Posted by SLS on December 5, 2014, at 8:40:27
In reply to Re: Is 120mg of Cymbalta too much, posted by pattisun16 on December 5, 2014, at 2:27:56
> I'm searching thru message boards for Cymbalta users.
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> I take fentanyl patch, 50mcg and Norco (4/day). I have spinal stenosis and bursitis in my hips.
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> I am tired of getting treated like a druggie here in California. I have to almost beg my nurse to get the Hand written script and if my doctors allow me my meds earlier than 30 days the pharmacy won't fill it, even if I am traveling!! And nobody understands that some months have 31 days....
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> So I have to take Lyrica along with the Cymbalta to control the pain.
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> I hope you are doing well, thanks for your help.
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> Patti in CaliforniaCymbalta (duloxetine) can be a great analgesic. It does not work in the same way that fentanyl (a phenylpiperidine opioid) does. The two are complementary and, perhaps, synergistic. I really don't know.
From what I have seen, 120 mg/day of Cymbalta can be more effective than 60 mg/day in a large number of people suffering from depression. It is thought by some that there is a small risk of developing serotonin syndrome when combining fentanyl with a serotonin reuptake inhibitor drug (SSRI and SNRI) like Cymbalta, but the rate of occurrence is deemed to be rare. Two cases of SS with such a combination have been reported in the medical literature.
Because Cymbalta is so uniquely effective as an antinociceptive in the treatment of various pain disorders, I think it would be reasonable to combine it with fentanyl and become familiar with the symptoms of serotonin syndrome. If combined treatment with fentanyl becomes an issue, you can look into using a non-phenylpiperidine opioid in place of fentanyl. At this point, there are no concerns regarding serotonin syndrome when using these drugs.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:997637
URL: http://www.dr-bob.org/babble/20141120/msgs/1073959.html