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Sinus & Vision Misery


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#1 CrochetKaleidoscope

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Posted 31 May 2018 - 07:28 AM

Hey all. My name is CK and I’m a duloxetene survivor 🏆😊

I’ve been off duloxetene since 18 May (tapered down since Feb). In April I came down with horrible sinus, throat & eye infections and I have continued to suffer with sinus infection symptoms. I had a throat swab done to see if perhaps it was strep but so far negative. The worst sinus infection felt like it was clearing up last weekend but now it’s starting all over again. 😩

My eyes are always itchy and I’m on my second round of Polysporin antibiotics for eye infections. I cough constantly and when I wake up it’s as though my chest and head are filled with, well, goo. It’s disgusting.

My question is, how long do these types of symptoms persist?

#2 fishinghat

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Posted 31 May 2018 - 08:32 AM

Usually they are some of the first symptoms to develop.. The good news is they usually last around 4 to 6 weeks. As bad as you have it maybe that is bad news.  lol

 

Have you tried any decongestants?


#3 CrochetKaleidoscope

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Posted 31 May 2018 - 08:56 AM

I’ve also been having the other usual symptoms (extreme muscle and body pain, headaches, peripheral neuropathy, brain zaps, emotional roller coaster, yadda yadda), however these sinus symptoms are by far the worst.

I take diphenhydramine and loratadine and at night I take benylin cough syrup for the incessant nighttime coughing which sometimes helps and oftentimes does nothing.

#4 fishinghat

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Posted 31 May 2018 - 09:28 AM

Diphenhydramine and loratadine are both good choices but not together. Both are antihistamines and are rated as having a drug interaction. In addition, loratadine is a non-sedating antihistamine and as such can cause some stimulant effects including an increase in nervousness. I would just stick with the Diphenhydramine as it has anxiety fighting characteristics.

I would still consider a good decongestant. Please read the section below and it might give you some ideas.

In addition, benylin cough syrup (of which there is 11 types can contain diphenhydramine, Dextromethorphan and other compounds of concern. You certainly don't want to double your dose of diphenhydramine. If you want to let me know which type of Benyl cough syrup you are taking I would be glad to take a closer look at it.


Cold and Flu Medications

Pseudoephedrine/Phenylephrine containing meds
Used to treat nearly all withdrawal symptoms.
Caution - Pseudoephedrine can raise blood pressure and cause nervousness in some people.

Tylenol Cold and Flu
Active ingredients
Dextromethorphan HBr 10 mg in each caplet
Guaifenesin 200 mg in each caplet
Phenylephrine HCl 5 mg in each caplet
Not to be taken with Cymbalta

gail - Tylenol flu is good for the brain zaps.

hailsmarie - Tylenol Cold and Flu completely took away my brain zaps,

dstanek - My husband said try some Nyquil I didn't have any but tried tylenol cold nighttime. In 20 min symptoms disappeared. I slept great no soaking night sweats. No nightmares. Zaps gone, I even had to shake my head to be sure. Woke up this morning feeling normal. I am going to get non drowsy version today and see if this truly is the miracle helper.

Caution - Tylenol cold nighttime contains
Acetaminophen 325 mg in each 15 mL
Dextromethorphan HBr 10 mg in each 15 mL
Doxylamine succinate 6.25 mg in 15 mL
Phenylephrine HCl 5 mg in each 15 mL
As such it should not be taken with Cymbalta (because of the Dextromethorphan) or diphenhydramine (because of Doxylamine).

Mucinex D
Active Ingredients: Guaifenesin (600 mg), Pseudoephedrine HCl (60 mg).

Coastgirl - Just wanna say I ran out of Mucinex D and got Advil Cold And Flu (behind the counter with pseudophedrine) and it also works to combat the brain zaps for me. My vertigo and zaps are 98% gone.

Sudafed PE
Dextromethorphan HBr 10 mg
Guaifenesin 100 mg
Phenylephrine HCl 5 mg

Caution -As such it should not be taken with Cymbalta (because of the Dextromethorphan)

Coastgirl - Tried to not take sudafed this morning and I feel so messed up! Just dizzy and can't think straight. I feel so out out of it.
(I mentioned in another post the Sudafed helps with the brain zaps....unfortunately it doesn't help too much with the mild nausea feeling).

Houdi - some days I had to take sudafed, the REAL sudafed and only 1/2 the dose cuz it reves me up.

Johnnyz - earlier today I read a topic in here about pseudoephedrine and its supposed effectiveness to alleviate SSRI withdrawal symptoms. I take 12-hour sudafed (the real, behind the counter sudafed) 1-2x daily as I have persistent nasal congestion. Yesterday evening, soon after the morning sudafed tab had worn off, I had a very stressful situation which caused an emotional low that had me sitting for 10 minutes feeling very depressed. I was able to talk myself out of that stupor and continue on in a neutrally emotional state until bedtime. I took a 12-hr sudafed around 11pm and woke up at 6am this morning feeling very good physically and emotionally, like I had a decent sleep. My point here is that, looking back at the previous 5 days of my Cymbalta/ Trintillex withdrawal plan and its relative low and tolerable symptoms, I wonder how much my daily use of sudafed has been a factor in my light symptoms.

Claritin-D 24 hour extended release tablets
10 mg loratadine for immediate release
240 mg pseudoephedrine sulfate is released slowly allowing for once-daily administration.

ittybittysmitty - WHAM, today I got blasted with three times as much dizziness and zapping...I feel zombie-like. Thinking it was part allergy symptoms I took a Claritin...that helped somewhat...less dizziness while seated.

irritableme - I started taking a Claritin-D and that seems to help. When I don't take the Claritin-D the brain swooshes and zaps return.

Advil Cold & Sinus
Ibuprofen 200 mg
Pseudoephedrine Hydrochloride 30 mg
Chlorpheniramine Maleate 2 mg


Coastgirl - Just wanna say I ran out of Mucinex D and got Advil Cold And Flu (behind the counter with pseudophedrine) and it also works to combat the brain zaps for me. My vertigo and zaps are 98% gone.

Carleeta - Have been taking advil cold and sinus daily..Seems to work.

Advil LIQUID BLUE GELCAPs Cocktail
Heartfeatherss - Try taking 4 ( yes 4) Advil LIQUID BLUE GELCAPs with a Coke. It has to be the blue gel caps and it cannot be a diet Coke. My neurologist told me to do this and I was so miffed, thinking he was just not understanding how bad it hurt... but dang! It works!! Hope this gives you relief. Contains ibuprofen and dihydramine. Should not be taken with other amines like benadryl.

Indian J Exp Biol. 2003 Nov;41(11):1322-4.
Influence of acidic beverage (Coca-Cola) on pharmacokinetics of ibuprofen in healthy rabbits.
https://www.ncbi.nlm...pubmed/15332505
The Cmax and AUC0-alpha of ibuprofen were significantly increased after single and multiple doses of Coca-Cola, thereby indicating increased extent of absorption of ibuprofen. The results warrant the reduction of ibuprofen daily dosage, frequency when administered with Coca-Cola.
Note - This sure sounds like it puts a lot of Advil into the system. The articles I read from migraine users all say the same thing it must be coke a cola and name brand Advil liquicaps.

Information on the cold and flu medicine ingredients

Chlorpheniramine (over the counter) is an antihistamine {H(1)R antagonist} used to treat allergy symptoms. It does cause sleepiness like other antihistamines and has significant anxiolytic effects. Caution - It has also been shown to function as an ssri and snri. As such it should never be taken in combination with those medications as it can cause seratonin syndrome. Due to its anticholenergic effects it frequently causes constipation. As with diphenhydramine do not take with other medicines that can cause sleepiness. Recommended dose is 4 mg every 4 to 6 hrs not to exceed 32 mg/day. Widely sold as an allergy treatment.
Begins working in 30 minutes to an hour
Peak levels - 2 to 4 hrs
Half Life – 12 to 43 hrs
https://www.ncbi.nlm...les/PMC3854398/
(8mg dose)
https://www.ncbi.nlm...pubmed/16876927
https://www.ncbi.nlm...pubmed/16156843
https://www.ncbi.nlm...pubmed/12951198
https://www.ncbi.nlm...pubmed/10541737

Dextromethorophan
FiveNotions - I didn't check, but my bet is that Tylenol Cold contains DMX -- "dextromethorphan" .... it's a serotonin agonist (enhancer - reuptake inhibitor) ...

Nyquil contains a lot of it, which is why someone taking Cymbalta (duloxetine) or any other SSRI shouldn't use Nyquil ... there are case studies about the combo causing severe serotonin syndrome ...

Loratadine

https://www.ncbi.nlm...pubmed/10444229
Loratadine, No effect on 'mood'.

While this is the only research I found it is interesting to note that around 4% of people taking loratadine report anxiety as a side effect. This is about the same number of diphenhydramine (Benadryl) users that report depression as a side effect. (FDA)

From Drugs.com
Cardiovascular side effects have included hypertension, hypotension, palpitation, supraventricular tachyarrhythmias, syncope and tachycardia.

Wiki
As a "nonsedating" antihistamine, loratadine causes less (but still significant, in some cases) sedation and psychomotor retardation than the older antihistamines because it penetrates the blood/brain barrier to a smaller extent.[14]
Note - Inability to significantly penetrate the blood brain barrier would make it an unlikely anxiolytic medicine.
Do not take with Tagamet or other antihistamines.

Half life - 8 hours.
Metabolism
Loratadine is an H1 receptor antagonist (blocks the action of histamine on the H1 histamine receptor). Does NOT cross the blood brain barrier.

Pseudoephedrine
Wiki
Patients who are prone to anxiety or panic attacks should use pseudoephedrine with caution, as anxiety and restlessness are common side effects, mostly due to the drug's stimulant properties. Pseudoephedrine should not be taken with beta-blockers.

http://www.sciencedi...080552323624882
Can cause anxiety as a side effect.

http://research.omic...Pseudoephedrine
Adverse effects
Common adverse drug reactions (ADRs) associated with pseudoephedrine therapy include: CNS stimulation, insomnia, nervousness, excitability, dizziness and anxiety. Infrequent ADRs include: tachycardia or palpitations.

https://www.ncbi.nlm...pubmed/10999495
"...the drug tended to increase anxiety scores. Depth resulted in a significant increase in anxiety scores and a significant decrease in verbal fluency test scores."

https://www.ncbi.nlm...les/PMC4518702/
Over-the-counter cold preparations contain phenylpropylamine and pseudoephedrine, obvious stimulants. Yet patients with unexplained dyspnea may believe they have allergies and take these medications frequently in order to treat their anxiety symptom, further exacerbating their dyspnea and anxiety symptoms. The use of energy drinks with combinations of both caffeine and stimulants is another important example.
And many more research articles....

http://www.ehealthme...loride/anxiety/
(FDA website)
140 people reported to have side effects when taking Pseudoephedrine Hydrochloride.
Among them, 12 people (8.57%) had Anxiety as a side effect.

Pseudoephedrine is an agonist at both alpha- and, to a lesser degree, beta-adrenergic receptors. Like ephedrine, pseudoephedrine also has an indirect effect by releasing norepinephrine from its storage sites. By stimulating alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine shrinks swollen nasal mucous membranes; reduces tissue hyperemia, edema, and nasal congestion; and increases nasal airway patency. Also, drainage of sinus secretions is increased, and obstructed eustachian ostia may be opened. Oral administration of pseudoephedrine usually produces negligible effects on blood pressure. In some patients, especially those with preexisting cardiac disease receiving higher doses, pseudoephedrine may increase blood pressure or irritability of the heart muscle and may affect ventricular conduction. Wiki
Phenylephrine is a selective α1-adrenergic receptor agonist of the phenethylamine class used primarily as a decongestant, as an agent to dilate the pupil, and to increase blood pressure. Phenylephrine is a sympathomimetic drug, which means that it mimics the actions of epinephrine (commonly known as adrenaline) or norepinephrine. Phenylephrine selectively binds to alpha receptors which cause blood vessels to constrict. Phenylephrine may cause side effects such as headache, reflex bradycardia, excitability, restlessness and cardiac arrhythmias. Phenylephrine is not suggested for use in patients with hypertension.
Available as Oral and nasal spray.
Medical research emphasizing that phenylephrine can cause anxiety.
https://www.ncbi.nlm...pubmed/20937329
https://pubchem.ncbi...d/phenylephrine
https://everipedia.o.../Phenylephrine/
People with a history of anxiety or panic disorders, or on anticonvulsant medication for epilepsy should not take this substance.

While considerable medical research indicates that Phenylephrine can cause anxiety the following research indicates differently.
https://www.ncbi.nlm...pubmed/20937329
Helps with anxiety

https://mdanderson.i...atergic-synapse.
https://mdanderson.i...tially-regulate


#5 CrochetKaleidoscope

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Posted 31 May 2018 - 11:22 AM

Thanks for the advice, fh.

Prior to weaning off cymbalta I was only taking loratadine for seasonal allergies but I will def stop taking it and stick with diphenhydramine alone. As for pseudoephedrine, that makes me jittery and nervous so I stay away from anything that contains that.

The two Benylin syrups I use are:

Benylin Extra Strength Dry Cough
1 tsp contains 15mg dextromethorphan hydrobromide

Benylin Sleeptime Dry Cough Night
1 tsp contains 12.5mg diphenhydramine hydrochloride

It appears the Sleeptime syrup is basically liquid diphenhydramine. No wonder it doesn’t do much to stop the cough but does help me to fall asleep when I don’t have a lot of coughing. Sheesh.

#6 fishinghat

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Posted 31 May 2018 - 12:40 PM

I am glad you checked that out. Have you ever tried phenylephrine as a decongestant?

#7 CrochetKaleidoscope

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Posted 31 May 2018 - 12:44 PM

No, fh, I haven’t. Does it cause nervousness or excitability?

#8 fishinghat

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Posted 31 May 2018 - 12:47 PM

It can but usually in a smaller percent of people than the pseudoephedrine. One way to test it without too much risk is to start up with a 1/4 dose and work up from there. That way if you do get jumpy then it won 't be too bad.

#9 CrochetKaleidoscope

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Posted 31 May 2018 - 12:47 PM

Actually, I just went onto www.drugs.com and it is contraindicated for those with thyroid problems, which I do.

#10 fishinghat

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Posted 31 May 2018 - 12:51 PM

Right again. Oh well. We tried.

#11 CrochetKaleidoscope

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Posted 31 May 2018 - 01:00 PM

Ya, I appreciate your help. I will forge ahead and hope this passes sooner than later.

#12 gail

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Posted 01 June 2018 - 06:32 AM

Hello CJ,

Oh yes, this symptom will pass. You're not alone with this, others have had it pretty bad also! Hold on to the mast!



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