Duloxetine / Cymbalta diary 2012

[NCP]

Hello All,

Haven't posted much, I'm about to start on yet another AD and wanted to write a diary of my experience for my own use. There isn't too much information on this forum about this drug, so I thought it might be helpful for others to share it here.

I have had GAD, Social anxiety and at times depression on and off (mostly on) since a teenager. I'm used to dealing with it and I just seem to be able to keep going despite the nasty symptoms. However, I'd rather not. I am having psychotherapy which is helping with various aspects but the mood stability and swings into anxiety persist which make life miserable and very difficult for me to maintain healthy relationships.

Like most people I have my reservations about any AD medication, they give with one had (sometimes) and take away with another with side effects (most of the times).

Background

I've been depressed and anxious since I can remember, although I didn't know what it was then. I just knew something was wrong.

I had my first major episode in University, I become so unwell I had to take a year out, I didn't want to leave the house and it wasn't pretty. I finally went to see a doctor under pressure from my parents. I was lucky to have a very understanding doctor who specialised in depression. It was amazing to finally meet someone that understood and could reassure me of what was happening and that I could get something help.

He decided that SNRI's (Serotonin-norepinephrine reuptake inhibitors) were the best solution for GAD/social anxiety and prescribed me Dutonin. I don't recall the exact side effects, I did have some, but I remember thinking that I had terible side effects from anxiety so as a trade off I could cope with a few side effects.

The effect of this drug was miraculous. I experienced what it felt like to be carefree for the first time in my adult life, perhaps in my whole life. A cloud was lifted and had a sense of confidence and was happy. I stopped worrying all the time, I stopped feeling paranoid of other people. I felt at peace with the world.

Sadly after about 6 months or so of use, my doctor asked to see me and explained that this medication was being withdrawn from the UK market. I was quite devastated. I've since found out that Dutonin had been the cause of numerous liver failures, so the manufacturers withdrew it for health reasons.

As an alternative I was put on Effexor (another SNRI) but I had really awful side effects on this, an no sex drive and other sexual dysfunction which effects men, not good for a young man at university.

I was then put on several SSRI's finally ending up with seroxat. I had a hateful time on all SSRI's and eventually came off them and said I would never go back on them again.

8 years or so on, struggling off and on with anxiety, disruptive relationships and depression I sought out a psychotherapist who was able to accurately diagnose the disorders I have been suffering from. Which is a sort of mild avoidant personality disorder, anxiety, social phobia and depression being the side effects rather than the problem itself. There is no real cure for these kinds of disorders, although with therapy you can reduce them and learn to cope. I won't go into these, as that's a whole new thing. Again it was great to finally get to the bottom of what the issues were and take responsibility of my own recovery/management of them.

My therapist still recommended I should look at medication for anxiety if I could find one which worked. And I have come around to accept that I may well have to live with these kinds of emotional disorders all my life and its worth giving medication another chance. Rather than constantly going in and out of anxious and depressive episodes wrecking havoc on my work and social life.

Recent medication

I was prescribed citalopram mid 2010 which I took for a year. It did help although it was a rough time adjusting to them. I never really had that feeling that I was really relieved from the underlying symptoms. And I never slept, sometimes days on end, was tired/energy-less, plagued by brain zaps/jitters, putting on weight and generally feeling the side effects outweighed the benefits. I came off them just before Christmas, although thankfully no real discontinuation symptoms.

I had a really bad episode of depression over Christmas, was bursting into tears all the time, didn't leave the house much and didn't really speak to anyone for weeks on end. I'm often not sleeping, sometimes literally staying away for 24 hours. I often feel sick due to anxiety.

I decided I would see if there was something else, as I'm hardly well without medication anyway.

Duloxetine SNRI

Given I had such a positive time on Dutonin, I started doing some reasearch into SNRI's, as mentioned I have tried Effexor before and didn't get on to well with it and I was quite happy to find Duloxetine which various websites suggest has the least side effects of all of the SNRI's/SSRI's.

I have of course found various experiences on the negative side on this and other forums, but you can never really tell how you'll respond until you try them.

So I am going to give them ago.

If you want to find out more about this drug, click link below.

http://www.cymbalta.com/Pages/learnaboutcymbalta.aspx

Dosage

Box is branded 'Yentreve' - duloxetine and I'm to take 40mg a day. Not sure what level others have been on?

One (20mg) capsule to be taken twice a day.

I have read some people prefer taking evening or morning, but this is suggesting one in the morning and evening, which is a pain if I sleep in (which I do alot).

Side effects

Its generally thought that this drug has the least of the side effects of all the AD's.

The blurb that came with the packet says.

VERY COMMON (affects more than 1 in 10).

*Feeling sick (nausea), dry mouth, constipation and tiredness. To be honest, I get these most of the time anyway.

There are some common symptoms and some very uncommon ones, but you can read those here from manufacturers website.

http://pi.lilly.com/us/cymbalta-pi.pdf

I really hope I don't get many side effects, I might get lucky, I've literally tried almost all others, so this is my last shot. Fingers crossed it goes well.

Websites that might be helpful:

http://www.cymbalta.com/Pages/cymbal...alanxiety.aspx

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

http://www.patient.co.uk/medicine/Duloxetine.htm

http://www.netdoctor.co.uk/medicines/100005102.html

http://www.nlm.nih.gov/medlineplus/d...s/a604030.html

[loreen]

Hi
I have been on Duloxetine(cymbalta) for a month now, after having little or no success with SSRIs.I have to say they really work for me!After just one week my anxiety and panic was under control and the dark hole from the associated depression has gone.
I do hope you find they help you,and I watch with interest to see how you get on.

Loreen x

[NCP]

Thanks Lareen.

Does't sound like you have much in the way of side effects?

Have you tried to drink alcohol at all?

One of the really tough things for me is that in my business I have to socialise to get contacts and its a real drinking culture. I can obviously limit my intake but giving up altogether always comes up against a lot of resistance.

With previous drugs where drinking was not adviced, I was always OK, hopefully these too.

Im considering waiting till the weekend as I have meetings all week, so weekend start migh tbe better idea.

Thanks again.

[loreen]

The only side effect I have is a dry mouth,which is no big deal after some horrible side effects with other meds.
I haven't tried drinking on them,partly because it may reduce the benefit of the drug,but also because I don't really drink anyway so giving up is no problem.
You need to do what is right for you,but I would advise you to go easy on the drink,and you may find people will respect your decision without it being a problem.
Loreen x

[NCP]

Yes, I don't intend to go crazy, but my work place is a bit of a boys club and any excuse to go drinking beer and most of them will. But I'm sure I'll cope.

Have you noticed any impact on your sex drive, that is the other things I find really hard to live with (don't feel you have to answer that if you'd rather not).

[shazzie b]

hi NCP...i thought id read some of your other posts since your input on my thread was v helpful

umm i looked on askapatient.com about this AD because i was curious and interested in finding out more on what sounds like a good med...and i can see nothing but BAD feedback and warnings...did you have a look?

[loreen]

Sometimes people only give feedback when a medication has no impact on their condition,or makes it worse. I can only speak for myself, but duloxetine is helping me to live "normally" for the first time in over a year.Every one responds differently to meds and the only way to find out if they are for you is to try them.Escitalopram has almost everyone saying how good it is,yet when I tried it I sank into a scary depression I have never experienced before.
As for the question about sex-I am finding no problems there.Infact,things are better,but that may be due to my better state of mind!

Loreen x

[NCP]

Day one Saturday 21st

I started this morning, apart from feeling a little bit of nausea at certain points, I've barely noticed it.

I had a meal for dinner but not much else all day, didn't make me feel sick and ate the same amount as usual. I took my second pill with dinner, so had my first full dose.

By midnight I felt quite anxious, less in my thoughts but in my body. That tight tension and anxious feeling across my chest, down my arms and in my stomach and a sense of jarred nervous and a bit jittery. And a bit apprehensive in general but also about the drug and last minute fears about side effects etc. And slightly sad/upset.

Had a strange nights sleep, tossed and turned a lot. My mind didn't switch off, when I did fall asleep I had lots of dreams, odd ones about work and things, I found I was fairly conscious and was sort of interacting with them, which was tiring in itself. I woke up at 5am not feeling very refreshed. But managed to go back to sleep till 10am. Bit queasy still and took my second days dose with breakfast.

No other symptoms to note.

[loreen]

I am keeping my fingers crossed duloxetine works well for you.

Try and keep busy and try not to think about possible side effects.

Good luck

Loreen x

[NCP]

Day four

Sleeping hass been a bit strange, I feel as though I'm not really sleeping, as I'm sort of semi conscious and my mind is racing with all kinds of utter nonsense. And I'm really restless, I've moved around so much I think I'm actually benefiting from exercise.

However, thankfully I'm not waking up feeling too exhausted and able to go about my daily business.

I'm actually experiencing very little in the way of side effects at the moment. My apetite is less and I am feeling slightly queasy at certain points. And as expected a slight dry mouth although on the positive side, its making me drink more water, which I should anyway. Nothing I can't cope with.

And I've had a couple of moments of sudden anxiety but I feel quite up-beat. Which is strange because I had as many fears as I had hope for it to work, so I can't really see it being a placebo effect. But they do say in some people SNRI's can work very quickly.

Regardless of the drug or not, I feel good and nothing bad to report so far.

NCP