I don't think you should be on ANY Paxil while taking the Cymbalta. Serotonin syndrome is serious, and if you have high serotonin for long periods of time, it can damage heart valves, and possibly cause pulmonary hypertension.
This is why some diet pills were taken off the market as they raised serotonin too.

Your pharmacy should have stopped you at some point, and explained this to you. So do be careful, please! I think you should discuss this ASAP with your doctor...and come to a safe solution with him/her.

I'm going to go and see my PCP in the morning. She gives me the Paxil and is easier to talk to than the neuro that prescribed the Cymbalta without noticing I'm on Paxil...and that's saying it nicely

After I read your last post I looked this up again and decided some of the same symptoms may have started after going on the Cymbalta approx. 12 weeks ago. Not going to take any chances per your suggestion and get it discussed. I'm guessing I'll have to titrate down on the Paxil ?

I have had the worst day as far as pain goes. Like I said before since dropping the gaba and Dr Greer adding the Lyrica the pain is sharper and there is more of it.....the fingers and toes are really doing a number on me and I can't sleep last night or tonight. Didn't realize until I dropped the gaba how much it was effecting my mind....my head is clearer but with dropping that came the change for the worst in my pain levels.

Oh well....I'll discuss with Amy tomorrow and see what we can come up with. I see Dr Greer at the end of next week to discuss my 3 weeks on Lyrica. If this pain doesn't let up some I'm thinking he'll have to change it again.....if there is something else for him to change me to.

Thanks again and I'll let you know what she says. I'm guessing she'll be ticked at the neuro and pharmacy for not noticing the Paxil and Cymbalta thing.

Debi in Georgia

I'm another person that has been using Gralise for almost a year with good results. The bad news I've been fighting with the insurance for almost that long to get it approved. Now they want me to try cymbalta but when I went to pick that up they said the insurance declined it, this was 3 hours after the Dr. said it was good to go

Like the earlier person said since you take it in the evening you sleep through the "cloudy issues" that the GABA causes. It has reduced or eliminated that period where it too early for a pill and the pain is increasing.

I'm not pain free but it's much more tolerable.

Good luck

Don'tcha love it when bureaucrats play doctor?

Cymbalta is either available generically or on the verge (I haven't tracked it that closely). If so, they may have wanted him to write the scrip generically; or if not, wait until the generic version is on pharmacy shelves.

...or a case of the left hand not knowing the where the right hand has its head up...

Doc

It's a beautiful morning in GA. Sun is shinning and I hope All of us on here have a good Sat.

I did go see Amy on Wed of this week and by then had a sinus infection that put me in bed for 3 days. Not the worst I've ever had but was very painful. I really do believe this SFN makes anything you get worse This is the 2nd sinus infection I've had in 4 weeks.

We discussed the Paxil/Cymbalta combo and she said yes, the neuro and the pharmacy should have noticed and notified me. But she does not want to take me off the Paxil. She well remembers what I was like a year ago when this started and doesn't want me to get back to that 'place' mentally. She also knows I'll probably be coming off the Cymbalta since the 60 mg a day is not working and I had too many side effects when increased to 90 mg.

Bad news: Amy, my PCP, is cutting her full schedule to 1 to 4 days a month for the next 18 to 24 months. I will really miss her and hopefully I'll be able to 'catch' her here and there for an appointment. She's going home to stay with her kids (one being a step-son in 7th grade that his mom doesn't want) and her 2 younger boys. Don't blame her one bit. I will be staying at that local office because the other 2 dr's can call Amy at any time if they need to discuss my case and she is the only one that prescribes my pain meds.

Saw my neuro yesterday morning. I've been on the Lyrica 75 mg 2 x's for the last three weeks and have developed stomach problems. Mainly stomach aches that knock me off my feet for about an hour.......this occurs on and off all day long. Neuro said he had never heard of Lyrica causing stomach issues but agreed to take me off of it for 3 weeks to see if it's the Lyrica causing it. I'm about 99% sure it is. I never have stomach aches or issues and these just started after I added the Lyrica.

So as of today I'm off gaba, Lyrica and only on Cymbalta 60 mg a day. Not sure where this is going pain wise but my head has been so much clearer since I stopped the gaba which I have been on since last year at this time at some dose or another. The only difference I've noticed in the pain is that it is 'sharper' and my fingers and toes seem to be worse pain wise. Or maybe it's just sharper because my mind is clear of the cobwebs that are now gone.

Good PS: I'm looking at my 20 lb cat, Bob, that I had shaved into a lion's cut yesterday and he is so handsome....he's a long hair and I usually shave him twice a year. He has 3 layers of different fur and my very black cat is now gray....lol...with a black head, tail and legs

Debi from Georgia

This link provides a pretty good list of symptoms from serotonin syndrome:

http://www.mayoclinic.org/diseases-c...s/con-20028946

I'd keep this list handy if you continue with both Paxil and Cymbalta. (you will not be able to take any cough/cold products with DM in them either OTC).

Serotonin is the main neurotransmitter in the GI tract and an excess of it will cause cramping and diarrhea.

Just a note my Walgreens pharmacist informed me of the serotonin risk and said if you are taking tramadol with the antidepressant I won't fill this for you I can't take either as hard to get on the antidepressant and I think the Tramadol started my morning jerking

LOL! You GOTTA post a pic of that on the Pets forum...

Doc

My sinus infection did not go away....just got worse. Wound up on 2nd round of antibiotic and 6 days of steroids. Of course this past weekend I felt like Superwoman because of the steroids and managed to have a few good days.

But alas that's over now......went to the mall on Sun...only went in to 2 stores but that did it for me.......now my right leg from butt to tips of toes is staying a 10+ unless I take 'whole' pain pills......and for any of you that have read my past posts I only take 1/2 a pain pill at a time.....it got so bad yesterday I was icing down the whole leg.

I'm trying to nip it in the bud this morning......just went ahead and took a whole pill. My 17 year old granddaughter is spending the day, her grades are excellent so her mom let her have a day off, and having her here always makes me feel better.

I would like to say that just when I get to thinking maybe I've got this under control...even having to use pain meds......my body knocks on the door and says "Hello Debi, you still have SFN"....lol......and guess I always will.....the nerves in my feet are dead and it seems to travel over my body here and there.

Boy I better go.....I'm a little whoozy and I'm sure some of this is the pain meds talking but at least my leg is not hurting at this exact moment....love those moments.

Debi from Georgia

Hi Debbie,
Sometimes when you are in extreme pain it is better to take your pain meds before the pain gets away from you. When you wait to long the meds really don't work as well.

Also, try to be sure to take them on the schedule given by your doctor. Not unlike myself, many of us here don't like to do that. But, when your pain is a 10+, it is the smart thing to do. At least for a day or two until your pain level subsides a little.

I really understand what you mean when you say your body knocks on the door or should we say SFN knocks on the door.

I hope tomorrow is a better day for you. Enjoy your granddaughter. Mine are a wonderful gift to me that keeps me fighting!