Hi,

Alan is on plavix, aspirin, metoprolol (since his stent) and zoloft, for his depression.

He tried the lyrica (but his ankles blew up). so he's off the lyrica, He can't take neurontin or elavil, got him deathly sick.

So most recently Alan was given samples of Cymbalta (for the nighttime PN pain). Well, it is working. The lower dose was only a bit helpful, the higher dose is working just fine.

Dr. Fred told Alan he could take the higher dose because he's having the spinal tap and he is afraid the pn will flare up when he has to lie down for 4 hours.

Now here's my question.


If Cymbalta is actually an anti-depression med, and Alan is already on Zoloft (I did ask this of Dr. Fred but he assured me that Alan can take both), my question is "how can someone take two different anti-depression meds".

Alan wakes up every morning and goes to the gym or does yoga.

I asked him yesterday morning, "why not stay home and relax and he said "are you kidding, I had a great night's sleep and I have this energy and I have to exercise it off".

He has energy????? He's almost 60. Where is he getting this energy???

I look like Quazimodo during a sciatica attack and this guy wants to learn to stand on his head. If it wasn't for the PN, he'd be perfect.

Is it the combination of the Cymbalta and Zoloft that is giving him the stamina to do this stuff. He got up at 6 a.m. to go into the city to some seminar. I mean, I lost tons of weight too, but I don't jump out of bed and and I'm not raring to go, (at least not until I have my coffee).

I thought a person could not mix medications. And I never thought a person could take cymbalta, zoloft, (and oh yes, he still takes the alprazolam at night to sleep). At least I think he does.

So he gets a real deep sleep and wakes up raring to go.

I can't wait to see how he's going to be at 70. He'll outlive me.

Melody

Using Cymbalta WITH Zoloft.

I would think the Zoloft could be dropped.

Cymbalta can raise blood pressure, and that should be monitored.
http://www.healthyplace.com/medications/cymbalta.asp

Taking them both together may cause serotonin syndrome.
Since Cymbalta is a potent antidepressant, why would anyone need
another SSRI ?

http://www.pdrhealth.com/drug_info/r.../cym1693.shtml
Because Alan had the reaction to Celebrex-- watch for allergic reactions
with him on the Cymbalta:
http://www.healthyplace.com/medications/cymbalta.asp

You need to discuss why both antidepressants..are needed with the doctor.
Keep in mind that non-psychiatric doctors don't understand SSRI drugs
very well.(or at all)

Well, when Dr. Goldfarb gave Alan the samples of Cymbalta, I, right off the bat said "wait a minute, he's on zoloft, isn't that a contradiction" and she said "no, don't worry, he's taking this dose for nerve pain".

So far Alan is fine as a clam, no adverse affects. He gets liver function tests all the times. He sees Dr. Fred all the time. They discussed the Cymbalta and Dr. Fred was fine with it.

So what am I supposed to look out for?

When we go to see Dr. Fred (end of the month), should I ask if Alan should be off the zoloft. I mean, I DID ASK THESE QUESTIONS, but both Dr. Goldfarb and Dr. Fred are not worried.

And Alan is doing splendidly, going to the gym, learning yoga, becoming more flexible, (and the depression seems to be gone, thankfully).

So far it's all GOOD.

He's been on Cymbalta for over 2 weeks now. Been on zoloft for almost 10 months.

Anything I should do? jeez. If I could be reborn, I want to come back as a man and have me for a wife!!!!!

Oh, I know what I'll do, when I fax Dr. Fred asking about the insulin level thing, I'll just pop in a question about the cybalta and the zoloft. That's good, right?

There are like 11 different serotonin receptor subtypes and different antidepressants work on a different mix of the receptors. That and also the receptors downregulate anyways.

You said this:

"There are like 11 different serotonin receptor subtypes and different antidepressants work on a different mix of the receptors. That and also the receptors downregulate anyways."


Now (not that I understand everything you said), but I gather I can translate this into the following:

"There are 11 places in the brain that react differently to different anti-depressants. So some parts of Alan's brain are reacting to the Zoloft, and the other parts of Alan's brain are reacting to the Cymbalta.

Now the part about receptors downregulate anyways, (I HAVE NO IDEA WHAT THIS MEANS).

Care to elaborate???

much hugs.

melody


I JUST LOOKED UP SEROTONIN SYNDROME: (by the way, Alan takes 100 of the zoloft (in generic form) one time a day and 60 of the cymbalta (one time a day).


Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. It is an iatrogenic (i.e. caused by medical treatment) toxidrome. It is most commonly referred to as serotonin syndrome, however, serotonin toxicity or serotonin toxidrome (from toxic + syndrome) is more accurate as it reflects the fact that it is a form of poisoning.[1][2]

Serotonin syndrome is not a spontaneous drug reaction, it is a consequence of excess serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. This excess serotonin activity produces a specific spectrum of clinical findings which may range from barely perceptible to fatal.[3]
It also mentioned the combination of different drugs and foods. talked about tryptophan (so no turkey for Alan I gather).
This stuff obviously didn't concern the doctors but it sure as hell scares the crap out of me. (sorry for the bad words).

I drafted a fax for Dr. Fred. Both Dr. Fred and Dr. Goldfarb are not in their offices today (closed)
Hopefully Alan will run into Dr. Fred at the gym tomorrow.

I shall ask him to have a talk on this with Dr. Fred.

jeez. just more stuff.

But Alan doesn't exhibit any of the symptoms it gave in the article. That much I know.


OH JUST SO EVERYBODY KNOWS ONE THING ABOUT ALAN, HE NEVER TAKES ONE SIP OF ALCOHOL.
NEVER......Even at a wedding, or party. He used to drink as a young man and I'm married to him for over 26 years, and he only drank at one party, got deathly drunk and never did it again

So no alcohol at any time.

http://en.wikipedia.org/wiki/Serotonin Look at the receptor list. There are some in the PNS, the CNS, blood vessels, all over the body. Some work on certain receptors more than others.

Receptors downregulate in number due to an excess in signaling. If you take an excess of an SSRI, the receptors downregulate to get back to normal. It's like if you take caffeine, you need more to get a stimulant effect after awhile since the receptors downregulated.