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Re: Has anyone had Cymbaltaź help GAD? ( yxibow) » johnnyj

Posted by yxibow on February 28, 2007, at 18:44:44

In reply to Re: Has anyone had Cymbaltaź help GAD? ( yxibow) » yxibow, posted by johnnyj on February 28, 2007, at 8:32:58

> Hi Jay:
> I see you have taken luvox. I started a trial about 5 days ago and have had a lot of anxiety with it. What side effects did you have with it? I heard it was supposed to be more sedating but I haven't found that to be the case. Without some klonopin(which I really don't want to take) I wouldn't be sleeping much if at all. I am about ready to chuck it. The internal nervousness is horrible. I have no idea if this will settle down or not. What to do next? Lexapro or paxil I guess. Sleep problems are my biggest problem. Thanks


It is theoretically the most sedating SSRI, though some say Paxil is. You may not be reacting to it in the same manner I did. Indeed it was slightly sedating, the main problems I had between dose adjustments was nausea, which I dealt with ginger. They subsided within a week or less.


Taking Klonopin (or Valium) for interdosal adjustments of an SSRI/SSNRI is not a bad thing; a small quantity shouldn't develop much tolerance and you can slowly shed it when you reach a higher dose that seems tolerable. Its a perfectly normal way of managing these things.


I got up to 450mg, though 400mg was eventually settled on. I was taking it for both dopamine deregulation (its complicated, but SSRIs do downregulate dopamine), and also OCD rumination about my complex (visual) Somatiform Disorder.


Like all serotonergic agents for me, I would and still get momentary electric shocks if I excercise hard or turn my head while doing so. But that's my personal experience, not everyone does so and I tend to be at higher levels than most. The same went for Remeron and now for Cymbalta.


How much Luvox did you start out with? If you start out with too large a dose of an SSRI you will definately experience some reaction. I believe the most conservative starting dose could be 25 or 50mg, I forget. If you started with a much larger dose, you might want to think about asking your doctor to start with a lower dose.


If Luvox is still untolerable, I would go to Paxil probably as a trial for an agent for people who tend to get anxiety with SSRIs. Just remember to take your Paxil on time as it has a shorter half life than the other agents. Luvox doesn't have a particularly long half life too, I believe it was twice daily.


I don't know much about how Lexapro affects people, I think it tends to be in the neutral side of things.


If you generally get nervousness with all SSRIs, all I can say is that 5 days is a little too soon to judge something unless we're talking wall crawling anxiety. It will slowly dissipate if it is to ever dissipate with any SSRI. Definately don't take Prozac, it won't get out of your system for a month (long half life) if you don't like it and I would predict you would definately not.


So I would give it a little more time, maybe another week or so at least -- if it is unbearable, yes, I think you're on track to try Paxil and then maybe Lexapro.

-- tidings

 

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