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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by spriggy on January 1, 2006, at 21:36:26
My appointment is this week- I am considering Cymbalta for fibromyalgia and the depression/anxiety.
I doubt I'd ever do a full dose- I am just very sensitive to medication.
But I wondered how many (or who) has received benefits from using the "open the capsule and pick out the pellets" formula for Cymbalta?
I'm considering trying that.
How many pellets should I start with?
Posted by Phillipa on January 1, 2006, at 21:47:24
In reply to Success with just Cymbalta pellets? not full dose?, posted by spriggy on January 1, 2006, at 21:36:26
Spriggy the first time I took cymbalta I started on 30mg. Didn't have any side effects. This time because of all I've read I'm having Greg empty out a few pellets but am probably taking 25mg. And I am med sensitive too. But I have to say since I started it my aches and pains are gone again. So try it. Fondly, Phillipa
Posted by Sarah T. on January 1, 2006, at 22:14:36
In reply to Success with just Cymbalta pellets? not full dose?, posted by spriggy on January 1, 2006, at 21:36:26
Hi Spriggy,
BarbaraCat used just a few pellets of Cymbalta and seemed to benefit from that small amount. Perhaps you can check her posts in the archives.
S.
Posted by spriggy on January 2, 2006, at 0:05:25
In reply to Re: Success with just Cymbalta pellets? not full dose?, posted by Sarah T. on January 1, 2006, at 22:14:36
Posted by blueberry on January 2, 2006, at 18:41:15
In reply to Success with just Cymbalta pellets? not full dose?, posted by spriggy on January 1, 2006, at 21:36:26
I have not tried the pellets for long enough to know how well that would work in the long term. But I do know for sure that in the short term it works awesome for me. I can go from depression to euthymic in about 6 hours after dosing. Lots of things like insomnia, lack of appetite, a bit of tiredness on top of the good activity level, and the fear of withdrawals, has always had me cut the trial short. But I've done it 3 times and each time was real nice.
I started with 4 pellets first day, and increased by about 4 pellets a day until I got up to 20 pellets. I was amazed how well it worked. I don't care what the drug instructions say or what the doctor says or what the clinical trials say, I go by what actually works for me.
If I get in trouble and really need a lift, a few pellets will do it every time. I just can't seem to commit to it long term. I am so sensitive to most meds. And since all meds seem to poop out sooner or later, I like to keep cymbalta onhand as my life preserver, but I don't want it to be on my poopout list after taking it every day for a long time.
I'm not sure, but I think something like 8 or 10 pellets equals 1mg. Someone said I was having a placebo effect...NOT. The idea is to fix the chemical imbalance...not to overfix it and create a new imbalance. One person may need just a little tweeking while someone else may need a huge tweeking. We're all different in what it takes to fix the underlying problem. At least that's how I see it.
Posted by Phillipa on January 2, 2006, at 21:57:44
In reply to Re: Success with just Cymbalta pellets? not full dose?, posted by blueberry on January 2, 2006, at 18:41:15
Blueberry I don't feel a thing on the 30mg I just started. What's wrong with me? Fondly, Phillipa
Posted by yxibow on January 3, 2006, at 1:27:30
In reply to Re: Success with just Cymbalta pellets? not full dose?, posted by blueberry on January 2, 2006, at 18:41:15
the doctor says or what the clinical trials say, I go by what actually works for me.
I respect that but...
>
> If I get in trouble and really need a lift, a few pellets will do it every time. I just can't seem to commit to it long term.A full up to 12 week trial of Cymbalta is the only way to find out -- its not a as needed drug like Ativan.
I am so sensitive to most meds.
I am sensitive to some medications too, especially phenothiazines and most all antipsychotics
And since all meds seem to poop out sooner or later, I like to keep cymbalta onhand as my life preserver, but I don't want it to be on my poopout list after taking it every day for a long time.
It may poop out in 6 months, it may work for years, but it won't work if you take it every fortnight and then. No SSRI or SSRNI possibly works that way. Changes in synapses and neurons are a slow process.
>
> I'm not sure, but I think something like 8 or 10 pellets equals 1mg. Someone said I was having a placebo effect...NOT.I guess it was me perhaps... and I dont want to create an argument, but 1) the color of the tablet and the size of the pellets vary by manufacture, and two, it is specifically "Delayed Release Capsules." That means you're ingesting drugs intended to last through a day immediately, causing possible greater side effects. And 1mg is a placebo, even for the most sensitive of people, I'm sorry to say. But, it is true that placebos work 1/3 of the time so, maybe it works for you. But the idea of splitting delayed release drugs is really a pharmacological nono. Its like freebasing, not to insult you or your sensitivity.
The idea is to fix the chemical imbalance...not to overfix it and create a new imbalance. One person may need just a little tweeking while someone else may need a huge tweeking. We're all different in what it takes to fix the underlying problem. At least that's how I see it.
I fully agree -- thats why they made 20mg capsules. I can't see how it can be effective much lower than that, but I understand how norinephrine reuptake inhibitors can be stronger in some people. Effexor was constant tachycardia and like a caffeine IV. Cymbalta in me is completely different.
I truly respect your notion of differences in imbalances, we all do come in different sizes, so to speak.. I'm a bit north of where I should be, though I'm working hard on that. Still, its a chemical experiment in the end to break delayed drugs. I know, the drug companies release XR drugs just to extend their patent -- but Cymbalta wasn't released that way.
Best regards
-- J
Posted by Phillipa on January 3, 2006, at 16:46:32
In reply to Re: Success with just Cymbalta pellets? not full d » blueberry, posted by yxibow on January 3, 2006, at 1:27:30
Lilly pharmacitacals is the only one with a patent on cymbalta at the time. So there is only one manufacturer til their patent runs out. But I remember a Thread awhile back that discussed various methods of taking the pellets with food and not chewing them. Evidently the theory is that if not chewed it would still time release. or buy empty capsules in the pharmacy and put in the desired amt. From what I understand the capsules are a type gelatin. I've been emtying out some of them and still can't figure out if my high anxiety and lethargy is the medication or the thought that I'm taking a medication I just don't know. Any thought? I'd really like to be able to concentrate enough to read a book. Fondly, Phillipa
Posted by yxibow on January 4, 2006, at 13:45:48
In reply to Re: Success with just Cymbalta pellets? not full d » yxibow, posted by Phillipa on January 3, 2006, at 16:46:32
> Lilly pharmacitacals is the only one with a patent on cymbalta at the time. So there is only one manufacturer til their patent runs out.
Oh I agree... I was referring to blatant patent extenders such as Xanax XR which serve nothing but reducing a few tablets and charging e.g.: Walgreens, 2mg apralozam/day, $17.. Longs Xanax XR 2mg, $302.
But I remember a Thread awhile back that discussed various methods of taking the pellets with food and not chewing them.
That's awfully hard to manage unless you're referring to swallowing applesauce whole, its like mixing it with cake sprinkles.
Evidently the theory is that if not chewed it would still time release.
I'm still not clear on that. The coating on the pellets may or may not be time release. The whole theory is a jacket in a jacket (i.e., the hard gelatin and the softer encrustation surrounding the pellets. And
From what I understand the capsules are a type gelatin.
Almost all capsules are gelatin from what I know.. its the formulation of it that depends. Time release are probably at least double sheets of gelatin. Plasticizers are added to alter time release and formulation.
http://answers.google.com/answers/threadview?id=609878
I've been emtying out some of them and still can't figure out if my high anxiety and lethargy is the medication or the thought that I'm taking a medication I just don't know. Any thought? I'd really like to be able to concentrate enough to read a book.Well I do believe you have mentioned in the past the hesitancy to take new medications -- that could be part of it. Cymbalta isn't associated with lethargy particularly I think nor weight gain, in fact the opposite, a slight lessening.
You may just be either hypersensitive to any amount of duloxetine or it is possible you're simply concentrating too much on the possible effects of a drug. Also, those kinds of side effects can wear off over time, as you increase your dose, especially lethargy, though it sounds like you're having paradoxical lethargy along with stimulation, which is a little unusual.Its hard to concentrate reading with an anxiety disorder in of itself, I know -- besides my main visual effect problem, I have racing thoughts and general attention deficit which means rereading passages, etc. Magazines are easier. If you're really having trouble reading, maybe have someone read to you for a while, or better yet, buy some books on tape. Just a thought.
If after some weeks you still can't tolerate the Cymbalta, then maybe your system is too sensitive to the NE reuptake. Some just are.
tidings
Jay
Posted by zero on January 4, 2006, at 17:37:03
In reply to Success with just Cymbalta pellets? not full dose?, posted by spriggy on January 1, 2006, at 21:36:26
I've used 4-8 pellets of Cymbalta a number of times when depression gets really bad (Effexor pellets same story). It boots me up out of depression.
I am very antidepressant sensitive (I get hypomanic/manic from all classes of them, at anything close to standard doses).
For 2 years I got significant benefit from Paxil 2.5mgs per day. Years ago I had a great 3 month period on 15mgs of Nardil, then the hypomania/mania kicked in.
I was in the "STEP-BD" program at Bellevue in NYC for bipolars, where I told my assigned doc' how I respond (he wanted me on a standard dose of Celexa) - he laughed and told me it was "impossible to get any response at those kinds of pediatric doses!"
Like who would know better than him anyway? Certainly not me, it's just my mind/body and my own observation of that. I left the STEP-BD program as soon as I could because of this doc'.
Still, every once in a while I use a tiny dose of Paxil or Cymbalta or Effexor to get my placebo/impossible/helpful antidepressant effect.
Everybody's different.
z.
Posted by Phillipa on January 4, 2006, at 19:16:10
In reply to Re: Success with just Cymbalta pellets? not full d » Phillipa, posted by yxibow on January 4, 2006, at 13:45:48
Jay where were you when the original Threads were posted. I think you should start a thread to let others know that mixing with food etc, is not the way to go. Fondly, Phillipa
Posted by yxibow on January 4, 2006, at 22:01:51
In reply to Re: Success with just Cymbalta pellets? not full d » yxibow, posted by Phillipa on January 4, 2006, at 19:16:10
> Jay where were you when the original Threads were posted. I think you should start a thread to let others know that mixing with food etc, is not the way to go. Fondly, Phillipa
I wasn't saying that if one decides to take on what is in a sense a non-doctor advised chemical experiment of splitting capsules that the individual pulsules couldnt be taken with food, but that it would have to be fairly liquid food or else one is bound to chew the pellets while eating.
That's all..
- J
This is the end of the thread.
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