Switching to duloxetine - any advice?

[Mark13]

After 4 months of being on pregabalin I don't feel it's having the same effect it once did.

When I last saw my GP he told me they did prescribe duloxetine (some don't due to cost implications). I said I might like to try it in future.

At the moment my anxiety is peaking again, and I have an appt. with my GP on Monday evening.

I'm going to ask to try duloxetine, but I realise I'll have to stop taking mirtazapine too, due to the risk of seratonin syndrome.

I'm hoping I can switch without a tapering period (I've tried several drugs since I first took mirtazapine with only a 48 hour "wash-out" period).

I've booked a few days off work in case of unpleasant side effects (this is my usual strategy when switching meds).

My only concern is that not being on mirtazapine may cause insomnia, this is something that really triggers my anxiety and something that would be a deal-breaker for me if it lasted more than a day or two).

Any experiences or advice would be much appreciated.

Mark

[Consider]

You can do both. Stay on Mirt. Start on Cymbalta at 20mg to avoid harsh side effects at the beginning. Cymbalta works, and it does WORK, but it has harsh side effects at the start which wean away after 2 weeks. After 2 weeks, up to 30mg unless the 20mg is working for you just fine. Cymbalta has a 60-day start up program, sign up and if you aren't satisfied, you get your money back. And also, ask for Diazepam to go along to deal with the side effects! Good luck. :) Serotonin syndrome is rare, and you shouldn't be too worried. I am on Paxil and Mirt, and do just fine.

[Tufty]

Just wanted to say good luck Mark. Are you going to stop the Pregabalin as well? You can take it alongside a SSNI. I also found that Pregabalin doesn't have the same beneficial effect after several weeks at the same dose but I have reduced it successfully from 450mg daily to 200mg daily over a period of 3+ weeks without problem, whilst introducing a SSRI. I'm planning to come off it completely when the SSRI is up and working.

Take care
Sam

[Mark13]

Thanks to both of you.

I have now found NHS confirmation that Mirt and Duloxetine can be taken together, so I'll put that idea to my GP.

I also know that pregabalin can be taken with these drugs (as it can be prescribed for nerve pain) but I'm wanting to try duloxetine because although pregabalin helps a lot, there are down periods which are increasing, and also I've put on (more) weight that won't shift even with the strictest Weight Watchers diet.

I put on weight with Mirt but then it settled (to 4 stone overweight, the mirt only accounted for maybe 10 lbs, I've always had weight problems).

But I've put on another 9lbs since starting pregabalin and it just seems to keep going up, or and best not going in the right direction!

[Consider]

Yes, cymbalta will definitely help you with the weight loss! Good luck Mark :)

[Mark13]

Yes, cymbalta will definitely help you with the weight loss! Good luck Mark :)
Thanks, Consider, much appreciated.

I did lose 2lbs this week, but on pregabalin, which I'm still on, I could just as easily put 3lbs on next week by eating the same amount, that's what bothers me about it :ohmy:

With Docs approval I hope to start duloxetine next week. I'll keep a diary on here in this sub-forum.

Mark

[bernie1977]

Hi Mark,

I was switched from Mirtzapine to Duloxetine. I had no problems at all during the start up of Duloxetine but unfortunately it didn't help my condition. Coming off Duloxetine was an unpleasant experience but not as bad as when I came off Venlafaxine. I'm now on Trazodone and finally after years of chopping and changing meds I've found one I'm happy on. I hope this is the case for you. Let us know how you get on. Good luck x

[Mark13]

Thanks bernie

Glad you found a drug that works for you.

It never ceases to amaze me how we all react differently to these medications.

Trazodone didn't suit me unfortunately, after 2 weeks I got bad insomnia and I found the sexual side effects unbearable.

I'm presuming the Doc will let me try duloxetine (he already told me he would but he rarely remembers me from visit to visit :))

I'm falling fast on the pregabalin, more up than down at the moment, but it reallyu worked well for a while.