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Old 02-01-2011, 06:28 PM   #1
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Pain and Cymbalta

Hello Pain friends,

Anyone taking Cymbalta?
Any experiences to share?

I have taken Effexor in the past and don't recall it working well. I'm hoping that Cymbalta will be an improvement.

~

 
Old 02-02-2011, 02:32 PM   #2
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Re: Pain and Cymbalta

My friend takes Cymbalta....and she says it is WONDERFUL for her pain.
Hope this helps some
Best of luck
Madison

 
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Old 02-02-2011, 04:23 PM   #3
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Re: Pain and Cymbalta

Isotope,

I took Cymbalta for a while and pain wise it did OK. I had problems with it causing tachycardia and VERY high blood pressure, and I ended up hospitalized for two days while they tried to get things back under control, so monitor your BP and pulse rate for a while to make sure you don't have a problem with that. When I took the Cymbalta it was with nothing other than baclofen for the pain, I think if it were added to what I take now it would take care of some of the nerve pain the ms contin and oxy don't handle. I'd say it's worth a try.

Tigg.

 
Old 02-02-2011, 04:56 PM   #4
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Re: Pain and Cymbalta

Hi Isotope,
I took Cymbalta for nerve pain and found it did very little. It did however completely take away the pain from my Fibromyalgia which was surprising.
I was on 90 mg/day when my insurance suddenly stopped covering it and it soared to $230/month for only that one drug. I had enough for 2 weeks and tried to metre it out and when I finally was down to the end of the medication I had the most horrific withdrawal I have ever experienced and I went cold turkey off of 120 mg of Ms Contin on another occasion!
For 7 weeks I couldn't eat, or read or drive without these incredible "brain zaps" It is just so had to describe. I lay on the couch everyday praying that it would get better.
My doctor was aware of the withdrawal experience but still felt that Cymbalta was of value to me. She kindly was able to obtain some free samples from the rep., but I was too scared to ever consider taking this medicine again.
I know that it has helped many people, but I just wanted to tell what happened to me. The neurologist I saw told me that he had a few patients that responded with the brain zaps- little fleeting moments where your brain can't keep up with your eyes and you feel an electrical zap after the med is discontinued. Very disconcerting to say the least.
There are many ads on TV for this drug. It seems popular. But investigate it thoroughly is my advice!! It is best to know all sides!
Best wishes, Daisy

Last edited by daisymaegrl; 02-02-2011 at 04:58 PM. Reason: add info

 
Old 02-02-2011, 09:03 PM   #5
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Re: Pain and Cymbalta

For me, Cymbalta has been a life saver for both the depression caused by my chronic pain and in conjunction with oxycontin/oxycodone regime has greatly reduced my sciatic nerve pain. Previously I had tried 5 or 6 other antidepressants over the course of 2 years with very little success in treating my depression. Within a month of starting Cymbalta my depression symptoms were greatly reduced with minimal side affects. I started Cymbalta with the intention of treating only the depression. The "extra" bonus for me was the unexpected reduction of the sciatic nerve pain which radiated down my right leg into my foot. After about 2-3 months of titrating the dose up to 90mg/day the nerve pain rarely goes beyond my upper thigh area, at a greatly reduced intensity. I have also noted that I have reduced pain in my neck and shoulder areas. Unfortunately it does not seem to help any of the pain in my spine (arthritis, bone pain, scoliosis) but I'm greatful for the pain reduction (cervical and lumbar disk herniations) that I have experienced.

From what I've read it seems that people either respond very well or not at all to this drug. I have been on Cymbalta for 2 years now and along with Oxy and soma my pain has gone from a daily average of 8-9 down to an average of 4-5, a result I'm very happy with. Should you and your doctor decide that a trial of Cymbalta be appropriate for you I hope you are able to achieve a similar result.

Good Luck,
KG

 
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Old 02-03-2011, 01:07 PM   #6
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Re: Pain and Cymbalta

I have been on Cymbalta for about three years. It does a good job for me of controlling the nerve pain. I use it more for the nerve pain than for depression., BECAUSE I AM SUCH A CHEERY PERSON ALL THE TIME! Yeah, told my hubby that and he just laughed. My PM said that it is unreasonable to expect people to be happy all the time when they are dealing with pain on a daily basis. Guess he has a point there.

It has worked well for me, and I don't have too many complaints. Anything that helps keep the constant pain down is a blessing.

 
Old 02-10-2011, 05:42 AM   #7
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Re: Pain and Cymbalta

Antidepressants work best on neuropathic pain, and much less well on visceral pain (such as you have iso)

Cymbalta might well be an effective antidepressant for you, but i wouldnt hold your breath fr it to cure your pain.

The older tricyclic antidepressants may be more effective against pain that Cymbalta, because as well as their effects on seretonin and noradrenalin, they also block fast sodium channels, in the same way local anaesthetics do.
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Old 02-11-2011, 12:18 AM   #8
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Re: Pain and Cymbalta

I loved Cymbalta and found it to be very effective for my nerve pain. It did make me a little jittery to start with and weaning off it wasn't fun (but not too hard either if you do it right) but I would take it again in a heartbeat!

My best advice is to see if you can start on 30mgs and then titrate to 60mgs, just in case it stimulates your system too much. I did two weeks at 30mg then went to 60mg and later 90mg. Apart from oxycontin, it is probably the single most effective medication I've ever taken.

My only concern, as Jon mentioned, is that although it works on the pain receptors, it's more nerve pain that it treats. That said, it's an SNRI rather than an SSRI and has been shown to be effective in fibro and myofacial type pains as well. We understand so little about these medications and how the brain works that it's hard to say with any real certainty. I would give it a go any day, it was that beneficial.

Good luck!

 
Old 02-11-2011, 11:25 AM   #9
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Re: Pain and Cymbalta

Thanks to all-

My intent with Cymbalta was to treat my General Anxiety and Panic. I had no clue that it had pain relieving properties. I haven't noticed any pain relief from it so far (30mgs/day). It did 'clear' my head, and gave me a more coherent consciousness. I'm now taking it in the evening instead of the morning to see how it effects my sleep.

Overall I would say it has been good, not sure if I should stay put at 30mg or ramp it up to 60mg, or more?

I did feel brain-zaps years ago when I tried Effexor, haven't felt it with Cymbalta yet....

I was also wondering about Nucynta and its qualities relating to brain chemistry and Depression/Anxiety? People don't seem too thrilled with Nucynta's pain relieving abilities but I can't help but wonder about the off-label uses.... Any thoughts?

Another SNRI is Pristiq.

Any thoughts on Cymbalta vs. Pristiq?

~

Last edited by Isotope; 02-11-2011 at 11:48 AM.

 
Old 02-12-2011, 04:14 AM   #10
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Re: Pain and Cymbalta

hey Isotope,

I too was thinking of trying Pritiq because I was told that it wouldn't ramp up my anxiety as Cymbalta did at first. However I stuck with it and found that the anxious nervousness turned to additional energy (something most of us PM patients desperately need) and I felt pretty good. I hesitated about going up - especially to 90mg - but a specialist pushed me to give it a go and it really helped. My advice is to just go slowly and see what you're comfortable with.

Which Nucynta off label effects interest you most? It's a drug I keep meaning to read up on but I've been a bit distracted lately. The SNRIs are a bit of a mystery to everyone still but I feel more comfortable on them than an SSRI...I've seen too many personality effects though I'm sure there are those that wouldn't live without them.

I had never experienced before I started weaning off Cymbalta but then I'd never taken an SSRI/SNRI for long enough in the past. They were pretty horrid at first but I just did the 50% a week wean and it wasn't too bad. I found clonazapam to be very helpful during this time. Hopefully you won't experience any while you're taking them because it seems to be mostly a weaning issue.

Glad it's working for you so far!

 
Old 02-13-2011, 06:45 PM   #11
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Re: Pain and Cymbalta

Pristique is basicly effexor, its a slight molecular change designed to extend the patent life when the patent life of effexor expired - indeed, in controlled studies, it has been slightly LESS effective than effexor.

If 30mg of Cymbalta is working, stick with it, of you need more relief, push the dose to 60mg - the correct dose of any drug is the lowest dose that does the job.

I actualy found that rather than taking a SNRI (Efexor0 I did better taking two drugs, one seretonin reuptake inhibitor (Zoloft) and one noradrenalin reuptake inhibitor (nortriptyline) - I guess it just shows there can be a lot of individual variation in response to drugs.

If anxiety is still bothering you, it might well be worth trying Buspar along with your Cymbalta
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Last edited by jonnstar; 02-13-2011 at 06:47 PM.

 
Old 02-13-2011, 10:13 PM   #12
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Re: Pain and Cymbalta

I may ask about adding Buspar..... The first few days of Cymbalta were good, a nice clearheaded feeling and lower anxiety. The last few days have been odd. Strange dreams, lots of twitching in the night.

Always hard to tell what's really going on -I'm finally off the Prednisone and just trying to head off any signs of relapse by taking Lomotil and Xifaxan. I'm still a fan of Opana but I'm overly obsessed with reading about Narcotics and Anti-Depressants, and GI drugs....

My GF is frustrated with me because my life revolves around the rollercoaster ups and downs of my health. I used to be very productive, making music, writing, painting, and enjoying life. Now, I just dread my existence, can't hardly go to work, have no interest in anything, and spend most of my time trying to isolate myself from others, including my GF.

This phase of my life (late 40's) has been horrible. On one hand I feel old and sick and done with it all, yet I'm still young and know that I need to snap out of it and get back into life!

I don't want to do the hard work of transformation, I just want a pill that will fundamentally alter me into someone else...... The ruts and patterns that are me these days, are unworkable crap!

Feels like a form of spiritual Alzheimer's has taken hold of my life -it's just all going away from me and I can't stop it..... I work at a Hospital, I see many patients who are elderly, sick, and hopeless. I see them, and I totally understand that sad decline......... It's all a joke right?

~

 
Old 02-13-2011, 10:55 PM   #13
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Re: Pain and Cymbalta

I know this is a bit off topic for a pain management board, but do take/have you tried probiotics/prebiotics to help your gut? Metamucil Fibre Sure (Inulin) is a trye of dietary fibre that is an excelent prebiotic, it serves as a food for good bacteria in probiotics, and encourages their proliferation in the gut.

NSI Probiotic 10 10 is a good probiotic, 10 different strains of good bacteria, 1 billion CFU of each in 2 capsules


Buspar didnt help me, but it does help a good percentage of chronic anxiety patients, and as it is cheap, safe for long term use and not at all habit forming, it would seem reasonable to try it if you are still bothered by anxiety.

Hydroxyzine in doses of upto 50mg tid has also been found helpful for some GAD patients, and again it is safe, cheap and non addictive, and has a benign side effect profile except for some drowsiness early on.
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Old 02-15-2011, 08:56 PM   #14
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Re: Pain and Cymbalta

Thanks John,

Yes, I've done the Probiotic rotations, for years. Studies are inclusive at best about their effectiveness. I find them a good idea but see no difference.

I'd like to ask my PCP to increase the Hydroxyzine because I do feel benefits from it as far as lowered anxiety..... Currently I'm prescribed 25mg 6x/d/prn.

Buspar will be discussed with my Psy-Doc. I'm still trying to assess how the Cymbalta is working. Clearheaded but wild dreams and twitches and weakness are bothersome. Prestiq has gotten mixed reviews so I may stay put on Cymbalta.

However, Cymbalta dosing..... Can anyone tell me what to expect if my dose was increased from 30mg/d to 60mg, or 90mg? And, Buspar dosing.... What is the range?

Will all of these meds work together?

Opana ER
Norco BT
Hydroxyzine
Zofran
Cymbalta
Buspar
Cipro
Xifaxan


It's a crazy list! Never have I needed so much Pharma intervention!

Last edited by Isotope; 02-15-2011 at 09:02 PM.

 
Old 02-16-2011, 03:57 PM   #15
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Re: Pain and Cymbalta

SSRI and SNRI antidepressants have a flat dose response curve - that is, doubling the dose doesnt give a doubling of the effect.

Pushing the dose to 60mg would be quite reasonable, beyond that you might not see much increase in effect.

Try Cymbalta 60mg + Buspar (start off at 15mg bid, push to 30mg bid after 4 weeks if needed)

If that still fails, it might be worth trying a small dose of an atypical antipsychotic (say risperidone 1mg at night) along with your cymbalta - this has been shown to releive anxiety and tension, as well as boost antidepressant response.


When I went through a bad spell, I was taking Zoloft 100mg in the morning,
Nortriptyline 75mg at night, risperidone 1mg at night, and xanax 1mg three times a day, I know thats a lot of crazy meds, but it kept me as a functioning member of society, holding down a management jon and all that, rather than a crqazy guy with an overgrown lawn, long straggly hair, and no friends, living on welfare and refusing to answer the door.
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Last edited by jonnstar; 02-16-2011 at 04:07 PM.

 
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