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MrRedShirt
02-04-12, 15:29
This morning at about 9:15 I took my first 30mg dose of Duloxetine.

I was previously on Mirtazapine, starting back in December, but after going up to 45mg and it not doing the job (it did something, but I fell very far short of remission) it was decided to swap me over to Duloxetine. So for the past 3 weeks I tapered down the Mirtazapine and didn't take any for the past couple of nights.

About an hour or so ago I had quite a large rush of the jitters and a surge of anxiety. I realized why my doctor had given me some Diazepam at this point (not a fan of the idea of benzos, and before a couple weeks ago I'd never taken them, but I've come to accept their usefulness).

Anyhow, I'm here just checking into Cymbalta-world and wondering if anyone can tell me how long I can expect this start-up anxiety to last? (or is that like asking how long a piece of string is...?)

I'm hoping what I've read about start-up anxiety being a good sign of eventual theraputic effect is borne out!

I'll try and post updates about my Duloxetine progress :)

dan1234
02-04-12, 16:08
I upped my dose to 60mg/d today and have also had a massive surge of anxiety. I imagine it will have settled down within a week or so max hopefully? Apparently the medication works within 2-4 weeks, and you should know after 6 weeks if it is worth coming off it - so it has a relatively quick mode of action.

Dan

MrRedShirt
02-04-12, 16:15
Hi Dan, I see in another thread that you started on 20mg.. Did you have any side effects with this dose?

I think this start-up anxiety I had with 30mg is manageable.. with a bit of diazepam along the way.

It was somewhat strange, the rush of anxiety I had. I felt almost faint physically and also a bit hot.

It's settled down a bit now.

And yes, the SNRIs do appear to do their thing a little quicker than the SSRIs, so hopefully within a month I'll have a good idea if Duloxetine is right for me.

My doctor wants me to stay on 30mg until I update with him in a few weeks.

dan1234
02-04-12, 16:30
Hi no side effects on 20mg. Stayed on this dose for about 5 days before increasing to 40mg for another few days, and today is my first day on 60mg.

Maybe the increase in anxiety isn't the duloxetine. I have my first CBT session tomorrow so am quite nervous.

Dan

MrRedShirt
02-04-12, 16:37
It's possible you're nervous I suppose, these things aren't always med-related! (although I'm pretty sure mine was earlier today).

There's no need to be nervous about CBT though.. I've done some and have found it fascinating, although perhaps not that helpful for me - I may return to it at some point. I did find David Burns' books very good to read though, regardless of whether or not they are that helpful for anyone's particular condition - both his 'When Panic Attacks' and 'The Feeling Good Handbook' are great, and good 'way into' the ideas of CBT.

dan1234
02-04-12, 16:41
You seem to have a good GP if he prescribed diazepam with the duloxetine. How many did you get? When I tried my first AD I had to go back to my GP and literally beg. Luckily my p doc prescribes them without fuss.

Dan

MrRedShirt
02-04-12, 16:51
Well now, Diazepam. This is the 3rd GP I've seen regarding my anxiety (as I've moved around a bit), the previous 2 weren't so willing, although to be honest this is the first time I've asked, and I had to get pretty desperate a couple of weeks ago before I wanted them. My doctor gave me 10 to cover the week after I first saw him and decided to swap - they ended up lasting 2 weeks, and he's just given me another 10 to cover this start up period.
All 2mg pills, so not so much as to make me reliant on them - I voiced my concerns about benzos when I saw him and he assured me the amount I was getting was quite safe as far as tolerance and addiction is concerned.

dan1234
02-04-12, 18:19
You will be fine. They say 6mgs for 3 weeks is where the risks start.
Dan

MrRedShirt
02-04-12, 18:26
I do hope so.

Hopefully the duloxetine will be helping me out a bit by the time I'm reaching the end of the 10 x 2mg that I have (9 x 2mg now..).

MrRedShirt
03-04-12, 13:03
Well, day two of Duloxetine. Haven't had quite such a massive rush of anxiety as I did yesterday (yet!), but I'm pretty jittery. I'm trying to distract myself and get through this start-up phase, it's not pleasant.

I'm keeping positive though - It appears that if one can push through it, the rewards are worth holding out for.

dan1234
03-04-12, 13:34
I am in the same position as you. I don't feel any increased anxiety today...

Def stick with it.. Hopefully it will help!

Dan

MrRedShirt
03-04-12, 13:38
Hi Dan,

You're on your second day of 60mg, right?
I'm wondering if I'll need to go above 30 if I'm reacting to it as I am doing.. hmm.

Is your CBT today?

dan1234
03-04-12, 13:48
Hi Dan,

You're on your second day of 60mg, right?
I'm wondering if I'll need to go above 30 if I'm reacting to it as I am doing.. hmm.

Is your CBT today?

Hi,

Yep second day of 60mg. I think the dose in the BNF for anxiety is 30mg if necessary 60mg. With the possibility of going up to 120mg.

I would see how it goes really. If it helps after 2 weeks, but not enough maybe it would be worth asking if you can increase.

CBT is today at 5.30pm. Really nervous.

Dan

MrRedShirt
03-04-12, 13:57
'Scuse my ignorance, but what's the BNF?
The leaflet in the box states 30mg as a 'starting dose' with a normal dose for GAD being 60mg. I thought this meant going up to 60 after a week or so, but my doctor wants me to stay on 30 until a review in a month or so. I think I'm happy to stick with his advice, knowing how I've reacted so far.

No need to be nervous about CBT. If it's your first session you may well just be introduced to the overall concepts and theories about it. Good luck with it! :)

dan1234
03-04-12, 14:25
'Scuse my ignorance, but what's the BNF?
The leaflet in the box states 30mg as a 'starting dose' with a normal dose for GAD being 60mg. I thought this meant going up to 60 after a week or so, but my doctor wants me to stay on 30 until a review in a month or so. I think I'm happy to stick with his advice, knowing how I've reacted so far.

No need to be nervous about CBT. If it's your first session you may well just be introduced to the overall concepts and theories about it. Good luck with it! :)

British National Formulary - What docs use when prescribing meds, contains all the facts about prescribing, cost, side effects etc.

http://en.wikipedia.org/wiki/British_National_Formulary


Thanks

Dan

MrRedShirt
04-04-12, 03:19
Well now, it's nearly 3:15am and about 90 minutes ago I woke up into a major panic attack! Not pleasant at all, one of the worst I think I've ever had. I took a 2mg of diazepam and it's taken the edge off it, but that was pretty scary..

This is proving to be tough going.

nicola1980
04-04-12, 07:34
Hi it could be a bit of withdrawal off the mirtazapine, i swapped from mirt to venlafaxine and was having panic attacks for about a wk after stopping the mirt plus nausea, shakes etc but it does pass and im using diazepam to help through the change over, mirt can be a hard med to withdraw from apparantly x x

MrRedShirt
04-04-12, 07:41
Hi Nicola,
You could be right actually, I haven't given that enough consideration perhaps. I had a relatively good couple of days after stopping the mirtazapine, but I suppose there was Still some in my system then.

I'm a bit calmer now, but that was nasty!

dan1234
04-04-12, 10:28
Hi Nicola,
You could be right actually, I haven't given that enough consideration perhaps. I had a relatively good couple of days after stopping the mirtazapine, but I suppose there was Still some in my system then.

I'm a bit calmer now, but that was nasty!

Good to hear. How are you feeling now??

MrRedShirt
04-04-12, 10:44
Hi Dan. I'm okish. Last night's panic has brought me down a bit really.

I've also got tinnitus (it started a couple of months after I started having panic attacks) and I when I get anxious it seems a lot worse. So last night it was screaming at me.

I had to consider whether the Duloxetine was directly exacerbating it.. but I've gone ahead and taken this morning's dose.

How was your CBT?

dan1234
04-04-12, 10:50
Hi Dan. I'm okish. Last night's panic has brought me down a bit really.

I've also got tinnitus (it started a couple of months after I started having panic attacks) and I when I get anxious it seems a lot worse. So last night it was screaming at me.

I had to consider whether the Duloxetine was directly exacerbating it.. but I've gone ahead and taken this morning's dose.

How was your CBT?

CBT went really well thanks. Got on well with the therapist and thought it was useful.

I think maybe the duloxetine will increase your anxiety / panic attacks initially. It certainly has for me... Have you considered Pregabalin maybe alongside the duloxetine?

Dan

MrRedShirt
04-04-12, 11:05
Glad the CBT went well. How often are your sessions?

Yes, the anxiety certainly has ramped up since I've taken the duloxetine.. as Nicola pointed out, I may be having mirtazapine withdrawals too.

Yeah I have mentioned Pregabalin to my doctor. I think he said something about that being a possible 'step after this one', meaning the Duloxetine.

I wish I could fast-forward through the next few weeks..

dan1234
04-04-12, 11:19
Glad the CBT went well. How often are your sessions?

Yes, the anxiety certainly has ramped up since I've taken the duloxetine.. as Nicola pointed out, I may be having mirtazapine withdrawals too.

Yeah I have mentioned Pregabalin to my doctor. I think he said something about that being a possible 'step after this one', meaning the Duloxetine.

I wish I could fast-forward through the next few weeks..

My sessions are weekly. He thinks I will need at least 6 but probably 9-12. Has CBT helped you?

Pregabalin has certainly helped me. But is expensive so usually used after the cheaper ADs. If the diazepam has helped you could always ask for more.. I know GP's aren't keen but they can only refuse. The BNF says it is often needed for the inital start up of the AD.

MrRedShirt
04-04-12, 13:16
I haven't really given CBT a fair crack of the whip to be honest.. I think I need a bit more of a lift from the AD for it to have any effect really. People do swear by it though.

I have 8 diazepam left now.. and can see myself taking one today easily.
I may give my doctor a call tomorrow, if just for reassurance that this startup of the Duloxetine isn't worse than it should be. It's pretty soul-destroying.

---------- Post added at 13:16 ---------- Previous post was at 11:27 ----------

Just got off the phone with the doctor. He pretty much said what I am experiencing is par for the course when a transition of meds takes place.

He's also prescribed me some more diazepam ahead of the Easter period.

MrRedShirt
05-04-12, 10:48
Day 4 (in case anyone finds this of use)

Just taken today's dose, so I suppose this post refers to the previous day and night.
Yesterday I started to feel the physical side effects. As I described to my doctor, I feel constantly tired, yet at the same time 'wired', so sleeping feels like what I should be doing, but is difficult. I did manage to nap though for a couple of hours.

The nausea has also started, although it's fairly mild so far. It means I'm not keen on eating and can only peck at food really. I made some hot chocolate milk to help settle my stomach at the end of the day and to hopefully promote sleep.

I was apprehensive about the night, due to the huge panic attack I had the previous night. It turned out ok, as the doctor said it was ok to use a diazepam before I went to bed and I had some white noise playing to lessen the impact of my tinnitus. I'm thinking the previous night was down to withdrawals from Mirtazapine, and 'rebound insomnia', as that was great for sleep.

Anyhow, a friend who's been through similar things has advised me to keep myself distracted during this startup phase, so that's what I intend to do.. (hence me posting this, I suppose)

Oh and does anyone else think duloxetine deserves its own category in the 'meds' forum? Just a thought :)

dan1234
05-04-12, 11:37
Day 13 on Duloxetine, Day 4 on 60mg

Duloxetine definitely deserves its own sub- section..

I have been on the duloxetine 60mg dose for several days now, and am starting to struggle to sleep. Keep waking up at night - not what I wanted. My anxiety is still raised. Hopefully it will be another week maximum before it levels out.

No nausea etc. Mr Red shirt have you tried herbal tea, maybe chammomile spelling?

Dan

LAURA48
05-04-12, 11:47
Hi you two - sorry you are having a rough starting up time with the duloxetine.

It will pass for sure and you have your diazepam.

Yes agree it definitely needs it own sub-section.

Chamomile/Peppermint tea can help - I also find a hot waterbottle on my stomach helps me.

Had an email from the Complaints dept and they are passing my message through - basically I am asking the impossible but why not - I mean a Nurse in June! Still got my private appoint booked for 19/4 - live on bread and jam in the meantime!

Hope you both feel better soon - am off to the local Garden Centre soon to get some Yankee Lavender candles! Find that helps at night! (Mr RS) not going on my rollersakes!!

MrRedShirt
05-04-12, 12:04
Hi Dan, yes I have, I even ordered a whole selection from the Twinings website! To be honest, I don't know how much they help calm me down, but I decided a while ago to cut out all caffeine, so these provide interesting alternatives to 'normal' black tea. Peppermint tea is also supposed to be good to settle the stomach.

Chamomile and spearmint, chamomile honey & vanilla, redbush strawberry and vanilla etc. etc.. all quite nice if you add some honey to sweeten.

Regarding sleep, duloxetine is (as you may have read) often associated with waking up, mid-sleep. My advice would be not to lie there 'wrestling' with yourself to get back to sleep but maybe get up and potter about?

Have you diazepam for the bad moments?

---------- Post added at 12:04 ---------- Previous post was at 11:49 ----------



Had an email from the Complaints dept and they are passing my message through - basically I am asking the impossible but why not - I mean a Nurse in June! Still got my private appoint booked for 19/4 - live on bread and jam in the meantime!

Hope you both feel better soon - am off to the local Garden Centre soon to get some Yankee Lavender candles! Find that helps at night! (Mr RS) not going on my rollersakes!!

heh, maybe your dream was a sign to take up a new hobby?

I've actually got some honeybush and lavender tea as part of my consignment from Twinings. It's pretty aromatic (stinky), not sure if lavender is my thing.. takes some getting used to. It's supposed to be good though.. I think I'll make some now actually..

Who do we ask to get duloxetine into its on sub-section?

dan1234
05-04-12, 13:06
Hi Dan, yes I have, I even ordered a whole selection from the Twinings website! To be honest, I don't know how much they help calm me down, but I decided a while ago to cut out all caffeine, so these provide interesting alternatives to 'normal' black tea. Peppermint tea is also supposed to be good to settle the stomach.

Chamomile and spearmint, chamomile honey & vanilla, redbush strawberry and vanilla etc. etc.. all quite nice if you add some honey to sweeten.

Regarding sleep, duloxetine is (as you may have read) often associated with waking up, mid-sleep. My advice would be not to lie there 'wrestling' with yourself to get back to sleep but maybe get up and potter about?

Have you diazepam for the bad moments?

---------- Post added at 12:04 ---------- Previous post was at 11:49 ----------



heh, maybe your dream was a sign to take up a new hobby?

I've actually got some honeybush and lavender tea as part of my consignment from Twinings. It's pretty aromatic (stinky), not sure if lavender is my thing.. takes some getting used to. It's supposed to be good though.. I think I'll make some now actually..

Who do we ask to get duloxetine into its on sub-section?

I assume we would need to ask a mod?

Thankfully I do have diazepam but am fairly reluctant to use it, as I can only get so much. I will have two 2mg tabs in a mo.

MrRedShirt
05-04-12, 21:08
We're now in our own sub-section :)

How was the rest of your day? Did your p-doc get back to you?

dan1234
05-04-12, 23:23
We're now in our own sub-section :)

How was the rest of your day? Did your p-doc get back to you?

Hiya yes I rang him. He said to stick with it. A few days of increased anxiety is normal.

I also found out that my GP thought I had a personality disorder. She faxed some stuff to my p doc. He said I don't thankfully. I had a disagreement with her over prozac, I think it has got to do with that.

He will prescribe me, more diazepam, I still have enough to get by.

How was the rest of your day?

Dan

dan1234
06-04-12, 10:27
Morning all, slept well last night without waking up. :) How are you MrRedShirt?

MrRedShirt
06-04-12, 10:57
Hi Dan, glad to hear you slept well! How do you feel this morning?

So, day 5..

As yesterday wore on I became more and more calm, and all without even thinking about diazepam. By the evening I think I was as close to being back to 'normal' as I've been since this all started back in September. I still remained physically jittery though, and also off my food somewhat, but overall glad to be calmer mentally. I even managed to get off to sleep without a diazepam, nor any white noise for my tinnitus. This all surprised me a bit as it was only the 4th day of taking duloxetine, and at 30mg.

..However, I woke at about 3:30am feeling a little odd.. but managed to get back to sleep.

..and this morning, I woke up and feel pretty dreadful. Anxiety is back, in the form of the 'deep-fear-in-the-pit-of-the-stomach' variety. Not nice. Diaz taken about an hour ago and it's not really having much effect yet. Hopefully this will pass soon.

dan1234
06-04-12, 16:23
Day 14 and day 5 on 60mg.

Generally on the whole I do feel calmer. There are moments where the anxiety flares up, right now I am shaking so bad I can hardly type. I think it is just a question of thinking positively and letting the medication take effect.

Dan

MrRedShirt
06-04-12, 18:29
I agree, I think we've just got to hang on in there.
I'm hoping yesterday for me was a hint of things to come..

Today isn't a great day though, anxiety-wise, it has to be said.

dan1234
06-04-12, 20:42
Just out of interest do you how SNRI's work. I would have thought that the norepinephrine element wouldn't help. I would have thought the adrenaline makes the anxiety worse.

MrRedShirt
06-04-12, 20:49
Actually, no I don't, and I've often wondered that myself. But I'm glad the overwhelming evidence is that they do!

I think the overall theory about chemical imbalance and increasing certain neurotransmitters is just the tip of the iceberg regarding how these drugs work. I reckon they set off a whole chain reaction that kind of 'kick-starts' the brain into re-modulating itself. Neurogenesis is another theory, and I think there's evidence that SS/NRIs promote this process.

But yes, that is an interesting question.. And it may be that the initial anxiety that we've both experienced might be the first part of these drugs' overall process?

nicola1980
06-04-12, 21:15
Hi guys does the dolextine have a short half life like venlafaxine seeing as there both SSNI's x x

MrRedShirt
06-04-12, 21:17
Hi Nicola, I think I read it has a half life of about 12 hours.

I'm pretty sure the capsules are of the extended-release type.

nicola1980
06-04-12, 21:23
Im not on the extended release of ven yet so have to take 75mg am and 75mg pm, what made you have duloxetine over ven? X x

MrRedShirt
06-04-12, 21:30
I have an eye condition that flares up with excess cortisol (they think!) and I came across evidence that duloxetine lowers cortisol in the short term, whereas Venlafaxine might raise it. That was the main reason for me requesting the Duloxetine.

Venlafaxine acts as an SSRI at lower doses apparently (below 150mg?), but duloxetine acts as a SNRI at all doses.

How are you finding the Venlafaxine?

nicola1980
06-04-12, 21:42
Im tolerating it alot better than cit, i increased to 150mg last week and it increased my anxiety but apart from that its going ok touch wood! X x

MrRedShirt
06-04-12, 21:45
How long have you been on it in total?

I took a total of one dose of citalopram, back in November. I wasn't warned about the initial side-effects and was put straight onto 20mg - needless to say I freaked out~!

nicola1980
06-04-12, 21:54
4 weeks i cross tapered over from mirtazapine, only started on 37.5mg and have gradually worked my way up to 150, the few weeks were the worst with the mirt withdrawal and the intiatial side effects of the ven :mad: am now on the dose i hope to stay on x x

dan1234
07-04-12, 09:53
Im not on the extended release of ven yet so have to take 75mg am and 75mg pm, what made you have duloxetine over ven? X x

Longer half life then ven, quicker acting, and at low doses ven only acts like a SSRI. Duloxetine is meant to be have less side effects when withdrawing which was the main thing for me. Duloxetine is a lot more expensive as well.

Dan

MrRedShirt
07-04-12, 10:39
How are you doing today Dan?

Yesterday for me was pretty rubbish, had high anxiety all day. I just managed to calm down for bedtime, thankfully, and slept okish.

This morning, day 6, I've woken up feeling ok. Not great, but ok. I'm also finding I'm feeling really tired physically in the mornings, but again, mentally a bit jittery.

LilyPad1991
07-04-12, 11:41
Hello everyone...

I've been on Duloxetine for about 6 or 7 weeks and it has been amazing for me. For the first three weeks I was coming off citalopram. I started up on 60mg of Duloxetine. Anyway, as I said the Duloxetine has been really good until the past few days when I've started to feel a bit jittery and spaced out again. I don't really understand why this has happened. I don't know if it's just a blip but i'm so worried.

Anybody got any ideas what's going on? I do think my diet has maybe got something to do with it. I'm a bit rubbish at eating regularly etc.

MrRedShirt
07-04-12, 11:47
Hi Lillypad,

I'm only on day 6 at 30mg, so can't really give you any insight beyond that..

How long was it before you felt any positive benefit? It could be that after 6 weeks the duloxetine is still evening out in your system? I've seen plenty of reports of folk not seeing any positive effect until 6 weeks or later.

MrRed.

LilyPad1991
07-04-12, 12:25
I was fairly evened out by about two and a half weeks but was still on the citalopram at that point. Who knows! It's all a guessing game I suppose and I'll just keep mooching onwards! Thanks for your reply :) how're you feeling today?

MrRedShirt
07-04-12, 12:38
Yes, keep mooching onwards.. (I like that phrase!)

Let us know how things develop. I think 6 weeks would still be considered as pretty early on, relatively speaking.

I'm okish today. No massive anxiety, but just an underlying feeling of 'not quite right-ness' though. A bit physically jittery too.

MrRed

LilyPad1991
07-04-12, 13:15
Not quite right-ness is a very good phrase! That's how I feel. I don't trust it as feelings go, it has the occasional tendency to veer into very-not-alright-ness.

But I will be strong!!!

dan1234
07-04-12, 13:51
Afternoon,

I just don't feel right. The anxiety isn't full on, nowhere near panic attack stage but I do feel jittery. Hoping this is something that will pass. To be honest I felt better on the pregabalin alone, but it is early days and the dose of duloxetine is fairly high 60mg/d. I think I will give the duloxetine another 14 days or so, and then will decide if it is something I want to stop.

My options are becoming limited, bar trying another SNRI, I would need to go down the TCA route, but I have already tried amitriptyline.

MrRedShirt
07-04-12, 14:02
Hi Dan,

Like you say, I think it's still very early days. I'd give the duloxetine a full trial. I've seen online polls showing a lot of folk not get consistent benefit until after 6 weeks or more. I know it's a long time, but those weeks will come anyway, so it'll be best to try it than stop and wonder 'what if I'd stayed on a week longer..'?

Although I totally empathise, it's far from easy.

dan1234
07-04-12, 14:19
Hi Dan,

Like you say, I think it's still very early days. I'd give the duloxetine a full trial. I've seen online polls showing a lot of folk not get consistent benefit until after 6 weeks or more. I know it's a long time, but those weeks will come anyway, so it'll be best to try it than stop and wonder 'what if I'd stayed on a week longer..'?

Although I totally empathise, it's far from easy.

Yes I think you are right. Can I ask where you have seen these polls?

Dan

MrRedShirt
07-04-12, 14:27
If you put 'How long before you consistently felt better on cymbalta' into google, you should find the poll I'm referring to.

LAURA48
07-04-12, 16:06
Sorry to hear Dan you are feeling jittery. No expert on Duloxetine but it is early days and as you say the dose is fairly high.

Needs to even out - give it another couple of weeks - as anxiety is heightened on the majority of a/ds like you know.

I have my appoint come through 19th - anxious about it - really regarding the medication side - need to be on something but the thought of starting over again - side effects, you know what I mean (think on the bright side!)

Anyway can always pm me if you want to talk.

Take care Dan - speak to you soon - Laura x

dan1234
07-04-12, 16:51
Sorry to hear Dan you are feeling jittery. No expert on Duloxetine but it is early days and as you say the dose is fairly high.

Needs to even out - give it another couple of weeks - as anxiety is heightened on the majority of a/ds like you know.

I have my appoint come through 19th - anxious about it - really regarding the medication side - need to be on something but the thought of starting over again - side effects, you know what I mean (think on the bright side!)

Anyway can always pm me if you want to talk.

Take care Dan - speak to you soon - Laura x

Thanks Laura,

Yes it will take its time and I do hope it evens out. I think I am also pushing myself to face the anxiety which of course will make it worse. I am coming through the other side, so all is good.

Really good news about your appointment. Yep think on the bright side, once you find a medication you are stable on, it is all plain sailing. Just getting there is the difficult part.

Likewise.

Dan x

MrRedShirt
07-04-12, 17:54
Not quite right-ness is a very good phrase! That's how I feel. I don't trust it as feelings go, it has the occasional tendency to veer into very-not-alright-ness.

But I will be strong!!!

I know that tendency all too well... I can feel the veering happening right now actually! bleurgh..

dan1234
07-04-12, 20:57
Anxiety has got worse, and I am taking quite a bit of diazepam...

I have 3 tablets left, put in a repeat on Thursday, but I won't be able to get any till Wednesday. Urghhhhh. I may lower my dose for a couple of days...

Apparently if the anxiety gets worse initially, it is a good sign. Fingers crossed. :noangel:

MrRedShirt
07-04-12, 21:07
Anxiety has got worse, and I am taking quite a bit of diazepam...

I have 3 tablets left, put in a repeat on Thursday, but I won't be able to get any till Wednesday. Urghhhhh. I may lower my dose for a couple of days...

Apparently if the anxiety gets worse initially, it is a good sign. Fingers crossed. :noangel:

Hi Dan, yes I've seen this stated before, and I hope it turns out to be correct!

Sorry to hear you're having a bad time a present (I'm having no picnic either).

Make sure you're being kind to yourself and not pushing yourself too hard.

dan1234
07-04-12, 21:16
Hi Dan, yes I've seen this stated before, and I hope it turns out to be correct!

Sorry to hear you're having a bad time a present (I'm having no picnic either).

Make sure you're being kind to yourself and not pushing yourself too hard.

Hi

How are you doing? I just hope the duloxetine will work, after all these side effects we have put up :weep::weep:. Luckily my p doc is fairly lax on diazepam, without him my GP wouldn't prescribe it.

nicola1980
07-04-12, 21:22
Anxiety has got worse, and I am taking quite a bit of diazepam...

I have 3 tablets left, put in a repeat on Thursday, but I won't be able to get any till Wednesday. Urghhhhh. I may lower my dose for a couple of days...

Apparently if the anxiety gets worse initially, it is a good sign. Fingers crossed. :noangel:

Ive also heard the same about ven and hoping its true!! X x

MrRedShirt
07-04-12, 21:26
Hi

How are you doing? I just hope the duloxetine will work, after all these side effects we have put up :weep::weep:. Luckily my p doc is fairly lax on diazepam, without him my GP wouldn't prescribe it.

I'm up and down. I just came through a few hours of fairly bad anxiety.

I'm still only pecking at food, but that's not really concerning me (especially after the bottomless pit I became on Mirtazapine). I seem to be physically tired a lot, but mentally wired. That's not pleasant.. Generally I feel a bit less like I've been hit by a truck though. I can also see me having to go up to 60mg at some point for some reason.

Luckily my doctor prescribed me some extra diazepam which I picked up before the Easter break.. although I'm still on the previous batch. The doctors at this new practice are much better than at my old one - in that they seem to understand!

dan1234
07-04-12, 22:07
Ive also heard the same about ven and hoping its true!! X x

Hope so, I had a quick look and can only see good results in trials for ven and duloxetine so fingers crossed.

MrRedShirt
08-04-12, 13:46
Afternoon... How are we doing today?

I've been worse, but again, I'm far from being ok. Jittery, but keeping myself distracted.

dan1234
08-04-12, 14:50
Same here. Just hope it has been worth it. Time for the dulox to start working now. Getting a bit fed up, and running out of diazepam. Put a repeat request in on Thursday, and with bank holiday etc I might not get it till Wednesday.

Dan

MrRedShirt
08-04-12, 15:57
I must admit, I'm currently feeling fed up too. I guess everyone who's taken these types of meds can empathize. I'm really not enjoying feeling so physically tired that I can't avoid napping, but at the same time feeling mentally racing and panicky.

Did you find that poll that I alluded to? About the start-up times?

dan1234
08-04-12, 16:27
Found it! Day 16 so shouldn't be too long. Otherwise I am just going to go on a daily dose of diazepam, and continue with the CBT. Why a non addictive, and tolerance resistant benzo can't be made is unbelievable.

Dan

MrRedShirt
08-04-12, 16:31
Found it! Day 16 so shouldn't be too long. Otherwise I am just going to go on a daily dose of diazepam, and continue with the CBT. Why a non addictive, and tolerance resistant benzo can't be made is unbelievable.

Dan
I guess that's what some people are hoping Pregabalin to be? (sort of)

What is your general impression of Pregabalin?

LAURA48
08-04-12, 16:41
I don't understand re benzos - why in this day and age with all the advances in science hasn't some boffin not come up with a non addictive/tolerance tablet? Tbh I am not bothered about addiction as been on low dose of lorazepam for years but wish I could take say take 4 a day! lol! this would sort my problems out!

This pill will probably come out in another 30 years!:weep:

dan1234
08-04-12, 16:46
I guess that's what some people are hoping Pregabalin to be? (sort of)

What is your general impression of Pregabalin?

Good but not brilliant. I am on the max dose of 600mg a day and it has helped a bit. The first week or so was brilliant, then it became less helpful.

Is there much difference between lorazepam and diazepam?

MrRedShirt
08-04-12, 16:52
These medications seem to be discovered more by luck than by design...

Remember that no-one actually knows exactly how SS/NRIs work!

I think the very first ADs were originally TB medications that were found to have mood-lifting properties.

---------- Post added at 16:52 ---------- Previous post was at 16:49 ----------


Good but not brilliant. I am on the max dose of 600mg a day and it has helped a bit. The first week or so was brilliant, then it became less helpful.

Is there much difference between lorazepam and diazepam?

Don't know much about lorazepam (Laura..?), but diazepam and clonazepam are the two longer-acting benzos (I think).

MrRedShirt
09-04-12, 15:41
Hey Dan, how're you?

More of the same for me, day 8. Bad night's sleep, jittery today, mild nausea.. constantly feel like I could slip into a bad patch of anxiety (and wouldn't be surprised if I do at some point).

dan1234
09-04-12, 20:14
Day 17,

Anxiety is still quite high, but that is to be expected I think. I went out to the pub today for a pint, felt good.. Luckily I had an extra 2 diazepam tablets in my wallet which I found, which is enough till the Doctors opens tomorrow.

I think given the level of anxiety I will be going on a daily dose for diazepam for 6-8 weeks. Will discuss with p doc on the 20th. I really want to wait it out, but on the other hand the anxiety is worse.

How you doing?

MrRedShirt
09-04-12, 20:23
I managed to stave off major anxiety today (so far). It's the nights that bother me most, I wake up and feel terrible in the middle of the night.

I'm physically knackered and nearly had another nap, but want to keep going so I'm tired enough to sleep later. I am unusually drowsy though.

haz
09-04-12, 20:25
Is there much difference between lorazepam and diazepam?[/QUOTE]

Hi Dan,

Not sure how much they differ in terms of how they affect the brain except that lorazepam is a lot stronger (and more addictive) than diazepam and is consequently given in much smaller doses.

Best Wishes.

Haz. x

---------- Post added at 20:25 ---------- Previous post was at 20:24 ----------

Still haven't quite got the hang of this "Quote" thing. :huh:

MrRedShirt
09-04-12, 20:32
Not sure how much they differ in terms of how they affect the brain except that lorazepam is a lot stronger (and more addictive) than diazepam and is consequently given in much smaller doses.

Best Wishes.

Haz. x

---------- Post added at 20:25 ---------- Previous post was at 20:24 ----------

Still haven't quite got the hang of this "Quote" thing. :huh:

Hi Haz,
Do you know if lorazepam is prescribed much these days? And am I right in thinking it's used a lot as a sleep aid? My sleep's gone haywire since I came off the mirtazapine.

MrRed

dan1234
09-04-12, 20:35
Thanks guys x

Had a mild asthma attack today which means I may have to stop the propranolol. Will monitor and discuss with p doc and GP.

Got CBT tomorrow, Physio on Wednesday and back specialist on Thursday. That is probably partly why I am so anxious. Hate being ill, but it is only upwards.

Haz would you say you are "stable" on your meds ?

haz
09-04-12, 22:10
@Mr Red Shirt

Lorazepam is still widely prescribed in psychiatric wards, not sure about psychiatrists prescribing on out-patient basis and I'm be surprised if many GP's prescribed it in the first instance or on a long term basis without the advice of a psychiatrist. Search for it on here, there are some folks on it who could probably help you out more. :)

@ Dan

Unfortunately Dan, I cannot say that I am completely stable on my meds at the moment. I am a lot more stable than I was and I have been stable on meds before, particularly paroxetine until they stopped working. Some people just get one episode of anxiety/depression, some have long stable periods in between episodes and sometimes it's just a constant battle. Sorry I can't be more positive at the moment but as I've said to you before, I'm at a funny age, hormones and that. :D

Haz

---------- Post added at 22:10 ---------- Previous post was at 22:05 ----------

@ Mr Red Shirt

Your GP may be willing to prescribe zopiclone sleeping tablets on a short term basis until your body adjusts?

MrRedShirt
09-04-12, 22:13
@ Mr Red Shirt

Your GP may be willing to prescribe zopiclone sleeping tablets on a short term basis until your body adjusts?

I may have to enquire about this, thanks.
He said I could take a diazepam at night as I've been prescribed them, but I'm not sure they are quite the right thing.

LAURA48
10-04-12, 08:41
Hi Mr RS/Dan & Haz

Hope we have a better day - know my anxiety has been very high the past few days - horrible.

In answer to the Lorazepam and Diazepam issues:-

Diazepam was introduced in 1963 - it doesn't hit the spot quicky longer to get into the system but once in the body stays there longer.

Obviously it depends on the dosage but 2mg is usually given and very mild.

Many many years ago an old GP prescribed them to me think 10mg! and I had been on lorazepam 1mg before and I did not know I had taken anything!! so went back to lorazepam. (Remember this was early 1980s) and I knew nothing about addiction, etc, then only 21!

Lorazepam introduced much later by Wyeth in 1977 - hits the spot immediately but does not stay in the body as long.

In my opinion Lorazepam has been a life safer for me - when well only take 0.5mg but at the moment 1 or 2 but on a really really bad day when my medication was playing me up and going gaga took 3! but it was a godsend.

The only time I have seen the latter prescribed where I work is when someone has had a bereavement. There is another one that sounds alike Loprazolam - which I think is for sleep?

Hope this helps a bit Laura x

They do say 10mg diazepam is equivalent to 1mg lorazepam but I don't know.

---------- Post added at 08:41 ---------- Previous post was at 08:38 ----------

sorry about some words missing - minds a bit fuzzy!

MrRedShirt
10-04-12, 08:42
Thanks Laura, that helps explain things, I was indeed thinking of Loprazolam for sleep.

I think I may need it too, had another terrible night awake virtually all of it. Feel really rough and rattled as a result. Makes me miss the mirt, I have to say...

LAURA48
10-04-12, 08:48
Hi Mr RS - oh sorry you had a rubbish night - yes look that one up - I know what you mean - the Mirt was good in that respect - did not wake up with churning stomachs - felt more at peace! I have a strip of 30mg left and have wondered whether to take an odd 15mg one to help with sleep to tied me over but don't know.

Hope we all have a bit better day - seems more back to normal now - as not liking weekends/bank holidays at the moment - I'm sure you know what I mean.

Speak to you soon and pm me when you want Laura

MrRedShirt
10-04-12, 08:55
I wish taking the mirt was an option for me - that's ruled out now I'm on the Duloxetine. Otherwise I'd definitely consider it I think.

I'm not too keen on public holidays either - everyone out enjoying themselves when I'm.. not. :weep:

dan1234
10-04-12, 10:15
Morning,

For sleep, I would ask your GP to prescribe you zopiclone. Probably better going that way rather than the benzo route.

Dan

MrRedShirt
10-04-12, 10:22
Thanks Dan. I've heard of this before, I'll look into it a bit more. How's your sleep at the moment?

Is it your CBT today?

dan1234
10-04-12, 10:50
Thanks Dan. I've heard of this before, I'll look into it a bit more. How's your sleep at the moment?

Is it your CBT today?

I am sleeping a bit better thanks. The pregabalin makes me drowsy so I take that an hour before bed. Also use Nytol which helps I think.

Yep CBT is later - looking forward to it.

Dan

haz
10-04-12, 12:53
I may have to enquire about this, thanks.
He said I could take a diazepam at night as I've been prescribed them, but I'm not sure they are quite the right thing.

Actually, in hindsight, probably best to just ask for "something to help you sleep" instead of naming drugs. Doctor's generally don't like to be told their jobs and you might get their back up. :D

Good Luck.

Haz. :)

MrRedShirt
10-04-12, 12:55
Actually, in hindsight, probably best to just ask for "something to help you sleep" instead of naming drugs. Doctor's generally don't like to be told their jobs and you might get their back up. :D

Good Luck.

Haz. :)

Thanks Haz, and a good point :)

LAURA48
10-04-12, 16:52
Yes - can be treading on very thin ground! but I think Zopiclone is the one they seem to give out now!

MrRedShirt
10-04-12, 18:40
Quite - I'm aware they will have had to justify prescribing me duloxetine, so I don't want to call up with another shopping list!

I think I am going to require something for sleep-assistance though. I've been so tired today I don't know if I'm coming or going.

dan1234
10-04-12, 19:28
Some doctors don't like patients suggesting meds. Fortunately for me my p doc doesn't mind. In fact he asks me what I want. My GP on the other hand is completely different.

I would just approach the situation carefully. Say you can't sleep and have done research etc, and what do you think of x drug. The doc will either say no or ye.

Dan

MrRedShirt
10-04-12, 19:34
The doctors at my new practice seem to be ok, but I think I'll let them suggest something.

The more I think about it, the more I think I might benefit from seeing a psychiatrist rather than GPs.. No idea how practical that would be though.:shrug:

dan1234
10-04-12, 20:15
You know best, why do you think a psychiatrist would be more helpful?

MrRedShirt
10-04-12, 20:26
Just a feeling really. Perhaps I'm impatient. Having seen a counseller and it not having helped much, and feeling like I wasted time on Mirtazapine and having to work out the best way to get the meds I need... I feel like I could do with someone to oversee and tailor a 'program of treatment' for me.

I have no idea, for instance, if I would benefit from giving CBT another go, or if another form of psychological therapy would be better... or if meds alone are best for me.

I might be wrong, but I think a p-doc would be more likely to provide this than a family GP.

:shrug:

dan1234
10-04-12, 20:51
Just a feeling really. Perhaps I'm impatient. Having seen a counseller and it not having helped much, and feeling like I wasted time on Mirtazapine and having to work out the best way to get the meds I need... I feel like I could do with someone to oversee and tailor a 'program of treatment' for me.

I have no idea, for instance, if I would benefit from giving CBT another go, or if another form of psychological therapy would be better... or if meds alone are best for me.

I might be wrong, but I think a p-doc would be more likely to provide this than a family GP.

:shrug:

Fair enough, did you have proper cbt or was it with a wellbeing practitioner or something like that.

dan

MrRedShirt
10-04-12, 20:57
It wasn't structured CBT, but integrated and touched upon during my counselling sessions. The therapist was trained in it though. When I started the counselling sessions back in September I had no idea what CBT was...

I've read David Burns' books and done plenty of mood log forms, but they don't seem to have really made much impact. But I just don't know if I haven't 'got it' yet, or whether it's just not for me. :unsure:

nicola1980
10-04-12, 21:16
Hi you can always ask your gp for a physchatrist referal, thats what i did as ive been messed about with meds and physchatrists are more clued up than our gps, they know their stuff on meds mines been fantastic x x

MrRedShirt
10-04-12, 21:22
Thanks Nicola, I may well do that. The last doctor I saw (a good one) mentioned the next stage would possibly involve a 'mental health team' - not sure what that comprises of. I think I'll follow him up on that and find out more.

nicola1980
10-04-12, 21:29
Thats what the referal will be to your community mental health team who will then assess you to see how they can help you, its them that will organaise you to see a physchatrist altho your gp can do an urgent referal if necessary x x

MrRedShirt
10-04-12, 21:32
Ah, I see... thanks. Yes, I might start pushing. I'm only registered as a visitor and the doctor said I'd need to be fully registered for that kind of thing to progress. I think I need to get that registration done and move things along.

nicola1980
10-04-12, 21:41
Yeah i would ive had fantastic support from my community health team and my physchatrist, good luck x x

MrRedShirt
10-04-12, 21:42
Yeah i would ive had fantastic support from my community health team and my physchatrist, good luck x x

Thanks Nicola :)

Hope you're doing ok at the moment?

nicola1980
10-04-12, 21:56
Im plodding on! Have lowered my ven dose as the anxiety was crippling and doc thought i was on a too higher dose than i need and getting an adverse reaction from it so now on 75mg in am and 37.5mg at pm which seemed to be working until i increased then panic attacks started again and the uncontrollable anxiety :mad: its all trail and error getting the dosage right x x

MrRedShirt
10-04-12, 22:06
Im plodding on! Have lowered my ven dose as the anxiety was crippling and doc thought i was on a too higher dose than i need and getting an adverse reaction from it so now on 75mg in am and 37.5mg at pm which seemed to be working until i increased then panic attacks started again and the uncontrollable anxiety :mad: its all trail and error getting the dosage right x x

Plodding on is a good way to describe it. Not much choice, really have we?
There's so much trail and error involved in all of this, it can be quite soul-destroying.. :weep:

I hope your current dose turns out to be the right one :)

LAURA48
11-04-12, 08:44
Mr Red - been reading through - would definitely register permanently at your practice - just ask for a form - really easy to do - then ask for a referral to a psychiatrist - not counsellor - there may be a wait though!

That is why I am having to go private - totally disagree. Tend to put you with a counsellor who then triages you, etc, but I do think if anyone has been messed about with meds, enough is enough - see the professional.

Hope you had a better night.

Let me know - Laura

---------- Post added at 08:44 ---------- Previous post was at 08:41 ----------

The registration is really easy - will give you a purple form to fill in - doesn't take long and a couple of other forms, eg, are you a smoker, medical conditions, etc.

Once they are completed - would only take around 5 mins to register you as a permanent patient. You do not need to ask your previous doctor for permission or anything like that. No hassle.

MrRedShirt
11-04-12, 09:57
Hi Laura,

Yes, I've got the form etc., I'm only delaying as registering here means kicking into motion a whole load of other stressful things - leaving my flat, putting everything into storage, registering with a different benefits agency etc. etc. and the thought of all that is a bit stomach-churning tbh (I'd normally be able to deal with it, but.. well, you know)... But it will need to be done sooner or later I suppose.

dan1234
11-04-12, 11:43
Morning,

CBT - went really well yesterday. Feel that I am going down the right track. No difference on the duloxetine front, but I have got 60mg capsules as opposed to having to take 20mg x 3 - lol. Still taking pregabalin 600mg. Picked up some more diazepam from my GP. Surprisingly she prescribed another 14.

Dan

MrRedShirt
11-04-12, 11:48
Morning,

CBT - went really well yesterday. Feel that I am going down the right track. No difference on the duloxetine front, but I have got 60mg capsules as opposed to having to take 20mg x 3 - lol. Still taking pregabalin 600mg. Picked up some more diazepam from my GP. Surprisingly she prescribed another 14.

Dan

Sounds like your GP is understanding your situation. I have been given 10 on each of the 3 times I've had them, still on the second batch, luckily.

Glad your CBT went well, sounds positive. :)

Still planning on sticking with the duloxetine?

dan1234
11-04-12, 12:10
Sounds like your GP is understanding your situation. I have been given 10 on each of the 3 times I've had them, still on the second batch, luckily.

Glad your CBT went well, sounds positive. :)

Still planning on sticking with the duloxetine?

Hiya,

Ye I think after I got a private p doc involved and complained about the NHS p doc she has taken me seriously. Which is what I need. I would seriously consider seeing a p doc if I were you.

Luckily my CBT guy is really good. Far better than the woman at IAPT.

Yep - I have bared the side effects for so long so I am not giving up yet. I think unless it gets worse I will give it 8 weeks. How about you?

Dan

MrRedShirt
11-04-12, 12:14
Hiya,

Ye I think after I got a private p doc involved and complained about the NHS p doc she has taken me seriously. Which is what I need. I would seriously consider seeing a p doc if I were you.

Luckily my CBT guy is really good. Far better than the woman at IAPT.

Yep - I have bared the side effects for so long so I am not giving up yet. I think unless it gets worse I will give it 8 weeks. How about you?

Dan

Luckily the docs at the practice I'm currently a visitor at are good, but I still think registering and getting the referral would be better.

Yeah I'm still sticking with the duloxetine. It's only day 10 or 11, although I'm only on 30mg. The sleep disruption is not nice, I have to admit. Hopefully that'll settle down.

dan1234
11-04-12, 16:59
I agree, sleeping has been a problem for me too. A bit of diazepam usually helps me sleep. I asked my p doc last time about zoplicone? But we didn't want to create a cocktail of drugs..

Got an appointment with a back specialist tomorrow, at 3 pm. Hopefully we will get to the bottom of what is going on, and he will prescribe some proper pain relief. Got a birthday party at a club to go too as well which I am looking forward too.

How are you doing?

MrRedShirt
11-04-12, 17:16
I'm having a bit of a rubbish afternoon.. had to have a diazepam a couple of hours ago, hasn't really done much.

I didn't realize you were suffering from back pain.. Does the Pregabalin help with this at all? Good luck at the specialist tomorrow.

dan1234
11-04-12, 17:41
I'm having a bit of a rubbish afternoon.. had to have a diazepam a couple of hours ago, hasn't really done much.

I didn't realize you were suffering from back pain.. Does the Pregabalin help with this at all? Good luck at the specialist tomorrow.

Hiya - I thought the pregabalin would, but it has done nothing for the back. The duloxetine has done more I think. I am on a whole host of medications but I won't bore you with the details lol.

2mgs of diazepam is very low. I usually take 2 together, and 3 or 4 to sleep so 4mgs for anxiety and 6-8mgs to sleep. Hopefully the duloxetine will take effect soon for both of us. Have you tried propranolol? What medications have you tried before duloxetine if you don't mind me asking?

Dan

MrRedShirt
11-04-12, 17:55
2mgs of diazepam is very low. I usually take 2 together, and 3 or 4 to sleep so 4mgs for anxiety and 6-8mgs to sleep. Hopefully the duloxetine will take effect soon for both of us. Have you tried propranolol? What medications have you tried before duloxetine if you don't mind me asking?

Dan
Well now.. I was first given citalopram - I had no idea what to expect and wasn't told of the start-up effects, nor that it would take weeks to kick in (by my old doctor), so after the first dose I freaked out and didn't take any more.
I was then given sertraline and two weeks into it I had the onset of tinnitus, so I stopped in case it was caused by the sert. Well, I still have the tinnitus, so I and my current doctor have concluded that it was a co-incidence. I was given propranolol at the same time, but didn't like the way it made me feel - a bit faint and it only took away the physical symptoms of anxiety, which I found weird.

So after the sertraline I was put onto Mirtazapine - this was mid-December. It showed early promise, but never really delivered on it. Great for sleep though! Just not for properly sorting out my anxiety...

So here I am, having switched to Duloxetine - I never had any diazepam before a few weeks ago either. I think I realised when I first took them that 2mg only barely touches an anxiety attack and that 4mg would be better.. I don't want to run out though!

I suppose in effect I've only given one AD a full trial so far - Mirtazapine.

dan1234
11-04-12, 18:07
Well now.. I was first given citalopram - I had no idea what to expect and wasn't told of the start-up effects, nor that it would take weeks to kick in (by my old doctor), so after the first dose I freaked out and didn't take any more.
I was then given sertraline and two weeks into it I had the onset of tinnitus, so I stopped in case it was caused by the sert. Well, I still have the tinnitus, so I and my current doctor have concluded that it was a co-incidence. I was given propranolol at the same time, but didn't like the way it made me feel - a bit faint and it only took away the physical symptoms of anxiety, which I found weird.

So after the sertraline I was put onto Mirtazapine - this was mid-December. It showed early promise, but never really delivered on it. Great for sleep though! Just not for properly sorting out my anxiety...

So here I am, having switched to Duloxetine - I never had any diazepam before a few weeks ago either. I think I realised when I first took them that 2mg only barely touches an anxiety attack and that 4mg would be better.. I don't want to run out though!

I suppose in effect I've only given one AD a full trial so far - Mirtazapine.

I know the feeling about running out of diazepam... Has your GP offered to put it on repeat??

I am still interested by how SNRI's work - something I will discuss with the p-doc.

Do you think giving duloxetine 8 weeks is enough to decide if it is worth staying on it or switching?

Dan

MrRedShirt
11-04-12, 18:15
I know the feeling about running out of diazepam... Has your GP offered to put it on repeat??

I am still interested by how SNRI's work - something I will discuss with the p-doc.

Do you think giving duloxetine 8 weeks is enough to decide if it is worth staying on it or switching?

Dan

No, no offer of a repeat for the diaz. I think I'm more comfortable with the current arrangement anyway, they have so far been ok about it and even offered to give me more the last time.

I'm interested too in the current thinking about SNRIs.. I guess they're doing what the old tricyclics did (dual uptake inhibition), just in a cleaner fashion? I'd be interested in what your p-doc says on the matter.

8 weeks at the same dose seems an ok trial.. But that's probably another question for your p-doc. When do you next see him?

dan1234
11-04-12, 18:22
No, no offer of a repeat for the diaz. I think I'm more comfortable with the current arrangement anyway, they have so far been ok about it and even offered to give me more the last time.

I'm interested too in the current thinking about SNRIs.. I guess they're doing what the old tricyclics did (dual uptake inhibition), just in a cleaner fashion? I'd be interested in what your p-doc says on the matter.

8 weeks at the same dose seems an ok trial.. But that's probably another question for your p-doc. When do you next see him?

Good you have a competent GP. Some don't prescribe diaz. The NHS p doc was so suprised that I had been prescribed diazepam...

I will ask him. Seeing him on the 20th. Will be 4 weeks on dulox then I think.

Dan

MrRedShirt
12-04-12, 09:18
Well, I just had another night of insomnia. For some reason when I wake in the middle of the night my tinnitus is really ramped up, making it a pretty unbearable experience, all-told. Really missing the mirt in these times!

I've just phoned the surgery asking for a doctor to call me back (that's their preferred method) and I'm going to ask for a sleep aid, or see what he suggests.

---------- Post added at 09:18 ---------- Previous post was at 09:08 ----------

Doctor just called back, he's prescribed me some zopiclone in the short term.

Hopefully that'll give me some relief..

LAURA48
12-04-12, 09:21
Hi - so sorry you are still suffering with that tinnitus - hopefully the Zopiclone will help you and will get a better night's sleep. You will probably feel more relaxed during the day then.

Keep me informed and hope you have a bit better day.

Laura

MrRedShirt
12-04-12, 09:45
Hi - so sorry you are still suffering with that tinnitus - hopefully the Zopiclone will help you and will get a better night's sleep. You will probably feel more relaxed during the day then.

Keep me informed and hope you have a bit better day.

Laura

Thanks Laura. He's given me a week's supply of the zopiclone. Should give me some relief..

I also mentioned possible treatment for my tinnitus and had a referral to an ENT suggested... SUGGESTED! :) I had to plead for a referral at my old practice and was basically told to go away and hope it settles down. Just goes to show the variability of the quality of GPs.

dan1234
12-04-12, 10:02
Good to hear you got zopiclone. How many were you prescribed?

Hopefully you will be able to sleep normally soon.

Dan x

MrRedShirt
12-04-12, 10:06
Good to hear you got zopiclone. How many were you prescribed?

Hopefully you will be able to sleep normally soon.

Dan x

Thanks Dan. How're you getting on?

I think he said a week's worth of zopiclone.. Does anyone know how they work? How long to kick in etc... I'm wondering if I can use them on an 'as-needed' basis or if I really need to assume in advance that I'm going to need it - if that makes sense.

dan1234
12-04-12, 10:36
Just checked the BNF and it says 7.5mg at bedtime? So I assume it would work pretty quickly.

I find diazepam very good for insomnia but I need 6-8mgs, 2mg is not nearly enough.

Dan

joy
12-04-12, 12:32
z,opliclone works quite quickly 20mins or so,takes pretty foul so take it with a big drink and dont chew it. Can leave a metallic taste in the mouth the next day and yes can be taken as and when

Joy

MrRedShirt
12-04-12, 12:34
Thanks for the info Joy.
I'll get some mint chewing gum in for tomorrow :)

dan1234
12-04-12, 13:12
Hiya,

Really nervous about seeing the specialist. Taken 4mgs diazepam which has done nothing. Not sure if I should take another 2mgs? Probably will. I want the anxiety to be low, so that I can discuss my back without worrying about other things.

Dan

MrRedShirt
12-04-12, 13:21
Hiya,

Really nervous about seeing the specialist. Taken 4mgs diazepam which has done nothing. Not sure if I should take another 2mgs? Probably will. I want the anxiety to be low, so that I can discuss my back without worrying about other things.

Dan
Write everything you want to say down, so you don't forget while you're there. Include the anxiety, as I'm sure the pain and anxiety feed into each other. Good luck and let us know how you get on.

dan1234
12-04-12, 13:55
Write everything you want to say down, so you don't forget while you're there. Include the anxiety, as I'm sure the pain and anxiety feed into each other. Good luck and let us know how you get on.

Thanks - I have written everything down. They asked for a drugs list. It is a page of A4.

I have written everything down - and my mum is coming... I think it will be a massive relief once it is over. Leaving in 45 mins. Appt at 3 pm.

Dan

---------- Post added at 13:55 ---------- Previous post was at 13:26 ----------

6mgs diazepam taken. Lets see how it goes.

MrRedShirt
12-04-12, 14:25
6mgs diazepam taken. Lets see how it goes.

Hope it goes ok. I have a few situations coming up that might require that much.. let us know how it goes :)

dan1234
12-04-12, 17:12
Hope it goes ok. I have a few situations coming up that might require that much.. let us know how it goes :)

In true NHS style I didn't see a consultant, infact it wasn't even a Doctor or nurse. She arranged a MRI, and physio, she was so rude. I was told my medication would be looked at, but they did nothing of the sort.. Absolute joke.
Fuming.

MrRedShirt
12-04-12, 17:18
Argh, that sucks.. did anything positive come of it at all?

LAURA48
12-04-12, 19:08
Well surprise surprise Dan - tbh were you that shocked!! It's digusting - all that wait and then you get that crap! Yes it is a joke - when you saw your GP did she mention a referral to a Orthapeadic? Surgeon - as bad as my referral - Consultant psychiatrist - didn't get that, a Gateway Worker! no didn't want that oh ok then a psychiatrict nurse in JUNE!!!!! Not saying anymore.

dan1234
13-04-12, 09:52
Load of crap. The nhs is going down the pan. I saw two specialists about 5 years ago and they were both fantastic maybe I am just expecting too much. The anxiety is sky high - the dulox has done nothing. My GP wrote in the referral letter that I have a personality disorder despite my p doc telling me I don't - furious.

MrRedShirt
13-04-12, 10:49
Don't be too disheartened Dan, and certainly don't let this cloud your judgement - I hope you stick with the dulox at least long enough to give it a fair trial.

The NHS does fall short from time to time unfortunately and I wish I knew what we could do in such situations? Could you write a letter to your PCT outlining your disappointment?

dan1234
13-04-12, 11:45
Don't be too disheartened Dan, and certainly don't let this cloud your judgement - I hope you stick with the dulox at least long enough to give it a fair trial.

The NHS does fall short from time to time unfortunately and I wish I knew what we could do in such situations? Could you write a letter to your PCT outlining your disappointment?

I have started having panic attacks which makes it a whole new ball game. I will stick with the duloxetine, but I think I should go on a daily dose of diazepam, with lorazepam as needed. It is something I will discuss with my p.doc. Dependence doesn't really bother me - tolerance does - people on this forum have been on diazepam/lorazepam without building up a tolerance so I am hopeful.

It is 3 weeks today that I started the duloxetine. On the maximum dose of pregabalin aswell.

I think I should have been referred to this clinic by my GP - better hospital as well. http://www.kingstonhospital.nhs.uk/RunScript.asp?page=89&id=64&f=1&p=ASP%5CPg89.asp

"On referral, patients are seen by a consultant anaesthetist (with special interest in pain management)"

LAURA48
13-04-12, 14:42
Hi Dan - sorry you are having a crap time - you won't be prescribed both Dan, eg, diazepam and lorazepam - one or the other.

I am cheesed off with the NHS big time - see my post under should I swap! sends my anxiety sky high again.

Would your gp do a referral to that hospital in Kingston - sounds a good one.

I know the NHS has gone so down hill - it's becoming a joke. I think that when I become well with go into AXA my husband gets it through his work but it has to be new conditions I believe - pay enough for my pup in Petplan - bless her - they get treated better than humans!

Have you spoken to your doctor Dan? about yesterday's fiasco!

dan1234
13-04-12, 15:07
Hi Dan - sorry you are having a crap time - you won't be prescribed both Dan, eg, diazepam and lorazepam - one or the other.

I am cheesed off with the NHS big time - see my post under should I swap! sends my anxiety sky high again.

Would your gp do a referral to that hospital in Kingston - sounds a good one.

I know the NHS has gone so down hill - it's becoming a joke. I think that when I become well with go into AXA my husband gets it through his work but it has to be new conditions I believe - pay enough for my pup in Petplan - bless her - they get treated better than humans!

Have you spoken to your doctor Dan? about yesterday's fiasco!

Hiya - Didn't think of that. I will ask re diaz/loraz. The short acting nature of loraz is what concerns me.

Funny enough my GP just rang me. As much as I do moan about the personality disorder thing, she is actually quite good. My pdoc said she was concerned about me - she cares.

Anyway her reason for not referring me to the kingston thingy is for the reason it clashes with the orthopedic team I am seeing. However she is going to manage the pain. She has prescribed morphine and diazepam. Hopefully some relief at last.

Seeing p doc in a week time to discuss the dulox and how things are going with the diazepam.

Dan

LAURA48
13-04-12, 15:20
Hi Dan

Oh that's good - the pain must be bad if she is giving your some morphine you will hopefully get the relief you deserve.

Good Luck Laura:yesyes:

MrRedShirt
13-04-12, 15:30
Good news Dan re: morphine. A friend of mine was recently prescribed diazepam and I'd forgotten it was originally for his back pain, so that's also going to be helpful.

These doctors do actually care.. I think it's the system that turns them into robots from time to time, or we don't get to see people we probably should.

dan1234
14-04-12, 11:55
Morning,

How are you all doing? For the first time since November my pain is literally disappeared - the morphine is great. Slept for nearly 12 hrs as well without waking up :ohmy:

GP has agreed I can take diazepam daily if needed, we will just slowly taper down.. It is a good muscle relaxant and helps with the anxiety, so points all round.

Dan x

LAURA48
14-04-12, 12:02
Hi Dan

Thats great news matey - so pleased for you - what is the name of the morphine?

Just thinking of my mum who had an ankle fusion many years ago and a complete balls up was made - in very bad pain?

MrRedShirt
14-04-12, 12:05
Morning,

Glad to hear you're getting some relief Dan!

I had another night of rest, thanks to the zopiclone. Amazing how restorative sleep can be. I think I'll have another night with the zop tonight and after that see how I feel.

Still a little jittery on the duloxetine, although it's settling. Not sure if my anxiety is dealt with, although I'm not pushing myself so it's hard to tell. I'm still on 30mg too, which is a relatively low dose.

dan1234
14-04-12, 14:22
Hi Dan

Thats great news matey - so pleased for you - what is the name of the morphine?

Just thinking of my mum who had an ankle fusion many years ago and a complete balls up was made - in very bad pain?

Hiya - Sorry to hear about your mum. It is the modified release version. Only have to take 2 a day, and there is a constant level of morphine. Called MST Continus.

Amongst other forms you can get oramorph which is a quick acting strong top up of morphine basically.

Has your mum tried co-codamol/tramadol ? They are usually used before morphine.

Dan

---------- Post added at 14:22 ---------- Previous post was at 12:26 ----------


Morning,

Glad to hear you're getting some relief Dan!

I had another night of rest, thanks to the zopiclone. Amazing how restorative sleep can be. I think I'll have another night with the zop tonight and after that see how I feel.

Still a little jittery on the duloxetine, although it's settling. Not sure if my anxiety is dealt with, although I'm not pushing myself so it's hard to tell. I'm still on 30mg too, which is a relatively low dose.

Hi,

Good to hear that you slept well.

I feel the same way about the duloxetine, the reviews on the whole seem quite positive for duloxetine so I am optimistic.

LAURA48
14-04-12, 15:09
Thanks Dan - will have a word with my mum's doc - nice doctor - helpful - have heard of both of them - was thinking more patches - Fetantyl

---------- Post added at 15:09 ---------- Previous post was at 15:08 ----------

sorry Fenatyl

dan1234
14-04-12, 15:43
Thanks Dan - will have a word with my mum's doc - nice doctor - helpful - have heard of both of them - was thinking more patches - Fetantyl

---------- Post added at 15:09 ---------- Previous post was at 15:08 ----------

sorry Fenatyl

They are expensive, and very very strong.. - I think they are usually used for cancer/ terminally ill patients.

Dan

LAURA48
14-04-12, 18:11
Hi Dan - they are used up to a point for that reason but for chronic pain too. Not advised for long term use but hey she is 80 - so worth a try.

Did they say Dan how long you would be on it? but glad you are getting some respite.


Laura

dan1234
14-04-12, 21:08
Hi Dan - they are used up to a point for that reason but for chronic pain too. Not advised for long term use but hey she is 80 - so worth a try.

Did they say Dan how long you would be on it? but glad you are getting some respite.


Laura

Nope depends on the MRI results etc. The morphine has horrible side effects, feel really sick, itchy, constipation etc. Apparently fentanyl has less side effects so I will see if my GP is willing to switch.

Any reason you were thinking fentanyl in particular. Usually they have to be on a strong opioiod before going on fentanyl.

Dan

MrRedShirt
15-04-12, 10:15
Morning all, how are we?

Day 14 for me and I think the main side-effects for me have passed. I don't think I get any increased anxiety due to the duloxetine start-up, just the same anxiety I had before (it feels a bit different).
Having said that, I have had zopiclone-assisted sleep for the past 3 nights, which might be masking horrid night-time anxiety..

No positive benefit for me yet, although it's still relatively early days and I am on 30mg - a low dose.

If anyone out there on Duloxetine who is on it or has taken it in the past want to share their experiences, feel free to chime in :)

MrRedShirt
17-04-12, 11:43
Day 16:

I think I may be feeling a bit better.. I certainly don't feel ready to take on the world, and I'm still fairly jittery. So far though, no huge anxiety and I haven't felt the need to reach for the diazepam for a few days.

The zopiclone may be partly behind this. Having a good night's sleep is invaluable and makes me feel much better in the mornings. I just wish I could take it indefinitely.. the thought of going back to insomnia with my tinnitus isn't one I relish.

I'll see if this improvement continues (and I'm certainly not pushing or testing myself), but if it levels off like this I think I'll need to go up to 60mg.

I hope everyone else is ok...?

dan1234
17-04-12, 14:09
Simon - I would try and get more zopiclone. Just as a short term fix - hopefully the duloxetine will then help. Maybe you need to go to 60mg/d?

Dan

MrRedShirt
17-04-12, 14:32
Hi Dan,

I have about 9 more doses of zopiclone left - I'll see if I can sleep without it towards the end of those.

I'll see how I do for the rest of the week on the 30mg duloxetine and then it'll be about the time to update with my doctor anyway.

How're you doing?

---------- Post added at 14:32 ---------- Previous post was at 14:29 ----------

One thing I am noticing is that I feel really drowsy mid-afternoon.. I could nap, but I know I'll feel better if I managed to avoid doing so.

Isa
19-04-12, 00:05
I've been lucky, I've read some of the posts on these boards where people have struggled with side effects of this medication so just wanted to say that I hope that these start to work for you and if they don't then please speak to your doctor about trying something else. The only advice that I can give is what was given to me when I started this medication. Take your Duloxetine straight after some food and try to take it at a similar time everyday.

As one of the lucky ones in the search for the right medication I started Duloxetine in September 2009 and it made me feel better in under 2 weeks with the minimum of side effects. It's not been working as well for a while and I have been changed to Trimipramine with no cross over which is proving to be a pretty hellish so just wanted to wish you luck and hope that this works for you.

MrRedShirt
19-04-12, 10:13
I've been lucky, I've read some of the posts on these boards where people have struggled with side effects of this medication so just wanted to say that I hope that these start to work for you and if they don't then please speak to your doctor about trying something else. The only advice that I can give is what was given to me when I started this medication. Take your Duloxetine straight after some food and try to take it at a similar time everyday.

As one of the lucky ones in the search for the right medication I started Duloxetine in September 2009 and it made me feel better in under 2 weeks with the minimum of side effects. It's not been working as well for a while and I have been changed to Trimipramine with no cross over which is proving to be a pretty hellish so just wanted to wish you luck and hope that this works for you.

Hi Isa, thanks for your input :)
I take mine between 9 - 9:30am and always have either a banana or toast before so it's not going onto an empty stomach.

I think the dulox has started to work for me - today is day 18 for me, so about 2 and a half weeks. I've still some way to go, but I'm definitely better than I was. Maybe going up to 60mg is the next step for me.

Can I ask what dose you were on?

I hope the trimipramine works out for you..

Regards,
MrRed

dan1234
19-04-12, 18:26
Hi guys,

I don't get the up and downs as much with the duloxetine any more. It will be 4 weeks tomorrow. I think it may have helped a bit. We shall see. It is looking positive. I will give it another 4 weeks or so.

I would consider increasing my dose at this point simon. See what your doc says.

Dan

MrRedShirt
19-04-12, 19:13
Good thinking Dan, give it a full trial. Glad it's all looking positive.

I had a bit of a wobble this afternoon (and now) but still think I'm generally better than I was a couple of weeks ago. I'll need to sort out a refill of my prescription in the next week so will ask the doctor about raising me to 60mg then.

MrRedShirt
23-04-12, 15:07
DAY 22.

Well, the duloxetine seems to be working! I think I first noticed a difference about a week ago, and since then the jittery feeling has subsided as has the drowsy feeling in the afternoon, although this is still a bit of a battle.

I haven't reached for a diazepam in over a week, maybe week-and-a-half, although I have been using (and loving!) zopiclone for sleep. I nearly tried sleeping last night without it, and as I lay there I realised how much better I was feeling upon going to bed than a couple of weeks ago. (I still took the zop in the end though..) The main reason for the zopiclone, for me, was my tinnitus, which when I was waking in the night was horrendous. That has generally eased off during the day too, so I'm hoping it won't be so bad if I try and sleep without the zop..

I'm also still on 30mg of duloxetine! Which I've always thought of as a 'starting' dose (and that's how it's referred to in the leaflet thing), so I now don't know what to do.. go up to 60? Or move up through 40mg? Hmm.. I'll guess that for my doctor and me to work out. I definitely need a bit more of a push, but I'm surprised I'm feeling like this on just the 'starting' 30mg...

Anyhow, that's the three-week update on my duloxetine experience. :)

dan1234
23-04-12, 15:28
DAY 22.

Well, the duloxetine seems to be working! I think I first noticed a difference about a week ago, and since then the jittery feeling has subsided as has the drowsy feeling in the afternoon, although this is still a bit of a battle.

I haven't reached for a diazepam in over a week, maybe week-and-a-half, although I have been using (and loving!) zopiclone for sleep. I nearly tried sleeping last night without it, and as I lay there I realised how much better I was feeling upon going to bed than a couple of weeks ago. (I still took the zop in the end though..) The main reason for the zopiclone, for me, was my tinnitus, which when I was waking in the night was horrendous. That has generally eased off during the day too, so I'm hoping it won't be so bad if I try and sleep without the zop..

I'm also still on 30mg of duloxetine! Which I've always thought of as a 'starting' dose (and that's how it's referred to in the leaflet thing), so I now don't know what to do.. go up to 60? Or move up through 40mg? Hmm.. I'll guess that for my doctor and me to work out. I definitely need a bit more of a push, but I'm surprised I'm feeling like this on just the 'starting' 30mg...

Anyhow, that's the three-week update on my duloxetine experience. :)

That is good news :D I think the leaflet says the target dose is 60mg/d but the BNF says 60 if necessary. I would give it another week before increasing the dose.

Dan

MrRedShirt
23-04-12, 15:34
That is good news :D I think the leaflet says the target dose is 60mg/d but the BNF says 60 if necessary. I would give it another week before increasing the dose.

Dan

Yeah, that sounds like a plan, although I'll need a refill before then.. but of what! Were you taking 2x20mg at one point? Would they prescribe 56 x 20mg?

dan1234
23-04-12, 16:34
Yeah, that sounds like a plan, although I'll need a refill before then.. but of what! Were you taking 2x20mg at one point? Would they prescribe 56 x 20mg?

I was taking 2x20 and then 3x20 till I ran out of 20's. My GP prescribed 28 - but me and my p doc decided to increase the dose.

You can get 40mg in one tablet. I wouldn't bother going to 40 - if you want an increase go straight to 60mg/d.

MrRedShirt
23-04-12, 16:43
You can get 40mg in one tablet. I wouldn't bother going to 40 - if you want an increase go straight to 60mg/d.

Oh I didn't know there was a single 40mg cap.. Hmm. Interesting.

Isa
24-04-12, 09:43
Hey guys,
How goes it? Sounds like it's starting to kick in which is good.

I started out on 30 Dulox and then increased it up to 60 after a couple of weeks. 60 worked really well for me for ages. It is possible to get 40 tablets, which i had when dosage was upped to 80 back in Feb, you can't take it all in one dose though so had to take it twice a day which doesn't seem to work as well. I'd defintely speak to the doctor about the possiblilty of upping the dosage. I think dan is spot on, going straight to 60 might be best. Good luck, hope it works :D

I've canned the Tirmipramine and went back to the dulox yesterday - i couldn't take it anymore. I'm seeing my doc today to see if we can try something else.

MrRedShirt
24-04-12, 10:50
Hey guys,
How goes it? Sounds like it's starting to kick in which is good.

I started out on 30 Dulox and then increased it up to 60 after a couple of weeks. 60 worked really well for me for ages. It is possible to get 40 tablets, which i had when dosage was upped to 80 back in Feb, you can't take it all in one dose though so had to take it twice a day which doesn't seem to work as well. I'd defintely speak to the doctor about the possiblilty of upping the dosage. I think dan is spot on, going straight to 60 might be best. Good luck, hope it works :D

I've canned the Tirmipramine and went back to the dulox yesterday - i couldn't take it anymore. I'm seeing my doc today to see if we can try something else.

Hi Isa,
Just got off the phone with my doc who has made me a refill with 60mg tablets. I told him that while I'm certainly not doing cartwheels or feel ready to take on the world, it's seemed to be doing something. I asked about an intermediate dose, but he thought I may as well go up to 60.

I tried sleeping without the zopiclone last night but at about 2am my tinnitus starting raging.. So my doc's giving me some more of these too. I really don't want to rely on them for sleep, but there's no way I can sleep at the moment.

Good luck finding something else, Isa. What have you tried so far? I saw your post in another thread about withdrawals - sounds nasty :mad:
Has the dulox well and truly pooped out on you?

MrRedShirt
26-04-12, 10:54
DAY 25 (I think)

Started taking the 60mg yesterday. I was braced for 'something', but nothing happened.. until the afternoon. Increase in anxiety (leading me to take my first diazepam in nearly 2 weeks), nausea and the jitters again. To be expected really I suppose, but still unpleasant.

Zopiclone took a while to kick in last night, due I suppose to the anxiety levels at the time, but once I was of I slept pretty well. Feel ok right now (about 11am), but whether I stay this way through the day.. well we'll see I guess!

dan1234
28-04-12, 10:45
5 weeks on, and about 4 weeks on 60mg and I have noticed absolutely no benefit from the duloxetine. I asked about increasing the dose but was told trials have shown no benefit on a higher dose. I think my next choice will be imipramine/clomipramine.

LAURA48
28-04-12, 15:09
Thought you were getting on ok with them Dan. They are old ones that you are thinking about?

nicola1980
28-04-12, 15:45
My sis tried imipramine and didnt help her at all, there the real old AD's x x

dan1234
28-04-12, 16:28
Ye they are old ones. My dad was on imipramine back in 94 for 6 months and they helped him tremendously post heart operation.

I think I should give the duloxetine a bit longer ....

I took 1mg of lorazepam which hasn't done a lot. May try a different benzo soon. Just a case of finding the right combination.

I have emailed my shrink about anti psychiotics - will wait for his reply.

MrRedShirt
28-04-12, 16:34
Hi Dan,

I agree I think at least 6 weeks at the 60mg dose would be a fair trial of the duloxetine. At least then you'll be able to rule it out comprehensively if it doesn't work. Best to give it a good go.. That poll showed some folks taking longer than that even, although I can understand the frustration.

dan1234
28-04-12, 16:49
Thanks Simon - I am determined to give it a fair trial after all the horrible start up side effects. Thing is my weight has increased dramatically - gone from about 82kg to 94kg in about 6 weeks. I know that due to my back I couldn't do much exercise has something to do with it, but I think the dulox does too.

MrRedShirt
28-04-12, 16:53
Sorry to hear about the weight gain.. could it be down to the pregabalin?

I'm not sure what the average effect of duloxetine on appetite is, but I've found mine to have returned to normal - possibly a bit less - but I was previously on mirt which made me eat for England.

nicola1980
28-04-12, 17:48
Ye they are old ones. My dad was on imipramine back in 94 for 6 months and they helped him tremendously post heart operation.

I think I should give the duloxetine a bit longer ....

I took 1mg of lorazepam which hasn't done a lot. May try a different benzo soon. Just a case of finding the right combination.

I have emailed my shrink about anti psychiotics - will wait for his reply.

Hi Dan what do you want anti psycotics for? Your anxiety? I take 5mg of olanzapine and only got prescribed that as i was having horrandous panic attacks and literally climbing the walls with my anxiety levels and altho it helped initially i cant say it does anymore. Does your shrink suggest meds he thinks suits your needs or do you ask for specific ones? X x

LAURA48
28-04-12, 18:02
Ye they are old ones. My dad was on imipramine back in 94 for 6 months and they helped him tremendously post heart operation.

I think I should give the duloxetine a bit longer ....

I took 1mg of lorazepam which hasn't done a lot. May try a different benzo soon. Just a case of finding the right combination.

I have emailed my shrink about anti psychiotics - will wait for his reply.


Dan

I think you should stick with the Duloxetine - it is still very early days. You are on a very good antidepressant and personally would just stick to the diazepam - you seemed to be getting on better with that one. Do not mix and match and chop and change antidepressants - I should know over the past few months - perhaps I should given have the sertraline longer - like you have got a diagnosis now and you do get frustrated. None are a quick fix, wish they were like a paracetamol and worked quick!

Anyway that's my bit of advice - for what's its worth!

Not a lecture just don't want to see you over-medicated!:okay:

dan1234
28-04-12, 19:14
Sorry to hear about the weight gain.. could it be down to the pregabalin?

I'm not sure what the average effect of duloxetine on appetite is, but I've found mine to have returned to normal - possibly a bit less - but I was previously on mirt which made me eat for England.

Could be. Yep heard about mirt.

---------- Post added at 19:13 ---------- Previous post was at 19:10 ----------


Hi Dan what do you want anti psycotics for? Your anxiety? I take 5mg of olanzapine and only got prescribed that as i was having horrandous panic attacks and literally climbing the walls with my anxiety levels and altho it helped initially i cant say it does anymore. Does your shrink suggest meds he thinks suits your needs or do you ask for specific ones? X x

Hiya, yes for anxiety. I normally ask and he agrees or suggests something else. He suggested Risperidone - but thought I didn't need it at this stage.

I am taking 10-12mg diazepam daily, are you still taking diaz or just when you need it ?

---------- Post added at 19:14 ---------- Previous post was at 19:13 ----------


Dan

I think you should stick with the Duloxetine - it is still very early days. You are on a very good antidepressant and personally would just stick to the diazepam - you seemed to be getting on better with that one. Do not mix and match and chop and change antidepressants - I should know over the past few months - perhaps I should given have the sertraline longer - like you have got a diagnosis now and you do get frustrated. None are a quick fix, wish they were like a paracetamol and worked quick!

Anyway that's my bit of advice - for what's its worth!

Not a lecture just don't want to see you over-medicated!:okay:

Thanks, I agree with you. The loraz was just for situations where I didn't need diazepam cos its so long lasting.

nicola1980
28-04-12, 19:56
I try to just take it as i need to now, im allowed upto 15mg a day at the min but i hate using them and literally have to be climbing the walls to take one x x

dan1234
28-04-12, 20:08
I try to just take it as i need to now, im allowed upto 15mg a day at the min but i hate using them and literally have to be climbing the walls to take one x x

I don't like using them either, but needs must and all that.

LAURA48
29-04-12, 09:40
Hi Dan

Personally don't think you should be taking Diazepam on a daily basis just as and when.

I have taken lorazepam daily since 1984 - I knew no better - doctors were given them like sweets - I did not know how addictive they were - however when well was always on 0.5 mg just half a tab - because coming off them after all those years would do more harm that good - so I have been told, but don't fall into my trap! There is so much more knowledge on benzos now!

Just a bit of advice!

dan1234
29-04-12, 12:17
Hi Laura,

I do agree with you to a point. But diazepam is safer and easier to stop than lorazepam. I have been told I can only take a max of 10 loraz's a month. I am going to bin them as I don't like them.

The diazepam helps with the back and anxiety, and because I am doing CBT, and on other medication the shrink is happy to prescribe it. He wouldn't if I didn't try and change the though process behind the anxiety. I take 10-12mg a day which isn't exactly a lot. I am hoping once the duloxetine starts working, and I have a few more CBT sessions I can stop the diazepam and use it PRN instead. The options at the moment are diazepam or anti psychiotics and I would rather be on diazepam.

I am also on morphine which is highly addictive, I am hoping to stop that soon.. Got a MRI on the 5th of May. Already decreased the dose from 100mg/d to 80mg/d. Am stable and have minimal pain so am happy.

Dan

LAURA48
29-04-12, 12:30
I understand Dan but at the end of the day it is still a benzo? and tolerance can build up - that's all - it is easy to get addicted to them - say after a month?

I should know been there!

That's all - just concerned

dan1234
29-04-12, 12:54
Hiya - yes it is still a benzo...

Appreciate your concern, but I am fairly happy with how things are going. How are you finding the citalopram ?

dan1234
01-05-12, 19:37
I am increasing to 90mg/d will see how it goes.

Dan

LAURA48
01-05-12, 20:06
Wow Dan that's a bump up? what is the maximum dose?

dan1234
01-05-12, 21:10
Wow Dan that's a bump up? what is the maximum dose?

120mg/d.

dan1234
04-05-12, 19:26
Update:

Taking 12mg diazepam, 90mg duloxetine, 600mg pregabalin, 80mg propranolol Extended release, and I must say the last few days I have felt better. Will see how it goes.

nicola1980
04-05-12, 21:10
Crickey thats alot of meds dan, will u eventually wean off the diaz x x

dan1234
05-05-12, 08:51
Hi,

Not sure really. The diaz has been a massive help. Aren't you taking 10mg diaz ? Anyway I need the diaz for my back. The shrink said if I need it for 6 months or 3 years that's fine.

Dan

LAURA48
05-05-12, 08:59
Hi Dan - how are you today - what time is your MRI? did you get any morphine extended relief?

nicola1980
05-05-12, 10:03
I agree the diaz is a big help but i try to struggle thro without as addiction petrifies me, good luck with your MRI x x

dan1234
05-05-12, 10:38
Hi Dan - how are you today - what time is your MRI? did you get any morphine extended relief?

11.30 hiya yes GP prescribed me more morphine extended release, and some oral morphine as needed or for breakthrough pain.

Dependent on the results, I will either be seeing the surgeons, or the pain clinic. Praying its the pain clinic lol.

Nicola how long did you take diazepam daily for?? My view is that anyone who has a chronic illness become reliant on their medication.

I am so nervous that I have taken 5mg diazepam this morning, and 2mg lorazepam ( the max the shrink suggested). Mum is driving me there so no concerns on that front.

Dan

nicola1980
05-05-12, 10:43
Im still taking them daily but try not to take my 10mg, im trying to cope thro it which is easier said than done! Did your shrink say how long it takes to build up an addiction with them as would be interested to know? X x

dan1234
05-05-12, 13:50
Im still taking them daily but try not to take my 10mg, im trying to cope thro it which is easier said than done! Did your shrink say how long it takes to build up an addiction with them as would be interested to know? X x

He said it takes about 6 weeks to get a dependence to them. Varies from person to person. Slowly decreasing the amount of diaz is the way forward.

Dan

LAURA48
05-05-12, 17:35
How did the MRI scan go Dan - hope went well

dan1234
05-05-12, 18:35
Hiya was good. Only 20 mins or so..

dan1234
06-05-12, 20:16
I have increased to 90mg/d and feel an improvement. Definitely better compared to 60mg/d.

MrRedShirt
06-05-12, 20:23
Glad to hear it Dan. Can you be sure it's the duloxetine though?

dan1234
06-05-12, 20:51
Well within a few days of increasing the duloxetine I felt better. Nothing else changed, so can't be sure but it is highly likely. How are you doing?

Dan

MrRedShirt
06-05-12, 20:54
I'm on day 12 of 60mg. About a 5 weeks in total. So much better than I was, still room for improvement though. Haven't had any diaz for about week, still on the zopiclone though.

dan1234
06-05-12, 21:05
I'm on day 12 of 60mg. About a 5 weeks in total. So much better than I was, still room for improvement though. Haven't had any diaz for about week, still on the zopiclone though.

Good to hear. I am still taking diaz though... but I am happy.

Dan

dan1234
10-05-12, 09:37
Simon have you stopped updating this thread??

MrRedShirt
10-05-12, 10:27
Hi Dan, no I'm still here. I've been doing pretty good, but wanted the effect to even out a bit before I updated.

MrRedShirt
17-05-12, 14:46
Update:
Well, I've been on 60mg for about three weeks, having been on 30mg for the previous 3 weeks or so.

Duloxetine has been really good for me. :yesyes:

I still have moment of wobbliness, but on the whole I feel pretty much normal - maybe 95%? This feeling has built over the past week or two. I haven't even thought about diazepam during this period. I just hope it continues to build.

I am still on the zopiclone as my tinnitus is causing my sleep to be tricky - I tried a night without it recently and I had an awful night, and it almost undid all the positive effects of the duloxetine the next day. I'll need to speak to the doctor about a long-term solution to sleep. Previously the mirtazapine helped me sleep (although came nowhere near the duloxetine in helping sort the anxiety).

I still occasionally jittery, but this is easing off and is nowhere near the level it was when I started.

Oh the whole, I give duloxetine the thumbs up! I just hope it continues :)

nicola1980
17-05-12, 14:49
Fantastic :yahoo: xx

MrRedShirt
17-05-12, 14:53
Fantastic :yahoo: xx

:) I've held off posting this for risk of jinxing it! :ohmy:

dan1234
19-05-12, 13:29
Just to add my input:

I am on a large amount of medication, so it is difficult to fully assess the situation but I think duloxetine has helped me. The first few weeks were pretty tough with ridiculously high anxiety levels, but now I am calmer and more relaxed.

Duloxetine definitely gets a thumbs up from me.

I have tried citalopram (12 weeks) Fluoxetine ( 3 weeks) and I think duloxetine is the best - just my opinion.

Dan

sophiebolton
27-11-12, 12:17
Well now, it's nearly 3:15am and about 90 minutes ago I woke up into a major panic attack! Not pleasant at all, one of the worst I think I've ever had. I took a 2mg of diazepam and it's taken the edge off it, but that was pretty scary..

This is proving to be tough going.


this is what happened to me, took my first med and then went asleep, woke up 2 hours later in a mjor panic feeling like i wasnt in my body, was soo strange, seems to have calmed down a bit, found some lorazepam in my bag from over a year ago, im tempted lol

MrRedShirt
27-11-12, 12:28
this is what happened to me, took my first med and then went asleep, woke up 2 hours later in a mjor panic feeling like i wasnt in my body, was soo strange, seems to have calmed down a bit, found some lorazepam in my bag from over a year ago, im tempted lol

Hi, from memory, I think the panic attack I had then could well have been due to my somewhat rapid withdrawal from mirtazapine.. but it's hard to tell with these things.

If it was your first dose you may have experienced an initial 'rush' (as I did), but these became less intense and disappear with subsequent doses.

The nausea is due to the serotonin in the digestive system being affected. I still get this, although it's nothing I worry about and is pretty minor now. Good luck with duloxetine :)

Tracey51
03-10-13, 21:24
I'm also on day 2 of Duloxetine 60mg. I've come straight onto this dose from 45mg Mirtazapine. I wasn't given any diazepam to help with the start up and have been feeling very jittery and unable to sleep through the nights. I had to come off Mirt quickly though as after 9 weeks of swelling up it became unbearable with even my eyelids swelling up with fluid retention. I do hope that this SSNRI helps.

MrRedShirt
03-10-13, 21:59
Hi Tracey, did you talk over the swap over with your doctor?

Did you start on 60 of Duloxetine or did you have some time at 30mg?

I am still on 60mg of Duloxetine and it's still helping me out.

crosser
05-10-13, 17:55
ive only been on 60mg of duloxetine for a few days and getting stomach aches which cause me to panic, has anyone else had this?

MrRedShirt
05-10-13, 18:37
Hi crosser,

Stomach and digestion issues are common when starting up. Apparently, 95% of the body's serotonin is found in the digestive tract, and these drugs affect serotonin so this is why. Some folk get diarrhea, I felt pretty queasy. It passed with me, like other start-up side effects.

panicky88
03-01-15, 02:37
Hi. I'm 26yrs old and just yesterday I was prescribed cymbalta for anxiety...even tho I still can't accept it is anxiety...I've suffered with dizziness, shakiness, heart racing, fear that something wrong with heart/brain, fear of heart attack or tumor etc..for the last 6 wks .all bloods, ct, X-ray, holter monitor, ECGs clear...but I can't seem to accept it.

Anyways, I went to doc yesterday cos I just couldnt calm myself - safe to say I was a mess! He prescribed cymbalta. I've never been on any other meds and safe to say I am stressing and probably even more anxious about side effects of it.

I'm on 30mg once a day and first dose was this morning. I already felt yuck I've had no appetite and have pains that I went to hospital for last night that they couldn't explain..ECG, bloods, X-ray fine aside from slightly elevated heart rate...I keep fearing I'm gonna have a heart attack again today and these pains which are in my ribs shoulder back and occasional harm and centre chest are the lead up to it.

I am feeling strange in the head like dizzyish or something but don't know if that's normal or a side effect of cymbalta...has anyone not had side effects? Is it working for anyone? I see my gp again on Thursday so I can be referred to a psychologist. Freaking out!

MyNameIsTerry
03-01-15, 05:58
When I took my first 30mg dose, I was next to the toilet within 20 minutes with nausea. Then I was really tired. The next day was similar but the nausea want quite as bad. After that it stopped.

After a few days I had a period where I felt a bit better but this didn't last and the anxiety started reverting back to how it was before. This was probably the sign to move to move to the regular 60mg dose.

The side effects going to 60mg were completely different for me, more adrenaline based. However, from talking to others on here, their experience was very different so mine seems more likely a more sensitive reaction because of my GAD sensitivity to physical symptoms.

Give it a few days and see how it changes.

It sounds like you have HA or panic disorder so getting support on here, on the relevant boards, will be a great help to you in working through but also in braving it through the side effect period.

MrRedShirt
06-01-15, 13:55
Hi I've been on duloxetine since I started this thread - so over 2.5 years. It gave me back my life!
I think I'm going to come off it starting from next month.

Beeble
19-01-15, 19:06
Good to hear positive things about this medication I have been put onto 60mg today (start tomorrow morning)...am on mirtazapine at the moment and am stopping that over next few days whilst taking the duloxetine. I hope I will be ok...

MrRedShirt
20-01-15, 13:23
Good to hear positive things about this medication I have been put onto 60mg today (start tomorrow morning)...am on mirtazapine at the moment and am stopping that over next few days whilst taking the duloxetine. I hope I will be ok...


Hi, I swapped from Mirtaapine too - be careful coming off it, and do so slowly. I took a week to come off it and that was probably a bit too quick.

Good luck with the duloxetine! I started on 30mg for a couple of weeks before going up to 60.

Beeble
20-01-15, 19:12
Thank you MrRedShirt for your reply. I did feel a bit sicky today but put it down to hunger. I am taking half a Mirtazipine tablet every other day until weekend. If feel rough at least it's the weekend.

Beeble
24-01-15, 17:11
Am doing ok so far on the 60mg dose....I take it in the morning. Is that when others take it?? I'm also on amitriptyline...10mg for pain.

panicky88
26-01-15, 00:38
I gave up the Cymbalta 2days in. I found I couldn't sleep, was extremely nauseas, dizzy, completely flat mood wise, had terrible diarreah, and was very shaky. That was 30mg starting dose. I felt absolute rubbish and couldn't continue past that to see if it got better - didn't help that I never wanted medication anyway but anxiety got to the point I know I needed to try something...

Strangely enough after I stopped taking it and those symptoms cleared up I had two awesome weeks symptom/anxiety free and felt back to my normal self. Unfortunately it was short lived and im suffering with anxiety but mainly my head feeling completely weird...I can't explain it but whatever my head is be it dizzy, lightheaded, brain fog I dunno...it seems to b what sets the anxiety off cos if my head feels normal I'm fine.

I think I'll speak to doc bout it but dunno what he could offer that's not medication. I'm due to have my first appointment with a psychologist on Feb 4

SarahMarshmallow
27-01-15, 10:20
Hi Panicky

Duloxetine made me feel dreadful for a few days when I first went on it but it did pass and then really helped me. It took me a few years and a few failed attempts over the course of years before I managed to stick with medication as it scared me. I am not anything now but I would go back on for sure if I needed to.

However, if medication is not the way for you then I really recommend CBT as this also really helped me and still helps me.

And boringly I also do loads of exercise and try and get good sleep as these things help me stay on an even keel.

all the best
Sarah x