Hi. Like I said I'm on Cymbalta and it just got increased to 60mg at dinner from 30. They said at cc that to work for pn the dose needs to be really high. I'm not sure how much that means though. I meant to ask and will on Thurs and will later tell you.

From what I know of Cymbalta it works well for some and not at all for others as far as pain goes. Of course that's the same old song and dance heard about SSRI's right from the beginning. It may take a higher dose to work for your pain. But there are more sides at higher doses usually.

What many people don't realize is that all the information in the prescribing info comes from short-term limited patient studies. I saw none that were based on a length of time greater than 6 months. After 6 months who knows what happens? Many people state (on various boards I've read) that the weight problems and other sides don't begin til right around or after the 6 month period. The drug companies are so intent on making money they don't want to take the time to do longer term studies before putting these drugs on the market. Scary isn't it?

Your right not just on meds but all different aspects of health care there is very long term follow ups. I think they look for just the basics and the move on to the next to save time but in the long run I think makes things longer. I was wondering if anyone knew the optimal dose for cymbalta for pain relief and is it always given all at once during the day. Like right now I'm up to 60 but at dinner and was wondering if it could be split up and then increased like neurontin?

I think that's something you need to discuss with your doctor. Being as these kinds of drugs work so differently for each person there is no optimal dose as far as that goes. It's a hit and miss situation. You may have to have your doctor just up the dose and see what happens.

I have to say this: Every time I see that someone is taking Neurontin I shudder. Neurontin, for me, made my pain worse the longer I was on it so the dose was increased. Oh, it worked fine at first. But after a few months the dose had to be increased. I was getting to the point of needing *another* increase when I stopped taking it. Most likely related to causing B12 deficiency. It also caused weight gain and bloating as well as suicidal depression for me. I'll never take it again.

I had bad reactions to neurontin too. I'm having such a hard time with meds. When I was on cymbalta 30 I was fine and took it at dinner. The first few days of the 60 I was fine but then I was so nausea last night I was on the floor in the bathroom. I didn't throw up though. I wonder if I could split it up and it would be easier on the systom. I will try though again though tonight before I ask.Jarrett what meds are you on now?

Daniella, have you ever taken a narcotic for your pain?

Yes I was on vicadin but off of it for 2 weeks and tramadol. There is no narcotics or pain killer use at the cleveland clinic so I had to go off. I'm not a med person at all. I always get other side effects but at the same time need some relief when doing more. I have been prescribed too naproxen I think and motrin 600. I'm trying not to take any so just pushing to the limit where I don't need but sometimes even at rest I do. I just know with the anti depressent for pain relief it takes awhile, a combo of meds,or a super dose. I can't imagine with the troubles I seem to have with meds. They sure as hell don't make me feel less depressed. Now or even in the past when I used them for that. I felt worse in that department. I must be a real nut that they don't even help. Hey at least I admit it. Just kidding.

I am a big believer that everyone should find a doctor they like and then take his/her advice, not try to get medical treatment form a forum like this, but it is interesting to hear what other people take and think and discover. So I am not recommending what I say, just throwing my two cents worth in. I feel like with narcotics, they have been around a long time, and there is a huge amount of data on them and their side effects and what happens long term and the fact that people who take them for pain relief rarely get addicted. They are not perfect, but we do know all the parameters about them. Now I take Lyrica, but with this and the other, newer, drugs, we really have almost no body of knowledge about them: how they will affect our health long term, what they might be doing to us in the way of side effects, etc. So I really do not understand why so many doctors are so hesitant to prescribe stuff like the fentanyl patches (a narcotic -- which I also take). The new stuff may turn out to be much more harmful in the long run -- or even the short run. It really frustrates me that people in terrible, life changeing pain are made to take all these new drugs in lieu of narcotics when they haven't even been tried on the best narcotics, like fentanyl, to see how they tolerate them or respond to them. I think it makes sense to try narcotics before going on a bunch of new stuff, or trying a bunch of expensive, less effective stuff like biofeedback and relaxation crap that has never been documented to be effective for severe chronic pain. So that is my two cents.

Word, Dakota.

I am on the Lyrica at a low dose for about 3 months 2x a day and the pain is greatly controlled...don't usually get pain until my day is winding down...7 PM. Sometimes it's not enough on the pain/disruption of life scale for me to take anything but about 60% of the time I take 1 5-500 Vicodin and it does the job. Now, my Dr has indicated that she'd like me off of the narcotics but I don't get any euphoria from this dose, I don't have a dependence on it...I've gone 3+ days without taking one. So why should I switch to, say, tramadol? It's just something new in my regimen that may or may not be fitted in easily...Why upset the apple cart, if you will? I feel like I've had to try so many different things over the past two years that I've been seeking treatment that now that I'm almost on a level plane, I'd like to try and enjoy my life for awhile...keep things status quo..

Boy, I soooo agree with you. Have you expressed this to your doctor? I think you are right on.