Hey y'all, has anyone around here heard of or tried Cymbalta? It's been approved for treating diabetic peripheral neuropathic pain but I didn't see any mention of avulsion type neuropathic pain. There are a bunch of Google sites that address Cymbalta.
Check it out at http://www.crazymeds.org/cymbalta.html
Dick
Cymbalta
Re: Cymbalta
I was just at a block party yesterday and my neighbor mentioned Cymbalta for neuropathic pain as an alternative to Neurontin. I checked out: http://www.lilly.com and under 'product pipeline'. Cymbalta is an anti-depressant but is also a DPNP(diabetic peripheral neuropathy). Cymbalta (an SSNRI) targets two chemicals, serotonin and norepinephrine, that are believed to play a role in how the brain and body affect mood and pain. I believe it's fairly new (about 1 yr), but would be interested in user feedback as well.
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jennyb
- Posts: 1183
- Joined: Fri Nov 02, 2001 5:24 pm
- Injury Description, Date, extent, surgical intervention etc: January 1980 Yamaha RD200 vs 16 wheeler truck, result, 1 totally paralysed right arm. I was 21, now 54. I had no surgery, I don't regret this. Decided to totally ignore limitations (easily done aged 21) adapted very quickly to one handed life, got married, had 3 kids, worked- the effect of the injury on my life (once the pain stopped being constant) was minimal and now, aged 54, I very rarely even think of it, unless I bash it or it gets cold, then I wish I'd had it amputated :) Except for a steering knob on my car, I have no adaptations to help with life, mainly because I honestly don't think of myself as disabled and the only thing I can't do is peel potatoes, which is definitely a good thing.
Re: Cymbalta
If you check up on a drug at the makers or official website, make sure you check elsewhere as well. The official sites tend to gloss over the risks and side effects-they don't tell lies but they aren't that up front with the truth either. Check the differences, here's the list of side effects from Lilly, the makers;
"Safety Information
Cymbalta has been approved by the FDA for the management of diabetic peripheral neuropathic pain (DPNP). It is safe for most people to use.
You should NOT take Cymbalta (duloxetine HCL) if:
You are allergic to duloxetine hydrochloride or other ingredients in Cymbalta.
You currently or have recently taken monoamine oxidase inhibitor (MAOI).
You have uncontrolled narrow-angle glaucoma.
You are taking Mellaril® (thioridazine).
Boxed Warning: In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders.* Anyone considering the use of Cymbalta or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients starting therapy should be observed closely. Families and caregivers should discuss with the doctor any observations of worsening depression symptoms, suicidal thinking and behavior, or unusual changes in behavior. Cymbalta is not approved for use in patients under the age of 18.
What to talk to your doctor about:
Patients on antidepressants and their families or caregivers should watch for worsening depression symptoms, unusual changes in behavior, and thoughts of suicide, as well as for anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call the doctor if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant at the beginning of antidepressant treatment or whenever there is a change in dose.
* A large study combined the results of 24 different studies of children and teenagers with depression or other illnesses. In these studies, patients either took a placebo (sugar pill) or an antidepressant for 1 to 4 months. No one committed suicide in these studies, but some patients became suicidal. On sugar pills, 2 out of every 100 became suicidal. On antidepressants, 4 out of every 100 patients became suicidal."
......and heres the list of possible side effects from Crazymeds;
"Cymbalta's Typical Side Effects: The usual for SNRIs and SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, urinary hesitancy (it is a med for urinary incontinence after all), loss of libido and a host of other sexual dysfunctions. Most everything but the constipation, urinary hesitancy and any sexual dysfunctions usually goes away within a couple of weeks. Although some women will get a sexual boost instead of a sexual dampening. It all depends on how much norepinephrine (and to a much lesser extent dopamine) reuptake inhibition is going on versus serotonin reuptake inhibition, and which receptors are getting tweaked. So it's all a matter of how you do in the side effect lotto.
For tips on how to cope with these side effects, please see our side effects page.
These aren't all the side effects possible, just the most popular ones.
Cymbalta's Not So Common Side Effects: Controlled narrow glaucoma (but you already have to be at risk for eye problems to start with), elevated liver serum (an annual liver panel with this med probably isn't a bad idea), blurry vision, muscle cramps, weight loss (hey, it's a problem for some of us).
These may or may not happen to you don't, so don't be surprised one way or the other.
Cymbalta's Freaky Rare Side Effects: Retinal detachment. Ouch! I don't want to know how the med caused that.
You aren't going to get these. I promise.
For all side effects, read the PI sheet."
More words on the Lilly site but a lot less info, no mention of the unrinary problems despite the drug being used for that purpose in Europe, no mention of the sexual dysfunction either, despite that being a side effect that usually doesn't go away and has been cited as a major problem for many users. No mention of the liver dangers and need for checkups.
This kind of thing makes me very angry, that these companies care more about profit than giving proper information.
Crazymeds is an excellent and informative site but not all meds are listed there, when I get a new one I type in its name (real name not product name) and the words risks, you get a host of sites then.
I have just been prescribed an antidepressant for pain and anxiety, haven't started taking it yet as I remember my last brush with these drugs, they are powerful stuff and you must take the warnings about coming off them seriously (the warnings on Crazymeds that is, again, Lilly somewhat brush that over too) frankly I'm a bit scared of the side effects as they affected me very badly before, my pain isn't constant and I'm not sure I want to jump on the SSRI bandwagon again.
Let us know how you get on!
Jen NZ
"Safety Information
Cymbalta has been approved by the FDA for the management of diabetic peripheral neuropathic pain (DPNP). It is safe for most people to use.
You should NOT take Cymbalta (duloxetine HCL) if:
You are allergic to duloxetine hydrochloride or other ingredients in Cymbalta.
You currently or have recently taken monoamine oxidase inhibitor (MAOI).
You have uncontrolled narrow-angle glaucoma.
You are taking Mellaril® (thioridazine).
Boxed Warning: In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders.* Anyone considering the use of Cymbalta or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients starting therapy should be observed closely. Families and caregivers should discuss with the doctor any observations of worsening depression symptoms, suicidal thinking and behavior, or unusual changes in behavior. Cymbalta is not approved for use in patients under the age of 18.
What to talk to your doctor about:
Patients on antidepressants and their families or caregivers should watch for worsening depression symptoms, unusual changes in behavior, and thoughts of suicide, as well as for anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call the doctor if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant at the beginning of antidepressant treatment or whenever there is a change in dose.
* A large study combined the results of 24 different studies of children and teenagers with depression or other illnesses. In these studies, patients either took a placebo (sugar pill) or an antidepressant for 1 to 4 months. No one committed suicide in these studies, but some patients became suicidal. On sugar pills, 2 out of every 100 became suicidal. On antidepressants, 4 out of every 100 patients became suicidal."
......and heres the list of possible side effects from Crazymeds;
"Cymbalta's Typical Side Effects: The usual for SNRIs and SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, urinary hesitancy (it is a med for urinary incontinence after all), loss of libido and a host of other sexual dysfunctions. Most everything but the constipation, urinary hesitancy and any sexual dysfunctions usually goes away within a couple of weeks. Although some women will get a sexual boost instead of a sexual dampening. It all depends on how much norepinephrine (and to a much lesser extent dopamine) reuptake inhibition is going on versus serotonin reuptake inhibition, and which receptors are getting tweaked. So it's all a matter of how you do in the side effect lotto.
For tips on how to cope with these side effects, please see our side effects page.
These aren't all the side effects possible, just the most popular ones.
Cymbalta's Not So Common Side Effects: Controlled narrow glaucoma (but you already have to be at risk for eye problems to start with), elevated liver serum (an annual liver panel with this med probably isn't a bad idea), blurry vision, muscle cramps, weight loss (hey, it's a problem for some of us).
These may or may not happen to you don't, so don't be surprised one way or the other.
Cymbalta's Freaky Rare Side Effects: Retinal detachment. Ouch! I don't want to know how the med caused that.
You aren't going to get these. I promise.
For all side effects, read the PI sheet."
More words on the Lilly site but a lot less info, no mention of the unrinary problems despite the drug being used for that purpose in Europe, no mention of the sexual dysfunction either, despite that being a side effect that usually doesn't go away and has been cited as a major problem for many users. No mention of the liver dangers and need for checkups.
This kind of thing makes me very angry, that these companies care more about profit than giving proper information.
Crazymeds is an excellent and informative site but not all meds are listed there, when I get a new one I type in its name (real name not product name) and the words risks, you get a host of sites then.
I have just been prescribed an antidepressant for pain and anxiety, haven't started taking it yet as I remember my last brush with these drugs, they are powerful stuff and you must take the warnings about coming off them seriously (the warnings on Crazymeds that is, again, Lilly somewhat brush that over too) frankly I'm a bit scared of the side effects as they affected me very badly before, my pain isn't constant and I'm not sure I want to jump on the SSRI bandwagon again.
Let us know how you get on!
Jen NZ
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Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: Cymbalta
I'm on it now. Max dosage. Unfortunately I've not noticed any help with the pain or depression. Mind you that I just got off all my opiates (methadone and suboxone) so it makes sense that I may feel misserable for a while longer. I'll post again down the road if things change. Best of luck to all.
Chris
Chris
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Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: Cymbalta
FYI - I've been on Cymbalta for 6 weeks now. Trading off from Effexor.
Chris
Chris
-
admin
- Site Admin
- Posts: 19873
- Joined: Mon Nov 16, 2009 9:59 pm
Re: Cymbalta
My son LTBPI,(accident 12/19/03) 5 avulsions, started taking Cymbalta about 5 weeks ago, so far it has worked really well but realize that it could change at any moment. He was on Percocet and it wasn't working anymore for the pain, we switched and saw a immendiate improvement. He still takes roxycodone (the doctor was worried about the tylenol aspect of Percocet) when he needs to but that has been reduced to minimal.
Re: Cymbalta
My 22 yr old son, LTBPI, (accident 12/19/03) 5 avulsions, started taking Cymbalata about 5 weeks ago. Was on percocet but the pain was getting worse. We saw an immdeiate improvement and its seems to be working really well. He still takes roxycodone when the pain gets really bad, but that has ben really reduced. Changed from percocet to roxycodone because doctor was worried about the "tylenol" component in the percocet and its long term side effects. (hopefully these "meds won't be long term)
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motoxxxracer_34
- Posts: 24
- Joined: Mon Jan 10, 2005 6:57 am
Re: Cymbalta
Hello, its been over a yr since bad accident and a yr & 1 mth since nerve graphing. I am currently on 80mg methadone, 3600mg neurontin, 3000mg keppra, 400mg Celebrex, 20mg Desepramine. My pain has gotten worse, some times i dont even take the keppra because it feels like it doesnt help. Any suggestions? Like to get off methadone (makes me sweat badly and doesnt help anymore). Also look at my new topic have some questions and insights.
Re: Cymbalta
Ihave rbpi that occured may 10th and stated taking cymbalta 3 weeks ago and it has decreased my pain from a constant 10 to a 1-2. I wa to the point where I was taking 240 mg of extened release morphine with no relief. I now am taking between 10 to 20 milligrams of vicodan a day if any. I directly relate this to cymbalta. I feel like a different person. It also helps with the phsycoligical aspects drastically. I know that everyone reacts diferently to different chemicals, as I had a near fatal reaction to amitrypilene. But Cymbalta has beena godsend.
Good Luck.
P.S. I am 31 with severe RBPI and just discovered this site! 4 mos. Like to hear from anyone and everyone.
Brandon Hubbard Pacific Northwest
Good Luck.
P.S. I am 31 with severe RBPI and just discovered this site! 4 mos. Like to hear from anyone and everyone.
Brandon Hubbard Pacific Northwest
-
Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA
Re: Cymbalta
Update-
Saw a different pain doctor in San Francisco, Dr. Robert Hines, he's the best I've met yet. Told me the dosage I was on, 60 mg, was the max dosage for depression and recommended dosage for neuropathic pain was double that, 120 mg. Well I upped it and didn't think it was much different. Although close family and friends said they noticed less cringing w/out me even mentioning things about meds. Low and behold when I was back east visiting family I ran short on meds and lowered the dosage back to 60 mg so I could make it back home w/out running out. After three days or so, the pain came slamming back and I then recalled my habit of forgetting how easily I forget the severity of pain, like the flu, until it returns. Long story short, it works for me. It takes away about 30% of the high end pain. It's still constant but better.
I hope this helps someone out there...
Chris
Saw a different pain doctor in San Francisco, Dr. Robert Hines, he's the best I've met yet. Told me the dosage I was on, 60 mg, was the max dosage for depression and recommended dosage for neuropathic pain was double that, 120 mg. Well I upped it and didn't think it was much different. Although close family and friends said they noticed less cringing w/out me even mentioning things about meds. Low and behold when I was back east visiting family I ran short on meds and lowered the dosage back to 60 mg so I could make it back home w/out running out. After three days or so, the pain came slamming back and I then recalled my habit of forgetting how easily I forget the severity of pain, like the flu, until it returns. Long story short, it works for me. It takes away about 30% of the high end pain. It's still constant but better.
I hope this helps someone out there...
Chris