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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 craiggetty on July 15, 2005, at 5:24:25
If so, what symptoms did it alleviate?
-CG
Posted by ed_uk on July 15, 2005, at 14:21:33
In reply to Anyone helped by just 20mg/day of Cymbalta?, posted by craiggetty on July 15, 2005, at 5:24:25
A couple of people on the board have been helped by as little as 5mg.
~Ed
Posted by Phillipa on July 15, 2005, at 18:54:48
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » craiggetty, posted by ed_uk on July 15, 2005, at 14:21:33
Ed, Is it racer or barbaracat? Can't remember. Maybe they'll see this Thread and respond. Fondly, Phillipa
Posted by ed_uk on July 16, 2005, at 8:29:18
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » ed_uk, posted by Phillipa on July 15, 2005, at 18:54:48
Barbaracat :-)
Ed xx
Posted by Phillipa on July 16, 2005, at 18:17:29
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » Phillipa, posted by ed_uk on July 16, 2005, at 8:29:18
Ed, Sure can tell who's addicted to PBabble. Maybe we should be on the addictions Board? Fondly, PJ O
Posted by Dave001 on July 18, 2005, at 14:32:46
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » craiggetty, posted by ed_uk on July 15, 2005, at 14:21:33
> A couple of people on the board have been helped by as little as 5mg.
>The double-blind studies create some doubt that the benefit from such a
dose is any greater than that of a sugar pill, however.
Posted by ed_uk on July 18, 2005, at 14:50:14
In reply to Re: Anyone helped by just 20mg/day of Cymbalta?, posted by Dave001 on July 18, 2005, at 14:32:46
Hi Dave,
>The double-blind studies create some doubt that the benefit from such a
dose is any greater than that of a sugar pill, however.Double blind studies are of no use in determining the dose which will be effective for any given individual. They are only useful in determining average/standard doses. We all respond to the same medication differently, some people are much more sensitive to Cymbalta than others.
Kind regards
~Ed
Posted by Dave001 on July 18, 2005, at 18:42:09
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » Dave001, posted by ed_uk on July 18, 2005, at 14:50:14
>> The double-blind studies create some doubt that the benefit from
>> such a dose is any greater than that of a sugar pill, however.
>
> Double blind studies are of no use in determining the dose which will
> be effective for any given individual. They are only useful inStudies wouldn't be of much use if that were the case. The advancement
of medicine (or any branch of science) is largely dependent upon the
repeatability of experimental conditions. Studies don't help us
appreciate idiosyncrasies, but in this case they do help us determine
the *probability* that an individual will respond to a given dose.> determining average/standard doses. We all respond to the same
> medication differently,Fortunately, that isn't the case. Otherwise, medicine wouldn't exist. :-)
> some people are much more sensitive to Cymbalta than others.
I'm not saying that it's not *possible* that so and so responded to only
5 mg of duloxetine; I'm saying that it's not *probable*. And we have no
way of knowing whether it's the medication or a placebo effect that is
responsible for the results.
Posted by ed_uk on July 19, 2005, at 17:31:44
In reply to Re: Anyone helped by just 20mg/day of Cymbalta?, posted by Dave001 on July 18, 2005, at 18:42:09
Hi Dave,
>Studies wouldn't be of much use if that were the case.
They are of use because they give a good indication of what dose would be suitable for 'most' people.
>Fortunately, that isn't the case. Otherwise, medicine wouldn't exist. :-)
Well yeah, you know what I mean. People can respond to the same drug very differently. I find SSRIs relaxing, other people get manic on SSRIs.
>I'm not saying that it's not *possible* that so and so responded to only
5 mg of duloxetine; I'm saying that it's not *probable*.Don't be so sure! I knew someone who responded to 1mg Prozac, he also had pronounced sexual side effects at this dose. Some people are slow metabolizers etc..........this is especially relevant to TCAs and other drugs metabolized by CYP2D6.
>And we have no
way of knowing whether it's the medication or a placebo effect that is
responsible for the results.True :-) We can only guess.
Posted by Dave001 on July 20, 2005, at 20:05:35
In reply to Re: Anyone helped by just 20mg/day of Cymbalta? » Dave001, posted by ed_uk on July 19, 2005, at 17:31:44
>> Studies wouldn't be of much use if that were the case. [... Studies
>> don't help us appreciate idiosyncrasies, but in this case they do
>> help us determine the *probability* that an individual will respond
>> to a given dose.]
>
> They are of use because they give a good indication of what dose
> would be suitable for 'most' people.That's more or less what I said. You snipped the relevant context
(reintroduced within brackets above).>> I'm not saying that it's not *possible* that so and so responded to
>> only 5 mg of duloxetine; I'm saying that it's not *probable*.
[...]>> And we have no way of knowing whether it's the medication or a
>> placebo effect that is responsible for the results.
>
> True :-) We can only guess.That's correct, and it is statistically more probable that the response
was a placebo effect (judging from the aggregate results of the
duloxetine studies). Thus the guess that it's a placebo effect seems
more plausible to me than the alternative explanation.
Posted by ed_uk on July 21, 2005, at 16:44:16
In reply to Re: Anyone helped by just 20mg/day of Cymbalta?, posted by Dave001 on July 20, 2005, at 20:05:35
>That's more or less what I said. You snipped the relevant context
(reintroduced within brackets above).Ouch.
>That's correct, and it is statistically more probable that the response
was a placebo effectBabblers who responded to very low doses of Cymbalta were unable to take 'standard' doses because they produced exceptionally intense side effects. As a result, it seems plausible to me that they are unusually sensitive to Cymbalta and might respond to an unusually low dose.
~Ed
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