My Experience with Cymbalta

I've been treating chronic depression with prescribed antidepressants since 1997. I've tried almost all of them out there: Prozac, Paxil, Remeron, Effexor, Wellbutrin -- you name it, I've probably tried it. Some didn't work at all; Paxil just made me irritable, and frankly, I don't need to take medicine to be irritable. Others worked with the depression, but caused major weight gain (think 100 pounds in 5 months) which in turn caused more depression (Remeron and Effexor were the culprits in that case). The other problem I've had is that every antidepressant I've taken works for a while, anywhere from six months to two years, but then they've seemed to stop working.

About two years ago my psychiatrist prescribed Cymbalta (the generic name is duloxetine). I started by taking the 30 mg oral dose once daily. My psychiatrist promised that this drug had fewer side effects than most other antidepressants, and had the added benefit of increasing energy for some patients. It is actually being prescribed at the 30 mg. dosage for Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) patients to help increase their energy levels. It took a few weeks, but I found both my mood and my energy level increasing. I didn't gain weight, but I didn't lose it either (weight loss is a side effect that the manufacturer says can occur), and the dry mouth? Well, I have it, but I don't know which of the several medications I'm on is the culprit. I had dry mouth before I started taking Cymbalta, and it didn't stop.

One of the best things about starting Cymbalta is that it stopped my suicidal thoughts, which is an enormous relief. I think only people who have suicidal thoughts, and those who treat them, can truly understand how terrible that is; when you're thinking rationally, you know that you don't really want to die, you just want the emotional pain to go away. But in the grip of depression, it can seem that dying is the only escape from that constant inner pain whose source you just can't pinpoint. It is a real blessing to be able to go for months at a time without that feeling.

As is typical for me, and for many people, after about a year, I started feeling less like my "normal" self and more depressed again. My doctor increased my Cymbalta dosage to 60 mg daily, which is the highest recommended dosage. Within a week my mood started to improve, and I began to feel like myself again. I still have ups and downs, but the downs are much more manageable with this medication.

Although my energy level did increase over the first year, it has seemed to be sliding back down since then. I have other chronic illnesses, including CFS and FM, which contribute to my fatigue level. It may seem counter-intuitive, but 15 to 30 minutes of moderate walking on pleasant days does help decrease the fatigue. More exercise than that, for me, increases my overall fatigue and pain levels. I also found that with the 60 mg Cymbalta dose, I began to gain weight again. That's not even listed as an "extremely rare" side effect by the manufacturer, but as my doctors pointed out, if anyone is going to get a strange side effect from a medication, it's me.

The other side effect I've noticed is shakiness or tremors in my hands. This is another of the side effects the manufacturers of Cymbalta (Eli Lilly and Co.)mention as "unlikely" but again, it's me, the side effect queen, so none of my health care providers are surprised. It's not severe enough to interfere with my function, most of the time, but it is noticeable.

Cymbalta's manufacturer advises against taking Cymbalta with the "triptan" class of migraine drugs. This is a bit of a problem for me, as I have frequent migraines. So far, however, I haven't noticed any interaction. The antacid cimetidine (brand name Tagamet) should also be avoided with Cymbalta, according to my pharmacist as well as Eli Lilly & Co.

I really have only one concern right now. I'm starting to feel more depression again, and I can't increase the dosage of Cymbalta, since I'm taking the highest recommended dose. I know some people do well on this for many years, and I'm hoping that my current "dysthymic" mood is temporary and situational rather than a part of my clinical depression, but only time will tell.

Cymbalta has, to date, the lowest incidence of side effects of any of the major antidepressants on the market, both in clinical testing and in my experience. Like any medication, it will work well for some people, and not for others, and like all antidepressants, it is designed for and has been tested on adults, and physicians will likely be very careful about prescribing it to children and adolescents, and their reactions to drugs are different than those of adults. It's my hope that Cymbalta can be life-changing to many who are truly suffering from depression, and change the suffering to recovery.