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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 llrrrpp on May 27, 2006, at 0:48:17
So I've been taking 30 mg of cymbalta for the first 7 days, followed by 60 mg of cymbalta for the next 16 days. I take cymbalta at night for MDD. I also take 25-50 mg seroquel in the evening for sleep. These are the only meds I have ever taken, so I am still trying to figure out what they're all about (haha, me and the pdocs!)
Well here's my question: If I stay up a little late (like right now it's almost 2 am EST!) and I haven't taken cymbalta in 24 hours, I feel kind of like a druggy feeling. Kind of like when I turn my head, it takes my perception just a split second to catch up. Also, I noticed that my balance or equilibrium feels a little funny in the late evening, and that my mood worsens (this could be a function of lifestyle, however, because the evenings are a lonely time.)
Is it possible that I don't have enough cymbalta in my system late in the day? Can I expect these effects (very mild and not noxious) to go away? Anyone else experience something like this?
Thanks!
ll
Posted by llrrrpp on May 27, 2006, at 1:08:54
In reply to Cymbalta halflife and dosage timing, posted by llrrrpp on May 27, 2006, at 0:48:17
Whoa!
freakiness
I just got some strange whole-body tremor-shiver thing, and I feel hot and cold and hot and cold.Is my body so used to the cymbalta & seroquel that taking it 3 hours late give me withdrawal symptoms???
My vision is kinda slanted and disorganized too.
I better get me off to bed before the boogieman gets me!
Posted by yxibow on May 27, 2006, at 1:42:41
In reply to Freaky!, posted by llrrrpp on May 27, 2006, at 1:08:54
> Whoa!
> freakiness
> I just got some strange whole-body tremor-shiver thing, and I feel hot and cold and hot and cold.
>
> Is my body so used to the cymbalta & seroquel that taking it 3 hours late give me withdrawal symptoms???
>
> My vision is kinda slanted and disorganized too.
>
> I better get me off to bed before the boogieman gets me!
Cymbalta reaches a steady state (continuous in your bloodstream) in 3 days and has a 12 hour half life. Seroquel has a 6 hour half life. If you've been taking it for 7 days, it shouldn't make a difference -- I think most people take 60mg once a day actually. I take 60mg in the morning and 30mg in the evening, personally, but thats just my body.
Posted by shasling on May 27, 2006, at 7:21:05
In reply to Re: Freaky! » llrrrpp, posted by yxibow on May 27, 2006, at 1:42:41
I find that Cymbalta wakes me at about 4 or 5 a.m. wide awake, motivated, almost manic. Then after about 3 p.m. or so I'm back to my natural trance-like depressive anhedonic state as if I am not even taking anything...Until 4 a.m. again where I'm semi-manic. Splitting the dose or altering the dosage timing or has no effect on this whatsoever. Anyone else get a partial-day black & white effect like this from Cymbalta?
Posted by SLS on May 27, 2006, at 9:43:27
In reply to Cymbalta halflife and dosage timing, posted by llrrrpp on May 27, 2006, at 0:48:17
Hi there.
I'm disappointed to hear that you are experiencing what seems like withdrawal symptoms. I never liked the idea of dosing Cymbalta only once a day. Like Effexor and Paxil, Cymbalta has a relatively short half-life. Many people find that it is critical not to miss a dose with these drugs. You might profit from splitting the dosage into 30mg in the morning and 30mg in the evening. Either that or add another 30mg in the morning for a total of 90mg per day. In the meantime, try to take your dose of Cymbalta at the same time each day.
- Scott> So I've been taking 30 mg of cymbalta for the first 7 days, followed by 60 mg of cymbalta for the next 16 days. I take cymbalta at night for MDD. I also take 25-50 mg seroquel in the evening for sleep. These are the only meds I have ever taken, so I am still trying to figure out what they're all about (haha, me and the pdocs!)
>
> Well here's my question: If I stay up a little late (like right now it's almost 2 am EST!) and I haven't taken cymbalta in 24 hours, I feel kind of like a druggy feeling. Kind of like when I turn my head, it takes my perception just a split second to catch up. Also, I noticed that my balance or equilibrium feels a little funny in the late evening, and that my mood worsens (this could be a function of lifestyle, however, because the evenings are a lonely time.)
>
> Is it possible that I don't have enough cymbalta in my system late in the day? Can I expect these effects (very mild and not noxious) to go away? Anyone else experience something like this?
Posted by llrrrpp on May 27, 2006, at 10:00:03
In reply to Re: Cymbalta halflife and dosage timing » llrrrpp, posted by SLS on May 27, 2006, at 9:43:27
Yes, I will definitely be really careful about timing my evening dose. I'll bring this up with pdoc at my next appt.
I think it's probably cheaper for me to take 60mg once a day, but be really rigorous about the timing. Otherwise I'd need another prescription, and another copay. ugh.
About the manic things in the middle of the night. I had some real problems with anxiety when I first started cymbalta, but I was also pretty anxious about life in general. I did send one panicky email to pdoc at 4 in the morning, which is probably why I was prescribed seroquel for sleeping. It helps with nighttime anxiety too, becuase it's kind of calming to the inner obsessive voices that keep me up.
Posted by Racer on May 27, 2006, at 11:29:19
In reply to Re: Freaky!, posted by shasling on May 27, 2006, at 7:21:05
that's about mirroring the diurnal cortisol cycle, so you might want to get that checked out. There's a lot posted on here about getting cortisol tested, and it can make the doctors think you're watching those TV ads. I'd tell you doctor, "I'm waking up manic at 4, getting depressed again at 15, so let's see what my adrenals are doing during those times..."
I'm gonna stop giving advice about how to talk to doctors, though. I hate doctors now.
Posted by shasling on May 27, 2006, at 15:06:29
In reply to Re: Freaky! » shasling, posted by Racer on May 27, 2006, at 11:29:19
> that's about mirroring the diurnal cortisol cycle, so you might want to get that checked out. There's a lot posted on here about getting cortisol tested, and it can make the doctors think you're watching those TV ads. I'd tell you doctor, "I'm waking up manic at 4, getting depressed again at 15, so let's see what my adrenals are doing during those times..."
>
> I'm gonna stop giving advice about how to talk to doctors, though. I hate doctors now.Thank you, Racer. And I totally second that!
Posted by Phillipa on May 27, 2006, at 21:41:17
In reply to Re: Freaky!, posted by shasling on May 27, 2006, at 7:21:05
I never thought of that when I was on cymbalta splitting the dose although it caused my legs to twitch and tremble and my head felt like it would explode as I wanted to cry and couldn't. Love Phillipa
Posted by yxibow on May 27, 2006, at 22:07:45
In reply to Re: Freaky!, posted by shasling on May 27, 2006, at 15:06:29
> > that's about mirroring the diurnal cortisol cycle, so you might want to get that checked out. There's a lot posted on here about getting cortisol tested, and it can make the doctors think you're watching those TV ads.
I had mine tested (normal) when I had a physical -- you're in for a fun ride if you get a cortisol (okay, I had to put a little humour into things). You carry around, preferably on a long weekend, a jar that you carry the good yellow stuff around with -- and if you run out of space in the pee jar, you can't use the toilet, you just use another water jug. Its done because cortisol varies over 24h and a blood test is nearly useless.
Posted by llrrrpp on May 27, 2006, at 22:19:36
In reply to Re: Freaky! » shasling, posted by yxibow on May 27, 2006, at 22:07:45
How funny,
I used to do a study where we measured cortisol, but we used salivary cortisol. Not so bad, you just chew a piece of gum and spit into a test tube. I don't see why you couldn't do this every hour or so? maybe it's not very well standardized or something. Sometimes I wonder if the doctors just try to make things unpleasant so that it seems "official" or discourages us from taking their time. It's kind of like having to change into one of those awful gowns for a simple checkup. If they asked us to bring t-shirt and shorts to change into, I'd be happy to. Or give us scrubs. ANYTHING but urine samples and "gowns"ugh.
p.s. I take my dose in 10 minutes.
This is the end of the thread.
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