SNRI's
 

Have those of you with PCS who have taken an SNRI found them useful? Has anyone else been on them and withdrawn from them. If so how long were you on them for?

I have been on Cymbalta since early March, firstly 30mg and now 60mg. I had a conversation with my doctor about coming off them because my symptoms are greatly reduced and I am back working long hours 3 days a week and I am about to move to 4 days.

I was surprised when he said he wants me to stay on 60mg for 3 more months and then 30mg for a further 3 months. I suppose I have been off work for 5 months and he doesn't want to take any chances. I didn't want to be on Cymbalta for 8 months but I will leave it in his capable hands.

I Can Relate
 

I am on Pristiq 50mg since January and in March M.D. raised to 100mg because I went in office upset because I needed a psychologist.I did not do the 100mg well.It physically jacked me up that I could not do anything because I was so fatigued. My TBI vestibular therapist told me I needed to get changed back to 50mg. She see's me 2 times a week and can tell how I feel.I was having trouble going to all my M.D.s appointments.That lasted 2weeks of dragging my feet and no motivation.

I went and demanded my dose back to 50mg.The withdraw was very bad that lasted about a week to get medicine back to a therapeutic blood level.

Why did he raise you?If you are not comfortable with this I would of demanded to not raise it!That's what I had learned about this whole PCS, that it is my body and if I do not want something then I do not have to.

This could cause you every 3months to miss more work because you will be going threw withdraw and you will not feel good.:grouphug:

Another doctor raised it for pain, because I had pressure in my ears - not that it made any difference to this problem. To be fair, 30mg is the minimum dose, I am now on the standard adult dose and don't really have any side effects. I do get fatigued, but this is down to going back to work and/or exercise mostly. I would be keen to know how I got on without any meds because all the issues with mood/anxiety relate to the PCS which I am getting over now. I wonder if this SNRI could also be causing fatigue.

It's a Catch 22
 

Yes it does have side effect of fatigue but it also can help fatigue.I only have fatigue in the beginning of taking SNRI, or when raised to much, or with withdraw.Did you already start the 60mg?

I have been on 60mg for over a month, it coincided with my return to work. I think it actually helped my fatigue when I started it at 30mg. It is hard to tell if 60mg is causing more fatigue because the increased dose coincided with my return to work. My routine consists of a 645am rise, 45minute drive and working 8-5 - which for someone who has been off for 5 months with PCS is going to be a challenge, but its going well! I honestly don't know if I would be at this stage without Cymbalta.

I Can Relate
 

I do not know where I would be without my SNRI as well.You are just getting back in the loop of work etc.You answered it yourself fatigue comes with progressing with life,work etc.

L-Tyrosine can help with norepinephrine production. It may have less side-effects. I don't know the dosage conversion numbers. It may be worth asking an open-minded doctor for assistance.

Has anybody here used L-Tyrosine ?

Mark, what is this exactly? Cymbalta is 10 fold serotonin to 1 norepineprine, so its different to other SNRI's like Effexor. To be fair, I don't really have side effects that I am sure of, but I suspect that fatigue could be an issue, but this fatigue I have is nothing compared to before when I had PCS in full flow. I was hoping I wasn't going to on any medication full stop, but I trust my doctor is doing the right thing.

L-Tryptophan is a good way to enhance serotonin. Some take 5-HTP because it is faster acting and cheaper but L-Tryptophan is much safer. I take 500 mgs of L-Tryptophan twice a day and have reduced my SSRI to half my previous dose. I will be cutting the rest of the SSRI by 50% soon.

L-Tyrosine is an amino acid available at the vitamin store or isle.

I think all of this serotonin is upsetting my stomach, I have had this for the last 6 days on 60mg tablets and I haven't had this before. I recently swiched to 60mg two weeks ago. I have switched to two 30mg instead and if this doesn't work I am going down to 30mg. I cannot continue to do my job properly if it keeps up, so will go back to what I started on.

Mouse,

Is it causing nausea or acid reflux ?

I get nausea from paroxetine (an SSRI). It was more of a problem early on.

Ask your pharmacist if it is a side-effect.

Maybe a transition off the SNRI onto L-Tryptophan with some L-Tyrosine may do the trick.

I have had diarrhea for the past 6 days on 60mg, and it has become unbearable. I cannot take imodium to counter this because I am allergic to it.

I am going to drop to 30mg today and see how things go. I cannot discuss with a doctor because its Sunday, but I have to do something. I will take extra omega 3 to counter potential brain zaps.

All my PCS symptoms have gone apart from headache and fatigue if I do too much.

Well its 7pm on my first day back on 30mg and I have had several sharp headaches that last about 30 seconds at a time, perhaps these are the brain zaps people talk about. I also lack energy and feel washed out.

I suppose its difficult to tell the full extent of any side effects at this stage, but the fact that I have only been on 60mg for a month might be helping.

I have had two extra omega 3 capsules which is supposed to be of help with Cymbalta withdrawal. Really watching my diet and eating simple basic food also.

If things don't change I will be telling the doctor I am coming off them altogether.

It's now Monday and I saw the doctor and he is happy with my transition onto 30mg. He says these symptoms are not down to Cymbalta, so he has referred me to a specialist. I am still convinced that it is down to the Cymbalta and now want to get off it, I feel that it has done its job because I am symptom free as long as I don't exercise. He seems convinced it isn't the Cymbalta after his examination, and prescribed me Lomotil until I see the specialist.

Really ill tonight and the Lomotil hasn't made one bit of difference, I have never had anything like this before. I really think its the SNRI but the doctor says its not and I have to see a Specialist. I dare not take time off sick having just gone back, so will just have to face work.

Did You
 

Did you take time off during this withdraw?
I had recently went threw a withdraw from my SNRI and it was bad that I barely left the bed for a week.I had to cancel all appts that week.I pulled threw I upped my vitamin C and it helped with the brain zaps etc.But I do not know much in the diarrhea.I did not do well with trial of Cymbalta because I was ill with diarrhea from one time trial.

I would def take it easy while in withdraw.It will get better when it get's to a theraputic blood level.Hope you get feeling better soon.:hug:

The diarrhea started 9 days ago, but got really bad in the past few days and this prompted me halving the dose during the weekend, and I haven't taken any time off.

My head is ok, and brain zaps are gone, and I am ok now on 30mg. I only felt strange for one day.

My problem is the fact that diarrhea is a very common side effect of Cymbalta, but my doctor is ruling this out. Samples are off to pathology so we will see if he is right. If it comes back negative and the specialist cannot find anything then I think I will be stopping the Cymbalta.

Did You
 

Did you take time off during this withdraw?
I had recently went threw a withdraw from my SNRI and it was bad that I barely left the bed for a week.I had to cancel all appts that week.I pulled threw I upped my vitamin C and it helped with the brain zaps etc.But I do not know much in the diarrhea.I did not do well with trial of Cymbalta because I was ill with diarrhea from one time trial.

I would def take it easy while in withdraw.It will get better when it get's to a theraputic blood level.Hope you get feeling better soon.:hug:

No
 

I took my lower dose of 30mg on Sunday and took things easy, and had extra omega 3.

According to others on the net 60mg to 30mg isn't that difficult. The main problems arise going to 20mg and then off it altogether.

I took Monday off work because of diarrhea, which is still very problematic today during work and the Lomitol is making no difference whatsoever!.

Hi Mouse,

Did you know that Omega 3's can cause diarrhea and symptoms of irritable bowel syndrome? Does your doctor know about your increased omega 3's? Just a thought. I hope you get it figured out soon!

I was on the starting dose of Effexor and after only two days, saw great benefits! I was having some stomach acid issues and stomach pain but that seemed to ease up. I had TONS of energy and no anxiety! Then, in the second week, I started not being able to sleep at all, I became manic and my blood pressure and pulse were way up. I enjoyed all the energy but was actually starting destructive behaviours from the mania.

I went back to my doctor and came off the Effexor. I am now on 30mg's of Cymbalta and have been on it for two weeks. I do not notice the side effects that I had on the effexor (pulse is still a bit high) and I do not have the stomach issues that you speak of. Next week I discuss increasing my dose with my doctor but if I can I think I will stay at 30mgs.

I am so happy to hear that you are having continued success with your return to work! I hope you get this issue figured out quickly and get back on track!

Good luck

CC

Cyclecrash,

I didn't know that, but only took extra omega 3 on Sunday. My problems were there long before this, and I still have them.

I had problems with my stomach from the moment I started taking Cymbalta but put up with it because it was helping reduce my PCS symptoms.

I also had problems sleeping with it as it also made me hyper (although I already had insomnia), but I switched the dose to morning and was fine after this and my months of insomnia were cured. After that I had no drug side effects.

I think increasing my dose to 60mg was a mistake as I was fine on 30mg. I am back down to the lowest dose again and am fine with this and work is going well thanks.

I have just spoken to my doctor and we agreed to stop the Cymbalta. The only thing is I have work tomorrow, so will probably pour a third of the pellets out of the capsule to wean myself off

I am glad the Cymbalta is helping you and if the 30mg is working you hopefully won't need to change things.