![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Bob on December 17, 2007, at 11:47:47
What is the general concensus here about Cymbalta's pain fighting abilities relative to other ADs on the market? Is Duloxetine better at pain relief than any other antidepressant, or is that just clever marketing? Wouldn't a med like Effexor also be could at pain relief?
Posted by Phillipa on December 17, 2007, at 11:57:37
In reply to Cybalta and Pain, posted by Bob on December 17, 2007, at 11:47:47
I just know from experience that when cymbalta came out I was able to take up to 60mg and did for three months and when I stopped had back pain I hadn't known I had before as it was absent on the med. Could be conincidence who knows? Phillipa
Posted by rskontos on December 17, 2007, at 12:41:44
In reply to Re: Cybalta and Pain » Bob, posted by Phillipa on December 17, 2007, at 11:57:37
cymbalta worked better for me for pain than for the depression or anxiety. did nothing for anxiety or depression but it also made me have thoughts of suicide for the first time.. and the side effects were more than than I deemed worth it. Not to mention it is tough to get off. I also knowing now what i know more about SSR's I don't like how they alter your metabolic rate. Not acceptable to me. It would seem in my humble opinion a better pain med could be found or at least try all other avenues first. JMHO though
rsk
Posted by Bob on December 17, 2007, at 17:02:07
In reply to Re: Cybalta and Pain..bob, posted by rskontos on December 17, 2007, at 12:41:44
> cymbalta worked better for me for pain than for the depression or anxiety. did nothing for anxiety or depression but it also made me have thoughts of suicide for the first time.. and the side effects were more than than I deemed worth it. Not to mention it is tough to get off. I also knowing now what i know more about SSR's I don't like how they alter your metabolic rate. Not acceptable to me. It would seem in my humble opinion a better pain med could be found or at least try all other avenues first. JMHO though
>
> rsk
Good info RSK. If you don't like the SSRIs and their metabolic rate altering, then what type of ADs would you use?
Posted by rskontos on December 18, 2007, at 18:15:53
In reply to Re: Cybalta and Pain..bob » rskontos, posted by Bob on December 17, 2007, at 17:02:07
Well Bob right now I am using supplements and am in between Ad's and hoping new p-doc will help. I really need an anti-anxiety worse than depression. While I have depression, anxiety is more my main problem. I took myself off the Ad, my therapist knows and is cool but the neuro that prescribe it doesnt. Still looking for new p-doc. Called one awaiting call back. I think holidays are the hitch.
I have found tons of informtion on this board and crazymeds.us that have possible solutions but I am not sure. Is pain your main concern. If you search the archives for depression and pain you will probably find tons of threads. rk
Posted by Phillipa on December 18, 2007, at 19:28:10
In reply to Re: Cybalta and Pain..bob, posted by rskontos on December 18, 2007, at 18:15:53
RK we're in the same boat what have you found for anxiety in your searches? Phillipa
Posted by Bob on December 18, 2007, at 19:43:23
In reply to Re: Cybalta and Pain..bob, posted by rskontos on December 18, 2007, at 18:15:53
> Well Bob right now I am using supplements and am in between Ad's and hoping new p-doc will help. I really need an anti-anxiety worse than depression. While I have depression, anxiety is more my main problem. I took myself off the Ad, my therapist knows and is cool but the neuro that prescribe it doesnt. Still looking for new p-doc. Called one awaiting call back. I think holidays are the hitch.
>
> I have found tons of informtion on this board and crazymeds.us that have possible solutions but I am not sure. Is pain your main concern. If you search the archives for depression and pain you will probably find tons of threads. rkPain has become an increasing problem in the last few years, but I have always had serious problems with anxiety, and depression.
I think my problems started out early in life as anxiety, then it gravitated to depression and all the problems that brings. Personally, I feel that the pain has largely been exacerbated my the ineffective treatements and the brutality they've effected on my body.
Posted by Phillipa on December 18, 2007, at 20:51:33
In reply to Re: Cybalta and Pain..bob » rskontos, posted by Bob on December 18, 2007, at 19:43:23
Same here first panic attack age 24 only anxiety til thyroid went now the depression mixed in. What have you tried since our symtoms and the way it started are the same? I did the cymbalta for thee months at 60mg. Phillipa
Posted by rskontos on December 19, 2007, at 11:11:38
In reply to Re: Cybalta and Pain..bob » Bob, posted by Phillipa on December 18, 2007, at 20:51:33
Bob cymbalta did nothing for anxiety. At least for me. My panic attackes got worse. Lexapro helped for general anxiety but not enough.
Phillip so far I am more confused than anything. I think a good swift hit in the head is in order.
Maybe benzo of some type to take as needed. I truly don't think depression is biggest issue for me it is anxiety. I am anxious all the time. And when it blows it blows HUGE. Way out of proportion so I need something to take then. And something that wont make me gain weight as then I will be depressed. Someone suggested Nardil because of its depressive uses to help but then it can make you gain weight not so good. It does help anxiety at least the internet says so. I think if I could keep the anxiety down I could work on the depression myself. JMHO. I am hoping my new p-doc when I find he/she will help with this. I can still dissociate when I get a panic attack but since I keep I am switching more and more I am not sure I can maintain this for long. I am little worried I am heading for someplace no good. In my head things are very shaky and I am losing my coping skills. So I will let you guys know what I find out. I keep checking crazymeds.us too to see what they know as well. They are really smart there too.
rk
Posted by Bob on December 19, 2007, at 22:33:09
In reply to Re: Cybalta and Pain..bob » Bob, posted by Phillipa on December 18, 2007, at 20:51:33
> Same here first panic attack age 24 only anxiety til thyroid went now the depression mixed in. What have you tried since our symtoms and the way it started are the same? I did the cymbalta for thee months at 60mg. Phillipa
I've tried almost everything my doctor and I could think of (including ECT), with the exception of MAOIs, because I couldn't imagine surviving the washout period both before and after trying a possible drug failure. I've been doing this for a solid 15 years and have been through some really, really bad times. I don't know any longer what to try really, so I wouldn't be of much help with the suggestions for someone else who might be like me.I'm at a complete loss for what to do now with treatments and have tossed around things like rTMS, VNS, and the like. I don't really hold much hope for things like that, but what else am I going to do. Going on and of drugs just to try them out is becoming less feasible.
Posted by Justherself54 on December 20, 2007, at 7:20:02
In reply to Re: Cybalta and Pain..bob, posted by rskontos on December 19, 2007, at 11:11:38
I have fibromyalgia and live in constant pain. I have found on Nardil that I still have pain, but Nardil has relieved the "flareups" that come if I've exerted myself more than I should, which is all the time now that I've found a whole stash of energy I never thought I'd see again. For me zero depression, anxiety down to just feeling a bit overwhelmed in crowds, socializing way up (I was a hermit before)..focus and concentration improving weekly..
I am overweight to being with from SSRI's..the way I'm trying to combat weight gain is simply not having anything sweet in my house. I have zero appetite during the day..it's at night that I can go crazy on carbs and sweets..also the diet has forced me to start cooking fresh suppers, whereas before I would just throw a frozen meal in the microwave..I've been on it since September and have gained 6 pounds but that was during the first month..so far I haven't gained anymore weight.
It may be worth a second look for you. My pain is always there but it's like I don't care..for some reason I can deal with it..I'm doing things that would have put me in bed for a day before, but not now..
Sorry to ramble..just wanted to share my experience with my chronic pain disorder and Nardil..
Posted by Bob on December 20, 2007, at 12:57:30
In reply to Re: Cybalta and Pain..bob, posted by Justherself54 on December 20, 2007, at 7:20:02
> I have fibromyalgia and live in constant pain. I have found on Nardil that I still have pain, but Nardil has relieved the "flareups" that come if I've exerted myself more than I should, which is all the time now that I've found a whole stash of energy I never thought I'd see again. For me zero depression, anxiety down to just feeling a bit overwhelmed in crowds, socializing way up (I was a hermit before)..focus and concentration improving weekly..
>
> I am overweight to being with from SSRI's..the way I'm trying to combat weight gain is simply not having anything sweet in my house. I have zero appetite during the day..it's at night that I can go crazy on carbs and sweets..also the diet has forced me to start cooking fresh suppers, whereas before I would just throw a frozen meal in the microwave..I've been on it since September and have gained 6 pounds but that was during the first month..so far I haven't gained anymore weight.
>
> It may be worth a second look for you. My pain is always there but it's like I don't care..for some reason I can deal with it..I'm doing things that would have put me in bed for a day before, but not now..
>
> Sorry to ramble..just wanted to share my experience with my chronic pain disorder and Nardil..
>
>
No need to apologize at all.I've always had trouble with heavy duty medicines like Anafranil, and Effexor. I guess that and the fact that Nardil seems practically guaranteed to cause me to become obese (I easily gained 50 lbs on Anafranil when my baseline weight was about 135-140) and never have sex ever again that has kept me from trying it, problems getting on and off of it not withstanding. I'm frankly afraid that a washout period could land me in the hospital.
You description of the eating patterns sounds very much like me. With any kind of therapeutic response to an serotonergic drug, my sleep patterns get severely shifted so that I'm up all night and sleeping late into the day and my eating develops into a crescendo of cravings late at night. Very similar.
The pain I have has become more and more of a fixture in the last few years mostly after my course of ECT. It is indeed becoming an increasing worry and leaves me wondering sometimes, is it the disease we have or all the medecines we take over the years that causes the pain? How would you describe your pain? Where does it exhibit itself the most?
Nothing is off the table for me as far as possible treatments go (with the possible exception of ECT again) so MAOIs might be an option in the future.
Posted by Justherself54 on December 20, 2007, at 18:20:15
In reply to Re: Cybalta and Pain..bob » Justherself54, posted by Bob on December 20, 2007, at 12:57:30
> > I have fibromyalgia and live in constant pain. I have found on Nardil that I still have pain, but Nardil has relieved the "flareups" that come if I've exerted myself more than I should, which is all the time now that I've found a whole stash of energy I never thought I'd see again. For me zero depression, anxiety down to just feeling a bit overwhelmed in crowds, socializing way up (I was a hermit before)..focus and concentration improving weekly..
> >
> > I am overweight to being with from SSRI's..the way I'm trying to combat weight gain is simply not having anything sweet in my house. I have zero appetite during the day..it's at night that I can go crazy on carbs and sweets..also the diet has forced me to start cooking fresh suppers, whereas before I would just throw a frozen meal in the microwave..I've been on it since September and have gained 6 pounds but that was during the first month..so far I haven't gained anymore weight.
> >
> > It may be worth a second look for you. My pain is always there but it's like I don't care..for some reason I can deal with it..I'm doing things that would have put me in bed for a day before, but not now..
> >
> > Sorry to ramble..just wanted to share my experience with my chronic pain disorder and Nardil..
> >
> >
>
>
> No need to apologize at all.
>
> I've always had trouble with heavy duty medicines like Anafranil, and Effexor. I guess that and the fact that Nardil seems practically guaranteed to cause me to become obese (I easily gained 50 lbs on Anafranil when my baseline weight was about 135-140) and never have sex ever again that has kept me from trying it, problems getting on and off of it not withstanding. I'm frankly afraid that a washout period could land me in the hospital.
>
> You description of the eating patterns sounds very much like me. With any kind of therapeutic response to an serotonergic drug, my sleep patterns get severely shifted so that I'm up all night and sleeping late into the day and my eating develops into a crescendo of cravings late at night. Very similar.
>
> The pain I have has become more and more of a fixture in the last few years mostly after my course of ECT. It is indeed becoming an increasing worry and leaves me wondering sometimes, is it the disease we have or all the medecines we take over the years that causes the pain? How would you describe your pain? Where does it exhibit itself the most?
>
> Nothing is off the table for me as far as possible treatments go (with the possible exception of ECT again) so MAOIs might be an option in the future.This about sums it up for fibro:
# Pain: The most prominent symptom of fibromyalgia is pain. Unlike arthritis, the discomfort is not in the joints but in the muscles and ligaments. The pain is commonly located in the neck, shoulders, back, and hips. The tenderness is worse in the mornings and has been described as flulike, burning, throbbing, aching, or stabbing.
# Fatigue: Another frequent complaint associated with fibromyalgia is fatigue. In fact, it occurs so commonly that some doctors think fibromyalgia and chronic fatigue syndrome are the same disease. The severity of the fatigue can range from mild to incapacitating. In its worse form, fatigue can be so debilitating that some people have trouble keeping their jobs. No amount of sleep at night or rest during the day is helpful.When you have a pain disorder it can feed into depression and you enter a vicious circle..I made a decision with my doctor when I was diagnosed that I wasn't going to use opiates..it's not a nice condition to have..that's why I'm so liking the Nardil..It seems to help manage the pain and I don't get the fatigue when I overuse my muscles and believe me I have been very active since being on it..I still have work to do with my eating habits and getting some cardio worked into my day..
Where is your pain and how does it exhibit itself? Chronic pain is serious as it and depression go hand in hand..
Posted by antigua3 on December 26, 2007, at 10:19:57
In reply to Cybalta and Pain, posted by Bob on December 17, 2007, at 11:47:47
Sorry if this has been suggested already, but I didn't read the whole thread.
Have you tried Lyrica? I take both Cymbalta and Lyrica and it's a great combo for me. Lyrica is prescribed for fibromylagia, but some pdocs are also using it as an AD.
good luck,
antigua
Posted by Bob on December 26, 2007, at 16:26:47
In reply to Re: Cybalta and Pain » Bob, posted by antigua3 on December 26, 2007, at 10:19:57
> Sorry if this has been suggested already, but I didn't read the whole thread.
>
> Have you tried Lyrica? I take both Cymbalta and Lyrica and it's a great combo for me. Lyrica is prescribed for fibromylagia, but some pdocs are also using it as an AD.
>
> good luck,
> antiguaI have not tried Lyrica yet. Thanks for the suggestion.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.