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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by llrrrpp on June 28, 2006, at 9:35:01
Hi folks,
about 10 days ago, I increased my dose of cymbalta from 60 to 90 mg once a day, at night. I also take seroquel. I increased this about 10 days ago from 25-50 mgI've been feeling very fatigued all day long, every day. the past 2 nights, i decreased my seroquel down to 25 mg. no effect on my fatigue.
I go to bed at the same time every night. Excellent sleep hygiene. white noise machine, cool, quiet room. I don't wake up much in the night. I get 8 hours sleep, and usually wake up on my own.
Coffee in am and caffeinated soda at lunch, or in afternoon.
Also, I feel disoriented and dizzy. I lost my balance twice yesterday, once banging my elbow on the wall on my way down, and once stumbling & stepping in a puddle. Loss of coordination the same as about 2 strong drinks chugged down quickly.
Felt kind of spacy, loopy, having problems typing accurately, but my mood is okay. Cognition is pretty much unaffected. Don't worry, i don't operate heavy machinery, just my computer :o)
Also loss of inhibition. Having trouble controlling my poker face. I've been expressing more of my anger/frustration/joy than I usually do, yesterday in socially inappropriate fashion. ((((prefrontal cortex))))
Do you guys think that these effects will go away? i.e. is it a side-effect of Cymbalta, or a main effect of Cymbalta.
*twitch*
-ll
Posted by honeybee on June 28, 2006, at 12:03:54
In reply to problem with fatigue and dizziness, posted by llrrrpp on June 28, 2006, at 9:35:01
Hey, chica,
LL, I'm so sorry to hear that you're having some problems with fatigue and dizziness. I would be surprised if it's the cymbalta. Sounds like more of a seroquel side-effect to me. A friend of mine on it had incredible fatigue (can't remember the doses he was on) that persisted throughout the day. He slept *a lot* on it.
Cymbalta, for me, has been much more of an upper. I'm having tachycardia on it right now. Yay! And some fasciculations that only klonopin seems to help. But it does help me sleep, I suppose, come to think of it.
Wish that I could offer you a more scientific and helpful observation, but I'm just posting so you know tha tI'm thinking about you. Hope that those pesky side effects go away...
hb
Posted by llrrrpp on June 28, 2006, at 12:12:35
In reply to Re: problem with fatigue and dizziness, posted by honeybee on June 28, 2006, at 12:03:54
I've been on the seroquel for 6 weeks now, and had a couple weeks with little or no fatigue/dizzy
I dunno. I'm going to try to eat a diet that will keep my blood sugar more constant. see if that does the trick.
thanks for thinking of me :)
-ll
Posted by Racer on June 28, 2006, at 12:53:34
In reply to Re: problem with fatigue and dizziness » honeybee, posted by llrrrpp on June 28, 2006, at 12:12:35
And I had fatigue on Cymbalta bad enough to stop taking it... (Then again, it didn't help the depression, either, so it was no great loss for me...)
I dunno what to suggest, except talking to your doctor about Provigil, or about another medication taht might work better for you...
Good luck, and sorry you're not having a great time..
Posted by Phillipa on June 28, 2006, at 13:23:15
In reply to Re: problem with fatigue and dizziness, posted by Racer on June 28, 2006, at 12:53:34
Same here it did nothing for me except make my head feel like it would explode as i wanted to cry and couldn't and the twitching of extremities was horrible. llrrrp E-mail me later. Love Phillipa
Posted by llrrrpp on June 28, 2006, at 20:11:27
In reply to Re: problem with fatigue and dizziness, posted by Racer on June 28, 2006, at 12:53:34
> And I had fatigue on Cymbalta bad enough to stop taking it... (Then again, it didn't help the depression, either, so it was no great loss for me...)
>
> I dunno what to suggest, except talking to your doctor about Provigil, or about another medication taht might work better for you...
>thanks for the suggestion Racer. Can anyone tell me more about provigil? Can I take it in addition to cymbalta?
I really do think that the cymbalta is helping me with the following depression symptoms:
psychomotor slowing
anhedonia
memory/attention/cognitive impairmentand the seroquel helping me with these symptoms:
anxiety
insomnia
loss of appetitebut the fatigue, spacyness, dizzyness and all that is pretty icky. The only days I am very functional are days when I have a LOT of caffeine- like 300-500 mg and then I feel jittery and sick. (but awake) surely there's a better solution. will provigil make me anxious?
I'll see pdoc on Monday
thanks all
-ll
Posted by Jost on June 28, 2006, at 21:45:51
In reply to Provigil for fatigue and dizziness? » Racer, posted by llrrrpp on June 28, 2006, at 20:11:27
Provigil should be okay with cymbalta. I took them together. If anything provigil was a mild AD and good promoter of alertness, for me.
It helped quite a bit when I was tired, and improved my mood, although not enough to be truly AD. It was more time-limited, so I felt better an hour or two after taking it, with lessening effects in the next few hours. I usually took it twice or three times a day.
It didn't give me a high--it was more that I felt more upbeat and had better energy for a few hours.
About your dizziness, I hesitate to suggest anything, but wanted to check one thing: Have you noticed any sensitivity to serotonin in the past?
I'm very sensitive to it, and was therefore limited in how much cymbalta I could take. I didn't have the symptoms you describe, but once when I mixed it with desyrel (trazadone) which also increases serotonin, I got really dizzy, and had a lot of trouble staying awake (but not in a good way).
There are mild forms of serotonin syndrome that aren't anywhere near dangerous, but are, on the other hand, not something you want to have.
Again, it just occurs to me--not that I think that's it, but only that you might want not to rule it out completely.
Jost
Posted by llrrrpp on June 28, 2006, at 21:58:30
In reply to Re: Provigil for fatigue and dizziness?, posted by Jost on June 28, 2006, at 21:45:51
> About your dizziness, I hesitate to suggest anything, but wanted to check one thing: Have you noticed any sensitivity to serotonin in the past?
>
> I'm very sensitive to it, and was therefore limited in how much cymbalta I could take. I didn't have the symptoms you describe, but once when I mixed it with desyrel (trazadone) which also increases serotonin, I got really dizzy, and had a lot of trouble staying awake (but not in a good way).
>
> There are mild forms of serotonin syndrome that aren't anywhere near dangerous, but are, on the other hand, not something you want to have.
>
> Again, it just occurs to me--not that I think that's it, but only that you might want not to rule it out completely.
>
> Jost
>Thanks for your thoughtful response Jost,
I have never taken any other psych meds, so I don't know how sensitive I am to serotonin. I will have to bring this up with my pdoc. Cymbalta is my first. I had good response at 60 mg, but I did have a 2 week slump that was pretty ugly. Therapy pulled me out more than anything else, but my pdoc wanted to try 90 mg of Cymbalta just to see if I would get a better response. Anyways, I took my 90 mg about 90 minutes ago, and I'm starting to feel loopy. It makes me a little hyper/wired too. not too bad, but I'm sure it's not helping with the insomnia. and I get a little twitchy too. little foot kicks and such. nothing as bad as phillipa describes, but a little odd. I need to push my pdoc a little more. see if there are other meds that might help me.twitchily yours,
-ll
<grin>
Posted by fairywings on June 28, 2006, at 23:47:18
In reply to problem with fatigue and dizziness, posted by llrrrpp on June 28, 2006, at 9:35:01
Hi LL,
Vertigo is listed as a side effect of Cymbalta. Maybe that's what made you lose your balance?
fw
Posted by llrrrpp on June 29, 2006, at 6:36:57
In reply to Re: problem with fatigue and dizziness » llrrrpp, posted by fairywings on June 28, 2006, at 23:47:18
hmm- I have been having some vertigo, probably describes my balance issues. It seems to be much worse when I'm fatigued, though.
thanks,
-ll
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