So I had an MRI last week - it came back negative and the Neuro has recommended me to see a psychiatrist and wrote me a prescription for Duloxetine - He has instructed me not to fill it just yet and that he will contact me in the next week or so.

Does anyone here have any experience with this? I've always been against taking anti-depressants but I feel like I have no other options at this stage - I am feeling awfully low.

Thanks!

Windseeker,

My question to the doctor is "What is the purpose of the Duloxetine?" What symptoms are the target.

What is the purpose of the psychiatrist visit?

Some doctors get twisted toward a diagnosis that excludes the concussion. Could your doctor possibly think you do not have a concussion but rather have a psychiatric disorder?

He believes I have PTSD due to negative MRI and the overlapping symptoms. I will admit that I likely am depressed and I do get panic attacks from time to time, I had these before my injury too but I just tried to soldier through them. I'm hoping that if I treat the depression it will help me recover.

So, he thinks the negative MRI means you did not suffer a concussion?

Using a negative MRI to rule out concussion is not supported by any standards of medicine.

Some better analysis of possible PTSD issues would be worthwhile before starting a strong med like Cymbalta/Duloxetine.

There are other ways to treat PTSD besides just meds. Figuring out what your triggers for anxiety attacks are would be a good start. Meds just mask the symptom. Finding the cause would be worthwhile.

Have you ever had a brain injury or brain trauma previous to your recent concussion?

He never ruled out concussion per say. He understands that since my recent injury I've been symptomatic, he is suggesting drug treatment so that I can regain some sort of sense of functionality in my life.

I would say that I've been a bit of a hypochondriac my whole life and have always been in a state of hyperviligance so with that in mind, its quite hard to say what causes my attacks. I usually analyze everything I did before hand to try and determine.

It all starts with butterflys in my stomach (that going over the edge of the rollercoaster feeling) and I know I'm in store for an attack for the next hour or two. I usually lie in a bed and try to breath my way through it.

Have I ever had head injury before my recent concussion? Here comes the can of worms I've been trying to avoid.

I suffered a serious head injury when I was 4. Fell 22 feet and my head broke the fall. Bone fragments in my brain, big tear in the dura. My brain was visible and exposed to my family who found me. I joke about the event because I did not lose consciousness (I remember it in FULL DETAIL) therefore I didn't receive a concussion, right?

I was extremely lucky to survive and without any side effects really. I guess it hard to tell what I would have been like had I not fallen but for all intensive purposes I've had the same level of function as everyone else, if not better. They attribute my success to my young age. My brain just rewired around the injured area. It was visible on the MRI.

I never had a seizure or any side effects from that accident and have lived a very active life. I had just finished flight school and then had the skateboard accident that caused all this so needless to say I was a high performer.

I had a concussion when I was about 13 that had me out of action for a day. That's the only head injury I've had that caused issues but I got over that very quickly.

Otherwise I've bumped my head as much as any other active young man. Taken a couple booms to the head sailing, been punched (not too hard) a couple of times.

I get that these are sub-concussive impacts and that they add up and I've read many a post by you on the issue.

I understand that my life has changed forever and I can't skate or sail or snowboard or do any of those high risk activities again. People will/have told me just wear a helmet next time but I'd rather not take the risk and just avoid them altogether.

Thats ok with me, I just want to get back to aviation.

I don't even dream of getting near an airplane until I make a full recovery (Safety Culture of aviation!) and I just want to get whatever tools I can to help me on that. I get that it may be 2 or 3 years before that happens and if that means I need to take antidepressants for a while then so be it, I'm willing to try anything at this stage because the resting and relaxing feels like it has stagnated.

Blah - that's alot - Digest and ask away if you have any more questions!

And just a quick bump to my original questions. Anyone have any experience with Cymbalta/Duloxetine? I'm trying to weigh my soon coming decision of whether or not I should explore that avenue

I tried cymbalta and couldn't sleep for few nights. It affects more than seretonin in brain and my brain couldn't tolerate it. Unless u try u don't know how it affects since each individual reacts different. To me it seems like a strong med.

Cheers!

Hello windseeker,

I have not taken cymbalta but was given a sample pack to take by my doc for the chronic head pain. After reading about it online I decided it was not worth all the side effects. There are many sites that discuss the severity of the effects when you try to get off it.


I had never taken an antidepressant before except nortriptyline. I couldn't even handle three days of it on the low dose for headaches.

But, I know that a lot of people here can handle the nortriptyline and it benefits them greatly.

I agree with Mark. That is such a strong med. I would see the phsyciatrist first and see if there are any non-medicinal interventions that you can have for the depression and PTSD.Then maybe start off on another medication first.

Just wanted to note, I have been reading your posts and if I'm correct you are around 7 months post concussion or so?

I was very depressed around that time in my recovery. It is a long time to suffer and feels very hopeless. But it got so much better for me. I have been on the boards a while and there are many people who post at that stage with a similar situation.

I would just like to add that I have had maybe four total panic attacks in 2.5 years. I have not had one for so long, maybe even a year. They seemed to get better and I did not take any meds.

I hope that you find help but maybe take it slowly and see your options first. I also agree with Mark about the doctor prioritizing your treatment in the anxiety/depression category instead of pcs. Even though of course they are interchangeable at times.