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Old 05-13-2005, 09:55 AM   #1
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Question from Cymbalta to Lexapro... question about antidepressants

I have just tapered off of Prozac, and my Dr wanted to put me on Cymbalta for my newly diagnosed fibro. That stuff really hurt my stomach, so now they want me to try Lexapro.

I'm wondering why they don't want me to just take Prozac again. Is Lexapro better for fibro?

I also have IBS, so I'm thinking that might be the reason, but i'm not sure.

Last edited by NickName; 05-13-2005 at 10:26 AM.

 
Old 05-13-2005, 11:22 AM   #2
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Re: from Cymbalta to Lexapro... question about antidepressants

Quote:
Originally Posted by NickName
I have just tapered off of Prozac, and my Dr wanted to put me on Cymbalta for my newly diagnosed fibro. That stuff really hurt my stomach, so now they want me to try Lexapro.

I'm wondering why they don't want me to just take Prozac again. Is Lexapro better for fibro?

Hi NickName!

I'd like to offer my help if I may. I just want to warn you, I usually reply with long posts when I give out info, because I think it's important that you have as much information as I know about what you are asking. So you have been warned! LOL I feel it's important for us Fibro's to learn as much about the meds we are using. Especially the ones that affect our emotions and the chemicals in our brains.

I am currently using Lexapro. I have never used Prozac because I heard of it's side effects and that it was hard to wean off. But I did use Cymbalta and it made me sweat so badly I quit using it. It seems like Cymbalta works to stop the pain but the side effects usually run people off. Seems like everyone has some side effect from that drug that makes them stop using it. Which sucks cuz I did notice a decrease in pain.

My Rheumy first gave me sample of it along with a script if I thought it helped. I also see a Psyciatrist for major depression and he too suggested Lexapro and he took over the Lexapro scripting from my Rheumy. Reason being that since I need Psyciatric help, in order to continue seeing the M.D. he needs to be prescribing me something, and I am applying for SSD and it looks better for my case being treated by a Psyc with anti-D's than being given anti-D's from a Rheumy.

So....let me tell you what I know about Lexpapro. It is given to Fibro patients to increase Serotonin. Serotonin is, you probably already know this, the chemical in Fibro's brains that helps produce endorphines which in turn gives us energy and helps us to withstand a higher level of pain. Fibro's brains do not make serotonin naturally like "normals" do. I have to be honest with you, I don't agree with pumping anti-D's into Fibro patients just to increase serotonin, especially when the Fibro patient is not depressed. But that is just my opinion and certainly not meant to discourage you on taking your medications. My issue with these Anti-D's being given to Fibro's to increase serotonin is that we don't have serotonin to begin with and these SSRI's are designed to "reuptake" the serotonin in our brains, boost it's production and "inhibit" the interaction of other substances we Fibro's carry (substance P) that stop the production of serotonin. So...if we have no serotonin to reuptake, what can a SSRI do for us? It's like trying to produce gas from an empty gas tank. I believe there are "natural" remedies that work the same without having all these complications that go with SSRI's and the withdrawl from some of these meds is horrible.

Okay, I'm down off my soapbox now! You didn't ask for all that, but I like to let people know how I personally feel about some of these meds and that there is an alternative which may work for some folks, but not all. HOWEVER, if you tolerate these meds well and most Fibro's DO experience depression, SSRI's can do wonders.

Lexapro is an SSRI wich is different than a tricyclic antidepressants (TCAs). The tricyclics just alter the chemicals in our brain that cause depression. They are not serotonin reuptake meds, which is why Fibro's are prescribed the SSRI meds.

Lexapro has been discovered to treat both depression as well as GAD (general anxiety disorder). This is why it is so popular and it's side effects are minimal.

The side effects include:
nausea, insomnia, problems with ejaculation, somnolence, increased sweating, fatigue, decreased libido, and anorgasma. Most of the side effects experienced by patients are mild to moderate and go away with continued treatment, and usually do not cause patients to stop taking Lexapro.

I have been on Effexor, Wellbutrin XL, Cymbalta, and now Lexapro. Effexor numbs your emotions so basically your emotions are "nil" and withdrawl from this med is pretty bad especially if you were like me, on it for awhile and at a fairly high dose (225mg). Wellbutrin XL is better in that it is supposedly not supposed to decrease libido. Decreased libido is a common complaint for any of these SSRI's. But with Wellbutrin, it allows your emotions to "come through". Mine were all over the map though. I felt so many emotions, it was nuts! And Cymbalta, it was the excessive sweating that got me there. My previous Psyciatrist told me how Effexor and Wellbutrin controlled your emotions, either by numbing them so much, you don't have emotions, or allow them to be experienced by the user. I never was told that when I was prescribed those meds. Just and FYI incase your doc suggests Effexor or Wellbutrin XL.

So, NickName, I was just recently prescribed Lexapro by my Psyc to treat my depression and my anxiety. My rheumy gave me samples of it, for serotonin reuptake and I knew at the time I had GAD and had already researched Lexapro so I new it would help with my anxiety, otherwise I would not have taken the samples. I told her why I didn't agree with the fact that rheumies are giving Fibro's all these anti-D's without enough info. I guess I resented the fact that when I first was dx'd with FM, I was given an anti-D and I wasn't depressed (then) although I was explained how they work as serotonin reuptake inhibitors, I wasn't told that there were other ways to increase serotonin.

Also be careful using any of these SSRI's as they can interact with other meds, like Tramadol. Be sure to read your med info regarding interaction with other drugs.

Give Lexapro a chance. I've been using it for a month now and it seems to work nicely as far as keeping me calm and I DO notice a bit more energy. But I am also on a stimulant for CFS. It has controlled my anxiety alot. And I haven't noticed any nasty side effects either.

Try and do as much exercise as you can. This has been proven and I have read many many posts here where people testified that when they got into a regular exercise program, their energy increased, their pain went down, and they felt better. It is tough at first, seeming nearly impossible, but once you get over the hump, people here have said it made a world of difference. Just proving that increasing serotonin by exercising and creating those endorphines DOES help us Fibro's.

Always ask your doc any question you have about your meds, and do not use any supplements without checking with your doctor, especially when you have been put on a new medication.

Good luck, and keep us informed as to how you are doing on the Lexapro. For me personally, I give it a thumbs up.

Here's wishing you a good spirit,
tk

 
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Old 05-13-2005, 12:49 PM   #3
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Re: from Cymbalta to Lexapro... question about antidepressants

you know, i was wondering i was put on effexor xr by my pain managment doc that fired me and i am up to 300mg. so far it has not done anything for my pain and i guess some for my depression but i also take lexapro 20mg to. how am i ever going to wean off of it. one time the nurse pract. that got me in trouble in the first place told me that i could try and decrease it so i did and after a week i felt terrible and increased it back up again. the withdrawls are awful. its like now what. i know that i will have to talk to my new doc about it whenever that happens. i have to get a refferal first and have the new doc look over my records to see if he'll even take me or not. i am on medicaid and there is only one pain doc where i live. sorry i know this is off track but i was just wondering
love,
robin

 
Old 05-13-2005, 12:54 PM   #4
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Re: from Cymbalta to Lexapro... question about antidepressants

Thank you for all the info, that definately helps. I decided to taper off of the Prozac, simply because I didn't want to take meds if I could possibly help it, so I have mixed feelings about starting another one.

I feel as though I do all that I can myself. I've exercised regularly for years now and I'm pretty fit to show for it, due to the IBS I eat as healthy as I can and I take vitamins as well. Even doing these things, I'm still in a lot of pain, as though my muscles don't want to relax.

I also have sleep apnea. I haven't been tested, but my husband tells me that I stop breathing a lot at night - and I have just about all of the symptoms. In a few months, after I get insurance through my work, I'm going to get tested for it and get whatever I need to help with that. That may be my whole problem, actually.

I think my Dr wanted to give me the anti-depressants because I do have depression, although I think its mild simply because I take care of myself, but its hereditary, it seems... so I can understand, in a way. It seemed more for the actual depression and sleep problems that he wanted me to try something. I mean, if you aren't resting and you're down, pain always seems worse.

I'm glad to hear that Lexapro can be helpful, that makes me feel better. I suppose if I find out that treating the sleep apnea helps all of my physical problems, I can taper off of it. I mean, if I can taper off of prozac, I think I have the patience to taper off of this too, if I need to.

 
Old 05-13-2005, 02:42 PM   #5
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Re: from Cymbalta to Lexapro... question about antidepressants

Helena,

You have a very healthy attitude, that's great! You are right on when you say that your sleep pattern is the key to your pain. That is another thing that us Fibro's are usually treated for as soon as were are dx'd. There are many meds out there you can take at bedtime to help you relax and sleep the way you were meant to sleep. Interrupted sleep is one of the biggest problems we Fibro's have. Even physically healthy folks cannot tolerate a disrupted sleep pattern. You aren't getting the "resorative sleep" that you need. Research indicates that we need at least 4 hours of "restorative sleep". This doesn't mean that only 4 hours of sleep is what you need, it means the stage of sleep that you are trully SLEEPING. Someone help me out here, what the heck is that stage of sleep called? LOL Well, you know what I mean! 4 hours of restorative sleep is when your body does exactly that, it RESTORES. It is not unusual for Fibro's who start using meds to help re-establish their sleep to sleep for 12 hours at first. Your body needs that. IMO, you should talk to your doctor about some of the meds that will relax you and help you get into a healthy pattern of sleep. Trazadone, Flexeril, Soma, Klonopin, even Valium are typical medications used to help you get sleep. Strictly sleep meds are usually not good for Fibro's since they don't act as muscle relaxants. Flexeril seems to help a lot of Fibro's. It is a sedative muscle relaxant. Zanaflex is the same as is Soma. They are all muscle relaxants that have a sedative ingredient. There is another thread here where someone asked about Clonzepam/Klonopin. This is a benzo type med, very addictive, but also very good for sleep. It is an anti-anxiety anti-siezure medication and is given to FM patients for Restless Leg Syndrome and to promote healthy sleep. It works great for most folks. I took it for 3 years and just recently switched to Trazadone. I switched for the main reason that I was on Klonopin for over 3 years and it was time to stop, and since I am using Lexapro which has anti-anxiety ingredients, so the two meds would be too much together.

I encourage you to talk to your doctor about getting your sleep pattern under control, or you will never feel better. You are doing all the right things as far as your diet and exercise, but your lack of sleep is counteracting all that good, thereby causing you pain. And yes, depression can cause pain, and vise versa. It's a vicious circle. That was why the big "hoo ha" with Cymbalta went on in the FM community. Doctors developed Cymbalta and designed it to treat the pain that comes from clincal depression. Since most docs, and Fibro patients themselves, know that you can become clinically depressed because of the chronic pain we suffer, Cymbalta seemed perfect for us Fibromights. I noticed that it did help a bit with pain, but the side effects were rather unpleasant. And from what I read here, the side effects of Cymbalta are what causes people to quit taking it. Which is too bad.

You are doing good, Helena (lovely name by the way), and you have a good sense of approaching the use of your meds. You are right, tapering off a medication that may cause withdrawl does take patience, it's good that you already know you have the stamina to do so. I haven't heard about any withdrawl symptoms from Lexapro. I don't know how long it's been on the market, but maybe not long enough where there are very many documented cases of withdrawl problems.

Keep us all posted on how you are doing. Seems to me like you are on the right track to handling FM the way it needs to be handled! You go girl!

Here's wishing you a good spirit,
tk

 
Old 05-13-2005, 03:18 PM   #6
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Re: from Cymbalta to Lexapro... question about antidepressants

Well, from what I've noticed, Lexapro has been on the market since at latest, 2001. That's a good thing, in my opinion. I really wish I could take the cymbalta, but I think that extended release coating is what was hurting my stomach.

I have the Zanaflex, I just forgot to mention that one. 2 mg tablets, and if I take 2, it really helps, but I don't do it every night... I didn't know if that would be a good thing to do or not. I don't want to get too used to that, but maybe that shouldn't be a concern. The exercise helps me sleep as well, along with making the effort to stay up past 7pm, ha ha. I just get so sleepy sometimes I want to fall asleep too early.

I meant to ask you earlier... what are natural ways to up seratonin?

 
Old 05-13-2005, 08:16 PM   #7
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Re: from Cymbalta to Lexapro... question about antidepressants

Quote:
Originally Posted by girl75
you know, i was wondering i was put on effexor xr by my pain managment doc that fired me and i am up to 300mg. so far it has not done anything for my pain and i guess some for my depression but i also take lexapro 20mg to. how am i ever going to wean off of it. one time the nurse pract. that got me in trouble in the first place told me that i could try and decrease it so i did and after a week i felt terrible and increased it back up again. the withdrawls are awful. its like now what. i know that i will have to talk to my new doc about it whenever that happens. i have to get a refferal first and have the new doc look over my records to see if he'll even take me or not. i am on medicaid and there is only one pain doc where i live. sorry i know this is off track but i was just wondering
love,
robin
Hey robin,

Sorry, I didn't see your post.

You are wanting to wean off Effexor XR? 300mg of Effexor XR each day is a pretty high dose, and I don't understand why your doc gave you Lexapro 20mg as well. That seems like an awful high amount of SSRI's in your system. Plus, 20mg of Lexapro is the maximum dose, it only comes in 10 and 20mg, far as I know.

You have to have a special Effexor XR "tapering off kit". There is a special pill pack that you are given with the different weeks of doses each lower than the last. It's a four week pack. Mine contained a week of 150, then two of 75's, then one week of 25's, I think. It's been awhile since I've weaned off Effexor so I may be wrong about the doses. But I know you have to use this pack to wean off effectively so that your withdrawl symptoms aren't so nasty. And they ARE nasty. We did a whole thread on the w/d symptoms of Effexor awhile back. That medication is nasty as far as I'm concerned. I don't think it's good to take a medication that robs you of your emotions. I was on it when my Mom was dying from cancer and through her funeral arrangements. Since, I'm an only child and the only other person who could have possibly helped me at the time was my Aunt and she was going through Chemo at the time. So I guess not feeling too much emotion at that time may have been a blessing! But I did notice that people were kinda looking at me funny cuz I wasn't shedding any tears or showing any emotional upset.

Anyway, robin, do you know why your doc prescribed you both of these meds? Was it two different doctors? Do you want to wean off the Effexor? Then you could probably ask your GP, or better yet, are you seeing a Psyciatrist? They would be the best to help you wean off the Effexor, but if you aren't seeing a Psyc, don't go out of your way to set up appointments with one just to wean off Effexor. Your GP should be able to prescribe the "kit" and monitor your w/d. Just explain your situation to him/her, letting them know you don't want to use the Effexor anymore and you want to continue the Lexapro. Personally, I think Lexapro is more effective than Effexor and it's a lower dose medication. As I recall, the Effexor is in capsule form so you can't split them in half.

Withdrawl symptoms for Effexor, as I experienced them, were nausea, dizziness, sleep disturbance, and trembling (like shakey hands). The nausea and dizzyness were the worse part.

I hope you get this all straightened out robin. Please keep us informed as to how you are doing. IMO, you are taking way too much SSRI meds. Effexor is not really intended for pain relief, that is not why it is initially given. It is given to increase Serotonin which will help increase endorphines which will increase energy which CAN help with pain. Too many FM's given these "wonder drugs" (SSRI's) are under the impression that they are a treatment for pain relief, which is not necessarily true. A series of chemical "events" needs to happen before you can notice any sort of pain relief. They by no means are pain killers, meaning that they do not block the neurotransmitters that cause pain. SSRI's do not work the same way pain killers do. Which is a good thing in some aspects since I don't think SSRI's are addictive the way pain meds are in that your body doesn't "crave" them, so you have less chance of misuse. Now anti-D's that are TRYCICLICS are in a different class and can be abused. Tryciclics are not selective serotonin reuptake inhibitors. These meds work by altering the chemical imbalance in your brain that is sometimes the cause of clinical depression. I believe these are the "zombie" drugs. Your Rheumy will not perscribe these type of anti-D's for FM patients, Tryciclics are given to the clinically depressed. I know, it's true, there ARE actually people out there whose only condition is clinical depression! (and I am by no means insinuating that clinical depression is not critical). Just an FYI that all anti-D's are not made the same. It is important not to mix SSRI's with these Tryciclic meds.

Pain meds merely "mask" the pain, they don't fix it. SSRI's can be used to help your brain react to pain stimuli more effectively, as well as treat depression. But I don't believe that Fibromights should rely on SSRI's for years and years as a treatment to increase Serotonin, I think that can be done without meds in some cases. However, if you are depressed or experiencing anxiety, then some of these meds can make a huge difference in your quality of life.

So, I know that was more info than you asked for, but I want folks to see what a mess can occur trying to treat pain of any kind, especially when you have FM. I beleive that more Fibromights are lead to think that these SSRI's will magically relieve their pain, when, in fact, that is not true. I also know that when you are in chronic pain that affects your quality of life, you want anything that will make it go away!

Keep us informed robin, on how you are doing and what you do about the Effexor and the Lexapro. And if you w/d from Effexor, and you begin to feel "nasty", remember we are here to help you however we can.

Hugs,
tk

Last edited by tkgoodspirit; 05-13-2005 at 08:45 PM.

 
Old 05-13-2005, 11:05 PM   #8
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Re: from Cymbalta to Lexapro... question about antidepressants

Quote:
Originally Posted by NickName
Well, from what I've noticed, Lexapro has been on the market since at latest, 2001. That's a good thing, in my opinion. I really wish I could take the cymbalta, but I think that extended release coating is what was hurting my stomach.

I have the Zanaflex, I just forgot to mention that one. 2 mg tablets, and if I take 2, it really helps, but I don't do it every night... I didn't know if that would be a good thing to do or not. I don't want to get too used to that, but maybe that shouldn't be a concern. The exercise helps me sleep as well, along with making the effort to stay up past 7pm, ha ha. I just get so sleepy sometimes I want to fall asleep too early.

I meant to ask you earlier... what are natural ways to up seratonin?

Helena,

Too bad about the Cymbalta. I forgot to mention in my posts that Cymbalta is a little different type of SSRI, Cymbalta also works with neoepenepherine, so it's a "modified" SSRI. I'm sorry if I confused anyone on that classification.

About using the Zanaflex, what is your doseage? Does it say "as needed" or to use it every night? I would use it every night as long as it's helping you and your scprit covers it, meaning you won't run out before you are scheduled to. Don't use a months worth of medication in two weeks, you know this. It is better to use a medication that has been prescribed to use on a daily basis, continually without breaks, or you lose it's effectiveness. You have to allow time for the med to build up in your system and stay there, especially sleep meds. Zanaflex is a muscle relaxant tho, used to help you relax and help you sleep. I used it every day when I was on it. But I was prescribed it for daily use as a muscle relaxant. I was on 5mg 3 times daily. It was prescribed because of my inflammed trigger points.

And about the "natural" supplements to help raise serotonin, most popular is an amino acid called 5HTP. I have a thread that I started awhile back that discusses this whole Serontonin thing and I have some good info from Dr. Rodger Murphee who has authored many books about FM and CFS. He is an M.D. who owns a FM Treatment Clinic/Center in Birmingham Alabama, and his approach to treating FM is mostly through exericise, Physical Therapy, and supplements. I will post a new reply with some of the "meat" of the original post that gives you the info about Serotonin and Dr. Murphee's research and his thoughts on serotonin and the meds we are given to help with it. It's pretty interesting, especially for those who don't like to use meds, but it is certaintly not meant to suggest that it works for everyone.

You exercise regular? That is great. Try and keep it up, and for us Fibromights, it's good to try and exercise at the same time every day if possible. This is one of the components to raising serotonin without medications. Exercise is extremely important for FM and it varies from person to person depending on their cabability.

Okay, I'm going to look for that old post of mine. If you decide to try any kind of supplement, be sure to run it by your doc first. Some of them will interact with prescription meds. Also, the very first thread on the FM board is about supplements and amino acids that are good for Fibromyalgia. It's a "sticky" thread, meaning it stays in that spot all the time. Take a look at that too, it has a lot of information about different supplements, amino acids and anti-oxidents that are specifically beneficial for FM. Malic Acid is a "goodie" for FM, although some people can't tolerate certain supplements, but for the most part they work for most folks. Just, again, tell your doctor exactly which supplements you intend on trying so that they don't interact with your prescription meds, or a physical condition you have. So check out the very first thread on the FM board, and I'll get the info you asked about and post after it following this post. I would like you to read what Dr. Murphee has to say about Serotonin and the medications we are given for it. Just for an FYI.

I'm glad I could be of some help to you. And going to bed at 7 p.m. is not shameful at all! You know when your beddy bye time is!

tk

Last edited by tkgoodspirit; 05-13-2005 at 11:23 PM.

 
Old 05-13-2005, 11:16 PM   #9
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Re: from Cymbalta to Lexapro... question about antidepressants

Helena,

Here is part of my original post. I modified it a little bit, but it's info is still the same. It contains some pretty interesting information from this author. It's there for consideration not for any other reason. Just another alternative to prescription meds. Good for some, but not for all.


Dr. Murphee author's a book titled: Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome - A Patient's Self-Help Manual. that provides the info about each subject. I believe this is a new addition to his book (A Patient's Self-Help Manual) already out titled "Treating and Beating FM and CF" (shortend, for space) This is a new "self help manual" out in April that address certain single problems we have with FM/CFS and takes us step by step showing us how to treat the ailment "naturally" and then there is a quesitonierre to help us understand exactly how these symptoms are affecting our lives and how we are best helped. Kind of a question and answer section for each ailment. Some of the info in this post is taken from parts of this book and manual as well as other sources of info that Dr. Murphee has written.

The Importance of Serotonin and Sleep

∑ Serotonin, a neurotransmitter, helps regulate sleep, digestion, pain, mood, and mental clarity. Normal serotonin levels help:
∑ raise the pain threshold (have less pain).
∑ you to fall asleep and stay asleep through the night.
∑ regulate moods. It is known as "the happy hormone." (*I like that! )
∑ reduce sugar cravings and over-eating.
∑ increase a person's mental abilities.
∑ regulate normal gut motility (transportation of food-stuff) and irritable bowel
∑ syndrome (IBS).

Next:

Here is some more info about serotonin that Dr. Murphee states in his book:

The amino acid (found in protein) tryptophan turns into 5-hydroxytroptohan, which turns into serotonin, and then into melatonin. Vitamins and minerals are essential, too, of course. A deficiency of any of the synergistic (I had to look this word up, but thought it was good for us to learn! ) nutrients magnesium, calcium, and vitamins B6, B12, B1, and B3 will prevent the production of serotonin. Prescription medications can block the production of these nutrients and so deplete serotonin.
Dr. Murphee says that we are naturally built with a "savings account" of the following chemicals, serotonin, dopamine, noriepinephrine, cortisol, DHEA, HGH, and others, these help us deal with stress. And everytime we experience stress or some kind of incident with our FM or CF Syndrome, it depletes this "savings account". He says that we are emptying this savings account by making more "withdrawls" than "deposits". He then goes on to discuss how we make "deposits" of these chemicals by obtaining deep restoritive sleep which makes serotonin. And since us Fibromites usually do not obtain deep restorative sleep, we don't make enough serotonin to replace what we lost during the day, so it's a vicious cycle. Here's where the anti-D's come into play. You know some of our docs push those SSRIS at us to "increase serotonin". Well, here is what Dr. Murphee has to say about these meds.

Why Not Just Take an Antidepressant?

Antidepressant drugs have been used with varying degrees of success in treating the sleeplessness of FMS and CFS. Many patients are on Selective serotonin reuptake inhibitors or SSRIS (Prozac, Paxil, Celexa, Lexapro, Zoloft, etc.). SSRIS are supposed to help a patient hang on to and use his or her naturally occurring stores of serotonin. This is like using a gasoline additive to help increase the efficiency of your car's fuel. But most of the patients Dr. Murphee sees, he claims, are running on fumes; there is no gasoline in their tank (no serotonin in their brain)! A gasoline additive (SSRI) won't help. SSRIS don't make serotonin, they only help a person hang on to and use the serotonin they already have.( *I did not know this, my doc never told me this part!) Unfortunately, most individuals with FMS don't have any serotonin. There is nothing to reuptake. (*Hmmmm.....)
No one has a SSRI (anti-depressant) deficiency.
This is where Dr. Murphee recommends 5HTP. He says it's like pouring gasoline straight into our "tanks". This is what he says about 5HTP: "5HTP is a derivative of the amino acid tryptophan. When taken correctly, it turns right into serotonin. Serotonin is the neurotransmitter or brain chemical that is responsible for regulating your sleep (getting you to sleep), raising your pain threshold (decreasing your pain), and elevating your moods. " He says that using this amino acid may take awhile to help build up your serotonin but he believes it is so much better than taking those scripts. Dr. Murphee also believes that 5HTP helps the additional problems: depression, FMS, insomnia, binge eating, pain, and chronic headaches. Now, mind you, these are just his determinations. He is a doctor, but he uses a homeopathic method to treat FM/CFS which may not be for everyone. A lot of folks are comfortable taking their prescriptions.

Okay, here is the part where he addresses all those sleep meds we take. He says that they simply "knock us out". We are not naturally falling into deep restorative sleep. If you don't dream for instance, you are simply medicated, you are not in natural sleep. I gotta say, I take one of these meds, and I am afraid to wean off of it, because it DOES, help me sleep straight through the night, but I DO notice that I usually wake up in the same position that I went to sleep in. I DO dream though. Not all the time, but I do. I like the idea that I'm not tossing and turning because of my back, I cannot turn myself over without help or support. Dr. Murphee claims that most of us will feel "hung over" in the morning while taking these sleep meds. I do feel that. Here is the list of meds that he says DO NOT (in his opinion) obtain restorative sleep:

Sleep Medications that don't Promote Deep Restorative Sleep:

∑ Gabitril (tiagabine) and Neurontin (abapentin)
∑ Zanaflex (tizanidine)
∑ Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam), Tranxene (clorazepate dipotassium), Serax (oxazepam), Librium (chlordiazepoxide), and Restoril (temazepam)
∑ Soma (carisprodol) is a muscle relaxant that can be very sedating.
∑ Klonopin (clonazepam) ***this is what I have been taking for nearly 3 years for sleep, I also take Soma, and have tried Zanaflex***(Klonopin is an anti-anxiety med, as are some of the other med's listed)∑ Unisom (doxylamine) is an over-the-counter antihistamine.

Sleep Medications that do Promote Restorative Sleep

∑ Ambien
∑ Elavil
∑ Flexeril
∑ Trazadone
***I have taken Flexeril and Trazadone, and they haven't helped me, personally***

Okay, there you have it. I just had to tell you about the anti-D's (hate those things! LOL) and in Dr. Murphee's book he address how exactly to use 5HTP so that it benefits you the most. Also, just a bit of info for those of us with CFS. There has been research that shows that 5HTP does not work for CFS patients. It is recommended that for those of us who have CFS, 5HTP be taken during the day, if possible, to help build up serotonin during the day. Now they recommend Fibromties use it at bedtime as well as during the day, depending on how it helps them. There is info in Dr. Murphee's book and on the web as to how to use 5HTP if you choose to go that route to help you increase your serotonin.

I hope some of you get a little "out" of this info. Roll it around in your mind. It's not for everyone. I don't take anti-D's, but I do take Klonopin for sleep. I DO believe that there can be alternatives to some meds we are taking.

Enjoy the read.

Here's wishing you a good spirit,
tk

P.S. Please be sure to check with your doc before trying any of the therapies mentioned here or in any book that promotes "homeopathic" treatments using supplements and amino acids.

Last edited by tkgoodspirit; 05-13-2005 at 11:25 PM.

 
Old 05-13-2005, 11:35 PM   #10
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tkgoodspirit HB Usertkgoodspirit HB User
Re: from Cymbalta to Lexapro... question about antidepressants

I need to correct myself.

I gave the wrong information about Cymbalta being an SSRI. It is a "modified" SSRI. Cymbalta works by helping not only increase Serotonin but also Neoephinepherine (sp? THAT is a big word!). I didn't want you all to be misinformed. That is why when Cymbalta first came out, it was in a different class of medications and considered very helpful for Fibromyalgia because of it's anti-depressant components, but also because it helped to decrease pain. These two attributes are what made Cymbalta unique. Too bad that most times, the side effects of this med caused most people to discontinue it's use. I think if they fix those problems in this medication, it could be quite helpful.

So, I'm sorry for giving out the wrong info. I get my SSRI's and my SSNRI's mixed up! LOL I get more than that mixed up, but I ain't admitting that right now!

Hugs,
tk

 
Old 05-14-2005, 09:39 AM   #11
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Location: austin, texas
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girl75 HB User
Re: from Cymbalta to Lexapro... question about antidepressants

hola TK, thank you for your info on effexor xr. you know its really hard when you get dismissed from a docs office after they had already started you on all the meds they did. i had my appt with a comm. clinic and the pain mangmt. doc only gave me enough norco till that visit. when i went to my visit the np said that they can't prescribe me the narcotic meds i am taking for long term use.
i was like ahhhh! so after we talked about it she went ahead and prescribed me skelaxin and ultram. and you know it is helping me. why didn't my pain doc every try that for me before. im not sure if these meds will help during a flare but i am going to be positive. the clinic is going to refer me to a new pain doc that takes medicaid here where i live so i just have to wait till they recieve my referral and see if they'll take me.
why does this happen to so many of us fibro patients?
oh well i have to keep moving on i guess.
love,
robin

 
Old 05-14-2005, 06:25 PM   #12
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Re: from Cymbalta to Lexapro... question about antidepressants

Quote:
Originally Posted by girl75
hola TK, thank you for your info on effexor xr. you know its really hard when you get dismissed from a docs office after they had already started you on all the meds they did. i had my appt with a comm. clinic and the pain mangmt. doc only gave me enough norco till that visit. when i went to my visit the np said that they can't prescribe me the narcotic meds i am taking for long term use.
i was like ahhhh! so after we talked about it she went ahead and prescribed me skelaxin and ultram. and you know it is helping me. why didn't my pain doc every try that for me before. im not sure if these meds will help during a flare but i am going to be positive. the clinic is going to refer me to a new pain doc that takes medicaid here where i live so i just have to wait till they recieve my referral and see if they'll take me.
why does this happen to so many of us fibro patients?
oh well i have to keep moving on i guess.
love,
robin
Hey robin,

I'm sorry to hear about your denial. I posted a good longie for ya!
I think the reason that your PM doc didn't prescribe Utram and Skelaxin for you is cuz Ultram is non narcotic and Skelaxin is an anti-inflammatory pain med, also non narcotic. Some PM docs have it in their heads that they should only be writing scripts for narcotics. Mine doesn't, but he doesn write scripts that typically aren't written by your Rheumies or your GP. But he will write "normal" med scripts too. Why all this goes on? Docs are different. Rheumies usually refuse to treat FM with narcotics, PM docs are usually the ones to write LA scripts, and GP's fall in the middle somewhere! Docs are different is the key phrase! LOL Maybe cuz you were in a community clinic, their policy on writing scripts for certain narcotics are more strict. Not saying anything bad about community clinics, I just think they are regulated differently than docs in private practice or part of a medical center clinic. That could be the reason. Sometimes you have to kiss a lot of toads, even if they are doctors, to find a prince! You'll get on track soon enough. It is the most difficult when you are introducing any kind of new med that you haven't used before, you have to go through a "tweaking" stage, sometimes for months before you find what's working best for you. Same way with new docs. You have to go through a "tweaking" stage with them too! LOL

Hugs to you my dear. Keep us posted on how it goes with your new PM doc.

tk

 
Old 05-21-2005, 03:08 PM   #13
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Join Date: Jul 2003
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Re: from Cymbalta to Lexapro... question about antidepressants

I'm sorry I haven't replied sooner...

tkgoodspirit, I appreciate your info. I have decided to set the medications aside for now, and research what I can do through diet, exercise, yoga, meditation, etc. After reading about fibro, I realise that although I definately have it, I don't have it as bad as some people. I don't have tremors in my muscles or crippling pain... I don't have headaches daily (although I do get them... it is just not as bad as what other people deal with).

I'm thinking that my fibro may be "mild" enough that I can manage it on my own.

I've been taking the Lexapro for about 8 days, and the Zanaflex at night... and I feel like crap! I know it takes a while for anti-D's to really work, but I don't want to be taking that. I'm not really depressed. I do get moody with pain, but I think that's normal for anyone.

Now I just need info on a diet for fibro/IBS.

 
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