Newest inductees in my walking pharmacy

Today was my first appointment with the psychiatrist nurse practitioner. She was very nice, patient, and said that she thinks that there is hope that I can get through this anxiety and depression. Well… I’m glad someone thinks so.

I have two new meds: Cymbalta and Klonopin. Cymbalta for the depression, and Klonopin for the anxiety. First, I will be weaning off the Prozac (Praise God for that!!!), and taking a low dose of Cymbalta (40mg of Prozac, then 30mg of Cymbalta). After the one week weaning period, then I’ll be on 60 mg of Cymbalta. The Klonopin is an as-needed med. for the anxiety. The nurse practitioner did warn me about drowsiness with the Klonopin.

I go back in a month for a meds re-check. I hope that this antidepressant will be one that works. I was on Prozac for two years, the last two months at the 80mg, and not seeing a bit of improvement. I could literally time my crying spells by the time of day.

So, friends, any comments about Cymbalta/ Klonopin? Benefits? Drawbacks? I’ve done some research, but I’d like to know what you all think.

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17 responses

  1. I don’t have any advice (never been on those meds) but I just want to say that I hope they do the trick for you! I know you’ve had a rough time of it for quite a while lately.

  2. I was on Cymbalta for a month recently. The doctor quickly switched me ‘cuz I got way more depressed in that month than before. I went from being somewhat depressed, to severely depressed while on it.

    That shouldn’t discourage you from taking it. We all react differently. Good luck.

  3. Yes, we ALL have a different make-up (DNA) and what will work for some, wont work for others. I have never taken the first med; Cymbalta- I’ve been on Celexa FOREVER and doc just added Wellbutrol *sp? I also have xanax for the times when the panic is not helped by deep breathing techniques…. I RARELY take the xanax because it can be habit forming and I do not need that in my life. I do believe, that NO pill is going to make you 100% happy. It can help, don’t get me wrong but following up with a therapist to find out where it’s coming from is key. It’s important to know what our responsibilities are too, techniques to work on, exercise, and eating good (the last 2 are very hard for me, as I hate to exercise regularly and I love to eat junk- so I’m really trying to work on that now.). I will pray that this new combo works for you…. remember you are not alone and we are in this together now πŸ˜‰ WINK! If ya ever feel blue, we are all here for you.

  4. @BookMama- Thanks. It has been a rough road, but I hope it will smooth out.

    @BPD and JavaQueen14- Yup, you both are right on how all meds affect us differently. Believe me, I NEVER wanted to be dependent on a med to help me feel better. Granted, I am asthmatic and I depend on that med to keep me alive. So, we shall see how this new med mix goes. Thanks for the encouragement!

  5. Hi there. Great about the NP. It’s always good to have someone who is willing to listen and be supportive.

    Sorry it took me a bit to come over but I had to do some checking on Cymbalta. I’ve never taken it. I’m one of the folks who can’t take ADs as with the Bipolar, they will make me go over the edge. Also, it was only relatively recently made available in Canada.

    I don’t know what you have read or researched so forgive me if I mention some things that you already know?

    Cymbalta is a SNRI so it blocks both Serotonin and Norepinephrine receptors. It also has a (much?) weaker effect on Dopamine but with the SNRIs it’s hard to tell the value people may get there. Prozac, as you know I am sure, is a SSRI–Serotonin only.

    In comparison to my looking at Cymbalta as a drug–very similar to Effexor? I did take that.

    You didn’t mention how you will be discontinuing the Prozac exactly. One week? You are on 40mg now. Will you be dropping back down to 20mg and simultaneously starting the 30mg of the Cymbalta? I was never on Prozac (except for my little discontinuation “trick” which lasted a few days.)

    You see, people out there are finally listening to the patients taking ADs and that there can be (but not always) some bad discontinuation effects. That is not in any way meant to scare you, however. It doesn’t happen with all people. I never had any problems with my SSRIs, just my Effexor. And of course I wasn’t on all SSRIs. Anecdotally, Paxil and Effexor have the worst track records for discontinuation problems.

    So let me know how you are discontinuing.

    I don’t know what other meds you have taken (i.e. any other SSRIs, Tricyclics, MAOIs) but this SNRI may help you as it is a different class and you may benefit with a bit more Norepinephrine available to you.

    Side effects? Who the hell knows? We’re all different so you have to just wait and see. That is the pain in the arse with ADs. You have to watch the calendar and endure what they do to you in the process.

    Klonopin. I’ve always likened benzos to a good pair of shoes. You just have to keep trying them on until you get a good fit. Indeed, there are differences between half lives, peak plasma levels, duration etc… so that can be taken into account. Also, possible sedation factors if you are using them for sleep vs. anxiety but that can also be dose related.

    What I do know about Klonopin (having been on it and also script wise) is that it is an excellent benzo for anxiety–or at least widely prescribed and seems to work well for a lot of people? Again…anecdotal but what they hey? My only problem was that it induced depression with continual use. That was only me, however. I did read that about the Valium I am now taking, however, so that may be a factor with all benzos but I am not entirely sure of that. I mean, in hospital, they can pass out Ativan/Lorazepam like candy sometimes!

    Again, anecdotally, I haven’t heard of a lot of others having that problem with other benzos when taken on a regular basis. I have also taken Serax/Oxazepam for years (sleep/anxiety) but it’s not strong enough for what I’m going through now and Ativan/Lorazepam which does nothing for me!

    There is the whole issue of “dependency” re: benzos but I think if you need them, you need them. Some people do have a problem that way but if it happens, hopefully you can do a gentle taper down. Or there may be other meds that can be used as a temporary measure to get you through. It really depends. I really wouldn’t worry about that as your order is prn.

    Also, you didn’t mention the dose of the Klonopin prescribed. What is it?

    As far as the Cymbalta dosages, they seem spot on. A good start and with fair monitoring up to that dose if necessary? Again, I’m not a M.D. but they are not off the chart, irresponsible or anything. No, they are the indicated dosages.

    I think that’s it? If you want to know anything else more specific, let me know…

    PA

  6. Well, this should be interesting…you do but the message with my post never showed up on the screen! Delete these silly ones if you want but if mine never made it through, I’ll rewrite it again…

  7. @PA- Glad you found your way over to “The Den”. πŸ™‚

    As for my meds weaning: I was on 80mg of Prozac to start. My NP said to cut down to 40mg, then take 30mg of Cymbalta, along with the decreased dosage of Prozac. I will do this for one week, then I’ll be on 60mg of Cymbalta after that. No more Prozac after that.

    The Klonopin- They wrote a script for .5mg. They’re HUGE pink pills (I got the generic version). The NP said I could take 1/2 of a pill to see what effect the med will have on me, then I can either stay with 1/2 or go with a whole pill. I haven’t tried it yet. Chicken… I guess.

    Last night I slept for crap. I think I only got 2-3 hours of sleep. Today one of my sons was sick, so I spent part of the day napping. The NP also said that I need to get to bed at a decent time at night. Gee, so has my therapist, my college professors, my physician assistant, my sleep specialist doctor… maybe I should listen?

  8. Well that is just plain ol’…wait a sec’…

    Huh.

    I think WP is catching on. They’ve been keeping an eye on me. They’re getting fed up with me bitching about the “Possibly Related Links” crap!

    *laughing*

  9. ROFLMAO! I turned that link off after I kept seeing what “links” were being generated on my blog. (groan)

    yeah- that’s it… it’s a WP conspiracy…. muhahahaha

    (ducking)

  10. Oh, and as for your meds etc…

    Good plan on the combo weaning. That way, less of a brain spaz out–if any or at all. Excellent. I like to hear of M.D.s finally doing things right for a change.

    The Klonopin dose is fab too. Nothing too heavy right away. Just a small dose to start with and as a prn if that is what you need. You also sound like you are being “prudent,” not a chicken!

    I seem to recall I got the generic as well (and I have the generic Valium now) and I think mine are about the same size as yours? Hey, you should see my 200mg Topamax! And my Biphentin is a pretty decent sized capsule. I just toss all five of my morning meds down my gullet in the morning and that’s that.

    Then only two at night?

    Happy, happy cocktail!

    And your sleep. Oh, yes. Like you’re not busy or anything.

    Someone sent me a link to some silly article about how sleep is soooo important (newsflash?) There was a comment board beneath it and one woman was saying she’d gladly like more but with kids and this and that… Then she said she also needed some time for herself to do some things to “relax” and find enjoyment in life.

    Some complete asshat jumped all over here for actually wanting a life instead of sleeping so it was her OWN FAULT for being so exhausted and sleep deprived. There were other really wacky comments too. I wish I still had the link but I deleted it as it was just too stupid.

  11. Hi there, Sorry can’t offer any advice on those particular meds, I myself have been on so many, iv’e forgotten some, so they had to put me on an old med called Nardil., I take 75mg of it and can’t go any higher. Only problem is you can’t eat certain foods or drink certain alcohol. It has helped me for the past 3 years, but I am finding that it is pooping me out, and I am having the bad feelings come back, as you read in my blog. Right now I am on the edge, and I don’t want to be there, I don’t want to end up back in the hospital as in the past. Thanks for your wonderful website, I will return often..regards..Nippercat

  12. Hi there-

    I’ve been on Cymbalta for 2 years. I love it. Works really well, and I notice no side effects. I also take Klonopin for anxiety prn, but I rarely take it. It works when I do take it. Once in awhile, especially if driving, I do notice drowsiness from it. So, I no longer take it if I am going to be driving any distance.
    Good luck. I think you will find Cymbalta a huge improvement over Prozac.
    etta

  13. @ Etta- It’s the new WordPress automated avatars. If you have a WP account, you can go in and change what kind of automated avatar you want.

    I agree- the evil green face is NOT you.

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