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What's So Different About Cymbalta Compared To Other Anti-Depressants?


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#1 buntbean

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Posted 18 March 2015 - 06:48 AM

I've been off since August but the anxiety has gotten beyond me.  I take lorazepam (ativan) 1X/day.  I'm so unsure of what to do anymore.  I'm seeing a counselor for the 1st time in 6 years today.  Why is Cymbalta so much worse than other anti-depressants?  I was put on it for nerve pain.  I honestly can't say my pain has increased since stopping but I'm also on gabapentin (neurontin).  I started having panic attacks again, first time in 7-8 years.  What other meds are good for anxiety.  I wake up every morning in dread and fear.  I joined a gym, try to stay busy, listen to music, talk to my mom but it keeps tugging at me.  I feel depression creeping in.  Some days I really wish it would just end.


#2 thismoment

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Posted 18 March 2015 - 08:37 AM

Hi buntbean

Sorry to hear your symptoms are still rough at 6-7 months out. This is about the time things start to lighten up, and hopefully you will find some relief soon.

It sounds like you've developed tolerance to the Lorazepam at the current dosage because of your high anxiety level. Talk to the doctor about this and he or she will either up the dosage or switch benzodiazepines. As you know, anxiety is the ultimate destabilizer and if endured too long, depression is soon to follow.

The SNRI (Cymbalta) introduced in 2004 followed Venlafaxine (Effexor) which came out in 1993. They prevent the re-uptake of both neurotransmitters serotonin (like a SSRI), and also norepinephrine. SNRIs might be considered broader-acting judging by the great variety of ailments for which they are prescribed. SNRIs appear to be more problematic in withdrawal, and perhaps that's related to their dual-action design; I don't know.

Get the anxiety down and you will level off. As you know, benzodiazepines are dependence-forming too, and withdrawal can be serious. Hydroxyzine is a non-dependence forming alternative. But addressing the anxiety comes first!

Good luck with your counselor today; let us know how it goes.

Take care.

#3 TryinginFL

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Posted 18 March 2015 - 08:43 AM

Hi bb!

 

I had a really long reply almost finished and then it went up in smoke!

 

TM seems to have covered everything, so I will just wish you luck with your counselor today! 

 

Liz


#4 lady2882Nancy

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Posted 18 March 2015 - 11:42 AM

Hi buntbean

 

Since you have been on Lorazepam for so long like this moment said you have developed a tolerance but also I know from experience this med will cause depression for some with long term use. I was one of those.

 

You need to be using something else for the anxiety that won't cause depression or the doctor will be wanting you back on antidepressants. If you have to use an antidepressant there are some old school ones like amitriptyline or nortriptyline that work or some SSRI's that are good for anxiety like Zoloft, Lexapro, Prozac just make sure you don't take another SNRI which there are a number of now not just Cymbalta (Duloxetine) and Effexor (Venlafaxine). Do your research and know what you are taking. A long half life is a must.

If you do a search online for anxiety medications or medications for anxiety you will see there are many to choose from and not just the Benzos which are habit forming and to which you develop a tolerance fairly quickly.

 

Take care of you and be well


#5 buntbean

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Posted 18 March 2015 - 01:15 PM

The counselor was very kind.  Due to it being my 1st visit there was a lot of paperwork and history to go over.  She wants to see my 1X/week for awhile.  Mentally I just can't break free of this anymore.  She suggested another doctor that works with a holistic approach (GABA, 5-HTP, etc. both of which I'm already taking).  It was nice she didn't just tell my to go back on the Cymbalta like my primary care doctor did.  So, tell me if I'm understanding this.  It's the fact Cymbalta also works on the norepinephrine that makes it bad?  If I do consider another anti-depressant in the future a strictly serotonin re-uptake with a long half life is what I should shoot for?  Is the problem with Cymbalta strictly in the withdrawal process?  I was on it for almost 10 years.


#6 fishinghat

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Posted 18 March 2015 - 01:45 PM

You are right about everything except the withdrawal being the only problem with Cymbalta. It can cause liver, kidney damage as well as a host of other problems.


#7 buntbean

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Posted 18 March 2015 - 05:13 PM

Don't all anti-depressants carry those risks?


#8 fishinghat

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Posted 18 March 2015 - 07:24 PM

Yes, most do.


#9 thismoment

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Posted 18 March 2015 - 09:30 PM

buntbean

Here's a website I've always found to be a good resource. Look into some articles by Dr Stuart Shipko.

http://www.madinamerica.com/

#10 FiveNotions

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Posted 18 March 2015 - 10:18 PM

Buntbean,

 

I'm sorry you're getting clobbered by the anxiety ... it's awful, isn't it?

 

Thanks to the folks here, I learned about clonidine for anxiety ... it's an "on label" med for hypertension, but it has an "off label" use for anxiety ... I've forgotten the specific mechanism of action (long day, brain farted out, sorry) ... but it has to do with shutting down the stress loop that gets going with what are called the two "stress hormones" -- adrenaline and cortisol.

 

It's worked wonderfully for me ... I also have borderline high bp, so it takes care of both the hypertension and the anxiety ...

 

it doesn't work for everyone, but it might be worth looking into ...

 

also, be aware that even if the benzo has pooped out for you, you may likely have trouble quitting it ... you'll need to dose down very carefully to avoid benzo withdrawal ...

 

hang in there ... and bravo for getting started back up with a therapist !





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