "ebb", I was referring to that period of time when my sex drive was at its lowest. That was one to two weeks ago. I am pretty sure that this was the result of taking Cymbalta.
- Scott
Posted by apenname on September 23, 2004, at 14:13:51
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 23, 2004, at 8:16:34
I've read through the thread, thanks Scott and others for sharing their experiences.
I'm waiting to take Cymbalta once I find a psychiatrist (recent move). I'll be the most comfortable doing the switch once I'm under a doctor's care.I'm on Effexor XR at 225mg, it's not enough for me, and hasn't been for the last 3 years, but higher doses, while they make the depression go from low or medium-level to gone, makes my blood pressure rise. I'm hoping the Cymbalta works.
I've tried Zoloft, Lexapro, and Wellbutrin with no luck.
My regular doctor told me that Cymbalta was just approved for treatment of diabetic neuropathy. Interesting.
Posted by Pristine on September 23, 2004, at 14:51:27
In reply to Re: Cymbalta (duloxetine) - report » Pristine, posted by theo on September 22, 2004, at 18:02:39
> I had none. After stopping Cymbalta did you have any discontinuation side effects?
Posted by SLS on September 26, 2004, at 14:10:00
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 23, 2004, at 6:51:09
9/23/2004
Day 38
6 days at 30mg
32 days at 60mg60mg (30mg b.i.d.)
I'm not doing too well. Darn it. I haven't lost hope, though. I'm still looking forward to my next two steps up. Unfortunately, my last two steps were back.
:-(
Darn it.
We'll see.
:-)
- Scott
Posted by paltiel on September 26, 2004, at 21:23:16
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 26, 2004, at 14:10:00
Scott -
Have you and your pdoc looked at your other meds? Maybe a little less mood stabilizer will give your Cymbalta a little more space without too much risk of mania. Or higher dose Cymbalta? Just a thought...
Watching you and seeing the help you've given others - I hope you get the help you need to make this work for you.
Posted by SLS on September 27, 2004, at 0:17:00
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by paltiel on September 26, 2004, at 21:23:16
> Scott -
>
> Have you and your pdoc looked at your other meds? Maybe a little less mood stabilizer will give your Cymbalta a little more space without too much risk of mania. Or higher dose Cymbalta? Just a thought...I see my doctor tomorrow. I will bring up both of your ideas.
> Watching you and seeing the help you've given others - I hope you get the help you need to make this work for you.Thanks!
:-)
- Scott
Posted by iris2 on September 27, 2004, at 11:04:17
In reply to Re: Cymbalta (duloxetine) - report - Thanks! » paltiel, posted by SLS on September 27, 2004, at 0:17:00
> > Watching you and seeing the help you've given others - I hope you get the help you need to make this work for you.
>
> Thanks!
>
> :-)
>
> Scott,I want to reiterate what this poster has said. Watching you and all that you give both to others, sharing your own personal medical and diagnostic profile, answering our unending questions your great personality is wonderful:)
You are truly a treasure. I hope so much that you find a solution to your problems either in the Cymbalta or something else very soon. I selfishly wish that even when you are all "fixed" you will continue to so unselfishly give of yourself on this board. You are invaluable here and not replaceable. We appreciate you. I hope you know this and feel good about it:):)
Many hugs,(don't know the symbol for hugs)
irene
Posted by SLS on September 28, 2004, at 9:21:34
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by paltiel on September 26, 2004, at 21:23:16
> > Have you and your pdoc looked at your other meds? Maybe a little less mood stabilizer will give your Cymbalta a little more space without too much risk of mania. Or higher dose Cymbalta? Just a thought...
> I see my doctor tomorrow. I will bring up both of your ideas.
Well, I saw the doctor and brought up both of your suggestions. He opted to leave the dosage of Cymbalta at 60mg per day and asked that I raise the Lamictal from 150mg to 225mg. I really don't like the idea because I experience cognitive impairments at that dosage, but I guess I can't afford to leave any stone unturned.Crap.
- Scott
Posted by alesta on September 28, 2004, at 12:16:40
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 26, 2004, at 14:10:00
Hi, Scott,:)
How are you doing today? I agree with the other posters; you’ve helped so many people! :-) and I recently read a past thread where you posted and was touched by your compassion and insight concerning the multitude of degrees of suffering. it was a haunting read..
I read some info concerning treating treatment-resistant depression recently, and I wanted to share it with you. there’s a new discovery indicating that treatment-resistant depressives actually have a dysfunction in the brain (rather than just temporary chemical level abnormalities or whatever of “normal” depressed people, I suppose), which is why they don’t respond to medications. And so now they’re taking this new finding and are going to try and develop an antidepressant specifically for treatment-resistant depressives! http://www.eurekalert.org/pub_releases/2003-10/pg-rbi093003.php This is so exciting! So there’s new hope on the horizon. http://www.eurekalert.org/pub_releases/2003-10/pg-rbi093003.
I also read an article that mentioned a *very* high dose of parnate as being an efficacious option for treatment-resistant depressives (people who don’t respond well to meds for depression). this makes sense--parnate hits more neurotransmitters than most, and then raising the dose way above normal in order to get a response is a great idea, and would be a fantastic way to get as much neurotransmitter action as possible. Here is the web site. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2710808&dopt=Abstract.
I see that your doc decided to raise your lamictal dosage. I think that’s a good idea, rather than raising your cymbalta dosage..lamictal sounds like a great antidepressant! I looked up some ratings for it a while ago, and it had rave reviews; there was no mention of cognitive problems. Is this a rare side effect? Anyway, also, I think a very high dosage of cymbalta could potentially be very difficult to withdraw from.
Also there’s some success of treatment with electromagnetic stimulation. http://www.pslgroup.com/dg/fe446.htm So that’s an option...
Oh, (you’re going to be bored by the end of this post :)) I also read that some ppl w/ treatment-resist. dep. could have food allergies. See: http://www.consciouschoice.com/issues/cc1211/foodallergies1211.html) I’m not saying you do..it’s just a possibility..and, also, aspartame causes depression and should be avoided. I hope some of this information might be helpful. I tried, anyway!..;)keep that chin up, chico!:)
Take care, Scott
Amy:)
Posted by SLS on September 28, 2004, at 16:19:47
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by alesta on September 28, 2004, at 12:16:40
Posted by SLS on September 29, 2004, at 7:53:51
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 26, 2004, at 14:10:00
9/29/2004
Day 41
6 days at 30mg
35 days at 60mg60mg (30mg b.i.d.)
Losing hope. I don't feel much better than I did when I was taking imipramine. Maybe a little? It has been 10 days since I experienced my last period of improvement.
Overall, Cymbalta feels cleaner than Effexor with regard to tolerability.
I want to thank everyone for their generous support and warm sentiments.
- Scott
Posted by flipsactown on September 29, 2004, at 8:02:33
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 29, 2004, at 7:53:51
I know you can hang in there Scott. It took 45 days for Lexapro to kick in for me, so perhaps Cymbalta will be kicking in soon for you. We are all with you, my friend.
FST
> 9/29/2004
>
> Day 41
>
> 6 days at 30mg
> 35 days at 60mg
>
> 60mg (30mg b.i.d.)
>
> Losing hope. I don't feel much better than I did when I was taking imipramine. Maybe a little? It has been 10 days since I experienced my last period of improvement.
>
> Overall, Cymbalta feels cleaner than Effexor with regard to tolerability.
>
> I want to thank everyone for their generous support and warm sentiments.
>
>
> - Scott
>
>
Posted by silversea69 on October 1, 2004, at 1:16:32
In reply to Re: Cymbalta (duloxetine) - report » nmk, posted by SLS on August 31, 2004, at 12:00:07
I have just started on Cymbalta 09/28/2004 at 9:00PM EST. By 10:30, I started to feel manic and needed to do to get up from the computer and I cleaned my kitchen and did dishes, which seemed to take care of it. 11:30PM my heart started racing and I found it hard to catch my breath. I went outside to go for a walk as it is a cool night and that usually calms me. I walked about 2 blocks and it felt as though someone was sitting on my chest! I returned home and it went away. My doctor told me to take this at night since it would cause drowsiness, well it has had the opposite effect on me. Around Midnight, my stomach started to hurt.
Posted by Wanderer on October 1, 2004, at 21:57:11
In reply to Re: Cymbalta (duloxetine) - report - Thanks! » SLS, posted by iris2 on September 27, 2004, at 11:04:17
Hi --
Dr prescribed this today but am hesitant to start as I normally have 2-3 glasses of wine with dinner several nights a week. Is this going to be a liver damage risk? The pamphlet says if you have heavy alcohol use you can have severe liver damage.
Thanks for your help!
Posted by iris2 on October 1, 2004, at 23:41:55
In reply to Cymbalta and Alcohol, posted by Wanderer on October 1, 2004, at 21:57:11
I would go with what the insert says. I read Cymbalta has a drug interaction with alcohol. Even if it were not, several drinks a day is going to have an effect on your liver. Your liver has to clean these toxins from your blood. In addition it will be more difficult for you to judge whether the medication is having a positive affect for you if you have alcohol in your system and the medication is being affected by that. It is to your benefit to stop or taper your drinking if only to evaluate the effects of the medication and to take advantage of them if they are positive. Drinking can and will only get in the way. I am not just preaching. I really mean it.
I started Parnate years ago and it was a life changing medication for me. Unfortunately at the time I was drinking some but smoking cocaine. I stoppped both and was able to take advantage of the wonderfull effects the Parnate had lifting my depression. I am not advocating abstonance. Conventional wisdom tells us that one glass of red wine a day is supposed to be benefitial to us.
I am not sure in your case how that would effect you when mixed with the Cymbalta.
My opinion from a lot of experience.
irene
Posted by jeopardy on October 2, 2004, at 11:38:01
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on September 29, 2004, at 7:53:51
SLS, What time of day do you take your second dose of Cymbalta?
Thanks, Jeopardy
Posted by SLS on October 2, 2004, at 11:58:13
In reply to Re: Cymbalta (duloxetine) - report, posted by jeopardy on October 2, 2004, at 11:38:01
> SLS, What time of day do you take your second dose of Cymbalta?
> Thanks, JeopardyI take my first dose of 30mg at 7:00am and my second dose at around 11:00pm.
- Scott
Posted by jeopardy on October 2, 2004, at 12:15:57
In reply to Re: Cymbalta (duloxetine) - report, posted by SLS on October 2, 2004, at 11:58:13
Scott, You've never had a problem with inteference with sleeping? I haven't decided when to take my 2nd dose...but bedtime would be perfect. Do you know if others, with your relationship on this board, take the second dose around the same time?
Jeopardy
Posted by cache-monkey on October 2, 2004, at 12:19:25
In reply to Cymbalta and Alcohol, posted by Wanderer on October 1, 2004, at 21:57:27
<<< Dr prescribed this today but am hesitant to start as I normally have 2-3 glasses of wine with dinner several nights a week. Is this going to be a liver damage risk? The pamphlet says if you have heavy alcohol use you can have severe liver damage. <<<
I'm not sure about the risk of liver damage with that amount of alcohol. But, I worry about the consequences for your mental health.
Alcohol is a depressant. The effect isn't immediate, rather it cumulates over time. You're going on Cymbalta for depression, I assume. I would imagine that whatever you're going through, the alcohol is probably lowering the valleys.
I used to drink about that, a little less. Maybe I'm just sensitive, but I've cut back lately to a drink every couple days and I've noticed the difference. Also, at least for me, I think that drinking when on an antidepressant can make hangovers worse; make the valleys even lower.
Anyway, just my two cents.
Take care,
cache-monkey
Posted by theo on October 3, 2004, at 7:51:55
In reply to Cymbalta and Alcohol, posted by Wanderer on October 1, 2004, at 21:57:11
Just a little input. I single, 40 and use to have my own business and huge parties. I've drank since I was 18 and finally stopped at age 39 in 2003. I started taking antidepressants around 1991-92.
After stopping drinking, antidepressants are so much better. I think taking these meds while drinking made my depression worse.
I used to read info like this in huge denial and think "whatever," but it does make a huge difference if you don't drink with these meds.
I'm sure it's exactly what you don't want to hear, but if you don't drink for at least 2 months, you should be able to tell a difference and then you can make a decision for yourself on the difference.
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