Jump to content

Cymbalta - Interested In Why Grubb And Other Prescibe


starry16
 Share

Recommended Posts

Hi all,

Just wondering for those of you taking Cymbalta, whether it was prescribed for the POTS symptoms (tachy, fainting, low BP, etc) or for nerve/fibro pain? It seems like its prescribed frequently, and I've seen many references to folks having it prescribed by Dr. Grubb or Bev (and them saying they've had a lot of success with it), but am not sure whether it's so popular because of the pain stuff or the other POTS stuff.

Would really appreciate hearing why it was prescribed for you (esp. if it was from Grubb/Bev/Low etc).

Thanks!

Link to comment
Share on other sites

Dr. Grubb prescribed a low dose of 20mg of Cymbalta for POTS symptoms about 2 years ago. It has worked miracles for me, and some others who I know who also see him. He said it improves neurotransmission, he equated it to a diabetic taking insulin or with Parkinson = dopamine. I am nearly symptom free on Cymbalta + exercise + fluids/salt, vitamin D (by prescription). He seems to favor Cymbalta where as my other Cardiologist who treats POTS was slower to catch on to it but now she also reports good success with it at low dose. I think it is a drug that less is more for POTS.

Link to comment
Share on other sites

I am going to ask my neurologist about cymbalta. I am currently on Lyrica for some neuropothy pain, but I have also put on 10 lbs since I have been on it. I have read where cymbalta helps in the same way as Lyrica, but does not promote weight gain, but weight loss. I could also benefit from the psych effects of cymbalta as I am mildly depressed due to all the stuff going on.

Link to comment
Share on other sites

Cymbalta works on the reuptake of serotonin and norepinephrine neurotransmitters, while regular SSRIs only prevent reuptake of serotonin (primarily). Norepinephrine is a vasoconstrictor (so it can raise bp) and it is also a hormone that speeds up the heart rate in the "fight or flight" response. One possible cause of POTS is a deficiency in the norepinephrine electron transporter (NET) protein, causing excess norepinephrine to spill over into the synaptic nerve, causing an increase in heart rate upon standing or postural changes. Cymbalta, as to my understanding, overrides this NET protein in order to prevent reuptake, so the excess spillover is reduced.

While on cymbalta I have noticed an improvement in the severerity of how high my heart rate would jump after a postural change. It also helps with anxiety/depression, which can exacerbate symptoms.

Anyway, this is my hypothesis on why cymbalta can be helpful.

Link to comment
Share on other sites

Jbrian, I can't say that I follow that logic...if Cymbalta overrides the NET protein and prevents reuptake of norepi, doesn't it also make more of it available? And wouldn't that have the same effect as excess norepi spillover?

I am really really glad to hear that it has helped some people though. These posts were very encouraging the other day when I signed on while feeling super nauseous due to side effects! I'm on day 6 of it (20 mg) and working through side effects. For those of you that it helped, may I ask what dosage you are one and how long it took before you felt some positive effect?

Thanks to all!

Cymbalta works on the reuptake of serotonin and norepinephrine neurotransmitters, while regular SSRIs only prevent reuptake of serotonin (primarily). Norepinephrine is a vasoconstrictor (so it can raise bp) and it is also a hormone that speeds up the heart rate in the "fight or flight" response. One possible cause of POTS is a deficiency in the norepinephrine electron transporter (NET) protein, causing excess norepinephrine to spill over into the synaptic nerve, causing an increase in heart rate upon standing or postural changes. Cymbalta, as to my understanding, overrides this NET protein in order to prevent reuptake, so the excess spillover is reduced.

While on cymbalta I have noticed an improvement in the severerity of how high my heart rate would jump after a postural change. It also helps with anxiety/depression, which can exacerbate symptoms.

Anyway, this is my hypothesis on why cymbalta can be helpful.

Link to comment
Share on other sites

Preventing the reuptake of norepinephrine does artificially make more of it available to the body, even though your norepinephrine levels do not actually change. Your body thinks it has more, since the NET protein is suppressed by Cymbalta. Just because more is available for use in the body does not necessarily mean that more will spillover unnecessarily into the synaptic nerve causing the adrenaline effect (i.e. high bp and hr). My hypothesis is simply that the spillover will be less (although not totally alleviated) by Cymbalta. In addition, since more norepinephrine is available for use, it will help replenish the norepinephrine that is unnecessarily spilling over into the synaptic nerve. I hope that makes sense to you.

By the way you also asked about dosage. I was taking 30mg, and that did help a lot. However, my PCP is trying me at 60mg (30mg 2x a day) to see how I will do on that. A dose of 60mg, as he told me, would be beneficial for people who are obsessed with their health or the way they feel. He said I am really in tune to my health and focus a lot on it (cause I don't feel well), which could be considered an obsessive compulsive habit. 60mg of Cymbalta can help with compulsively worrying about your health.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...