Duloxetine / Cymbalta Diary 2013

[Mark13]

Thanks Simon

I had read your start up effects but thought I'd got away with it for the first few hours

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

[MrRedShirt]

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!)

[Mark13]

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

[Consider]

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]

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?

[Mark13]

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.

[Mark13]

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

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]

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.

[Tufty]

Happy Birthday Mark
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

[Mark13]

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.