I’ve tapered back to 30mg of Cymbalta. It’s clearly not the medication for me. To be blunt, sexual dysfunction doesn’t even begin to describe that particular side effect, and my anxiety is worse than being off medication.

My next appointment with my GP is September 7, so I am going to stick with the 30mg and then get advice on tapering off it. I have no doubt that this is wrong medication for me because it’s an SSNRI, emphasis on the “N”.

Norepinephrine is both a hormone and a neurotransmitter, and as a hormone is secreted by the adrenal gland. It is almost identical in structure to epinephrine and works in conjunction with epinephrine and adrenaline to give the body the sudden energy it needs in times of stress. This is known as the “fight or flight” response.  Mild elevations in our Norepinephrine levels create heightened arousal, a state produced by stimulants. Some individuals using SSNRIs develop a state of emotional elation (hypomania).

Most importantly, in my case, moderately high levels of Norepinephrine create a sense of arousal that is uncomfortable and includes intensified worrying, anxiety, increased startle reflex, jumpiness, fear of crowds and tight places, impaired concentration, and restless sleep.

It’s clear that SSNRIs such as Cymbalta and atypical anti-depressants such as Wellbutrin will increase my anxiety, which is unacceptable. And while my most recent issue has been depression, the anxiety issue remains.

…. are the new normal.

According to my friend who is a trained pharmacist, Cymbalta can cause anxiety, just as Wellbutrin does as well in some patients. And yet in both cases, these drugs have been approved for treatment of anxiety. I have no idea which drug is causing these emotions.

I had an anxious morning this morning followed by a tearful early afternoon. When I got called into a business meeting run by the CEO, I had no problem putting on the face and acting professional and contributing to the meeting.

I felt so good yesterday and I feel so bad today.

Right now I am sitting at my desk desperately try not cry. I am not sure how it got to this point today as I was certain I was on the mend after a week on Cymbalta. Perhaps it’s not the right medication for me. These drugs have numerous side effects so it’s hard to know what’s affecting me, the Cymbalta or the Wellbutrin that’s still in my system.

Last night I decided to go to bed early to get a full night’s night sleep and see how it affected me the next day. I ended up waking at 4 a.m. in an anxious state – I had slept about six hours and felt fairly alert.

At this point I opted to take my 60mg of Cymbalta and an Ativan, but found it difficult to fall asleep again completely until about 6 a.m. until I woke up again around 8, all anxious again. Yesterday I felt pretty good, but today I’m so anxious and edgy and it’s as if I’m not on any medication at all.

I’m now on 60mg of Cymbalta. I started with 30mg last Thursday, the last day I took 100mg of Wellbutrin. My mood is a lot better, although I am rather edgy and still waking up to panic attacks.

The attacks come on before I even have a chance to have a conscious thought, which suggests the attacks are caused by sub-conscious worries or simply a chemical imbalance. I am hoping as I adjust to the Cymbalta these panic attacks will disappear. Right now I am taking Ativan before bed in the hopes it will lesson the symptoms in the morning and another when I wake up to recover the from the attack more quickly.

Once I get going I’m pretty good, but pulling myself out of bed in the morning as the adrenaline rushes through the moment my eyes open has been a challenge. I’m still working the Wellbutron out of my system, which was causing me serious anxiety and tremors the past few weeks. It definitely wasn’t the drug for me.

I see my doctor September 7, and at that point we’ll see how many side effects I have and whether he wants to up the dosage. The maximum dosage for Cymbalta is 120mg.

The Wellbutron was “activating” so I was able to get up early in the morning (granted, I was getting little sleep because it caused insomnia) and I’m finding I’m sleepier in the morning on Cymbalta, which was my primary complaint with Celexa.

Indication

Cymbalta is indicated for the treatment of major depressive disorder (MDD). The efficacy of Cymbalta was established in four short-term and one maintenance trial in adults.

Cymbalta is indicated for the treatment of generalized anxiety disorder (GAD). The efficacy of Cymbalta was established in three short-term and one maintenance trial in adults.

Cymbalta is indicated for the management of diabetic peripheral neuropathic pain (DPNP) and fibromyalgia.

Important Safety Information About Cymbalta

Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

Who should NOT take Cymbalta?

You should not take Cymbalta if:

• You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
• You have uncontrolled narrow-angle glaucoma (increased eye pressure)
• You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?

Before starting Cymbalta, talk with your healthcare provider:

• about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
• about your alcohol use
• if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
• if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
• if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, talk with your healthcare provider:

• if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
• if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
• before stopping Cymbalta or changing your dose
• if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose
• about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
• if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
• if you develop problems with urine flow

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, sleepiness, increased sweating, decreased appetite, dizziness, and weakness. This is not a complete list of side effects.

Other safety information about Cymbalta:

Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.

I’ve been struggling to lose weight for years and the most I could manage despite a serious diet and working out with a personal trainer is five pounds.

It the last three weeks I’ve somehow managed to lose another five pounds without really working at it. Probably doesn’t hurt that I have no appetite (either because of my mood or the Wellbutrin or both) and I’ve been relying on coffee as breakfast.

I didn’t eat much this weekend either, so hopefully Cymbalta is at least weight neutral (I started taking it Thursday). I probably still have Wellbutrin in my system at this point.

I felt listless the entire weekend, but no crying spells until this morning on the bus to work. I really wish those would go away.

I hope it’s just the overcast weather this weekend, but I can’t shake concerns that Cymbalta is going to have the same effect as Celexa in that it turns me into a lifeless zombie.

I accomplished very little today except trying to sleep away the day. I didn’t even do that well. The apartment is a mess and I barely focused on watching a couple episodes of TV. At the same time, I find myself start to feel anxious as Sunday comes to close, pondering another Ativan and regretting that I accomplished nothing today. It took all my willpower just to sit down in front of this computer and write this entry.

Right now my doctor has me on 30mg of Cymbalta with a move to 60mg in week two. I hope it works for me; any drug will have an adjustment period and it does work for some people, causing them very few side effects. Then again, so does Wellbutrin and Celexa, and they were not the right drugs for me.

My GP faxed over referral to participate in a group Cognitive Behavior Therapy program. He said not to get my hopes as the weight times are long, but CAMH has centralized its intake process so I received a call same day.

I will have to wait a little for an evaluation appointment but this is moving a lot quicker than I’d imagined.