Starting Duloxetine

[MrRedShirt]

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]

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]

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]

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]

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]

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]

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]

You will be fine. They say 6mgs for 3 weeks is where the risks start.
Dan

[MrRedShirt]

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]

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.