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 Has anyone else been on them and withdrawn from them.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.