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[iliao93]

Cymbalta's pros and cons:(just cons)



Cymbalta's pros and cons:

From:http://WWW.crazymeds.us/ left side (Cymbalta)

Cons: It appears as if the discontinuation syndrome for Cymbalta (duloxetine hydrochloride) is just as harsh as that of Effexor (venlafaxine) for many people. So if you have to stop taking, be careful and do so slowly. Read the section on how to stop taking this MED for more information. While nothing works for everything, this is the first time I've read a case report about an antidepressant making PTSD worse.

In case the link about an antidepressant making PTSD worse. Isn't clickable:

http://WWW.ncbi.nlm.... ... =Abstract( you have to buy this article from here for $20!

After some creative searching found it free here:
http://WWW.primaryps... ... icleid=385
(if you want the footnotes go to the page, long)
? ? ? ?
Exacerbation of Posttraumatic Stress Disorder Due to Duloxetine
Posttraumatic stress disorder (PTSD) is a chronic, disabling condition that afflicts approximately 10% of the United States population.1 Core symptoms include reexperiencing of the trauma, avoidant behaviors and emotional numbing, and hyperarousal symptoms. In addition, individuals with PTSD also frequently experience irritability, aggression, impulsivity, anxiety, and depression. More than one-third of patients with PTSD fail to recover even after many years of suffering with the disorder.2 While selective serotonin reuptake inhibitors are currently considered the drugs of choice for PTSD, several other classes of medications have also been found to be useful. Alternatives include other antidepressants, adrenergic agonists and antagonists, atypical neuroleptics, anxiolytics, anticonvulsants,3-13 and even the ?-aminobutyric acid (GABA)-B agonist muscle relaxant baclofen.14

Duloxetine is a serotonin norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of major depressive disorder and diabetic neuropathy. Compared with the SNRI venlafaxine, duloxetine is 17 times more potent in serotonin inhibition and 34 times more potent in norepinephrine inhibition.15 In addition, duloxetine is 17 times more potent at inhibiting dopamine transport and, through indirect mechanisms, also appears to increase dopamine in the nucleus accumbens.16 The following is a report of worsening of PTSD attributable to the use of duloxetine.17

A 53-year-old married Vietnam veteran with PTSD and bipolar disorder not otherwise specified (NOS) has been treated at his local Veterans Administration (VA) hospital since 1997. His PTSD symptoms include intrusive thoughts of Vietnam several times per week, occasional nightmares, avoidance of crowds, and mild hypervigilance. Despite their chronicity, these symptoms have been relatively well controlled with a combination of valproic acid, propranolol, and risperidone. For the past several years, the patient has also suffered from moderate depression with symptoms of anhedonia, anergia, amotivation, concentration difficulties, lack of libido, and intermittent passive suicidal ideation. His depression has been refractory to numerous adequate trials of medications including nefazodone, fluoxetine, sertraline, citalopram, bupropion, venlafaxine, mirtazapine, trazodone, carbamazepine, lithium, and olanzapine. While some psychotropics initially helped only to lose benefit later on, most provided no mood benefit at all. Trials of lithium and carbamazepine were aborted prematurely as they were not well tolerated.

In 2004, the patient received a trial of duloxetine 60 mg/day. However, within the first week he experienced a severe exacerbation of PTSD symptoms including daily flashbacks of Vietnam, nightmares, emotional numbing, increased startle response, and extreme hypervigilance. He also had daily suicidal thoughts which he attributed to his distress from reexperiencing the symptoms. The rest of his depressive symptoms remained unchanged. Upon reduction of his daily duloxetine dosage to 30 mg, his PTSD symptoms lessened but still were more severe compared to before the introduction of duloxetine. After duloxetine was totally discontinued, his PTSD symptoms returned to baseline.
As noted by the authors of this report, at least some of the symptoms of PTSD—particularly heightened startle response, hypervigilance, and increased arousal—may result from an overly sensitive noradrenergic system. Increased 24-hour urinary catecholamine,18 24-hour plasma norepinephrine,19 and cerebrospinal fluid norepinephrine levels20 have been found in PTSD patients. Furthermore, yohimbine, a noradrenergic agonist, has been shown to increase the amplitude, magnitude, and probability of the startle reflex in combat veterans with PTSD as compared with combat controls.21 Not surprisingly, B-adrenergic antagonists, such as propranolol, and a1-adrenergic antagonists, such as prazosin,22 have demonstrated efficacy in alleviating PTSD symptoms of increased arousal, reexperiencing, and numbing.23,24 Based on this data, the most likely mechanism for the worsening of PTSD described in the patient above derives from the noradrenergic effects of duloxetine. Clinicians who prescribe duloxetine and other noradrenergic medications, ought to consider the potential adverse effects of these medications in those who suffer from PTSD. Controlled studies are necessary to confirm these anecdotal reports. PP

The bold area's in the above article are by me.

Be Well !

[iliao93]

Yes, DC it has been sickening me for years. I've been into alternative health and actually life for most of my life. Our society as it stands today is altogether sickening. My son(the one in Australia) was raised on whole foods, herbals and alternative ways of living and thinking. He hated it when he was small ! No junk food, whole grains, learning to make his own decisions & now he is grown he is glad for it. I am still amazed I messed up so badly in taking this crap Cymbalta...I knew better :evil:
I hope the stuff I posted on PTSD will help anyone reading on here with it cope better & understand it's the system and Cymbalta that has poisoned them , they aren't to balme!
Be Well !