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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by dgold on October 30, 2004, at 19:28:12
according to studies Cymbalta has much less sexual side effects than the other SSRI.
I wonder if this is B.S. or truth.
IS anybody on cymbalta and can speak from personal experience with this drug and sexual side effects.
Thanks , David.
Posted by ed_uk on October 30, 2004, at 19:38:07
In reply to Cymbalta and Sexual Side effects, posted by dgold on October 30, 2004, at 19:28:12
I have never taken duloxetine(Cymbalta) but I would expect the incidence of sexual side effects to be similar to the SSRIs. Remember when the SSRIs were first introduced sexual dysfunction was reported to be a rare side effect!? Probably because the people doing the study failed to ask the participants whether they were experiencing sexual problems. I expect some people were too embarassed to admit their sexual problems even if they were severe.
Ed
Posted by Interject79 on October 30, 2004, at 20:01:31
In reply to Re: Cymbalta and Sexual Side effects, posted by ed_uk on October 30, 2004, at 19:38:07
I am taking it at 60mg with little sexual difficulty. Remember that it is a dual RI and that for many the norepi will diminish the side effects from increased serotonin, like the sexual ones.
Posted by ed_uk on October 30, 2004, at 20:15:08
In reply to Re: Cymbalta and Sexual Side effects » ed_uk, posted by Interject79 on October 30, 2004, at 20:01:31
Hello...
Cymbalta is indeed a dual reuptake inhibitor but it remains to be seen whether inhibiting the reuptake of norepinephrine really does reduce the sexual dysfunction due to serotonin reuptake inhibition. It's a good marketing strategy though isn't it! :) Nevertheless, since it acts as an NRI it may be an effective treatment for depression at doses which cause less serotonin reuptake inhibition than effective doses of SSRIs would cause in the same patients. In that sense, it may be expected to cause less sexual problems but it's only a theory.
Ed
Posted by CrazyCO on October 30, 2004, at 21:31:22
In reply to Re: Cymbalta and Sexual Side effects, posted by ed_uk on October 30, 2004, at 20:15:08
I have been taking Cymbalta for close to 3 months now, and I haven't had any sexual side effects at all.
Posted by boomarang on October 30, 2004, at 22:23:21
In reply to Re: Cymbalta and Sexual Side effects, posted by CrazyCO on October 30, 2004, at 21:31:22
i've been taking cymbalta since 9/10 and i've wandered from complete anorgasmia to success after more work than usual. it is a tougher road for me now but not insurmountable.
Posted by yznhymer on October 31, 2004, at 1:37:49
In reply to Re: Cymbalta and Sexual Side effects, posted by boomarang on October 30, 2004, at 22:23:21
I quit Cymbalta after 2 weeks in the short term because of increased anxiety and agitation, but in the long run because the sexual side effects were so intractible. It took about 5 days after discontinuing Cymbalta for the sexual side effects to subside.
Posted by ed_uk on October 31, 2004, at 7:01:55
In reply to Re: Cymbalta and Sexual Side effects, posted by yznhymer on October 31, 2004, at 1:37:49
Personally I've always been lucky in that I've rapidly developed tolerance to the sexual side effects of the drugs that I've taken eg. paxil, prozac, celexa, effexor etc. Unfortunately many people don't seem to develop tolerance to these effects.
Ed
Posted by SLS on October 31, 2004, at 7:18:44
In reply to Re: Cymbalta and Sexual Side effects, posted by ed_uk on October 31, 2004, at 7:01:55
I've noticed a reduction of sex-drive. I don't think this would be too big a deal if the drug were to work for me, though, as the recovery of the libido lost to depression would probably return.
- Scott
Posted by theo on October 31, 2004, at 8:03:13
In reply to Re: Cymbalta and Sexual Side effects, posted by SLS on October 31, 2004, at 7:18:44
Scott,
How's the drop back to 60mg Cymbalta treating you?
I'm still going back and forth wondering if it's worth trying another SSRI/SSNRI, but may give Cymbalta a spin after I equilibrate to my dose with my Lamictal.
By the way, what do you think is a good evaluation time frame for Lamictal dosage increase, decrease when you have been above 100mg for several months? I was at 100mg for several months, went to 150mg for about 15 days and felt foggy and blaugh in general, so dropped back to 100mg and was at this dose for another month and felt pretty good. Then, my pdoc said "instead of going from 100mg to 150mg, go from 100mg to 125mg for a month then to 150mg for a month." Well, now I'm at 150mg again (about 20 days) and feeling blaugh and foggy at 150mg once again.
I know for SSRI's a good 6-8 weeks is probably a good time frame for evaluating a certain dose, but what about anticonvulsants like Lamictal? Do you think 2-3 weeks is long enough to evaluate a dose after you have been on at least 100mg for several months? I'm seriously considering dropping back to 100mg because normally this class of meds makes you feel better in the beginning and then fade away leaving you an ever so slight mood lifting effect, so my thinking is that 3 weeks at 150mg is plenty of time.
I know you have mentioned you bounce between 150mg and 200mg. What has your experience been as far as evaluation time frame for a certain dose?
I also notice when I go from 100mg to 150mg, I get a huge craving for sweets and have gained 8 pounds at 150mg.
My doc is flexible and even suggested I "play" with the dose, but really didn't know from experience how long to stay at a dose before moving up or down.
Any input from your experience with Lamictal would be appreciated.
Posted by SLS on October 31, 2004, at 11:21:09
In reply to Re: Cymbalta and Sexual Side effects » SLS, posted by theo on October 31, 2004, at 8:03:13
Hi Theo.
> How's the drop back to 60mg Cymbalta treating you?
Well, it is not working, but at least the side effects of sleepiness and amotivation have decreased (although they have not completely disappeared).
> I'm still going back and forth wondering if it's worth trying another SSRI/SSNRI, but may give Cymbalta a spin after I equilibrate to my dose with my Lamictal.
Maybe you should start a new thread asking for "Cymbalta - Any Robust Responses?" or "Cymbalta - Any Complete Remissions?"
> By the way, what do you think is a good evaluation time frame for Lamictal dosage increase, decrease when you have been above 100mg for several months?
How about one week at each dosage to make adjusments and three weeks to evaluate the target dosage?
> I was at 100mg for several months, went to 150mg for about 15 days and felt foggy and blaugh in general, so dropped back to 100mg and was at this dose for another month and felt pretty good. Then, my pdoc said "instead of going from 100mg to 150mg, go from 100mg to 125mg for a month then to 150mg for a month." Well, now I'm at 150mg again (about 20 days) and feeling blaugh and foggy at 150mg once again.
I think you should remain at the highest dosage you can tolerate, and add an antidepressant. Lamictal does not often provide sufficient improvements by itself when treating unipolar depression. Your approach so far has been optimal. Unless you would like to push the dosage to 200mg to see what happens, I think you should settle back to 100-125 and add something. How do you feel about this?
- Scott
Posted by theo on October 31, 2004, at 16:15:00
In reply to Re: Cymbalta and Sexual Side effects » theo, posted by SLS on October 31, 2004, at 11:21:09
I am going to drop down, just not familiar with adusting to anticonvulsants and didn't want to give up to soon at 150mg. I dropped back to 125mg and will probably drop to 100mg. I wish Lamictal came in a 125mg tablet. It could get costly having to get a scrip for 100mg and 25mg pills.
I think I might add a low dose of an antidepressant. Paxil for me was by far the best med for social anxiety but the sexual dysfuntion at 20mg was horrible. My doc suggested trying 12.5 CR or 10mg regular Paxil. By the way, my pdoc said something about Paxil CR hitting different receptors since it absorbs in the lower bowels. Do you know anything about this? My only concern about trying it again is I've heard on this thread that once you take Paxil and stop it, the effects aren't as good the second time. It has been over a year since I last took it so maybe I'll give it a shot since it worked so well before.
Posted by jerrympls on November 1, 2004, at 1:24:51
In reply to Cymbalta and Sexual Side effects, posted by dgold on October 30, 2004, at 19:28:12
> according to studies Cymbalta has much less sexual side effects than the other SSRI.
> I wonder if this is B.S. or truth.
> IS anybody on cymbalta and can speak from personal experience with this drug and sexual side effects.
> Thanks , David.David-
I've been on Cymbalta for almost a month at 60mg and it has increased my sexual desire. It also has helped with some pain relief and anxiety. Still waiting for it to really help my depression - but other than that - no side effects - well, except when I started on it it put me to sleep - but that went away rather quickly (after about 3-4 days).
Hope this helps.
Jerry
Posted by John9999 on November 1, 2004, at 14:23:43
In reply to Cymbalta and Sexual Side effects, posted by dgold on October 30, 2004, at 19:28:12
I've been on Cymbalta for a week now (x30mg). So far no sexual side effects. If anything it's increased my desire for sex. I was on Lexapro for a week prior and that killed my ability to orgasm w/in the first couple of days.
I'm supposed to switch to 60mgs starting tomorrow, so I'll update if that has any effect. So far I wouldn't say Cymbalta has greatly helped my depression, but at least the side-effects haven't been intolerable.
Posted by Iansf on November 1, 2004, at 19:06:26
In reply to Re: Cymbalta and Sexual Side effects, posted by John9999 on November 1, 2004, at 14:23:43
I'm having a mixed effect sexually from Cymbalta. It actually has increased my libido a bit, but it's more difficult to get an erection. It's sometimes difficult to climax, but sometimes not at all. Most importantly, however, it hasn't reduced sensitivity. the way the pure SSRIs I tried did. All in all, I can live with the shortcomings, where I couldn't with the SSRIs.
On the other hand, the combination of insomnia at night and sleepiness in the daytime is a struggle. And the constipation is a real bear. If those problems don't dissipate, I won't be able to continue with Cymbalta long-term.
John
Posted by jerrympls on November 1, 2004, at 23:31:52
In reply to Re: Cymbalta and Sexual Side effects, posted by Iansf on November 1, 2004, at 19:06:26
> I'm having a mixed effect sexually from Cymbalta. It actually has increased my libido a bit, but it's more difficult to get an erection. It's sometimes difficult to climax, but sometimes not at all. Most importantly, however, it hasn't reduced sensitivity. the way the pure SSRIs I tried did. All in all, I can live with the shortcomings, where I couldn't with the SSRIs.
>
> On the other hand, the combination of insomnia at night and sleepiness in the daytime is a struggle. And the constipation is a real bear. If those problems don't dissipate, I won't be able to continue with Cymbalta long-term.
>
> JohnJohn - when do you take the Cymbalta? morning? night?
-jerry
Posted by sunshine211 on November 2, 2004, at 0:38:25
In reply to Re: Cymbalta and Sexual Side effects » Iansf, posted by jerrympls on November 1, 2004, at 23:31:52
Thought I would add my two cents. I definitely have noticed an increase in 'desire,' but that is said from going paxil to cymbalta, so I will have to give it some more time to see id the desire leads to some action, I know my guy would be happy. lol
Posted by yznhymer on November 2, 2004, at 8:20:13
In reply to Re: Cymbalta and Sexual Side effects, posted by sunshine211 on November 2, 2004, at 0:38:25
I haven't done a count here, but the impression I'm getting is that Cymbalta is kinder to women re sexual side effects than to men. Any thoughts?
Posted by banga on November 2, 2004, at 8:46:20
In reply to Re: Cymbalta and Sexual Side effects, posted by yznhymer on November 2, 2004, at 8:20:13
I'm starting to read into the posts that with Cymbalta (when compared with SSRIs) the libido begins to return, but function and orgasm can still be affected....for obvious reasons--well, OK Ill spell it out--if you can't get an erection, sex is still hugely affected for men, but is not such a barrier for women. So for women, if libido is back, you're a good half way on your way..but for men, if getting erection is still difficult, you have a big block. this is just a guess....
Any thoughts on that theory?
Posted by shiz on November 2, 2004, at 15:24:26
In reply to Re: Cymbalta and Sexual Side effects, posted by CrazyCO on October 30, 2004, at 21:31:22
how would you rate the cymbalta helping you
Posted by sunshine211 on November 2, 2004, at 15:38:53
In reply to Re: Cymbalta and Sexual Side effects, posted by shiz on November 2, 2004, at 15:24:26
on a scale from 1-10 with 10 being the best, so far i would give it a 9. i also go to therapy once a week
Posted by shiz on November 2, 2004, at 17:01:36
In reply to Re: Cymbalta and ratings, posted by sunshine211 on November 2, 2004, at 15:38:53
have you ever missed a dose
Posted by Iansf on November 2, 2004, at 21:25:22
In reply to Re: Cymbalta and Sexual Side effects » Iansf, posted by jerrympls on November 1, 2004, at 23:31:52
> > On the other hand, the combination of insomnia at night and sleepiness in the daytime is a struggle. And the constipation is a real bear. If those problems don't dissipate, I won't be able to continue with Cymbalta long-term.
> >
> > John
>
> John - when do you take the Cymbalta? morning? night?
>
> -jerry
>I've tried both. The same pattern seems to occur no matter when I take it. It doesn't seem to make sense, but that's nonetheless what happens: insomnia at night, sleepiness during the day.
Posted by sunshine211 on November 5, 2004, at 22:35:43
In reply to Re: Cymbalta and ratings, posted by shiz on November 2, 2004, at 17:01:36
I have taken a dose about 12 hours late, didn't really notice anything big, just a little anxious and wound up.
Posted by John9999 on November 7, 2004, at 21:16:14
In reply to Re: Cymbalta and Sexual Side effects, posted by John9999 on November 1, 2004, at 14:23:43
> I've been on Cymbalta for a week now (x30mg). So far no sexual side effects. If anything it's increased my desire for sex. I was on Lexapro for a week prior and that killed my ability to orgasm w/in the first couple of days.
>
> I'm supposed to switch to 60mgs starting tomorrow, so I'll update if that has any effect. So far I wouldn't say Cymbalta has greatly helped my depression, but at least the side-effects haven't been intolerable.
>
>Well, I'm about done with week 2 (60mgs this week). I'm feeling much better, but sadly the sexual side effects have appeared (delay). Oh well, at this point I'm happy with how Cymbalta is making me feel so I'm going to talk to my pdoc about continuing my trial for at least a few more weeks.
Other than the orgasm delay the side effects this week have been minimal. I was pretty up and down last week w/ some odd dreams and grumpy days. After going to 60mg (or maybe just after a week adjusting from Lexapro to Cymbalta) I've definitely started feeling better and more positive. Constipation and a decreased appetite are the other two side effects I've noticed. Also I only had nausa the first day after taking my first 30mg dose.
Hope that's insightful to someone, and I'll update as I get farther along. I should note I'm a 27yr male. Smoked marijuana for 7 years to deal with depression, and I've finally been forced to go the legal route. This is my first good experience. Welbutrin(2 weeks) made me tired all the time, and gave me crazy dreams - didn't help at all for me. Lexapro did seem to help but I was markedly more tired than usual, and it was my first experience with anograsmia so we decided to try something else. I guess the switch didn't really help on that, but I'm beginning to think it may be unavoidable....based on what I've read around here.
-J
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