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SNRI for nerve pain ?

Emmarose47

Senior Member
Messages
2,115
Location
UK
Hi doc is recommending Duloxetine ( Cymbalta SNRI which can be useful in helping neuro pathic pain ..
Anyone have experience of this ?
I already take SSRI for depression and am aware it seems to give me a background adrenaline / bit short of breath / nervous feeling ....so I really don't want any more of that or any other side effects really ....

The pain in my arms / legs hands and feet is getting too much
 
Messages
72
Hi,

Duloxetine was the very first AD I tried. And it was very bad - got me extremely agitated. I stopped it on the second or so day. A year later or so, I tried it again with the same side effect so had to stop again. Although, I felt a very prominent positive effect this time - some radical improvement in my digestion. So, I went to Wiki page and found an AD with the lowest norepinephrine activity yet the highest serotonin and dopamine ones - Sertraline. And it worked pretty well (got rid of many symptoms) for me until I realized it was doing something bad to my urinary system so I had to stop it (all other ADs did the same to me, so no luck with it).
 
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Emmarose47

Senior Member
Messages
2,115
Location
UK
Hi,

Duloxetine was the very first AD I tried. And it was very bad - got me extremely agitated. I stopped it on the second or so day. A year later or so, I tried it again with the same side effect so had to stop again. Although, I felt a very prominent positive effect this time - some radical improvement in my digestion. So, I went to Wiki page and found an AD with the lowest norepinephrine activity yet the highest serotonin and dopamine ones - Sertraline. And it worked pretty well (got rid of many symptoms) for me until I realized it was doing something bad to my urinary system so I had to stop it (all other ADs did the same to me, so no luck with it).
Thanks for sharing
What's AD ?
May I ask what you were trying to treat with the drug ?
Do u know what norepinephrine activity does ?
I tried sertraline for dep / anxiety once man the physical racing and suicidal thoughts trying to titrate it were off the scale !
 

xebex

Senior Member
Messages
840
from what i've heard cymbalta is very dificult to come off, I mean all antidepresents can be difficult to taper on and off but cymbalta seems exceptionally so. I've heard that wellbutrin is actualy pretty good for Nerve pain. That's not to say it couldn't also have it's problems.

https://journals.lww.com/clinicalpa... of this open,or much improved with bupropion.

i actuayl found ritalin pretty good for my nerve pain which is similar in a way to wellbutrin - but I could only take it once a week and then eventualyl it stopped being helpful - the side effects outweighed the benefits.
 
Messages
72
AD is short for antidepressant.

I was prescribed with Cymbalta by my neurologist because he heard "all-over-the-body pain" complaint from me. Yes, Duloxetine for some reason is a first line of treatment drug for fibromyalgia, but I would never suggest it to anyone who has anxiety issues of any kind.

Here is the quote from Wikipedia' Norepinephrine page - "The general function of norepinephrine is to mobilize the brain and body for action" - a recipe to exacerbate any anxiety or to build one when you are a CFS sufferer...

As for Sertraline, or any other antidepressant, from my experience it is critically important that you deal with all of the major issue outside of you body first - you must accept what happens around you as something irrelevant at this point or event better focus on good stuff only, otherwise this type of drug may have the opposite to the desired effect.

I also found it more effective to combine Sertraline with 15mgx3 per day Baclofen to minimize the starters side effects. It worked very well for me until I could not pee without a shower anymore :(
 

Emmarose47

Senior Member
Messages
2,115
Location
UK
As for Sertraline, or any other antidepressant, from my experience it is critically important that you deal with all of the major issue outside of you body first - you must accept what happens around you as something irrelevant at this point or event better focus on good stuff only, otherwise this type of drug may have the opposite to the desired
Thanks
I'm not quite understanding the above could u explain please
 
Messages
72
Thanks
I'm not quite understanding the above could u explain please
If there is something big in your head that worries you day after day (besides the illness itself), then find a way to get rid of that before starting any antidepressants. That was my experience - AD worked extremely well when I had nothing big to worry about and on the contrary, it did exacerbate my state when I was in the middle of the bunch of problems I had to solve.
 

Emmarose47

Senior Member
Messages
2,115
Location
UK
If there is something big in your head that worries you day after day (besides the illness itself), then find a way to get rid of that before starting any antidepressants. That was my experience - AD worked extremely well when I had nothing big to worry about and on the contrary, it did exacerbate my state when I was in the middle of the bunch of problems I had to solve.
Ah I got you thanks ..
Ye I'm in housing crisis so ....
 
Messages
72
Ah I got you thanks ..
Ye I'm in housing crisis so ....
Yes, that's exactly what I meant.

I would recommend either to wait until the crisis is resolved or to reconsider your attitude towards it and then try AD again, but be sure that nothing new substitutes your housing worries when those are gone - our mind tends to do so once caught in this bad state..

Yea, I know - it's easier said than done, but this approach helped me to get some substantial benefits from AD.

Good luck!
 

Judee

Psalm 46:1-3
Messages
4,461
Location
Great Lakes
I know this might seem like a bandaid on a gaping wound type suggestion but have you tried ginkgo for the neuropathy pain? It helps me some but I only take a pinch as needed because it can also cause tachycardia.

Sometimes my skin feels so smacked, I get tremors or my arms and fingers tingle and the ginkgo does seem to help. It even helps me to fall asleep when those things are keeping me awake. Plus, I think it helps my tinnitus lessen.

Also on the Duloxetine...a rheumatologist prescribed it for me as well but I didn't want to take it after reading about side effects and people struggling to go off of it. However, my hearing for SSDI was coming up and they look at compliance so I made myself take two tiny pebbles out of a cap. Yikes. 3 day migraine and 10 day IBS flair.
 
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Emmarose47

Senior Member
Messages
2,115
Location
UK
I know this might seem like a bandaid on a gaping wound type suggestion but have you tried ginkgo for the neuropathy pain? It helps me some but I only take a pinch as needed because it can also cause tachycardia.

Sometimes my skin feels so smacked, I get tremors or my arms and fingers tingle and the ginkgo does seem to help. It even helps me to fall asleep when those things are keeping me awake. Plus, I think it helps my tinnitus lessen.

Also on the Duloxetine...a rheumatologist prescribed it for me as well but I didn't want to take it after reading about side effects and people struggling to go off of it. However, my hearing for SSDI was coming up and they look at compliance so I made myself take two tiny pebbles out of a cap. Yikes. 3 day migraine and 10 day IBS flair.
Thanks for sharing judee ❤️
How do u take the ginkgo ? And do u know what dosage recommended ?

With the Duloxetine didn't against and so glad I asked here.
The pain has beeb really bad this time . Used to just get it at start of flare but this was for 5 days . I realised I had some voltarol ( diclafenac ) topic and tried it and it did work ... However I am finding things can work initially with the pain until they don't ..
Will see . Doc said fine to use and put on prescription . She mentioned co codamol but I said no too addictive for me .. but that was when I hadn't been sober long some yrs ago so could be an option to try as long as I stay accountable with it .
Glad to report I'm out the worst of flare and pain greatly reduced ...
Now it's the easy does it phase
 

hmnr asg

Senior Member
Messages
558
Hi there,

I take duloxetine for nerve pain, specifically trigeminal Neuralgia. My pain was so bad that I couldn't have survived without it. Yes antidepressants are bad yada yada but we wouldn't be taking them if we didn't have to. Yes you have to deal with life circumstances but that won't solve your nerve pain.

In my case the first few weeks were tough as is usually the case with antidepressants which is to be expected. Also the original dose was too much for me and I couldn't sleep, so I went to 40mg a day from 60mg. The dose you need might even be 20mg, so you have to experiment.

It did wonders for my anxiety, ocd and nerve pain. But as others have said, getting off this antidepressant is an ordeal for most people. Of course the internet is filled with worse case scenarios and I know people who have gotten off cymbalta pretty easily but that is generally not the case. You'd have to drop down very very slowly and it will take months (some say years) to get off of it. In my case I failed twice to get off of it because it was worsening my trichotillomania. But overall it has been a great antidepressant minus that.

You could try and see what happens. But if you do give it a month or two unless you have an extremely bad initial reaction.

Also keep in mind there are other antidepressants for nerve pain like nortriptyline or amitriptyline. Lyrica is also commonly prescribed for nerve pain ( I take that too).

Ps the effects on norepinephrine is why duloxetine works for nerve pain and why Zoloft will do nothing for it.
 
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Judee

Psalm 46:1-3
Messages
4,461
Location
Great Lakes
How do u take the ginkgo ? And do u know what dosage recommended ?

I don't know what dose unfortunately especially since pwME are generally so sensitive to things. That's why I just open a capsule and take a pinch...really what you would get if you were putting a pinch of salt into a recipe.

Sorry I can't be more specific than that.
 

Emmarose47

Senior Member
Messages
2,115
Location
UK
Hi there,

I take duloxetine for nerve pain, specifically trigeminal Neuralgia. My pain was so bad that I couldn't have survived without it. Yes antidepressants are bad yada yada but we wouldn't be taking them if we didn't have to. Yes you have to deal with life circumstances but that won't solve your nerve pain.

In my case the first few weeks were tough as is usually the case with antidepressants which is to be expected. Also the original dose was too much for me and I couldn't sleep, so I went to 40mg a day from 60mg. The dose you need might even be 20mg, so you have to experiment.

It did wonders for my anxiety, ocd and nerve pain. But as others have said, getting off this antidepressant is an ordeal for most people. Of course the internet is filled with worse case scenarios and I know people who have gotten off cymbalta pretty easily but that is generally not the case. You'd have to drop down very very slowly and it will take months (some say years) to get off of it. In my case I failed twice to get off of it because it was worsening my trichotillomania. But overall it has been a great antidepressant minus that.

You could try and see what happens. But if you do give it a month or two unless you have an extremely bad initial reaction.

Also keep in mind there are other antidepressants for nerve pain like nortriptyline or amitriptyline. Lyrica is also commonly prescribed for nerve pain ( I take that too).

Ps the effects on norepinephrine is why duloxetine works for nerve pain and why Zoloft will do nothing for it.
Thanks for sharing ..
Is it a THING that Duloxetine is harder to come off than other ADD ?
I'm on SSRI and came off 3 times over the yrs it was hard ....
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,089
Location
australia (brisbane)
What about going on Tramadol maybe as needed? I find it good for nerve pain as it not only as some opiate action it also has some noradrenaline serotonin effects that seem to work well for nerve pain. 12hr slow release tabs are good. It's not prescribed for depression but certainly helps
 

Emmarose47

Senior Member
Messages
2,115
Location
UK
What about going on Tramadol maybe as needed? I find it good for nerve pain as it not only as some opiate action it also has some noradrenaline serotonin effects that seem to work well for nerve pain. 12hr slow release tabs are good. It's not prescribed for depression but certainly helps
Thanks can't use anything addictive ...I'm an addict in recovery ...
To be clear I don't need ADD for dep
 

hmnr asg

Senior Member
Messages
558
Is it a THING that Duloxetine is harder to come off than other ADD ?
Yes, it is in fact a thing. I have also safely and easily gotten off multiple antidepressants without any issues. But failed to get off duloxetine.
So if you plan to try it, you have to do it knowing that getting off will be an ordeal.
There are generic versions that have 5mg pellets. Im planning to use that method to get off, but other people use the powder version and a very precise scale to go down much slower in order to get off of it. (also, some people can get off of it relatively easily, like any other antidepressant).
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,089
Location
australia (brisbane)
Thanks can't use anything addictive ...I'm an addict in recovery ...
To be clear I don't need ADD for dep

Understand, makes things alot harder.
The part about depression wasn't referring to you be depressed or not but more to the fact that it shows it works on serotonin and noradrenaline, which is helpful in blocking nerve/pain signals. Also good for people to know if on an antidepressant, to be careful of tramadol as the combo can cause serotonin syndrome.

I guess I write replies to the person who started the thread but also to anyone else who may read this.