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I keep seeing Cymbalta coming up on the forum. Many seem to have tried it.

My autonomic doc suggested I try it, but I have been reluctant because med changes scare me as the side effects are often worse than the POTS/dysautonomia symptoms I'm trying to treat.

I'm on effexor xr for depression, but does cymbalta have some benefits other than anti-depressant that I'm unaware of?

If so, I'll give it a whirl!

Dari :):)

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Dari,

I don't think that anyone actually knows exactly how anti-depressants work in dysautonomias. I think that it is linked to serotonin being involved in signals in the nerves of the autonomic nervous system (it is NOT because POTS is due to depression, although many people with chronic illness do develop a degree of depression as a result of their illness).

It is often recommended that the SSRI (selective serotonin reuptake inhibitors) class is used because of their action on serotonin. There are members on here using many different SSRIs and some suit one person better than others - it can be trial and error to find the right one for you.

Venlafaxine (Effexor) and Duloxetine (Cymbalta) are both serotonin and noradrenaline reuptake inhibitors. I think that I have read somewhere that increasing noradrenaline levels helps some POTS patients (I wouldn't have thought that it would be a good idea for people known to have the hyperadrenergic form of POTS though).

I would talk to your doctor about why they want to try Cymbalta - it would probably mean switching from Venlafaxine. I can understand that you are nervous of trying new meds but sometimes it is only through trying things that we can know if they are going to help or not.

Flop

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I don't know why it works, but cymbalta helps me and a few others I know, a lot. I take only 30 mg. Definitely helped with brain function and that tendency to sometimes feel I was jumping out of my skin. I am just much more comfortable in my body with it.

That said, it was hard for me to get used to and I had noticable side effects for about a week. But now it is one of those I would not want to be without.

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I have been on effexor xr for several years and I was just diagnosed with POTS/MVPS a few months ago.

I have had POTSy symptoms far longer than I have been diagnosed, but I don't really notice a correlation with this med and the POTS.

Technically, my symptoms worsened following effexor xr, but I don't know if any of this is related.

When I saw the doc at MVP Center in Birmingham she told me that effexor xr was her choice anti-dep with patients prior to cymbalta being introduced. Now, she uses cymbalta more often. I'm not sure why.

As for my depression, effexor xr is the thing that has helped the most. It wasn't until a doc tried effexor xr that I realized other anti-depressants hadn't been working effectively. I would get relief from the depression enough to function and not feel suicidal, but I was never happy and the dark cloud of depression was always hanging over me. On effexor xr I can actually feel like the cloud is out of the picture sometimes. COmbined with wellbutrin sr only once a day I have finally begun to feel happy. I have never felt happy! Who knew it was possible?!

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Be very, very careful with Cymbalta- it can cause mania and hypomania, especially if you are taking it for something OTHER than depression, such as POTS or joint pain, like I was. It is also extremely difficult to stop- there are several withdrawal symptoms associated with this drug. In addition, it was NOt approved by the FDA for joint pain/stress incontinence because of the connections with suicidal impulses in trials. See: http://www.yourlawyer.com/topics/overview/cymbalta

In May 2006, GlaxoSmithKline and the FDA cautioned Paxil may raise the risk of suicidal behavior in young adults too and changed the drug?s label to reflect that risk.

On October 17, 2005, Eli Lilly expanded its warning about potential liver-related problems with its depression drug, Cymbalta, and cautioned doctors against prescribing it to patients with chronic liver disease, U.S. health regulators announced. The new label for the drug also contains reports of hepatitis, jaundice and other liver-related problems in patients using Cymbalta.

The FDA has recently issued a new warning about the potential for suicidal thinking in adults taking antidepressants, but the agency specifically singled out Cymbalta (generic: duloxetine) because of a higher than expected rate of suicide attempts in recent studies. Cymbalta is a relatively new antidepressant manufactured by Eli Lilly that has been associated with suicide risk since its clinical trials.

The warning comes after a review of Cymbalta by Eli Lilly; found that 11 of nearly 9,000 women taking it for urinary incontinence tried to commit suicide. The fact that these patients were suffering from urinary incontinence and not depression is significant because the drug companies have long argued that antidepressants are used by depressed people who have a higher likelihood of committing suicide

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Thanks for this info. I'll proceed with caution.

Actually, I am of the "if it ain't broke, don't fix it" mentality.

I don't want to change things when they are going well.

Dari

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Hi Dari,

If I were you I'd be asking the doctor what the difference is between Effexor and Cymbalta and why they want you to change meds. They both belong to the same drug class so unless the Dr has a specific reason for changing then you might be right to consider staying on the Effexor that seems to be agreeing with you at the moment.

Flop

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  • 3 weeks later...
Hi Dari,

If I were you I'd be asking the doctor what the difference is between Effexor and Cymbalta and why they want you to change meds. They both belong to the same drug class so unless the Dr has a specific reason for changing then you might be right to consider staying on the Effexor that seems to be agreeing with you at the moment.

Flop

Dr. Grubb put me on it for POTS and it improved my ability to function almost immediately. He equated it to giving a diabetic insulin, it gets my nervous sytem functionin closer to normal. I like it, though I only use 20mg. I have another friend with POTS also put on Cymbalta by dr. grubb and she has done even better than I have. It isn't for everyone, but for me I am almost back to normal. I was able to quit all other meds -- flornief, midodrine.

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dr1713

I am intrigued. Cymbalta sounds like a great choice, at least for you.

I will ask my doc next visit. I would LOVE to feel better in my own skin! B)

The specialist in Birmingham strongly advised Cymbalta saying her patients have great results with it. She didn't elaborate.

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dr1713

I am intrigued. Cymbalta sounds like a great choice, at least for you.

I will ask my doc next visit. I would LOVE to feel better in my own skin! B)

The specialist in Birmingham strongly advised Cymbalta saying her patients have great results with it. She didn't elaborate.

I will add that my Gastrointerologist has a patient with celiac and severe dysautonomia (I am gluten intolerant which is why we were talking about POTS) and she is in bad shape so he was very interested in my improvement , she was give cymbalta by a neurologist at UCLA but did not fair as well. Dr. Grubb started me at 20mg and a year later when I went back he wanted me to go to 30mg to see if it would help, I felt more medicated on 30 and went back to 20 (a pediatric dose he says) and will likely stay at 20. I exercise and eat well, drink alot of H20 and sodium and am pretty stable after severe orthostatic intolerance pre-Grubb treatment. Cymbalta, in my opinion. is definitely worth a try. Dr. Grubb was VERY PLEASED with my improvement and said "keep doing what your doing, living your life" in his optimitisic way.

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I take cymbalta 30 mg and it is very good for me. Wish I'd had it years ago! Two other patient friends have noticed big improvements after starting cymbalta too. So it is one of those "find what works for you" situations.

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