Friday 7 August 2015

Out with the Old, In with the New (Duloxetine)

This morning as I was waiting for the kettle to boil, I routinely took my morning meds without thinking, only questioning myself as to whether or not I needed something extra.

As I swallowed, a wave of panic washed through me. My pills are doled out for the week into separate cases for morning, noon, and night by my mother, so I don't think much about it. But this morning, I swallowed a blue pill - a new colour in my pharmaceutical rainbow.

I'd completely forgotten that I was starting a new antidepressant today, and I just swallowed it without so much as a Google. Those three weeks went by quickly. I couldn't even remember the name of it!

Find the box, and off to Dr. Google.

It's called Cymbalta, or Duloxetine. For once, the pharmacist didn't give me an information leaflet with the first packet of a new antidepressant, but I did end up finding a copy online.

Unlike most of the other antidepressants I've been trialled on in recent years, there weren't many big red flags. The side effects seem pretty usual; mostly things like nausea and dizziness and insomnia, which is nothing I don't deal with already.

My biggest hang-up would be that it's an SNRI. Not something I'd heard of before, but from what I gather, basically SSRIs (selective serotonin reuptake inhibitors) work on serotonin alone, hence the 'selective', and SNRIs are 'serotonin noradrenaline reuptake inhibitors' - noradrenaline being another neurotransmitter.

When I get a new antidepressant, one of the first things I look for is what class it is, because I refuse to take another SSRI.
Long story short, I was given Fluoxetine at age 12, it made me more suicidal and ended up with me in ICU after taking every pill in the house. It was years before I'd touch any type of antidepressant again.

So I'm not too sure what to think about an SNRI. Should I be put off, attracted, or not care either way? I just don't understand neurotransmitters and all that jargon enough to tell. I don't know if I should be concerned at all, or if my fear of SSRIs in general is even rational. Plenty of questions for the GP next week.

I did read somewhere that it's not a first line treatment, which is good. It makes me feel like I'm getting somewhere instead of just crossing off the next pill on the list.

And on the upside, as of today, I am officially off Gabapentin! One more useless antidepressant down, a pharmacy-full to go.


On Monday, I had the day home alone. And how did I choose to spend it?

I chose to stay on the couch, in my pyjamas, smoke inside and re-watch Inside Out, followed by 18 consecutive episodes of How I Met Your Mother.
I did absolutely nothing. I didn't stress. I didn't plan, or watch the clock. I just hibernated in the moment. I was warm and comfortable. I was calm.
My ideal day.

I stayed on the couch for eight hours straight, from 8:15am-4:15pm, only getting up to go to the toilet or refill my drink. Even Billy and Misty didn't get off their couch for the bulk of the day.
I know it sounds pathetic, but amidst the craziness, I miss relaxed days like that.


So, any thoughts or feedback on Duloxetine, or SNRIs in general?

Any experiences or input would be greatly appreciated, as always.
Apart from that, keep your fingers crossed for me that this isn't just another useless antidepressant.




xxBella

11 comments:

  1. I was on Cymbalta for quite a while Bella
    But my memory is so fuzzy
    I don't think I was in a good place while taking it
    But that's the thing
    It's different for everyone
    Prozac didn't help you
    And in fact made you worse
    But it did help me
    At least I think it did
    I wish now that I had kept a record over the years of all the different meds I've been on
    How they helped
    Or didn't help
    Side effects etc

    But you know what Bella
    There is no harm in trying
    I've been on a plethora of meds over the years
    And thankfully found one last year that is compatible
    I've read that Prozac is especially good for people suffering with bulimia
    So maybe it was the right match for me

    Having said all that
    I would keep record of your mood over the next couple of months
    I'm guessing it will take 4-6 weeks to take effect
    So maybe be mindful of any changes that occur

    I don't know if this helped
    Just my two cents

    I have everything possible crossed that this one is the one x

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  2. I get what you mean. Prozac made me suicidal and angry. Good luck with your new medication.

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  3. I have no experience with anti depressants. I do hope this one can help though.
    Glad you had a nice relaxing day on Monday, you do need the break from all the anxiety.
    Much Love

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  4. Bella, the start of this post could've been written by me. just saying.

    it certainly has a pretty name (the new pill).

    when you say neurotransmitter, my heart starts to race and i get all lovey-dovey. *glows over it for a few moments*

    i remember the Fluoxetine story. it still makes my heart ache just to think about it...dear God.

    "I just don't understand neurotransmitters and all that jargon enough to tell."
    "So, any thoughts or feedback on Duloxetine, or SNRIs in general?"

    a neurotransmitter is a substance released at a synapse. a synapse is between two neurons. the substance is released from the pre-synaptic and has an effect on the post-synaptic. different neurotransmitters have different effects on the body. a neurotransmitter can either produce or inhibit an action potential. now, that neurotransmitter doesn't stay in the synapse (or it will keep on producing/inhibiting AP's in the post-synaptic) so it is broken down to prevent it from acting on the post-synaptic. to break them down are very specific enzymes.

    an SSRI is an antagonist and blocks the enzyme. so it prevents it from breaking down serotonin (only serotonin) so that it acts longer in the post-synaptic. it's very efficacious and as you know, SSRI's do have serious side-effects. SNRI's are also of similar efficacy (we're talking potency here). they block the breakdown of both serotonin and NA (as you also said) and have less severe side-effects (also as you said).

    did you know i legitimately read a lecture just to tell you this? (i'm studying neuroanatomy/neuroscience right now, and haven't gotten to this lecture yet, but i just thought: what the hell i'm studying this anyway). also, Duloxetine is in my "further reading" section for the USMLE.

    you know anything that ends up in the "further reading" section nobody really reads?

    i say not to care for now. it'll do what it does but there's no use to fret about it, sweetheart. it won't make anything better, really. <3

    "And on the upside, as of today, I am officially off Gabapentin! One more useless antidepressant down, a pharmacy-full to go." YAY FOR GOING OFF GABAPENTIN

    i hate useless meds. let's take this pill that doesn't do anything at all by possibly shorten your lifespan every time you take it!

    "I did absolutely nothing. I didn't stress. I didn't plan, or watch the clock. I just hibernated in the moment. I was warm and comfortable. I was calm." a girl after my heart! sounds like my ideal sort of day as well ;)

    my fingers are always crossed for you, love.


    -Sam Lupin

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  5. I was on cymbalta.. I think it worked ok? Not well or not for a long time for me.. maybe. Sorry it was a while ago. I was on a lot of medications in high school and almost nothing worked, and I know some stuff says that medications don't work the same on adolescents (can make things worse even) than adults.. so I have trouble remembering. I do know it was not one that made things worse.. that was Prozac (fluoxetine) for me too. I have been on an SNRI (venlafaxine or Effexor) that worked well for a while, so that's another in the same class.

    I understand the hesitation. I am glad you're trying something new because I know the gabapentin wasn't helping, and I honestly feel it's not a very useful medication. I was on it for anxiety, and it didn't help.. and I guess I was on a substantial dose too.

    Have you ever been to this site? I got this link from a friend a while back, and it's actually a good site for looking up medications. The person who writes it is a bit cynical, but it's got more honesty in places than webmd and other sites. You can look through meds by name or by class and it talks about the classes too. http://www.crazymeds.us

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  6. Neuroscience was one part of uni that I was actually good at, but Sam's already got you covered on that one. Action potentials are the little impulses in neurons. That's possibly the only thing I can add.

    I'd say to not care but be aware if anything changes to be similar to your experience of fluoxetine.

    Your day sounds wonderful; it reflects in the tone of the passage and I'm so glad you enjoyed it.

    <3 xxx

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  7. I'm on an SNRI and it's the first antidepressant to have any effect on me. Granted it isn't the amazing magic pill that takes everything away, but it take the edge of my depression as well as my anxiety. It's called Venlafaxine the SNRI I take. Fluoxetine did nothing for me, neither did sertraline, neither did citalopram nor others I can't remember the names of, which is why, for now, I will be sticking to my SNRI because it's the first one to show any signs of helping me. Hopefully it will be the first one to have an impact on you too. I really hope it helps you Bella. Fingers crossed for you xoxoxox

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  8. I'm on both a SSRI and a SNRI, Cipralex and Reboxetine. Both help, in different areas, and I do hope this will be the last pill you will have to try. It is really trying having to get on and off medications all the time.

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  9. Hi darling,

    I'm currently on the SSRI antidepressant Sertraline ("Zoloft") and for once this one has actually seemed to give me minimal problems. Like you, I had a terrible reaction to fluoxetine/Prozac (made me horribly suicidal), and Citalopram was like taking a sugar pill every morning. Sertraline's the only one I've really felt has helped my anxiety, but maybe that's because before I started taking it, my anxiety was abnormally through the roof, so any adjustment thereafter felt like a big one. Of course anxiety lends itself to paranoia, which relates directly to constantly checking in with oneself - am I ok? How am I feeling right now? Am I feeling anxious? How happy/energetic/depressed am I feeling in this moment? etc. - and the biggest change for me after starting Sertraline was that I stopped obsessively questioning every little flicker of emotion that passed through my head, probably because I gave myself permission to calm down after seeing someone and starting a new course of medication.

    Sorry, that was so long and rambling. Hope you're okay wonderwoman.
    xxx

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  10. Hi darling,

    I'm currently on the SSRI antidepressant Sertraline ("Zoloft") and for once this one has actually seemed to give me minimal problems. Like you, I had a terrible reaction to fluoxetine/Prozac (made me horribly suicidal), and Citalopram was like taking a sugar pill every morning. Sertraline's the only one I've really felt has helped my anxiety, but maybe that's because before I started taking it, my anxiety was abnormally through the roof, so any adjustment thereafter felt like a big one. Of course anxiety lends itself to paranoia, which relates directly to constantly checking in with oneself - am I ok? How am I feeling right now? Am I feeling anxious? How happy/energetic/depressed am I feeling in this moment? etc. - and the biggest change for me after starting Sertraline was that I stopped obsessively questioning every little flicker of emotion that passed through my head, probably because I gave myself permission to calm down after seeing someone and starting a new course of medication.

    Sorry, that was so long and rambling. Hope you're okay wonderwoman.
    xxx

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  11. Yeah the only thing I ever took was sertraline, it worked for me but I gave it up after I switched insurance companies. The US sucks at stuff like that. Glad you enjoyed your day, but I look forward to reading about a time when you have fun doing something out in the world. You're young and beautiful and I know you can do more. I know its hard, but I'm cheering for you.
    -Jax

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