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Dr. Bob is Robert Hsiung, MD,
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Posted by Paul_d_234 on September 6, 2004, at 19:31:30
In reply to Re: Cymbalta Journal - Day Four, posted by 4WD on September 6, 2004, at 17:32:17
SOunds great, sounds like progress. Does Cymbalta have any wieght gain affeects? Was weight gain a problem on Effexor?
Posted by Bill LL on September 7, 2004, at 9:02:12
In reply to Re: Cymbalta Journal - Day Four, posted by 4WD on September 6, 2004, at 17:32:17
It sounds like you are off to a good start in that you have more energy, less anxiety, more libido, doing more activities such as yard york and gym, and less nasal congestion. Hopefully your mood will lift soon. If it does not, you may want to try a higher dose.
Your log as been very helpful to me so far. I take Lexapro (an SSRI) 30 mg and Strattera 120 mg. The Lexapro gives me a certain degree of nasal congestion, but its not too bad. I think that's because it and some other antidepressants act as an antihistamine which causes dryness.
As for the enteric capsule, you may be correct that Lily is being greedy in trying to make a pill that cannot be cut. I'm going to check into that. I think that some enteric pills can be cut because the enteric protection is spread throughout the pill and not just on the coating. But I'm not sure.
Posted by 4WD on September 7, 2004, at 14:24:17
In reply to Re: Cymbalta Journal - Day Four, posted by Bill LL on September 7, 2004, at 9:02:12
> It sounds like you are off to a good start in that you have more energy, less anxiety, more libido, doing more activities such as yard york and gym, and less nasal congestion. Hopefully your mood will lift soon. If it does not, you may want to try a higher dose.
I don't know if I can take a higher dose because of the buzz/tone thingy in my head. That is such a weird side effect - my doctors all shake their heads. I know it's from SNRIs, though, because it goes away if I switch to an ssri or if I'm not on meds.
>
> Your log as been very helpful to me so far. I take Lexapro (an SSRI) 30 mg and Strattera 120 mg. The Lexapro gives me a certain degree of nasal congestion, but its not too bad. I think that's because it and some other antidepressants act as an antihistamine which causes dryness.Thanks. I was wondering if anyone was reading it. I was thinking this morning that Cymbalta feels a little like Lexapro without the sexual side effects. Mostly in that I am waking up earlier after less sleep and I have more energy. I get the nasal congestion from all a/d's I've tried.
>
> As for the enteric capsule, you may be correct that Lily is being greedy in trying to make a pill that cannot be cut. I'm going to check into that. I think that some enteric pills can be cut because the enteric protection is spread throughout the pill and not just on the coating. But I'm not sure.
Here is what I can't figure out. My 30mg Cymbalta is a capsule. It's filled with the little pulvules, just like Effexor, except all the granules are the same size. Now, these granules can't each individually be enteric coated, can they? So it must be dissolving in the stomach environment. So why is the 60 mg in tablets and why do *they* need to be enteric coated? This matters a lot to me because I think I may need to be on 30mg/day but in divided doses or possibly 40mg/ in divided doses. I.e. 15mg morning, 15mg night.Does anyone know whether the 40mg is capsules or tablets?
Marsha
Posted by Cecilia on September 8, 2004, at 2:40:40
In reply to Re: Cymbalta Journal - Day Four » Bill LL, posted by 4WD on September 7, 2004, at 14:24:17
That`s interesting that your 60mg dose is in a tablet. I haven`t actually seen Cymbalta yet, but the prescribing info I printed off from Lilly`s www.cymbalta.com site says it comes in 20 mg, 30 mg and 60 mg capsules(20 mg green, 30 mg white and blue and 60 mg green and blue) and that all are enteric coated and should not be chewed, crushed, sprinkled on food or mixed with liquid. I agree it`s probably greed that made Lilly design a form that can`t be split. Anyone with spare cash probably won`t go wrong by investing in pharmaceuticals. Cecilia
Posted by 4WD on September 8, 2004, at 14:52:01
In reply to Re: Cymbalta 4WD, posted by Cecilia on September 8, 2004, at 2:40:40
> That`s interesting that your 60mg dose is in a tablet. I haven`t actually seen Cymbalta yet, but the prescribing info I printed off from Lilly`s www.cymbalta.com site says it comes in 20 mg, 30 mg and 60 mg capsules(20 mg green, 30 mg white and blue and 60 mg green and blue) and that all are enteric coated and should not be chewed, crushed, sprinkled on food or mixed with liquid. I agree it`s probably greed that made Lilly design a form that can`t be split. Anyone with spare cash probably won`t go wrong by investing in pharmaceuticals. Cecilia
Hi Cecilia,
Actually I don't have a 60 mg dose. I just thought I'd read here that someone was thinking about splitting their 60 mg "pill" and I assumed it was a tablet. But I have been splitting my 30 mg dose. I was having trouble with waking up earlier than I wanted and thought it might be because the single morning dose I was taking was wearing off (they say doses below 60mg day should be taken b.i.d.). So I'm taking half the 30mg capsule in the am and half at night now. I did sleep longer this morning. Who knows? Maybe at my next appointment, I will request 20mg b.i.d. I don't want to go to 60mg if I don't have to.
Marsha
Posted by 4WD on September 8, 2004, at 17:32:55
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Days 5 & 6
Cymbalta 30 mg
I had a really bad day yesterday (day 5). Lots of anxiety in the morning which didn't really abate last night like it normally would. I felt really grim and bleak. I've had this feeling before so I went back to my calendar to look and try to make some connections. I found I had noted feeling this way after switching from Effexor to Wellbutrin and also after switching from Effexor to Paxil. It finally occurred to me that the problem may not lie with the *new* drug but with withdrawal from the *old* drug. My pdoc had told me to continue my Effexor at my regular 37.5 mg dosage, add Cymbalta 30mg for 3-4 days, then start tapering the Effexor. I hate Effexor so much that I decided (brilliantly) to stop it completely immediately-figuring that going from one SNRI to another would be a snap. After I got my epiphany yesterday, though, I took about 1/8 of a 150mg Effexor. Again today I took about 1/8 (or 19mg) Effexor. I feel better already. The anxiety has lessened by about 50% and the grim bleak feeling has almost gone away. (I was only completely off the Effexor for less than 1 week)
Anyway, my mistake in not tapering the Effexor obviously is going to have some influence on how I'm feeling and what I'm reporting here. Sorry.
Side effects: Still some dry mouth. Some slight orgasm delay but nothing like with an equivalent amount of Effexor, Zoloft, Prozac or Celexa. Still have the ringing in my ears.
No increase or decrease in appetite or weight.
I am falling asleep more easily at night but was waking up earlier than I should. I thought this might be because the once daily morning dose was wearing off too quickly so yesterday I took half the capsule in the morning and half before bed. I woke up earlier again but was able to go back to sleep easily til my normal time.
Efficacy: I have much more energy. The psychomotor retardation is completely gone. I am no longer a slug. However, I seem to be more sensitive to caffeine. Two cups of tea made me a bit jittery.I am not depressed in the sense of feeling sad or hopeless. I am no longer having suicidal ideation.
I still don't feel much inner motivation to "go out and do things." I still can't think of anything that seems like it would be pleasurable to do. So I guess that means:
No improvement in anhedonia.
I did involuntarily smile a couple of times today. That hasn't happened in a while. I didn't realize I hadn't smiled (except deliberately) until I noticed myself doing it today and was surprised by it.
Marsha
Posted by Paul_d_234 on September 8, 2004, at 20:01:51
In reply to Re: Cymbalta Journal -Days Five Six, posted by 4WD on September 8, 2004, at 17:32:55
Marsha,
I am very happy to hear of your progress. Good luck - hope the smiles keep coming.
Posted by iris2 on September 8, 2004, at 21:50:21
In reply to Re: Cymbalta Journal -Days Five Six, posted by 4WD on September 8, 2004, at 17:32:55
Marsha,
Sounds like things are looking up. In fact if it were me writing my family and friends would be celebrating and baking me a cake( which I would not eat of course:) ).
I'm looking forward to your continued progress and HAPPINESS
irene
Posted by 4WD on September 8, 2004, at 22:13:58
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
I don't know if this is from the Effexor withdrawal or if it's because there isn't enough Effexor and the Cymbalta hasn't kicked in good yet or if the Cymbalta is making me anxious. I was even more anxious on no meds and on Paxil but I am pretty much freaking out. I was trying to tell how bad the ringing in my ears was and so I went in the closet where there was no refrigerator running, no AC running etc. The ringing was very loud and my head felt pressurized. I got out and now I'm so scared. I was scared earlier and went to get the Klonopin Rx filled but nobody had it in stock since it's the wafers (0.125 mg - can that possibly be enough to help anyway?)
I am really scared. There is no one here but me and now I'm crying. I'm so tired of feeling bad. And all the meds have side effects and I'm so tired of trying to cope with all this crap. I don't want to be on meds at all. I just want to be normal. I am so miserable. I don't usually have these attacks at night.
This happens to me every thime I go off effexor. I feel addicted to it like I'll never be able to get off. I hate it. I know it's only been 6 days on cymbalta but it hurts so bad. I feel so bad. I'm so tired of trying. I've put so much into trying to get better and done everything I know to do and I never get better. I'm so scared. At least I have smoe Zyprexa I can take.
Posted by iris2 on September 8, 2004, at 22:27:38
In reply to Help, I'm panicky, posted by 4WD on September 8, 2004, at 22:13:58
It is going to be okay. Is your family coming home soon? The Zyprexa should help a lot. Probably is better than the klonopin would have been so maybe it is a good thing they were out of it. You already know that you have been through this before so remember that and you'll know that it always goes away. Really for panicy stuff I always think Zyprexa or perphenazine or one of the major tranquilizers does the trick in a pinch. I'll be up for a while so I'll check in later to see if you're okay. I hope you just fall asleep though.
irene
Posted by 4WD on September 8, 2004, at 22:39:37
In reply to Re: Help, I'm panicky » 4WD, posted by iris2 on September 8, 2004, at 22:27:38
> It is going to be okay. Is your family coming home soon? The Zyprexa should help a lot. Probably is better than the klonopin would have been so maybe it is a good thing they were out of it. You already know that you have been through this before so remember that and you'll know that it always goes away. Really for panicy stuff I always think Zyprexa or perphenazine or one of the major tranquilizers does the trick in a pinch. I'll be up for a while so I'll check in later to see if you're okay. I hope you just fall asleep though.
>
> ireneThank you Irene. My husband will be home fromn work in about half an hours but I don't want him to come home and find me crying and terrified. He has had to pull me through these attaack so many times befoe\re he must be sick of it by now. God lknows I am sick of it myself. I will wait for the zyprexa to kick in and maybe I will feel better. In the meantime I will just pace and wring my hands and i can't stop crying. i guess it's partly that i feel so sorry for myself right now.
marsha
Posted by iris2 on September 8, 2004, at 23:09:05
In reply to Re: Help, I'm panicky » iris2, posted by 4WD on September 8, 2004, at 22:39:37
Marsha,
Strange I was going to suggest to you to respond to that particular post a few minutes ago.
The Zyprexa should have a fairly quick onset of action so you should start to feel better within the hour. I know the perphenazine I take when I get like that takes about 1/2 hour to start to work. So hopefully you will feel calmer before your husband gets in. Does it make you tired or sleepy? It does for me. Just writng so you'll know that you're not alone. I am usually awake until at least 2pm or later.irene
Posted by 4WD on September 9, 2004, at 20:09:02
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Cymbalta Day 7 - 9-9-04
Whew. Last night was bad. The Zyprexa helped.
Thanks for all the support (Irene).
Today I feel much better. I've got a few days of a small dose Effexor back in me and will now taper properly.
Efficacy: I still have a lot more energy. I am more talkative, less withdrawn. I feel a little bit of motivation to use the energy only as of today. I have managed to get myself to the gym four times in the last week which definitely did not happen on Effexor.Side effects: The tone in my head is still very bothersome especially if I am somewhere quiet. I don't notice it as much with the AC, computer, refrigerator etc. running but if I am in a quiet place, it is really loud. My head feels like there is too much pressure inside it - this is part of the ear-ringing thing. I complained to my PCP today about it and I am having an MRI done on Monday since I also have another problem which could indicate a pituitary gland tumor. The ear-ringing could be related.
Don't know if the orgasm delay has gotten any better or worse - haven't tried to find out in the last couple days.
My anxiety level has gone back down in general since restarting a small dose of Effexor three days ago. I still have quite a bit of anxiety and have had a couple of bad spells but now that I know it's from the Effexor withdrawal I'm feeling better about it.
I'm still having some dry mouth.
Other than that, no side effects.
Small improvement in motivation.No improvement in anhedonia.
Posted by hope4best on September 9, 2004, at 20:20:57
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Marsha,
Hang in there, we're pulling for you and there with you in spirit. Thanks for sharing your experiences. I don't want to sound cliche, but for me, the saying "This too shall pass" is always helpful when I feel low, since both good times and bad times shall pass.
Wishing you good times!
Posted by SLS on September 10, 2004, at 7:21:19
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
> Efficacy: I still have a lot more energy
> Small improvement in motivation.
> No improvement in anhedonia.You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
- Scott
Posted by 4WD on September 10, 2004, at 18:39:29
In reply to Re: Cymbalta Journal, posted by SLS on September 10, 2004, at 7:21:19
> > Efficacy: I still have a lot more energy
>
> > Small improvement in motivation.
>
> > No improvement in anhedonia.
>
> You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
>Thanks, Scott. I was wondering about that but had never heard one way or the other. You know, when my PCP told me she wanted me to have a brain MRI because I have some symptoms that would hint at a pituitary gland tumor my first thought was "oh I hope so! That could explain my depression and they could remove it and then I'd be okay!" Kind of twisted. I guess only another depressed person would understand.
Marsha
>
Posted by 4WD on September 10, 2004, at 19:48:25
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Cymbalta 20mg
Effexor 15 mg(to mitigate withdrawal)Day 8 9-10-04
I lowered the dose of Cymbalta today to see if the ringing in my ears might lessen on a lower dose. Just an experiment; I'm going back up to 30mg tomorrow. I've added back about 15-20 mg Effexor to help with the withdrawal symptoms I've been having (anxiety). I'll slowly taper the Effexor over the next few weeks.
I can't really give an accurate report today. I took some prescription pain meds yesterday and so today I feel kind of groggy and out of sorts. (This always happens.)
Taking the pain pills has showed me one new side effect, though. When I take those pain meds, I get a lot of energy and motivation and enjoy doing constructive things. So I went out and worked on my little garden area in the back yard yesterday after I took the meds. I discovered that I sweat a lot more with exertion now that I'm on Cymbalta. Admittedly it was about 85 degrees and I was digging with a shovel but I usually don't perspire much even when I'm hot. Luckily it only seems to happen with pretty heavy activity. I haven't noticed any sweating at all during normal activities.
I'll be able to report better tomorrow. I should be about back to "normal" by then.
Marsha
Posted by 4WD on September 10, 2004, at 21:09:22
In reply to Re: Cymbalta Journal, posted by SLS on September 10, 2004, at 7:21:19
> > Efficacy: I still have a lot more energy
>
> > Small improvement in motivation.
>
> > No improvement in anhedonia.
>
> You are on the right track. Energy is usually the first thing to return, with anhedonia being the last. All systems go!
>
>
> - Scott
P.S. It's really nice of you to be supportive, Scott, since the Cymbalta doesn't seem to be working so well for you. I truly do appreciate it.Marsha
Posted by iris2 on September 11, 2004, at 0:09:11
In reply to Re: Cymbalta Journal - Day 8, posted by 4WD on September 10, 2004, at 19:48:25
> I lowered the dose of Cymbalta today to see if the ringing in my ears might lessen on a lower dose. Just an experiment; I'm going back up to 30mg tomorrow.
Marsha,
Just a thought. Do not knwop the half life of Cymbalta but do you think that one day of lowered Cymbalta is long enough to observe an accurate change in the ringing in your ears?
irene
Posted by 4WD on September 12, 2004, at 16:28:27
In reply to Cymbalta Journal, posted by 4WD on September 4, 2004, at 15:58:30
Days 9 and 10 (Saturday & Sunday, Sept. 11 &12)
Cymbalta 30mg
Effexor 15 mgDay 9 (yesterday) was pretty bad. It was partly from still feeling groggy and tired from taking too many pain pills (hydrocodone) on Thursday so that was my fault. I had just been so tired of feeling so bad for so long that I desperately wanted to feel GOOD for a little while. Now I'm paying for it.
It was also from the pressure in my head and the ringing tone in my head. This is much worse than it was on 37.5 mg of Effexor and with Effexor I never had the pressurized feeling. Last night about 10 o'clock it got really bad. My neck and shoulders got real tense and started to draw up. My head felt like it was overstuffed with heavy wet cotton- my brain felt like it was swollen. When I'd turn my head from side to side it felt like my sore brain was banging against the inside of my skull. Then it turned into an actual painful headache starting at the base of my skull and moving over the whole top of my head. I took some ibuprofen and went to bed.
Day 10 Sunday didn't start out so great either. I felt okay (though still tired from pain pills) but a little scared when I got up. Within a hour I was very anxious and in another hour got panicky. I took 1/8 mg of Klonopin and the panic subsided into fear. I waited about an hour then took another 1/8 mg K. Now I feel okay but my head still feels pressurized. It's like I'm in an airplane but my ears won't pop x five and my brain is vaguely sore. ANd the tone in my head is driving me nuts.
It's hard for me to tell how I'd be feeling if I weren't having the tone in my head and if I weren't having to take Klonopin. The K makes me feel a bit down.
I don't know if the anxiety is completely from Effexor withdrawal or not. I tend to think it is since my anxiety has increased every time I switch from Effexor to another drug.
Today I do not feel energetic, motivated or hedonic. I think yucky/nervous might describe it. I am sleeping great, though.
Marsha
Posted by iris2 on September 13, 2004, at 9:14:05
In reply to Re: Cymbalta Journal, posted by 4WD on September 12, 2004, at 16:28:27
Marsha,
Sorry to hear that things are not so well the last couple of days. Hope most of it is from the Effexor withdrawel. That will be over soon enough so keep you chin up. I'll be thinking of you of course.
irene
Posted by 4WD on September 13, 2004, at 21:03:07
In reply to Re: Cymbalta Journal » 4WD, posted by iris2 on September 13, 2004, at 9:14:05
> Marsha,
>
> Sorry to hear that things are not so well the last couple of days. Hope most of it is from the Effexor withdrawel. That will be over soon enough so keep you chin up. I'll be thinking of you of course.
>
> irene
Thank you Irene. I am much better today. It was partly from the pain pills, partly from the Effexor withdrawal. The pain pill part is over but I'm still having panic attacks from the Effexor withdrawal.Marsha
Posted by 4WD on September 13, 2004, at 21:37:02
In reply to Re: Cymbalta Journal, posted by 4WD on September 9, 2004, at 20:09:02
Day Eleven, Monday, 9-13-04
Cymbalta 30mg (15mg a.m., 15mg p.m.)
Effexor XR 10mg
Klonopin .25 mg as needed, mostly in the morningsNOTE: I may not be posting after today or tomorrow for a while. Hurricane Ivan is headed straight for where I live (between Mobile, AL & Pensacola, FL)
I'm doing much, much better today.
The bad feeling from the pain pills has worn off. I'm still experiencing anxiety and some panic attacks presumably from the Effexor withdrawal.
Efficacy: I have so much energy. I am bouncy. Part of this is nerves from the hurricane, however. I am sleeping better than I have in years. I go to bed and am asleep within 20 minutes. This is miraculous for me. (this is without klonopin) I am feeling maybe a bit more motivation but not a lot. Still can't say there's any improvement in anhedonia.
Side effects: Absolutely no sleepiness after dosing, either at 30mg in the morning or when I divide the doses. I am dividing the doses because I have found myself waking up after fewer hours sleep than I want to get. I thought maybe the Cymbalta was wearing off too soon and anxiety was waking me up too early.
The buzz/hum/roar in my head is still there. I am trying to ignore it. It's not too hard except when I'm in a quiet place; then it's maddening. The pressurized feeling is less though.
Mild delay in orgasm. Libido seems okay, not much opportunity lately.
Dry mouth is less.
I can't decide whether it would be better to taper the Effexor rapidly and get it over with while I'm taking Klonopin or to drag it out and have to take the Klonopin longer. It doesn't seem to matter how slowly I taper, I'm going to have anxiety regardless and as soon as I quit it completely, it's going to get worse. I'm afraid the ringing in my ears is worse because I'm taking Effexor + Cymbalta - they both cause it.
In general I'm very happy with Cymbalta - if the dratted ringing in my ears would go away, I'd be thrilled.
Marsha
Posted by boomarang on September 13, 2004, at 22:20:08
In reply to Re: Cymbalta Journal Day 11, posted by 4WD on September 13, 2004, at 21:37:02
hi marsha,
i am also experiencing panic attacks. i think it has more to do with the lamictal i'm taking than the cymbalta. i've been on cymbalta four days and the panic attacks started a week before that. i think my lamictal dose was too high, causing way too much anxiety and now i'm probably still having them because i'm reducing the lamictal fairly quickly.
Posted by Allie Blue on September 14, 2004, at 11:30:38
In reply to Re: Cymbalta Journal Day 11, posted by 4WD on September 13, 2004, at 21:37:02
> Day Eleven, Monday, 9-13-04
>
> Cymbalta 30mg (15mg a.m., 15mg p.m.)
> Effexor XR 10mg
> Klonopin .25 mg as needed, mostly in the mornings
>
> NOTE: I may not be posting after today or tomorrow for a while. Hurricane Ivan is headed straight for where I live (between Mobile, AL & Pensacola, FL)
>
> I'm doing much, much better today.
>
> The bad feeling from the pain pills has worn off. I'm still experiencing anxiety and some panic attacks presumably from the Effexor withdrawal.
>
> Efficacy: I have so much energy. I am bouncy. Part of this is nerves from the hurricane, however. I am sleeping better than I have in years. I go to bed and am asleep within 20 minutes. This is miraculous for me. (this is without klonopin) I am feeling maybe a bit more motivation but not a lot. Still can't say there's any improvement in anhedonia.
>
> Side effects: Absolutely no sleepiness after dosing, either at 30mg in the morning or when I divide the doses. I am dividing the doses because I have found myself waking up after fewer hours sleep than I want to get. I thought maybe the Cymbalta was wearing off too soon and anxiety was waking me up too early.
>
> The buzz/hum/roar in my head is still there. I am trying to ignore it. It's not too hard except when I'm in a quiet place; then it's maddening. The pressurized feeling is less though.
>
> Mild delay in orgasm. Libido seems okay, not much opportunity lately.
>
> Dry mouth is less.
>
> I can't decide whether it would be better to taper the Effexor rapidly and get it over with while I'm taking Klonopin or to drag it out and have to take the Klonopin longer. It doesn't seem to matter how slowly I taper, I'm going to have anxiety regardless and as soon as I quit it completely, it's going to get worse. I'm afraid the ringing in my ears is worse because I'm taking Effexor + Cymbalta - they both cause it.
>
> In general I'm very happy with Cymbalta - if the dratted ringing in my ears would go away, I'd be thrilled.
>
> Marsha
>
>
> Marsha,Are you splitting the 30mg cymbalta capsules? Are there any problems with splitting and how do you split them? I'm thinking about doing that too but the manufacturers insert says not to split?
ALLIE
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