View Full Version : Duloxetine / Cymbalta Diary 2013
Well I actually start tomorrow, but I saw my GP yesterday evening and he was happy for me to try this drug.
I managed to find a late Chemist so I could obtain the drug straight away (as I'm at work today and don't leave till 7).
He reckons I can come off pregabalin quickly (over 3-4 days) which I am doing, although it's causing some insomnia which really doesn't help my anxiety, which is rebounding fast too.
I've taken 3 days off work in case of unpleasant side effects.
Fortunately I'm able to continue with Mirtazapine, so hopefully that should help combat the insomnia to a degree.
So, tomorrow will be day 1 on this drug - although if it doesn't work out my GP agreed that I could go back on pregabalin, but that's negative thinking - this new drug will be great :D
Congrats Mark, I am happy to hear you will be able to stay on the Mirt too! This will combat some of Cymbalta's side effects too such as low libido and nausea as Cymbalta's side effects to start up can be quite harsh for some people.
Good luck and I hope this works for you! Also, Cymbalta has a savings card you can use if you find it too pricey in the future. It's located on their website.
Also, Cymbalta has a savings card you can use if you find it too pricey in the future. It's located on their website.
The beauty of the UK's NHS system, Consider, is the drug cost is irrelevant to the patient.
We pay Insurance contributions and taxes from our wages which help fund the NHS system. Although those people who don't work still get free treatment.
It costs each local NHS Trust money to prescribe these drugs, so our GPs may be reluctant to prescribe due to their own costs, but the patient only pays a standard NHS prescription cost - about £7.50, regardless of the actual drug cost.
So the only consideration for the patient is whether the GP is happy to prescribe a drug.
bernie1977
09-04-13, 18:27
Good luck Mark. Fingers crossed that you have a side effect free time on these meds. :)
Have you thought about prepaying your prescriptions? I pay just over £10 and get 6 items every month.
Good luck Mark, I've heard good things about Duloxetine and this will hopefully be the drug for you.
Keep posting about your experiences and we'll support you along the way
Take care
Sam
We pay loads here for our drugs. >< I swear I am paying an arm and a leg for my Nexium! The other drugs I take are generic, but the generics here are cheaper but not always great, we have to watch to make sure they didn't switch companies, that's where the real trouble comes in.
MrRedShirt
09-04-13, 21:48
Good luck with duloxetine. It's been a lifesaver for me. I started it about a year ago after coming off Mirt (which didn't do enough for me). I did wonder if I could've remained on the Mirt as the main side effect I get from the duloextine is insomnia (specifically, waking in the middle of the night - every night). It's not so much of a problem though actually.. I've gotten used to it.
I had a little diary on this forum about my starting up - have a look it's still here.
From what I can tell, the benefits of dulox seem to appear somewhat sooner than with other ADs.
Have you thought about prepaying your prescriptions? I pay just over £10 and get 6 items every month.
I already do bernie, although I only started doing so a few months ago when I started having 3 drugs per day. TBH it's not actually cheaper for me but much more efficient so it's worth it in that I get my drugs without having to mess about with mere money :D
---------- Post added at 22:46 ---------- Previous post was at 22:44 ----------
I had a little diary on this forum about my starting up - have a look it's still here.
I did read it a few weeks ago, in fact it's one of the reasons I decided to "risk" duloxetine. There's nothing like positive reviews to encourage you to take the plunge :)
---------- Post added at 22:48 ---------- Previous post was at 22:46 ----------
Good luck Mark, I've heard good things about Duloxetine and this will hopefully be the drug for you.
Keep posting about your experiences and we'll support you along the way
Take care
Sam
Thanks Sam.
It's the support on here that really helps, you know.
I read the experiences of others, and better than sites where reviews are left, here I can ask the poster questions about their experience too.
Day 1, well ½
Took my first tablet when I got up.
About 5 hours later my anxiety hit the roof, bad as ever, already upset my wife with my paranoia, obsessions and overanalysing of everything. Back to how I was at my recent worst.
Hoping to ride it out for a few days, it could be the pregabalin withdrawal acting on me too.
I think I'll know by my birthday on Saturday (good timing to try a new drug!) whether I'll be able to cope with these.
If it causes insomnia, which really spikes my anxiety, I'll be off them like a shot, but I'm hoping my usual mirtazapine will help me get some rest.
Mark
MrRedShirt
10-04-13, 22:06
Hello Mark,
If you look at the my thread http://www.nomorepanic.co.uk/showthread.php?t=112780 You will see that I also had a rush of anxiety after my first dose of Duloxetine. I think this is to be expected for a few days at least. Please try and ride it out, and give the drug at least a few weeks before passing judgement.
Also, it may cause insomnia, it may not.. But if you have insomnia, but without anxiety, then I would suggest that this is a side-effect worth having. The mirtazapine may well help with this though. (is your doctor fully aware of this combination of drugs? - I've heard it called 'Limerick Rocket Fuel' before, although I know some docs are reluctant to combine such drugs).
Good luck!
Simon.
Thanks Simon
I had read your start up effects but thought I'd got away with it for the first few hours :weep:
This is not much worse than missing a dose of pregabalin and at least it reminds me of how bad I was before I went on that, so I'll be able to measure improvement against how I feel today.
Insomnia makes my anxiety unbearable, I would much rather have anxiety and sleep OK than have insomnia.
That said the anxiety became difficult to cope with on mirtazapine alone for 5 years, so I'm trying to achieve relief from both now.
My GP is aware of the combination as he reissued me with a mirtazapine prescription at the same time.
It was me that told him they could be combined though, he's doesn't normally prescibe duloxetine apparently. I was his guinea pig for pregabalin too, as he'd only prescribed that for nerve pain before.
I did get the info on drug combinations from an NHS site though. And I am aware of the risk of serotonin sydrome, I've been on AD augmented therapy before (Citalopram & mirt, fluoxetine & mirt, now duloxetine & mirt).
Also I'm only on 15mg of mirtazapine, which is why it's actually classed as augmentation rather than combination I believe (one AD at a low dose non-therapeutic level enhances the effects of the AD that is at a therapeutic dose).
I genuinely appreciate your concern but I did do my research :D
MrRedShirt
10-04-13, 23:24
Ah good :)
I wasn't suggesting you hadn't, just curious really. I'm sort of envious, I do wish I'd been able to continue with the mirt to help with sleep.
I'm not sure if my doctor had prescribed Duloxetine much, but he was aware of it.
Anyhow, I hope tomorrow is a little better, but however it is, keep going!
Off for a night of broken sleep now... (and I'm ok with it, honestly!) :)
TBH Simon, when I read your diary I nearly decided against duloxetine due to the insomnia and coming off mirt.
I only decided to try it when I realised I could take both. And to be fair, that info took some finding, although the combination / augmentation is mentioned on Wikipedia too.
Cheers
Mark
Cymbalta and Remeron is definitely a great combo. I am on Paxil and Remeron, and the Remeron combats against certain side effects, such as insomnia, nausea and libido from SSRI/SNRI's. :)
MrRedShirt
11-04-13, 22:17
Cymbalta and Remeron is definitely a great combo. I am on Paxil and Remeron, and the Remeron combats against certain side effects, such as insomnia, nausea and libido from SSRI/SNRI's. :)
Hi, did you start the two together, or add on the Mirtazapine after experiencing these side-effects?
Cymbalta and Remeron is definitely a great combo. I am on Paxil and Remeron, and the Remeron combats against certain side effects, such as insomnia, nausea and libido from SSRI/SNRI's. :)
Genuinely glad that combo it works for you.
I found the mirt helped with the insomnia caused by citalopram and fluoxetine (or maybe I didn't get it with the SSRIs, hrd to say for sure since I've been on mirt for so long).
The mirt never counteracted the SSRI sexual side effects for me, that one the reasons I came off both. Also I never got any beneficial side effects on an SSRI, and I was on one (fluvoxamine) for a few months IIRC.
Days 1, 2 and 3
Thought I'd give it a few days before starting the diary proper.
Side effects from the duloxetine:
increased anxiety
extreme tiredness
insomnia (even with the mirtazapine)
headaches
mild nausea
low appetite (and weight loss).
I've lost 5lbs since coming off pregabalin a few days ago, which shows how much fluid retention it was causing :ohmy:
I know the SNRIs are similar to the SSRIs in that you feel worse for a while before feeling better so I intend to hang on in there, as long as my sleep improves (insomnia makes my anxiety sky high).
Might go for a walk for my birthday, haven't been out the house for days :)
MrRedShirt
13-04-13, 14:51
Days 1, 2 and 3
I know the SNRIs are similar to the SSRIs in that you feel worse for a while before feeling better so I intend to hang on in there, as long as my sleep improves (insomnia makes my anxiety sky high).
Might go for a walk for my birthday, haven't been out the house for days :)
Keep going, it's still very early days! I didn't notice any benefit until about 2/3 weeks, then I went up to 60mg and another 2/3 weeks after that I felt the most benefit.
Happy Birthday Mark :bighug1:
I hope you managed the walk today and you get some sleep tonight (sad really isn't it) I'd love to write I hope you got your Ferrari and had a great party but I think a good nights sleep and reduction in anxiety might be on top of your wish list for today.
Take care
Sam
Thanks Sam
Had a saddo meal for one for my lunch (my wife was at work).
Just taking it easy, did pop out to the shops, but exhausted when I got back. It's like having mild flu at the moment with these side effects.
MrRedShirt
17-04-13, 17:57
How's it going Mark?
End of first week at 30mg
At least I managed to get out of bed on Sunday. I went for a 6 mile walk with my wife at a nearby park.
Was close to going sick from work yesterday, but pushed myself to go in and perked up a wee bit during the day.
Anxiety still higher than without duloxetine, usual obsessive thoughts etc.
Also it's really getting my wife down as I've been struggling for months now, and trying to find a drug that works well for me. Pregabalin gave me probably a total of 3 good months out of the 4 I was on it, but I was more down than up by the end.
I think I'll give it another week before I ask the Doc to up me onto 60mg.
Following your thread with interest Mark and wishing you well!!!
Keep going:)
Thanks for the support, Simon & Sarah :)
Days 8, 9 & 10
Still sleeping "differently". Waking up 60-90 minutes earlier than I used to, but still apparently getting enough sleep, I'm certainly not sleepy during the day.
I'm having periods during the day when I feel pretty good, and the odd period where the anxiety spikes along with some depersonalisation - I just ride that out it doesn't last too long.
Today, after feeling anxious on waking (but not as bad as previous days) I've felt quite calm (for me) at work. Not too much nagging or paranoia going on in my head today.
My anxiety goes up and down whether I'm on medication or not, I just want it to be more manageable on a day to day basis and not to obsess over the little things.
So, after a rough first few days (which may have been partly pregabalin withdrawal) I'm becoming more hopeful that this drug may help.
Also my libido has increased slightly from zero on pregabalin, and I've also lost 8lbs in 3 weeks - I believe the pregabalin was keeping my weight artificially high with fluid retention. So those aspects please me.
Looking forward to upping my dosage to the standard 60mg as soon as I get the OK from my GP.
MrRedShirt
19-04-13, 17:08
Sounds like it's going in the right direction :)
Sounds like it's going in the right direction :)
Only for one day unfortunately :weep:
Saturday was awful, my anxiety was sky high.
Sunday not so bad, once we went out for a walk at a local park.
Getting mild "brain zaps" though, the last few days. Nothing like I got years ago when I withdrew from fluvoxamine, but a little disconcerting all the same.
Still feeling slightly worse on duloxetine than I was without but as I'm still sleeping OK I'm happy to continue - should get the go ahead to up to 60mg this week too.
Mark
Days 13 & 14
Still feeling rough, not sleeping well. Waking up with anxiety during the night and when I finally awake for the day. Disipates slightly after I get up, but still as high all day as it used to be without duloxetine.
Still suffering from side effects:
dizziness
insomnia
headaches (having to take paracetomol, a drug I rarely use)
tremors
feeling the cold / shivers
mild brain zaps (very frequent and annoying)
fuzzy head (hard to describe)
trouble concentrating
very little energy
Going up to 60mg on Thursday, now I've got my GPs go-ahead. Hope that'll do the trick.
Hey Mark!
Been reading the diary, hope the Cymbalta experience isn't too bad. Hang in there though, cause this drug really does work for a lot of people. :)
Hey Mark!
Been reading the diary, hope the Cymbalta experience isn't too bad. Hang in there though, cause this drug really does work for a lot of people. :)
Thanks Consider, I intend to.....mainly because the withdrawal syndrome sounds so horrific :D:ohmy:
The only really annoying side effects at the moment are the mild but annoying brain zaps many times a day, and a loud droning tinnitus in my right ear (as well as the high pitched screeching tinnitus I always have, seriously).
That said my right ear is blocked at the moment, using ear drops on it, so that may be related, but I think it came on first. The brain zaps started after about 6 days on the drug which was pretty weird, unless they're some remnant of coming off pregabalin (but that isn't supposed to have a related withdrawal syndome).
Confused and a bit miserable ATM.
Hope both SEs go away soon, and the benefits start to appear :unsure:
Oh and ejaculation is painful, I mean you couldn't make this up.:blush:
This has probably the most difficult side effects of any drug I've been on, but willing to see it out, because if my mood and anxiety improve these effects may be worth the sacrifice - obviously physical effects are more stressful when you're feeling down.
Blocked ear, I know I have had that before. An ENT can clear this up. Brain zaps on Cymbalta are pretty common, they will go away in time. One month after my anxiety went away, I laughed at actually how silly it was. I was like, "Anxiety, what anxiety?". That will be you too at some point in time. Remember, that this too, shall pass.
I really appreciate your support, Consider.
At the moment my anxiety is about as bad as it is without duloxetine (which is a step up, because for a while on this drug it was much worse).
So I'm hoping the next step will be a reduction in my daily anxiety and obsessive thoughts and worries.
Strangely the brain zaps seem to happen in the first 10 hours after taking the drug and not in the morning before I take my dose.
It's not the full disorientating, dizziness and nausea producing ones I got with fluvoxamine withdrawal, but they can still be very frequent and demoralising.
Still plodding on though :)
Had to get some stronger eardrops today, my blocked ear isn't clearing and my earache is annoying (bit of a wimp where pain is concerned).
It's the nurses at our GPs practice that do the ear syringing, but last time I went it was very painful and I had ear and headache for days, so I'm hoping to avoid another visit :)
End of 1st week at 60mg, after 2 weeks on 30mg
Feeling awful at the moment, hope things improve soon.
I'm still getting brain zaps, dizziness, lethargy and tiredness.
Also extremely high anxiety and worst of all, a touch of depersonalisation which always freaks me out. I feel like I'm not in my own body - horrible.
Still determined to see it through to the other side :)
nicola1980
01-05-13, 00:31
Hi mark, Im following your diary with interest as Im on a similar med venlafaxine and to start with my anxiety hit the rough as its done with every increase since but it soon calmed down, have you any diazepam to help you through this hard part? I was prescribed 10mg of it a day to help with the side effects, hope things settle down for you soon, the start up of meds can be so tough x x
Thanks Nicola. No, our GPs are loathe to hand out Benzos unfortunately.
Normally I'd have given up on these by now, but the fact the withdrawal sounds awful, and the further fact that I'm almost out of medication options keeps me determined to carry on for at least another month.
I'm hoping that this drug, seeing as it's strong enough to make me feel worse, should be strong enough to make me feel better when they settle down.
At least I feel they're doing something - even if it's in the wrong direction :)
I'm hoping that this diary sees me emerging from the rough period a new man - I know fluoxetine has a habit of making you feel worse initially, I'm hoping this is just the same and that things will improve.
Day 9 at 60mg after 2 weeks at 30.
I don't know how much longer I can cope with my anxiety being so high. I feel worse now than I have for years.
The sexual side effects are very depressing also.
nicola1980
02-05-13, 13:37
Hi mark, i was exactly the same when i increased my venlafaxine but fortunately i had diazepam to help, hang on in there things should settle soon x x
Days 11 & 12 at 60mg after 2 weeks at 30mg
I didn't want to jinx it by posting yesterday, but I actually felt quite good yesterday - not too bad today either.
The anxiety is there but the obsessive rumination over past events (some very minor) seems to be reducing a bit.
My body is still hyper (pounding heart, chills, tremors, stomach churning at times) but some of that is down to the SEs of the drug I think.
After reaching my lowest point on duloxetine on Thursday, I'm cautiously optimistic that I may get some benefit from this drug.
Looking forward to going out in reasonable weather tomorrow and Monday, walking in the country with my wife and taking photos - my favourite things to do.
Still not sleeping well, even with the mirtazapine, but getting enough sleep despite the wakefulness during the night.
Mark
Hi Mark,
Hope things go well with you with the medication and the walks.
It's been quiet on the pregabalin thread since you left! Nevertheless, I hope your new medication works out for you. Unfortunately, a number of people on NMP have left pregabalin in part or in whole because of side effects.
Take care,
Hanshan
Thanks for the good wishes hanshan.
To be fair the pregabalin had less severe side-effects for me, it worked great for 2-3 months but then it seemed to stop.
I started on Duloxetine last September after being on Paroxetine for 15 years. I felt I needed a change. I have been taking 40mg twice a day, but felt no different to being on Paroxetine. However, I also suffer from acid reflux and my GP suspects that it may be making it worse, so I have withdrawn from it and started Sertraline.
I started on Duloxetine last September after being on Paroxetine for 15 years. I felt I needed a change. I have been taking 40mg twice a day, but felt no different to being on Paroxetine. However, I also suffer from acid reflux and my GP suspects that it may be making it worse, so I have withdrawn from it and started Sertraline.
Good luck with the sertraline, ducky, I hope it suits you better.
Hello Mark,
I hope the duloxetine is starting to have a positive effect.
It`s all quiet on the pregabalin front - a week since the last post to NMP. I haven`t been a thread starter up to now, but this may stir me into action.
Take care,
Hanshan
I think I'll have to post something there :)
Day 30
Still feeling OK. Not calm all the time, there's still plenty of anxiety, but the obsessive rumination on past (sometimes minor) events seems much more under control, and for me, that's the main thing that was triggering the constant anxiety.
I still get offended easily (even if it's an imagined slight) but get over it quicker.
The change brought about by duloxetine is not a huge contrast, it's more subtle, but very welcome just the same.
Day 31 (17th day on 60mg)
I think I must have jinxed myself yesterday. I've felt awful since posting.
I've had depersonalisation on and off, which is the symptom I find most disconcerting, and my physical anxiety is high (jaw clenching, churning stomach, heart pounding etc).
I'm getting a bit frustrated. Maybe I'm just expecting too much too soon, but after a few good days I thought I was on the up, only to come crashing down again.
I'll certainly give this another few weeks unless it becomes unbearable.
I'm seeing the Doc on Monday so I'll discuss future options just in case, but I really just want this drug to work.
Hi Mark.
Hope something good comes from the Monday appointment.
Hi Mark.
Hope something good comes from the Monday appointment.
Thanks hanshan
I've been feeling pretty good today, better than I have in years - then I remembered I'd not taken my tablet today :)
However all that duloxetine in my system must be doing something.
I saw the Doc today due to sexual / urinary SEs caused by the duloxetine. Basically this drug is also for urinary incontinance so it slows down your "output" which is a bit unpleasant.
Also ejaculation is painful - this is an SE I've never encountered before (I'm not embarassed to post this - I'm fairly anonymous here).
After reading info on the web I asked him for tamsulosin, a medication for enlarged prostate - it's supposed to solve these SEs.
Not surprisingly he was unwilling to prescribe a drug specifically to overcome an SE from another drug, but I persuaded him to let me give it a try, but he was really reluctant and told me he would not issue another prescription for it unless it was working perfectly, as it was an "off-label" use.
My argument was that the sexual and urinary problems could be a "deal-breaker" for me on this medication and that relieving these symptoms would ensure I'd give duloxetine a fair go. Which is true.
My sex life is important to me. No point in having less anxiety if I'm just miserable.
To finish on a positive note, as I said above, best day for years anxiety wise. Long may it continue, but I'll be taking it one day at a time.
Hi Mark,
Don't be afraid to ask GPs for medications in situations where they have not prescribed them before. In my experience, their prescribing is often years behind the most recent indications, at least for anxiety-related illnesses.
Hopefully the new medication will stop the side-effects of the duloxetine. Please keep us posted.
Hello Mark,
Can you find a nice owl picture? The new one's really scary! :)
Yeah it is a bit creepy, but I like it :)
Obviously the last pic was of the Sheffield Wednesday mascot, so I thought I'd create my own unique picture.
I bought one of those plastic glow lights (I think they're for kids bedrooms) that change colour.
Then I took a few pics of it last night in the dark, and cropped it to fit.
At least I picked it when it was on blue, the red-lit version looked Satanic :)
No worries.
Congratulations on making your own picture. Beyond me, I think.
Glad the drugs are working Mark :)
Glad the drugs are working Mark :)
Thanks Sarah.
The effects have dulled a bit but I'm certainly able to focus more on the present rather than obsess about the past.
I'm still very nervous, excitable and easily stressed, but I seem to "come down" quicker.
---------- Post added at 20:17 ---------- Previous post was at 20:12 ----------
No worries.
Congratulations on making your own picture. Beyond me, I think.
Actually, you may be right. I know folk come on here and they're maybe in a fragile state of mind. I'm certainly easily freaked out.
I'll create something less disturbing :)
I may have some owl piccies I took at the local Bird Gardens.
As for photography, it's my obsession (in a good way). So I have several programs like Photoshop Elements for editing pics.
As you can see from the last post in this thread, it's been another month on duloxetine 60mg.
I'm pretty happy with them although at their best pregabalin was better, but I feel this drug dulls the anxiety well most days.
I still have the odd obsessive day, when I can't shake nagging thoughts, but they usually just last the one day at a time.
So I'll happily take what duloxetine gives me, because at the moment it's more consistent on a weekly basis than other drugs I've tried. It quietens the mind nicely and any fleeting negative thoughts are easily brushed aside.
I still get nervous and agitated, but I'm not on the verge of tears as I used to be every time I got stressed.
In fact the only drugs better than this at their best were valium (had a 10 day course of it once) and pregabalin (although the best affects tended to last hours rather than days).
Also, as I'm now diabetic, the current drug regime at least doesn't put weight on me, so my diet (carb counting) should help bring my weight and bllod sugar down - I still get the munchies at times, but I'm eating a lot of fat free natural yoghurt with fresh blueberries or strawberries that I add to it. Fills me up nicely :)
Hope everyone who reads this is doing OK themselves.
Hi Mark,
Hard to find you now you are off the pregabalin thread. So glad you are feeling better and the Duloxetine is working for you. Dont forget us on the other side:)
Hi Mark,
Hard to find you now you are off the pregabalin thread. So glad you are feeling better and the Duloxetine is working for you. Dont forget us on the other side:)
Thanks Sarah
I do keep popping into the pregabalin thread as it has a wee bit more traffic than this one :)
After a few weeks of up and down I feel this drug is doing very little now. The benefits have worn off to such an extent that it's no longer worth the side effects (sexual, gastric, insomnia).
I intend to see the Doc as soon as possible and arrange to start weening off.
He did agree a different combination last time I saw him (because, as I was going downhill fast I felt the time would come when another change was necessary, but I kept going in the hope things would pick up).
So I'm hoing to swap duloxetine for amitryptiline, then slowly increase my mirtazapine, so that it's at a therapeutic level, with the TCA to help me sleep.
Not looking forward to the duloxetine withdrawal though :ohmy:
So sorry to hear that Mark.....keep going! I am sure you will find the right combination :hugs:
Sarah
Thanks Sarah
I think I was just having a bad few days.
Since then I've come to the conclusion that this drug is definitely helping, but I can't expect miracles.
I don't think my next idea of a combination would really work - I think mirtazapine is better in high doses for depression rather than anxiety, or in low doses for insomnia - which is what I take it for.
I think I'll give the duloxetine a while longer and I intend to try some mindfulness (I have a book, but wasn't in a fit state to take it all in when I bought it) and hopefully the combined drug / self-help regime will work.
Mark
How are you doing Mark?
I'm doing OK thanks Sarah.
Just enjoying the sun, getting burned and going on long walks :)
The duloxetine seems to work well still, it's not as good as pregabalin at it's best, but I have much fewer bad days with this drug.
I still get agitated and stressed at times but I'm also capable of pretty good relaxation which I wasn't before so I feel I've taken a big step forward.
Hope things are going well for you too.
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