As some of you know, I have been tapering off of cymbalta due to osteoporosis. It is a s/e of cymbalta.

Yesterday, the pain was completely unbearable from my SFN. A little background, last Saturday I lowered my cymbalta from 90mgs to 60 mgs. The first s/e I had was severe nausea. That lasted for about 4 days. I was unable to really eat and had no appetite .

On Tuesday I had an IVIG Rx and my doctor ordered Zofran with my Rx and it helped since then the nausea has only been intermittent. Tuesday night after my Rx I could not sleep at all and my pain was unbearable. I did not sleep all night. Finally, at 6am on Wednesday I fell asleep just because I was exhausted. I was only able to sleep for 4 hours. I was in so much pain yesterday all I did was cry off and on. I did take Percocet 5mgs twice to help but nothing really made a difference.

I went to bed last night and took a Benadryl. I was still awake at midnight so I took another. I did fall asleep and slept through the night. Thank goodness! When I woke today the pain was a little better. Wondering if that is from using the mag lotion before bed. It is still worse than usual. I feel really anxious and I know it is the lower dose of cymbalta!

Now I have to decrease the dose again. I was going to wait till after the weekend but I think I am going to drop another 30mgs tomorrow. My husband will be home for the weekend. This way if things get too bad he'll be here.

I'm not looking forward to this. Mrs. D I know you recommended L-tryptophan. During research I saw it was counterindicated for those taking tramadol so I don't know if I should try it. I am going to get the multivitamin for the B6.

If I had know how hard it is to come off of cymbalta I would not have taken it. I'm a mess! Crying, anxious, severe pain! I actually feel terrible because I recommended this med to others.

For those of you who do, please say a prayer for me. I still have several weeks left to get through this. Hopefully, it goes better than this first week!!

Sorry for be so down. I'm bringing it here because I know all of you understand

Hopeful,

I am so sorry for all your pain. I can totally empathize with your pain.

I may have read your story but you know my memory is messed up with all the medications I am taking so please forgive me for not remembering it. I never tried Cymbalta though it was offered to me as an option just as Lyrica. I am taking Gabapentin. It is not the best medicines but at least its not metabolized in the liver (my major consideration).

I take 1800mg but since Dec 2013, I started taking 1500mg. To compensate for the reduced dosage, I am using a compounded cream (Clonidine, Ketamine, Baclofen and Gabapentin). It is helping me more than the full 1800mg I used to take. I was in pain at least 90% of the day since October 2011. The irony of it, not one of my 6 neurologists ever recommended (or even mentioned) about the compounded pain cream knowing how I was struggling with the pain -- it was my rheumatologist who recommended for me to try. Well, I basically tried almost everything out there so I thougth I'd lose nothing if I give it try.... I am glad i did.

I just dont know what would be the side effects in the long term. You know how these chemicals, there is nothing really 100% safe.

Why are you tapering off your Cymbalta? Is it not working anymore?

I hope you find some relief from your pain....

Mary

Hi,
I'm stopping the cymbalta because I had a bone density test that showed osteopenia in my left hip and osteoporosis in my lumbar spine. I had this test done right when I first got sick and had no osteoporosis.

With some help on this site I found out that cymbalta can cause osteoporosis. My rheumo said that is true and I needed to come off it. It actually worked very well for me. I wish it did not have this s/e.

Thanks for the support!

Just want to jump in quickly and ask if you receive any steroids as a pre-med to your IVIG? It is very common to pre-med the infusion with a single dose of IV steroids or even oral in some cases.

If so, I would consider this being your cause of osteoporosis instead of the Cymbalta.

Hi enbloc,
I did consider this. I do get 20mgs of solumedrol with each IVIG. I brought it to the doctors attention. He said it is too low of a dose to be the cause. I also have only gotten the solumedrol for about 5 Rx's.

What do u think?

I personally don't see much online for osteoporosis caused by cymbalta. Yes, it can be found but certainly not a major side-effect or one that is widely posted on reputable sites like drugs.com. Actually of the 40+ side effects listed, bone loss or osteoporosis is NOT one of them. Nor is it listed in the 20+ common side-effects. The only place I could really find something was comments on forums and they were not many.

I'm not saying it isn't caused by cymbalta, but I certainly believe the risk is MUCH higher for ANY steroid use...and 20 mg of IV solu-medrol is not really a low dose. It is not a huge dose, particularly since it's just once a month, but the risk is still higher.

There are other factors that must be considered in your development of osteoporosis. Age, menopause, exercise, diet, etc. ALL of these are significant to developing this, especially coupled with steroid use and maybe the cymbalta.

Hi,
I found a few research studies concerning cymbalta snd osteoporosis. Not really all that many. When I went to my rheumo I brought a few studies with me but I didn't need to show him. He already new that cymbalta can cause osteoporosis. That's why I figured it was that. I believe it is a s/e that has only been discovered recently. Actually, what I found in research is that the FDA originally ok'd cymbalta for osteo pain.

I just wish I knew for sure but I can't take the chance. I am also on a hormone replacement so it is not from that. I also have a decent diet. As for exercise, I did not do much in the last 3 years but before that I was at the gym 4-6 times a week. Use to weight lift 25/30 lbs. I don't know if your bones could be that effected in a few years of not exercising. I have exercised since I was 18 through pregnancies etc.. That was one reason I always thought I would be safe from osteo.

I appreciate your help!

Here is a paper that explains this problem in more detail:

http://www.hindawi.com/journals/jos/2012/323061/

The serotonin reuptake inhibitors were not really studied in depth
(or those studies have been withheld by the drug companies) when they went on the market.

Because serotonin is a biogenic amine which in the body does many jobs, there are potentials for problems and side effects which only now come to light.
The obvious ones on the GI system (since serotonin is a neurotransmitter in the gut) were first listed because they are so common. But the effects on bleeding (on the platelets) were only discovered as post marketing events. This new information on bone modeling is similar.

Here is an article explaining most of the actions of serotonin in the body:
http://www.medicalnewstoday.com/articles/232248.php

I certainly don't doubt it can cause bone loss. It's obviously just not as common as steroids and it's known history for causing it. You seemed to go from NO bone loss to osteopenia in one area and full blown osteoporosis in the other...in a relatively short time period. That is significant. So I don't think it came from just one source, particularly a source that you have to dig to find reports showing its relation. I really believe that you got this from the cymbalta AND steroids...and even just the aging process (HRT is fine but i doubt the same levels as a younger full hormone woman).

I can just see you going through this process to get off the cymbalta (that works well for you) and the bone scan might not improve. However, I do understand you having to do all you can to try and this should be considered. But I would look at the known source first, then secondary sources. Just my opinion, of course.

Hopeful... I am going to suggest you try something.

If you have some Sudafed PE or regular...brand or generic on hand, or want to buy some (generic is less $$). 30mg tablets for sudafed or 10mg tables for PE (phenylephrine).

Your Cymbalta has two components, a norepi reuptake and the serotonin one.

If you have NO problems with blood pressure etc, you could try one of the phenylephrines in the morning and see if your day is less painful. I discovered this effect when I had my sinus neck problem I had to take some of this medication to open my blocked sinus and I found it helped tremendously with my pain issues too. This would lessen the withdrawal of the norepi part of the Cymbalta. I think the discontinuance agonies for this drug that we see online are because of the dual action of the product. If you don't see any benefit, then just save them for a rainy day cold or sinus attack in the future.