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Cymbalta, Wow!

Discussion in 'Pain and Inflammation' started by vamah, Jul 7, 2013.

  1. vamah

    vamah Senior Member

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    Have been on Cymbalta for a few days after experiencing a huge crash that had me in severe pain/sleeplessness for over a week. It is working amazingly. Pain in my legs and back is a fraction of what it had been and even less than it was before I had the crash. Headache pain much better although I still usually end up taking some ibuprofen during the day.

    After reading suggestions from other forum members, I am taking at night because it makes me very groggy. Can actually get me to fall asleep without other sleep meds. However, I wake a few hours later and need to take something else to stay asleep. Am experimenting with going back to ambien in combination rather than trazadone or Seroquel because my medical advisor is concerned about me taking many psych meds in combination. I am now taking 20 mg Prozac in the am and 30 mg Cymbalta in the pm. He thinks I should go to just Cymbalta and not take in combination with Prozac. I'm a little worried to taper too quickly. I had been on 40 mg Prozac and was reducing by 10 mg every month or so. Depression is still a big problem for me.

    Would appreciate any thoughts/experiences.
    heapsreal likes this.
  2. SOC

    SOC Moderator and Senior Member

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    Cymbalta worked well for me for ME/CFS pain, too. It's a shame some people have serious problems with it.

    I took it at night with trazodone (which I need to maintain sleep) in relatively high doses without problems. I was not taking another antidepressant at the same time.

    Cymbalta is an SNRI, trazodone is an SARI, and Prozac is an SSRI. I would discuss with your med advisor whether you need the SSRI effect in particular. For example, I think the Prozac has an anti-OCD effect that the others don't have. If you are dealing only with depression, the Cymbalta and trazodone (which also have benefits for ME/CFS) may be sufficient and you could drop the Prozac if there's a concern about too many different antidepressants.
    heapsreal likes this.
  3. vamah

    vamah Senior Member

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    My first symptom, many years ago, was OCD and prozac does seem to control that so I don't think I want to dicontinue that right now. Not sure what to do about the sleep issue. Seroquel was working very well for me until a few weeks ago, when it suddenly wasn't. Have tried benedryl, ambien, trazadone with only slight success. Thinking maybe this is just part of the crash and have to ride it out.
  4. Ema

    Ema Senior Member

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    Please be very careful with Cymbalta.

    It worked really well for me for pain at first and then things all went terribly pear shaped. If I missed a dose, even by a short time, my pain flared where it felt like someone had poured gasoline on me and lit a match. I could hardly walk. Eventually it made me nearly catatonic except for brief periods of intense rage.

    I only took this drug for a few weeks but I still feel the negative effects to this day.

    Ema
    NilaJones likes this.
  5. SOC

    SOC Moderator and Senior Member

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    To get the right sleep med, you need to know the nature of your sleep dysfunction. A sleep test could help with that. My problems were very obviously both sleep initiation and sleep maintenance so my doc didn't have much trouble advising Benadryl for initiation since that was not the worst problem, and trazodone for the maintenance, which was a really bad problem.

    Benadryl and Ambien (sleep initiators) are not interchangeable with trazodone (sleep maintainer). Trazodone had a mild hypnotic effect, so it has some sleep initiation effect, but it significantly increases stage 3 and stage 4 sleep, which is how it acts as a "maintainer". If your problem is frequent waking or not getting deep sleep, then you need a different med than if your problem is only falling asleep.

    Prozac (along with some other SSRIs) has actually been shown to disrupt REM sleep and increase nocturnal arousals. Other antidepressants such as sertraline (Zoloft), also an SSRI, do not and are as good or better than Prozac for depression/OCD/anxiety.

    Again, a sleep specialist and possibly a sleep study could help you sort all this out. Sleep is complicated all on its own. When you add depression to the mix, the med combinations can get tricky and beyond the ken of mortal men (including GPs, even if they think they know it all).
  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I find one needs a benzo to initiate sleep and the other stuff like traz, doxepin, antihistamines prolong sleep and things like baclofen and lyrica i have found improve sleep quality but on their own dont do alot. seroquel though seems good for sleep initiation and sleep maintenance. Tizanadine i have found good as its short acting and if i wake up in the middle of the night i may use it, im not wanting to take another benzo and at that stage probably still have enough in my system but tizanadine helps me get back to sleep.

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