Cymbalta for health anxiety

[NoraB]

Maybe you don't even need to take it to get a positive response, the treat of doing so alone might be enough. The placebo effect in reverse.

Pain has lessoned while I have been deliberately not lifting heavy stuff or stretching up so this is looking like a 'mechanical' issue. Taking meds causes other issues so I will only try the drug if I'm desperate. Last drug I tried (re another issue) stopped me from being able to wee, and that was also an antidepressant. Have taken AD's historically with no issues, but not anymore.

[panic_down_under]

I’ve tried Zoloft, Prozac, buspar, Hydrozine, Wellbutrin, and now cymbalta.

So two SSRIs, buspirone (Buspar) which works well for a few and not at all for most and then only for GAD, hydroxyzine which is a antihistamine with fairly good anti anxiety properties, but usually not enough for HA and bupropion (Wellbutrin) which is a stimulating AD that can have many with anxiety disorders almost literally climbing walls.

I'm not a fan of SNRIs because of their short half-lives and slow-release formulations which can make starting and stopping them difficult. The older tricyclic class ADs (TCAs) are a better bet, imho. They are arguably more effective than SSRIs and SNRIs, less likely to poop out and most are available in small dose tablets relative to their therapeutic dose range making it easy to start on low doses to minimise initial side-effects and also to wean off in small steps. The TCAs tend to produce less severe side-effects and withdrawal symptoms anyway.

At first they didn’t even want to put me on a AD as they thought I could manage with just hydrozine as needed and counseling.

Hydroxyzine was worth a shot. It isn't quite as potent an anxiolytic as the benzodiazepines, but for milder anxiety it is often potent enough. However, HA is on the OCD spectrum which are the anxiety disorders that are most treatment resistant, defying both ADs and therapy so I'm not surprised it wasn't enough. A combination of both meds and therapy seems to produce the best outcomes.

She still only wants me on this for no more then a year.

Sounds like she might have a mild case of pill-phobia - there's a pill for that! Most guidelines advise taking ADs for no less than 12 months the first time so don't get rushed off medication. I've seen many quit their meds after a few months because they thought they had the problem licked only to crash and burn soon after and then really struggle to get things back under control. Plus, for a few of us, e.g. me, anxiety disorders are chronic conditions which fluctuate in intensity but don't ever go away completely so remaining permanently medicated is the best long term option.

[quaksalver]

I am a bit confused about what is this about. Somebody wants to start a med but is worrief about what migj t happen when they stop? Shouldnt they cross that Bridges when they get there?

Im new so not sure if I am allowed to suggest another forum but surviving antidepressants is very good for this type of thing

[Anxiety218]

So two SSRIs, buspirone (Buspar) which works well for a few and not at all for most and then only for GAD, hydroxyzine which is a antihistamine with fairly good anti anxiety properties, but usually not enough for HA and bupropion (Wellbutrin) which is a stimulating AD that can have many with anxiety disorders almost literally climbing walls.

I'm not a fan of SNRIs because of their short half-lives and slow-release formulations which can make starting and stopping them difficult. The older tricyclic class ADs (TCAs) are a better bet, imho. They are arguably more effective than SSRIs and SNRIs, less likely to poop out and most are available in small dose tablets relative to their therapeutic dose range making it easy to start on low doses to minimise initial side-effects and also to wean off in small steps. The TCAs tend to produce less severe side-effects and withdrawal symptoms anyway.



Hydroxyzine was worth a shot. It isn't quite as potent an anxiolytic as the benzodiazepines, but for milder anxiety it is often potent enough. However, HA is on the OCD spectrum which are the anxiety disorders that are most treatment resistant, defying both ADs and therapy so I'm not surprised it wasn't enough. A combination of both meds and therapy seems to produce the best outcomes.



Sounds like she might have a mild case of pill-phobia - there's a pill for that! Most guidelines advise taking ADs for no less than 12 months the first time so don't get rushed off medication. I've seen many quit their meds after a few months because they thought they had the problem licked only to crash and burn soon after and then really struggle to get things back under control. Plus, for a few of us, e.g. me, anxiety disorders are chronic conditions which fluctuate in intensity but don't ever go away completely so remaining permanently medicated is the best long term option.

I can’t be permanently medicated right now, I’m only 21 and I want to have a. Baby in the next year.

[Anxiety218]

I am a bit confused about what is this about. Somebody wants to start a med but is worrief about what migj t happen when they stop? Shouldnt they cross that Bridges when they get there?

Im new so not sure if I am allowed to suggest another forum but surviving antidepressants is very good for this type of thing

She mentioned it for short term use. I’m just weighing my options on what would be best since it has a short half life. I can’t take the chance of crossing when I get there if I end up pregnant and need off it immediately. ( not that I would try while being on it but obviously stuff happens).

[Anxiety218]

So two SSRIs, buspirone (Buspar) which works well for a few and not at all for most and then only for GAD, hydroxyzine which is a antihistamine with fairly good anti anxiety properties, but usually not enough for HA and bupropion (Wellbutrin) which is a stimulating AD that can have many with anxiety disorders almost literally climbing walls.

I'm not a fan of SNRIs because of their short half-lives and slow-release formulations which can make starting and stopping them difficult. The older tricyclic class ADs (TCAs) are a better bet, imho. They are arguably more effective than SSRIs and SNRIs, less likely to poop out and most are available in small dose tablets relative to their therapeutic dose range making it easy to start on low doses to minimise initial side-effects and also to wean off in small steps. The TCAs tend to produce less severe side-effects and withdrawal symptoms anyway.



Hydroxyzine was worth a shot. It isn't quite as potent an anxiolytic as the benzodiazepines, but for milder anxiety it is often potent enough. However, HA is on the OCD spectrum which are the anxiety disorders that are most treatment resistant, defying both ADs and therapy so I'm not surprised it wasn't enough. A combination of both meds and therapy seems to produce the best outcomes.



Sounds like she might have a mild case of pill-phobia - there's a pill for that! Most guidelines advise taking ADs for no less than 12 months the first time so don't get rushed off medication. I've seen many quit their meds after a few months because they thought they had the problem licked only to crash and burn soon after and then really struggle to get things back under control. Plus, for a few of us, e.g. me, anxiety disorders are chronic conditions which fluctuate in intensity but don't ever go away completely so remaining permanently medicated is the best long term option.

What are some TCAs?

[panic_down_under]

What are some TCAs?

Clomipramine (Anafranil) was the AD for OCD until the SSRIs became available. Imipramine (Tofranil) and amitriptyline (Elavil) may also be effective. One SSRI, fluvoxamine (Luvox) proved as effective as clomipramine for OCD, however, because of the way it is metabolised it can affect many other medications which may become problematic if there are other health issues. But it should be considered if your doctor baulks at prescribing TCAs (unfortunately, many doctors these days have little to no experience of prescribing anything other than SSRIs/SNRIs - older doctors who worked before the SSRI/SNRI era still tend to favour the older ADs, TCAs, even MAOIs).

[quaksalver]

Sory, your not making much sense.

Have you thought about seeing a therapist or psychiatrist?

[panic_down_under]

I can’t take the chance of crossing when I get there if I end up pregnant and need off it immediately.

You probably wouldn't need to come of duloxetine if you became pregnant. With the possible exception of paroxetine (Paxil) there is little evidence that ADs cause birth defects and this seems equally true for duloxetine too. However, if planning to breastfeeding sertraline (Zoloft) may be preferred as very little, if any of the med is expressed in milk (Pinheiro E, 2015).

Also, quitting isn't necessarily a zero sum strategy. Maternal anxiety and depression can also pose risks to the baby, both during gestation and later in life (as may post-partum paternal anxiety and depression).

Unfortunately, antidepressants and pregnancy is an issue where there is no clear-cut 'right' answer. I suggest you discuss this thoroughly with your family doctor and obstetrician and/or gynecologist well before becoming pregnant and follow their recommendations.

[quaksalver]

Hi miss anxiety,21

Im sorry if I sounding like your Mom but I really think it is not a good idea to have a baby while your menyal health is bad. Getting ptegnant and giving birth may actually make you worse. Then you need to ask yourself if it is fair on your partner if you havr one to have to care for two person if you find you cannot cope.

If the medication route is yourbest chance you should go for it or at least give it a try
Dan here (panic down,) is a psychiatrist and medicinal expert. His advice is as good as any you will get in the real world.

Please do what is best for you