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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by frombe on October 22, 2004, at 2:57:45
I'm in my late 20's and was just diagnosed with serious clinical depression. Shoot, I didn't even think I was depressed. The doc has me on 30mg of lexapro per day and now wants to move to the 60mg Cymbalta b/c he feels I am not responding to the lexapro. I can't really disagree with him b/c I don't feel any different. The question in my mind is this. Lilly has nothing but good press on their product as well as webmd, who's major sponsor is Lilly. Crazymeds.org? How can you trust a site with a name like that? All I hear are bad things about it on news groups. Now I'm freaked out that I’m going to lose my mojo, sleep all day, and freak out when I'm awake. I don't personally know anyone who has taken it but I trust my doctor not to screw me over. What is really the deal? Are there others out there who have had good experiences with the drug? Where can I get non-biased information?
Thanks,
Frombe
Posted by jboud24 on October 22, 2004, at 6:16:49
In reply to Cymbalta - looking for information, posted by frombe on October 22, 2004, at 2:57:45
The real deal? I'm not sure anyone knows that. I can tell you though that IMHO Cymbalta is the best of the new anti-depressants out there including Zoloft, Prozac, Paxil, Celexa, Lexapro, and Effexor. I wouldn't be affraid to give it a shot. I've never taken it personally, but people who are SSRI non-responders often do well with SNRI's like Cymbalta. There are also the MAOI's if the Cymbalta fails. Lexapro and Celexa helped my depression, but did zip for my anxiety.
I wish you luck with whatever route you decide to take,
Justin
Posted by golfgirl74 on October 22, 2004, at 8:38:49
In reply to Re: Cymbalta - looking for information, posted by jboud24 on October 22, 2004, at 6:16:49
I too was only recently diagnosed. Cymbalta is the first med I've ever taken. It's been about a week and a half and it's worked a miracle on me. My anxiety is gone and I'm not depressed anymore.
Posted by Racer on October 22, 2004, at 11:00:01
In reply to Cymbalta - looking for information, posted by frombe on October 22, 2004, at 2:57:45
First of all, you're absolutely right to be skeptical about the various websites out there. Congratulations for being much more sophisticated than many people, and for using your critical reasoning skills. Those are things that really matter to me.
This site, too, has a bias, since many of us are here because we've had a hard time finding a medication that works for us. Many of us are seriously treatment resistant, which skews the results a good deal.
Now on to your question:
Lexapro is a selective serotonin reuptake inhibitor. That means that it stops serotonin from being reabsorbed once its delivered its message to a receptor at a synapse. So, you have more serotonin floating around in your synapses, in both your brain and your digestive tract.
Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor. Now you've got more norepinephrine to keep that serotonin company in the synapses. For many people, the addition of norepinephrine will make a huge difference in response to a medication. Serotonin alone is not the philosopher's stone of depression treatment, but most of the SSRIs are selective enough that it would have to be for them to work for everyone.
The oldest antidepressants, the MAOIs and the tricyclics, were not selective, and they hit all the monoamines: serotonin, norepinephrine, and dopamine. (I think some of them affected other chemicals, too, but am pretty ignorant about these things.) Those drugs worked pretty darn well for most of the people who took them, but they came with a pretty high price in terms of side effects. Some of them have a pretty narrow therapeutic window, with dangers like cardiotoxicity once you exceed the top of the range; others, like MAOIs, require major adjustments to lifestyle and diet to avoid serious adverse effects; and most had side effects like dry mouth, constipation, and weight gain. The newer drugs are more or less equally effective, statistically, but have far fewer and more benign side effects.
Cymbalta, which I've been taking for the past two months, is probably the most benign of the antidepressants I've taken personally, although I've been having two problems with it. I'm on a high dose, 90mgs, and I've had trouble with antidepressants of all sorts in the past. At the high dose I'm on, I'm tired all the time, not sleeping well, and it's not doing much for my depression. That's me, and it's similar to what I experienced on a very similar drug, Effexor. Of the two, Cymbalta is a much, much smoother ride than Effexor was for me: none of the major adjustment effects that I had with Effexor at first. I strongly suspect that it's a very good antidepressant, even if it's not working very well for me.
One benefit of Cymbalta, by the way, is the fact that it was held up in the approval process at the FDA for an extended period while the whole "SSRI-suicide" stuff was being reviewed. That means that it's been studied in a lot more depth and breadth than most. Some of the studies were for extended periods, which is very unusual for antidepressants, and it means that there are very few surprises to it. Also, it is good for chronic pain -- I can attest to that, since my arthritis is much less bothersome than usual at this time of year.
So, for what it's worth, I think Cymbalta is a good choice for a trial. Give it a go, and see what happens. You may find that it'll give you a good ride, and you may find that you're much more aware of depression once it lifts! Good luck, and be well.
Posted by yznhymer on October 22, 2004, at 11:23:18
In reply to Cymbalta - looking for information, posted by frombe on October 22, 2004, at 2:57:45
I'll keep it short. Cymbalta didn't work out for me because of the side effects... I reacted pretty much the way I do to SSRIs. That said, I think its definitely worth a trial. From my reading here, quite a few seem to be doing well with it and many don't experience the side effects. Good luck!
M
Posted by boomarang on October 22, 2004, at 11:24:33
In reply to Re: Cymbalta - looking for information » frombe, posted by Racer on October 22, 2004, at 11:00:01
hi racer,
so are you going to stick with cymbalta for awhile more even tho you don't see a lot of a/d response? if not, what are your next thoughts?
Posted by Cecilia on October 23, 2004, at 2:56:31
In reply to Cymbalta - looking for information, posted by frombe on October 22, 2004, at 2:57:45
Just my opinion-if the only other AD you`ve tried is Lexapro, I wouldn`t try Cymbalta until you`ve tried a few of the drugs that have been around longer. It`s brand new-who knows what rare side effects are going to show up that didn`t show up in the clinical trials. I`ve tried practically everything and for me it had terrible side effects. But everyone is different. Cecilia
Posted by Racer on October 23, 2004, at 12:25:43
In reply to Re: Cymbalta - looking for information » Racer, posted by boomarang on October 22, 2004, at 11:24:33
Well, I called the doctor, who doesn't want me to start tapering down on it until we've had a chance to talk about it. I'm not best pleased by that, since I'm pretty miserable right now. It's not the drug making me miserable, more that the combination of amotivation and lethargy are preventing me from getting anything useful done, which increases my depression and hopelessness.
When we started the Cymbalta, it was one of three choices offered me: Cymbalta, Luvox, and Wellbutrin. Since Wellbutrin seemed to be starting to help me when I was on it briefly last year, that's what I'm hoping we'll try next. I don't know if we'll switch to it, or add it to a lower dose of Cymbalta. I know that this new doctor doesn't like mixing meds, and respect that, so I'm guessing it'll be a straight switch. If Wellbutrin doesn't work on its own, I will suggest adding a lower dose of Cymbalta to it, and see how that goes. Or the doctor may add some thyroid medication to one or the other of these drugs.
So, I have no idea what will happen next. I'm hoping, though, that Wellbutrin will be involved.
There, now you can be as much in the dark as I am...
Posted by frombe on October 28, 2004, at 21:48:20
In reply to Re: Cymbalta - looking for information » boomarang, posted by Racer on October 23, 2004, at 12:25:43
> Well, I called the doctor, who doesn't want me to start tapering down on it until we've had a chance to talk about it. I'm not best pleased by that, since I'm pretty miserable right now. It's not the drug making me miserable, more that the combination of amotivation and lethargy are preventing me from getting anything useful done, which increases my depression and hopelessness.
>
> When we started the Cymbalta, it was one of three choices offered me: Cymbalta, Luvox, and Wellbutrin. Since Wellbutrin seemed to be starting to help me when I was on it briefly last year, that's what I'm hoping we'll try next. I don't know if we'll switch to it, or add it to a lower dose of Cymbalta. I know that this new doctor doesn't like mixing meds, and respect that, so I'm guessing it'll be a straight switch. If Wellbutrin doesn't work on its own, I will suggest adding a lower dose of Cymbalta to it, and see how that goes. Or the doctor may add some thyroid medication to one or the other of these drugs.
>
> So, I have no idea what will happen next. I'm hoping, though, that Wellbutrin will be involved.
>
> There, now you can be as much in the dark as I am...HI Racer,
Thanks so much for your and everyone else's insightful input. FYI: I had quite a bit of lexapro left in the script before I was suppose to switch to cymbalta so I decided to up my lexapro dose to 40mg per day. I started to feel better. I don't know if that was because I was excited to start a newer, stronger med or the extra dose of lexapro. So far, I am on day 5 of cymbalta and am not sure if it is doing anything for me but who expects to feel anything on day 5. I feel more anxious since I quit the lexapro and started the cymbalta but I that seems normal as I felt anxious when I first started lexapro and it went away. My gut feel now is to try this for 30-60 days and if I don't feel any better, I want to drop back to lexapro but use a high dose. However, I have no medical or intellectual reason for thinking this way.BTW, anyone know of any real risk of taking valium or alcohol with cymbalta or lexapro?
Thanks,
Frombe
Posted by noel1d on March 30, 2005, at 9:52:19
In reply to Re: Cymbalta - looking for information » boomarang, posted by Racer on October 23, 2004, at 12:25:43
I've been taking maoi for 1 year. It seems to be doing ok. I would like to try cymbalta so I wont have the diet restrictions that maoi has. Nothing else seemed to work for me but maoi. I tried all the ssri's. 3 years ago I was taking prozac which worked fine for me, but I took myself off it, and went into a tail spin. When I tried to take it again, it didn't work for me. Has anyone gone from maoi to cymbalta, and had good results with it.
Posted by barbaracat on April 7, 2005, at 0:44:53
In reply to Cymbalta - looking for information, posted by frombe on October 22, 2004, at 2:57:45
I'm on week 8 of 13 pellets out of a 30mg capsule. If you care to read my in-depth story of this rather remarkable experience, it's posted in several threads. I started out with 30mg and went through the roof. I'm bipolar and have had great difficulty with all ADs, even though I need an AD along with lithium.
I'm grateful I listened to my inner voice to keep on trying with Cymbalta but to go painfully slow. This may not be appropriate for everyone, but for those who find Cymbalta's side effects too much to tolerate, you may be in a group who generally does not fare well on higher doses of some drugs. Try emptying out the capsule into a cup and taking a few pellets onto your fingertip and into your mouth. You should feel something, a bit of anxiety, a slight headache, something to let you know it's working, but not so much that it's uncomfortable. Within a few days, if all goes well, you'll find your thoughts moving from 'I Can't Stand One More Thing!!' to 'Yeah, I can take this.'. I love it. And that's saying something from someone who's been on this merry-go-round for 25 years. - BarbaraCat
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