That the pharmacological treatment of PD is a "moving target". The only explanation that I have for cymbalta being a "better" antidepressant than others , is tthat it has norepinephrine reuptake inhibition, which allows more of the "catecholamine", norepinephrine (which is derived from the same bioprecursors as the dopamine synthesis cycle), so the brain concentrations of dopamine need not be as high to satisfy the biosynthesis of other neccessary "Catecholamine neurotransmitters". And the pain attenuation of cymbalta is not mediated through opiate receptors.
One N Donna, I take Dilaudid for breakthrough pain of Oxycontin therapy. It's not as strong as morphine and perhaps not as likely to make you sick. It is also less of a kappa opiod, having less constipation properties.
A general point is that I'd say that most of us suffer from clinical depression to some degree and won't admit it. Antidepressant and /or antianxiety treatment more than likely would help a lot of PWP who refuse to believe that they need yet another pill to help them . Try to believe me, if you are sad, miserable, or angry (which is more than common among PWP) ask you doc about antidepressant therapy, it can only help, it can't hurt you except in rare cases.
Tena my sister, I hope that you can continue to find things that help you. You have had pd as long or longer than just about anyone one the board, except for a few of you whom I won't mention who are at the 17-20 year level of PD. God bless you long timers, and those who don't post anymore because you really can't. THose of us who know who you are, we think of you and hope that you are getting the care that you need. cs

Chuck;

I am entering my 17th year of diagnosed PD, 23 years of symptoms. Thank God for DBS!! It gave me my life back.
It is not pre-ordained that we will become bed-ridden vegetables!
Tena is a pretty lady, who exibits little in the way of symptoms, of course I only have met her when she was "on".
MAny do not have the support structure in place to deal with advanced PD. This is very sad to me.
Remember though, most of us DO have choices!!

Charlie

thank you for the okay, the pain has really been a grand reduction -now I hardly take more than 200 mg's of motrin (3) per day!
thank you my dear cs!!