Posted by bleauberry on April 18, 2008, at 21:40:41
In reply to What to expect from Cymbalta?, posted by AdamCanada on April 18, 2008, at 20:10:15
Go to askapatient.com and check out reviews from Duloxetine users. You'll find experiences spanning a wide range from miraculous to horrendous. It is I believe impossible to predict.
If the starting dose of 30mg feels too much, you can always back off. 10 beads = 1mg. Count them into apple sauce or count them back into the capsule (not as easy as it sounds). Applesauce is easy. The beads are enteric coated, the capsule is not.
Duloxetine has provided all the benefits you are looking for to some people. Check out that website and you'll see what I mean. It has also been the opposite. You'll see that too. It varies so much from person to person.
The weight gain thing. That caught my attention. The inability to gain weight, especially while on a known weight-gainier like Paxil, is a pretty good clue you need some cortisol support. Hydrocortisone in 2.5mg to 20mg doses is not a common treatment in mainstream medicine, but it is THE medical treatment for hypoadrenalism, and is supported by mainstream medical literature and the drug's label. It is the primary reason for prescription, and the recommended dose is 20mg to 30mg for "physiological replacement" of low cortisol, as termed on the drug's label. A simple 24 hour cortisol saliva test will show if you have that condtion or not. I suspect, based on your symptoms, reactions to meds, and inability to gain weight, that you are hypoadrenal and need Cortef (hydrocortisone) in low physciological doses that will not atrophy or shut down the adrenal's natural production.
It took me a year of developing a doctor-patient relationship and many trials and errors with this doctor before he finally said let's try hydrocortisone. It is becoming more and more common, and as he said, there is now a pretty good body of scientific and medical evidence supporting it.
Sorry to get off topic from Duloxetine. The weight gain thing, and the other things, just screamed low cortisol really loud. Your entire description is textbook perfect for hypoadrenalism. I mean, you couldn't have described it any clearer. If my hunch is true, nothing, absolutely nothing, is going to work satisfactorily until cortisol is brought back into normal range. If my hunch is true, you might as well forget about anything else for now and just focus on that. It is the foundation for all your other efforts to stand on, or crumble on, depending on whether treated or not.
poster:bleauberry
thread:824137
URL: http://www.dr-bob.org/babble/20080412/msgs/824154.html