Cymbalta: My Experience with the Antidepressant Drug

I was involved in my very first car accident a little over a year ago. The pain went from annoying to unbearable, and consequently I became extremely depressed. And so began my year-long journey with Cymbalta®.

Like many others, I was initially prescribed Cymbalta® as a means to lessen peripheral neuropathy, or some types of nerve pain, in conjunction with depression and lack of energy. I tested positive for nerve damage in my left leg, and experienced constant agony . I had never felt real, intense pain, and certainly hadn't lived with pain for any length of time. I had no idea about what to expect, and naturally placed all of my faith and trust in the doctors to take the pain away.

Besides the Cymbalta®, I had four epidural steroid injections, a nerve block, and a slew of tests to find out where the pain was coming from. I went from hydrocodone to oxycodone in four months, and took every commonly prescribed muscle-relaxant available. As is the case with many sufferers of sudden-onset back pain, the doctors prescribed many treatments and drugs at once, hoping that one would prove to be the answer to my problems.

Cymbalta® was very "in" in the fall of 2006, dispensed to many for symptoms as different as depression, nerve pain, general feelings of anxiety, etc. Most people in my situation will find that a doctor does not explain the nature of the prescribed medication. I grew up watching House and ER, so this concept came as a complete shock to me. Doctors do not deign to enlighten us simple folk as to the side effects and reactions that may be expected, nor even how the medication actually works. I was simply told to take the Cymbalta® and to pay attention to how it would impact my pain mental state. At this point, the pain had started a chain reaction that ended up with serious feelings of depression.

I was given an initial dose of 30 mg, to be taken once per day for two weeks, and twice per day afterward. I would later find out that the term of the prescription was completely undetermined, as was the dosage. Cymbalta® was fairly new, and different symptoms and body types were reacting differently to several dosages.

Before the accident, I had never experience real pain, and certainly never dealt with long-term pain. I had also never battled with clinical depression, and so had never been prescribed psychiatric medication. I like to refer to Cymbalta® as the "crazy drug that changed my life." As you might discern from my nickname for it, these changes were not particularly pleasant. The first two weeks of taking the drug went off without a hitch, though: There were no changes in my mood, state of mind, and, most importantly, my pain. Nothing happened, but the doctors told me to wait, and so I did.

The next dose of 60 mg proved nearly unbearable. I vomited, my vision blurred, my blood pressure spiked. And of course, my pain was still there. The pain laughed at Cymbalta®, and told it to go screw itself.

Because of the heavy doses of narcotic medication I was taking at the time, my doctor instructed me to lessen the dose, and to take only 30 mg of Cymbalta®. I felt better, in that most of the nasty side effects disappeared; but the pain remained the same.

I remained in this state of limbo for two long months. I was in terrible agony most of the time, but I took that useless blue and white capsule every morning nonetheless. I prayed for the day that my pain would get a little better. I hoped that the Cymbalta® would kick in all of a sudden, when everything else had failed. The epidurals were useless, the tests showed almost nothing, the narcotics didn't do jack, and I was running dangerously low on patience. But I waited.

I successfully quit the useless narcotics in January 2007. I refused further epidurals and conventional pain management medications. I turned to alternative treatments, giving massage, acupuncture, and other non-traditional therapies a shot. I walked away from modern medicine, convinced that it had nothing more to offer me.

As my new physician assisted me in weaning off of the oxycodone, I found out that the Cymbalta® had found itself a nice, cozy place in my brain, mixing with my neurological chemistry in ways that I still fail to understand. I was told that because of the length of time I had taken Cymbalta®, I must continue to take it for a certain period of time, in order to prevent deepening my depression. I was once more placed on 60 mg. It was at this time that I was told that the effective dose of Cymbalta® was really at a minimum of 60 mg; the entire time that I had taken the 30 mg was a complete waste.

I thought that the 60 mg had to work, that Cymbalta® may have still held some secret promise to make all of my problems go away. But I found that even if I took the medicine early or on time, I was hyper over the next few hours, something I hadn't yet experienced because of the sedating powers of the narcotics. If I took the Cymbalta® late, I was struck with feelings of disorientation and fatigue. And thus began the Cymbalta® headaches.

Everyone has a headache from time to time. You pop a pill and relax, and it's supposed to go away. But this was so very different. I would discover, in my own special way, what a serotonin let-down headache was. It is one of the most unendurable, absolute truths I have encountered thus far in 23 years of life, and an experience I would not wish upon any fellow human.

Cymbalta® works as a selective serotonin-norepinephrine re-uptake inhibitor, per the package insert given to patients who are dispensed Cymbalta®. According to a Cymbalta® article on Wikipedia (titled Duloxetine, one of the Cymbalta® generic names), Cymbalta® should block the nerve receptors in the brain from reabsorbing too much serotonin and norepinephrine. So because the serotonin released in my brain could be left alone and not re-absorbed, its natural anti-depressive effects could be felt for longer periods of time than is natural for a depressed human. Also, this extended released of serotonin and norepinephrine would change the way my brain perceived continuous pain. In simple terms, the pain signal from my leg transmitted to my brain would arrive, then be re-interpreted as less painful. Whatever the scientific basis, this chemical interaction was completely lost on me. Maybe my brain is dumb, or my pain was smart, or Cymbalta® just sucked.

Once the chemicals of Cymbalta® enter the brain, and the brain becomes accustomed to these new serotonin levels, it can be very difficult for the brain to act reasonably when the serotonin levels change, even in minutia. Twenty minutes after I had previously taken a dose the day before, my head would begin to pulse and throb. My vision slurred, and my eyes would not focus properly. My blood pressure would shoot off the charts. Every time I spoke or moved my eyes, a feeling of extreme vertigo would take over for a split second. The head rushes I felt were ever-increasing in number and frequency, and I was scared. My brain fought with itself in this matter for hours and hours, no matter if I took the medicine late by a matter of minutes.

These things went on in a similar manner for two more months. But one day I began to experience these horrible feelings in an even more intense manner - and I had taken the damn Cymbalta® on time. For weeks this went on, though I kept taking the medication earlier and earlier. When I finally spoke about this with my doctor, he explained that I had become accustomed to 60 mg, and that I must raise the dosage to 90 mg.

At 90 mg of Cymbalta®, your brain really begins to cruise. I felt better, stronger, faster...or did I? Hours flew by without notice, and life seemed to move at record pace. Tasks seemed to take less time, though mental processing speed and ability took a back seat. My concentration and powers of reasoning ground to a halt, and once mundane items on life's to-do list seemed to take a long time to figure out, if less time to perform physically.

And then those damn headaches came back, but this time they really had it out for me. I could swear to you, as the day is long, my brain was actually trying to leave my skull. My poor battered and broken mind had had enough, and was preparing to make a run for it, no matter how much it hurt. And it hurt. A lot.

And so once again, the dosage was raised: I was at 120 mg, and I felt great again. Outstanding Terrific. Aces. Over a period of a month and a half, I went from 60 mg to 120 mg, the highest limits, the max, the end of the road. And boy did that dead end suck. At 120 mg of Cymbalta®, my heart raced when I turned around to look at something. Every sentence read from a book pulsed with vivid color and meaning that only Cymbalta® could give them. Mania usually refers to a state of seeming invulnerability, or extreme highs in energy and stamina. For me, mania meant that every word I uttered had to leave my mouth at record speed. I had to tell anyone who would listen about what a fabulous day it was, why life was so great, and then apologize and explain when I couldn't shut up for two seconds. Then, upon realizing how I had changed into a weird, exaggerated version of my former self, I would sit and stare into space, uncertain what to do. I couldn't laugh, cry, scream, get mad, anything: I was a useless shell, a false imitation of the human I once was.

After a week at 120 mg, I couldn't stand or sit still. I began to snap, stomp, and curse at random, and for hours on end. My brain had officially left my head, exited the atmosphere, and was last spotted near Mercury, attempting to set itself on fire. Food was nauseating. Cymbalta® turned the volume up, so that each sentence I heard seemed to have been screamed, and each sentence I uttered threatened to deafen me permanently. Colors flashed, and lights danced, but not in a fun way; they danced as though they were at a rave party, and decided to induce epileptic seizures in anyone who dared to gaze upon them. Everyone and everything around me threatened to drive me to the point of no return: next step, loony bin.

Finally, I had had enough. I was going to quit this evil crap before I was rendered a pathetic shell of my former self. I told the doctor to stick Cymbalta® where the sun would never shine again, and begged for something to take the side effects away: another anti-depressant, a tranquilizer, permission to drink heavily, a loaded gun, anything to make it stop.

From that moment on I was determined to get the poison out of my system, though for the next week I almost begged for the Cymbalta® time and again. As bad as all of the side effects of taking it were, they couldn't shake a stick at the withdrawal symptoms: extreme nausea and car-sickness, an inability to look at lights or hear any sounds or speak. I had quit heavy-duty narcotics in the blink of an eye, but I believed that quitting Cymbalta® might actually kill me. I curled into a ball and prayed for it to end.

And what do you know, my prayer was answered.

I have been off of Cymbalta® for over a month now. The feeling of freedom and relief from that evil stuff has no parallel, no comparison to anything I've ever experienced. And I hope never to know those agonizing feelings again. I still have pain, but I deal with it. My mind seems to be returning to normal, and life seems like it will keep getting better. Depression hurts. And so does Cymbalta®. But now I don't have to.
Sources

"Duloxetine." Wikipedia.