4 replies to this topic

[Hornet1937]

Hello friends,

 

I am a 33 year old male. A month and a half ago, I was prescribed duloxetine 30mg XR twice daily for debilitating anxiety. Concurrently, I quit drinking and recreational smoking. My GAD is comorbid with adult ADHD, for which I take prescribed amphetamines. I also drank energy drinks daily.

 

In the past, I had tried a suite of SSRI with little effect. My experience on duloxetine has been mixed, but so far the positives have outweighed the negatives. My chronic worrying and panic attacks have completely disappeared. I have been able to better cope with the withdrawal symptoms associated with my substance-abuse cessation. And over holiday break I was unable to fill my amphetamine Rx, yet felt positive, clear-headed, and motivated without it (granted these changes could also be associated with my newly found sobriety).

 

During this period I also experience my first dose of side-effects from duloxetine. There are several that have brought me here today: withdrawal irritability (at ca. 5pm before taking second dose), syncope (episodes of light-headed dizziness, nearly blacking out), excessive thirst (and subsequent urination), leg/foot cramps (has this been reported by others?), and sleep issues (insomnia, night sweats, vivid dreams).

 

I've since been more adamant about taking my second dose before the onset of irritability. I can be rather absent minded though, and I realize that if/when I stop treatment, I am likely to suffer. I have also been giving myself more time to sleep, restricting caffeine after second dose, and using mindful meditation to help get to sleep. I am actually getting more sleep than prior to starting the new chemical. On amphetamines, I am accustomed to insomnolence and profuse sweating, but it is still inconvenient. The syncope, I've noticed is strongly related to energy drink consumption so I've switched to plain soda. It feels very much like a blood sugar crash, and in fact, before finding this site I was researching the possibility of pre-diabetes. After reading here and elsewhere, I learned many of my new symptoms are likely duloxetine related.

 

The over-all feel of this website is that Cymbalta/duloxetine is an awful drug, yet I cannot deny that psychologically I have improved markedly. I am curious if the side effects subside over time? Obviously, not withdrawal, but the other lesser ones (thirst, insomnia, dizziness). Any suggestions for muscle cramps? Is it related? Can it be remedied? There are also a lot of people reporting that they are trying to get off the medication. Does it lose effectiveness or are y'all getting fed up with your side-effects? I am concerned because I've already started down the rabbit hole and I am just now seeing what it contains. I fear I have already ventured too far to turn back now. Thoughts? 

 

Thanks,

Hornet

 

Edit: I also had some persistent headaches during break. They have seemed to have gone away at the moment.

[fishinghat]

Welcome Hornet.

 

The symptoms you describe in the third paragraph could all be related to Amphetamine withdrawal OR side effects of the Cymbalta. Does the timing coincide with the discontinuation of the Amphetamines?  On the other hand you are at about the right stage to develop the side effects as your blood concentration peaks out. Most side effects fade some over the next 2 or 3 weeks. There is only one way to find out, Wait, There are sooooo many side effects from Cymbalta that there are too many to list here. The most prominent/serious ones are the loss or diminished sexual function, weight gain, suicide ideation, liver and kidney damage. The manufacturer recommends an annual Liver Function Test (LFT) to keep an eye on that issue. Given what you have been through in your recent history it is difficult for me to recommend coming off the Cymbalta at this time. On the other hand it is still early and would only be more difficult later. Only you know how strong you are at this time and if you think you can handle life without Cymbalta. I wish I could be more definite.

 

Let me also say that you should be very proud of yourself for the sobriety, stopping smoking, stopping energy drinks and substance abuse cessation. Great job.

[brzghoff]

Hi Hornet and welcome!

 

everyone is different. we all took the C for different reasons, likewise for why we chose to come off.

 

if it is working for you, that's important to consider. the C is used frequently with good results for GAD. knowing how severe anxiety feels - that's huge to consider. 

 

side effects can get worse/better and/or pop up later. most typical based on the anecdotal evidence on this site are:

 

flatness of emotions. rarely cry, laugh much less often. motivation and creativity also flattened.

alcohol abuse - heavy drinking where not previously a problem. as soon as i quit, within days, i went from drinking a couple beers and 1/2 to an entire bottle of wine to drinking nothing. mixing alcohol and the C are dangerous due to risk of liver toxicity

weight gain

high blood pressure

raised cholesterol (result of weight gain)

chronic acid reflux

sleepiness

vivd dreams - i liked that one, they were all positive, adventurous and often would pick up where they left off the previous night - like binge watching a tv series on netflix ;-)

inability to empty bladder fully - resulting in an increase in UTIs

i got muscle cramps in withdrawal but not while on the C

no menopause symptoms - i liked that side effect too!

 

I am a little concerned about your past and the alcohol thing with the C. also the amphetamines combined with the C could create issues with blood pressure. i am kind of surprised that your doc is prescribing what amounts to be "speed" concurrent with the C - but i don't know the details of contraindications of the two. 

 

as for quitting some wanted off due to the C pooping out. others lost their insurance coverage of the C and couldn't afford it. others because the side effects became intolerable. and many of us because we don't want to be dependent on a med that puts us through hell if we can't keep our 'scrip current. for me the brand name was almost $500 for 30 caps the generic was $250 for 30 caps. i had to go off cold turkey as a result, and it was hell. that was 19 months ago. only lingering issue is anxiety. i am using CBT tools learned in therapy. i also take 5 htp off and on to take the edge off anxiety. since october one month on one month off. now that stressful holidays are over i am going off 5htp again. other reasons i quit the C were the side effects and i didn't think i needed it anymore. i believe i was duped by the behavioral health industry's current proclivity to put everyone on meds for life even when not necessary. 

 

the blood sugar crash feeling is classic and was the first symptom of withdrawal i'd feel if i was late taking my capsule. i called it the "elevator down" sensation. the other immediate symptom was getting "the runs" within 2-4 hours of missing my dose. i never felt the anxiety withdrawal symptom or the physical pain withdrawal symptoms until i quit for good - took several days to manifest. i never had brain zaps in withdrawal - but i was lucky. most folks suffer them for weeks or more. not dangerous but scary from what i understand

 

you definitely have a lot to consider. it is your choice to make i am sure others will chime in shortly with their take on your situation and things to consider.

[Hornet1937]

I too am enjoying the dreams. Additionally, I have been taking Valerian root to help sleep and it exacerbates the dreams. Further still, I've been told that chronic recreational smoking can disrupt the communication between brain hemispheres and subsequently disrupt dreams. After quitting, many 'heads' have really vivid dreams. So I am having a dream triple whammy!

 

Where I stand now, I would rather discontinue my amphetamine than "C". Yet, occupationally it is imperative that maintain productivity having had issues in the past with performance, culminating into an emotional break-down, and subsequently, has lead me to "turn my life around".

 

I know I am making a lot of changes at once and it is hard to pin-point what is cause and what is effect. But I have limited to time to complete this large work-related project and I am under a lot of pressure to make my deadline. With that said, I am here wasting time on mental health research, instead of working. While off-topic, I have wondered if some of my difficulties at work are a consequence of the Speed hindering creativity, a necessary component to my task at hand. 

 

Never-the-less, I am in a much better place than where I was during my break-down, even despite some of the inconvenient side-effects. I intend to continue my treatment as prescribed. 

 

Thanks for the feed-back.

 

Hornet

[brzghoff]

Hornet,

 

as our long-time forum member who goes by the name "thismoment" likes to remind us, its not about being med free "its about quality of life"

 

all the best to you. keep in touch!