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Dr. Bob is Robert Hsiung, MD,
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Posted by iris2 on February 2, 2005, at 23:48:07
In reply to Re: Cymbalta (duloxetine) - report, posted by tendency on February 2, 2005, at 19:01:36
Has anyone ever heard of getting very emotional on Cymbalta? I only took it one day and waws way out there. Need to decide whether to try again and to stay on it longer.
Thanks,
irene
Posted by SLS on February 3, 2005, at 2:34:48
In reply to Re: Cymbalta (duloxetine) - report, posted by tendency on February 2, 2005, at 19:01:36
> What's the latest on cymbalta? Has this thread pooped out too?
I guess so. I responded to Cymbalta only briefly - for about a week. I have a pattern of responding briefly to antidepressants very early in treatment, usually during the second and third weeks. Of course, I was hoping Cymbalta would be different. I guess you never know until you try.
> On another note, Scott, have you heard about the selegiline patch (I believe it's being, or will be, marketed under the name Emsam)?
I am really not too enthused about selegiline because I had absolutely no positive response to the oral form. Then again, I don't remember going any higher than 30mg/day. Perhaps that was too low. Oh well, at least it will be something to hope for. You never know...
Thanks for the suggestion. I haven't heard about anything that would cause a delay in the approval of EmSam, so that's a positive.
Where are you at with things?
- Scott
Posted by SLS on February 3, 2005, at 2:47:59
In reply to Re: Cymbalta (duloxetine) - report, posted by iris2 on February 2, 2005, at 23:48:07
Hi Irene.
> Has anyone ever heard of getting very emotional on Cymbalta? I only took it one day and waws way out there. Need to decide whether to try again and to stay on it longer.
It sounds like an unusual reaction to a single dose of Cymbalta - only because I haven't seen anyone else report that yet. Of course, I don't get to read every post.
Can you be a bit more detailed in your description of what you experienced?
Cymbalta is a powerful drug, as are all of the antidepressants, and I don't doubt for a minute that you could have had such an immediate reaction. This reaction is probably not the desired antidepressant response, though.
"Getting emotional" is not necessarily a bad thing, as it sometimes indicates the very beginnings of a positive response to a medication, especially if the depression itself leaves one emotionless or with flat affect. But I doubt this would apply to you with your regard to your immediate reaction. I will say this, though. Although it usually takes two weeks or longer for an antidepressant to begin working properly, some people describe a brief positive "blip" that can occur withing the first three days.
What other drugs have you tried, and what were your responses to them?
- Scott
Posted by iris2 on February 3, 2005, at 10:26:45
In reply to Re: Cymbalta (duloxetine) - report » iris2, posted by SLS on February 3, 2005, at 2:47:59
Scott,
The reaction I got did not feel positive in any way. I would describe it as extreme heartache. Although it was not a physical pain it almost felt like it. As if something terrible had happened and I could not wrap my mind around it and deal with it.
I have tried so many medications I do not even remember them all. Several SSRIs with no response at all. Several Maoi's and Parnate and Marplan and Moclobimide worked for several years and then pooped out. They were the only ones that worked. I thought effexor was going to work but I was unable to continue on it because of "interstitial cystitis"(I.C.), a bladder disease. I tried Mirapex and Milnacipran recently. I was unable to take either due to side effects. I was on reboxetine and in combination with Maoi's it helped some. I have been on Ritalin for years and it helped some but not so much any more. I was thinking of trying Adderrall? I had a great affect with Amineptine but had to discontinue it again due to the I.C. and have been unable to reproduce the positive outcome after several tries. I tried Provigil and Modafranil and Tianeptine. Years ago I tried two tricyclics but was not on either long enough to have any antidepressant response. I had some positive result with Amisulpride but my prolactin got very high and it messed with my period and body shape and I have bulimia. I also occasionally take perphenazine; long ago I took a lot and was a zombie. ( bad pdoc bad clinic) When I stopped the Amisulpride the second time a tapered onto the perphenazine and it seemed that I got a similar response like the Amisulpride but not as uplifted.
I have tried many more to include several stimulant medications, as I seem to have a positive response to stimulating meds but have not been able to tolerate others again the I.C. I also tried Lithium and was on Depakote in combination with Parnate. Parnate was like a miracle drug for me for a couple of years. I wish I had had a good therapist at the time to take advantage of feeling so much better. There are more but these were on the tip of my tongue. You have helped me before and I appreciate the input. AndrewB is trying to help me but I cannot start what he has suggested until I am able to go off the oxycontin I am on for bladder pain. By the way the oxycontin was prescribed to be taken for the depression too. It does stop the massive anxiety. Now that I am thinking about it I have had to increase the dose the last few weeks for pain and I realize that I have been much less anxious. I know it but I did not realize why.
Thanks,
irene
Posted by ed_uk on February 4, 2005, at 6:10:21
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by iris2 on February 3, 2005, at 10:26:45
Hi,
>AndrewB is trying to help me but I cannot start what he has suggested until I am able to go off the oxycontin I am on for bladder pain.
What does he want you to start?
Ed.
Posted by JennaStarrett on February 14, 2005, at 19:38:05
In reply to Re: Cymbalta (duloxetine) - report » SLS, posted by iris2 on February 3, 2005, at 10:26:45
Hi everyone!
I have been reading this thread for about 2 hours now.... yall sound very understanding, and I feel like I know some of you already! I just received my sample box of Cymbalta today, and of course had to get the real low down from normal people and not promotion stuff. I just went through an extremely horrible "near death" withdrawal from Effexor XR (which I discontinued because I couldn't remember name, much less be alert for emergency response!- among lots of other things). I have been on Wellbutrin XL for about two months, but for the past few weeks have had the constant broken record in my head about topics to do with my self esteem, social anxiety (even aggitation and LOTS of anxiety). These are my usual problems when I get very depressed (I'm almost certain I have PMDD also). Right now I feel like I have an elephant standing on my chest from the anxiety. BUT HEY!!!! No side effects (go figure). I am hoping the mixture of the Wellbutrin and Cymbalta will help me feel better, I'm just hoping I don't get tons of side effects. Has anyone out there tried this combo? I'm finally back into my normal clothes and can have an orgasm after stopping Effexor. Most of all, What is the withdrawal from Cymbalta like (I don't want to go through another Effexor type withdrawal). Not sure if anyone has got that far yet. Thanks for listening,
Jenna
Posted by sabre on February 18, 2005, at 2:11:22
In reply to Re: Cymbalta (duloxetine) - report, posted by JennaStarrett on February 14, 2005, at 19:38:05
Hello Jenna
I haven't tried Cymbalta yet. How is is going for you so far?
It is unnerving trying new drugs but also exciting hoping that it is the one.
Good luck.
sabre
Posted by barbaracat on February 21, 2005, at 16:29:28
In reply to Re: Cymbalta (duloxetine) - report, posted by iris2 on February 2, 2005, at 23:48:07
Iris,
You're not alone. I had quite a strange reaction to Cymbalta just recently. Long story short, prescribed Cymbalta because I'd fallen into a very severe depression. I was taking lithium and St. John's Wort which was doing fine until I hit a bad stress event.Was leery about an AD because I'm also BP-II and had just also had a dosage change from lithium to depakote and seroquel (I was hospitalized and hence the med change), so there was a lot of med mixing going on. But with Cymbalta at 30mg I had the feeling of doing acid, colors, shifting and sliding landscapes, a 'claw' like feeling in my neck, cramping muscles, extremely emotional. My pupils were dilated and I truly felt there was an intense serotonin thing happening, as there is with psychedelics. I felt that the seroquel was not mixing well with this and didn't like it anyhow.
I ended up throwing away the Seroquel, going back on lithium and holding the Cymbalta at bay because I do feel it was doing 'something' with my mood. I felt absolutely crazy, but not depressed and there were moments of absolute delight. But I was also feeling on the verge of hysteria most of the time.
Two days ago I ditched everything and went back to lithium and St. John's. The very next day I woke up feeling just great, wonderful, as though my brain went though a chemical ECT. I don't understand this and would hate to think the Cymbalta was responsible for this reprieve and oh sh*t, I sure don't want to go back to where I was a month ago.
I'm going to start very slowly back on Cymbalta, a few grains at a time instead of the 30mg at a pop - way to strong for me. I'm interested if I'll experience those same rather extreme and bizarre effects now that my system has cleared out of the other drugs.
Does any one have any thoughts on going very slowly with this drug? Sometimes low amounts do weird things and just prolong the agony of adjustment. - Barbara
> Has anyone ever heard of getting very emotional on Cymbalta? I only took it one day and waws way out there. Need to decide whether to try again and to stay on it longer.
>
> Thanks,
>
> irene
Posted by ravenstorm on February 21, 2005, at 20:42:27
In reply to Re: Cymbalta (duloxetine) - report » iris2, posted by barbaracat on February 21, 2005, at 16:29:28
Barb--Did all of this happen just recently? I remember seeing your posts about lithium and SJW and how well you were doing not long ago.
Were you taking SJW with the cymbalta? That might really screw things up for you. And I don't know what the half life of SJW is, so I don't know how long you would have to be off of it before starting the cymbalta.
So sorry things went south for you. That sucks!
Sorry I don't have info on cymbalta, I just wanted to offer my support.
Posted by barbaracat on February 22, 2005, at 14:28:15
In reply to Re: Cymbalta (duloxetine) - report, posted by ravenstorm on February 21, 2005, at 20:42:27
Dear Raven,
Thanks so much for your support. I really need it right now as I'm going through one of the hardest times of my life.No, I wasn't on SJW during Cymbalta. I'll give you some background I hope doesn't take too long. Probably will, because my heart is heavy right now. I was doing quite well on lithium and SJW and then some very stressful events occurred around finances and my husband's inability to find work. He's been very blocked in that area, going through his own stuff but it's been going on 5 years and my disability check (I have fibromyalgia on top of bipolar), is, of course, not enough. He's stuck, we've had some financial hits, and I'm terrified because it also triggers huge childhood survival issues. Nor should a sick woman be continually supporting a healthy man. Big issues that were too much for my minimalist meds support.
I began to get constant panic attacks and once again had a collapse physically and mentally and had to be hospitalized.
In the hospital, I was taken off lithium and put on depakote because my hypothyroidism was worse (lithium isn't good for the thyroid, as I'm sure you know and the hypothyroidism I'm sure made things worse). I was also put on seroquel. This eventually put me into a very lethargic depression and, without the lithium, I began to cycle into an irritable hypomania - the lovely mixed states.
I was already pretty wired as well as despondent when I saw my new psych nurse practitioner. I've been on every SSRI/SNRI in the book and utlimately didn't do well on them, but maybe this 'new Cymbalta' would be different and worth a try.
Mind you, I was not on lithium at this point, only high doses of seroquel (depakote was dropped, but the new thought in psych cicles is that antipsychotics can be used as mood stabilizers alone - wrong in my case).
The first few days of Cymbalta were interesting in that by now I was truly hypomanic and the Cymbalta was adding a weird but interesting psychdelic layer over it - colors, melting watches and so forth, which increased serotonin sometimes causes. But soon I began to have very uncomfortable physical symptoms of a claw-like pressure in my neck and throat and a contraction in my muscles, dizzyness, my pupils were dilated, my eyes staring, I was hearing and feeling electricity all around and in me, couldn't sleep and feeling very anxious.
I looked at this wild woman in the mirror and said 'screw this, I'm going back on lithium'. I dropped the Cymbalta and seroquel (never liked it) and went back on lithium and SJW. For a a few days I had wonderful peace and normalcy, a taste of what it must, and used to be like. But then the torrent of sadness hit, wrenching sobbing, scenes of every painful event of my life ripping through me and all I can do is sob. I can't get anything done. The house looks like a tornado came through and all I can do is stare at the piles and can make no sense of them. My husband is depressed as well and so we're quite a pair. I don't want to stop this grief from coming up, even though I wonder how many times I have to go through with processing it. Putting an antidepressant on what's coming up for me would be like trying to stop Niagra Falls with a cork.
But I can't deplete myself with the stress of what I'm going through. It's definitely PTSD and I don't need to live through that again - but the pain of it is finally coming up. So I need lithium for sure, I know that, I need a gentle AD and I need BENZOs, lots of them, to find some gentleness, some soothing.
I don't know if the combo of meds I was on, especially the Seroquel, interacting with the Cymbalta, or that fact I was not on lithium at the time and if I should give it a chance once the bipolar element is stable. But I look at the side effects, my past history with SSRI type meds and think 'do I want to go there?'. No, I want to do this another way that does not suppress whatever process I need to go through and yet does not exaggerate it either.
So thanks for letting me talk, Raven. I really really needed a friend right now. - Barbara
- > Barb--Did all of this happen just recently? I remember seeing your posts about lithium and SJW and how well you were doing not long ago.
>
> Were you taking SJW with the cymbalta? That might really screw things up for you. And I don't know what the half life of SJW is, so I don't know how long you would have to be off of it before starting the cymbalta.
>
> So sorry things went south for you. That sucks!
>
> Sorry I don't have info on cymbalta, I just wanted to offer my support.
Posted by SLS on February 22, 2005, at 15:56:33
In reply to Re: Cymbalta (duloxetine) - report » ravenstorm, posted by barbaracat on February 22, 2005, at 14:28:15
How about adding Lamictal to the lithium?
- Scott
Posted by Phillipa on February 22, 2005, at 16:53:30
In reply to Re: Cymbalta (duloxetine) - report » barbaracat, posted by SLS on February 22, 2005, at 15:56:33
You're not alone. My husband has been out of work since we moved. He tried to start his own business but it's too seasonal here. Now, after l l/2yrs, he can't get his old job back. This after they assured him that he always could. His twin sister's husband works at the same job there, and there are just no jobs now. We chose pdocs, etc., in that area so we could move back. Yes, he's depressed, and I've been playing doctor with him and giving him something to sleep each night. We only have my Disability to live on, so I know what you're going through. And, if you're anxious and depressed yourself, it's a vicious circle. I'm sure his problems would disappear if he could again work. Then my anxiety would increase because he's not home. Why did I ever stop working and become so disfunctional? Fondly, Phillipa
Posted by barbaracat on February 22, 2005, at 16:56:47
In reply to Re: Cymbalta (duloxetine) - report » barbaracat, posted by SLS on February 22, 2005, at 15:56:33
Ah, Lamictal. It worked just great for about 6 months at a fairly low dose, pooped, and I had to go up to 150mg where I began to get the rash and had to stop. Eventually did get the rash, Stevens Johnson Syndrome, in all it's glory from another drug, but I believe the prodromal rash state from Lamictal sensitized me.
Kiddo, I'm one sensitive unit and it appears to me that pharmaceutical meds are not a good choice in my healing path.
> How about adding Lamictal to the lithium?
>
>
> - Scott
Posted by barbaracat on February 22, 2005, at 17:05:17
In reply to Re: Cymbalta (duloxetine) - report, posted by Phillipa on February 22, 2005, at 16:53:30
But if he goes back to work, your anxiety would definitely lessen and I'm sure you'd find things to do. I know I would. I'd put on music and get back to belly dancing in the living room and not care about how fat he thinks I look shakin' it in my coin belt. You know? You could have your own thoughts and energy back and it may be hard at first, but you'd get into the flow. I know I will.
My husband and I tried to start our own computer consulting business and it went OK for a while then business dried up. Yes, times are very tough and realizing this is rather frightening. What's happening to this country is another story...
You could write to me privately through babble mail if you want. I enjoy your posts to me and do feel not so alone. - Barbara
> You're not alone. My husband has been out of work since we moved. He tried to start his own business but it's too seasonal here. Now, after l l/2yrs, he can't get his old job back. This after they assured him that he always could. His twin sister's husband works at the same job there, and there are just no jobs now. We chose pdocs, etc., in that area so we could move back. Yes, he's depressed, and I've been playing doctor with him and giving him something to sleep each night. We only have my Disability to live on, so I know what you're going through. And, if you're anxious and depressed yourself, it's a vicious circle. I'm sure his problems would disappear if he could again work. Then my anxiety would increase because he's not home. Why did I ever stop working and become so disfunctional? Fondly, Phillipa
Posted by Phillipa on February 22, 2005, at 17:50:31
In reply to Re: Cymbalta (duloxetine) - report » Phillipa, posted by barbaracat on February 22, 2005, at 17:05:17
Thanks, I will. Fondly, Phillipa
Posted by Rhapsody on February 22, 2005, at 18:14:32
In reply to Re: Cymbalta (duloxetine) - report » iris2, posted by barbaracat on February 21, 2005, at 16:29:28
Barbaracat,
I wish you success with taking Cymbalta at a low level. It took me several weeks (about 5) to begin to see positive affects from Cymbalta.
Please let us know how it goes for you. Also, I feel certain that you and your husband will get through this difficult time together. Take care!
My Best, Rhapsody
> I'm going to start very slowly back on Cymbalta, a few grains at a time instead of the 30mg at a pop - way to strong for me.
>
Posted by ravenstorm on February 23, 2005, at 15:46:42
In reply to Re: Cymbalta to Barbaracat, posted by Rhapsody on February 22, 2005, at 18:14:32
Barb-I'm glad you are back on the lithium, it has always seemed to work for you. I know you also take thyroid meds. Do they help at all with the lithium induced thyroid problems?
I think we know our bodies. If you have never done well on an SSRI or SNRI even while on lithium, then it probably isn't worth the risk. If all of your trials were WITHOUT a mood stabilizer, than you met have reason to rethink it.
Hang in there!
Posted by barbaracat on February 23, 2005, at 19:05:22
In reply to Re: Cymbalta to Barbaracat, posted by ravenstorm on February 23, 2005, at 15:46:42
> Barb-I'm glad you are back on the lithium, it has always seemed to work for you. I know you also take thyroid meds. Do they help at all with the lithium induced thyroid problems?
**I go through periods of relative stability with my TSH around 2.0 or so, but then it will rise for whatever reason. I've gone back to straight Synthroid T4 instead of the natural T3/T4 so we'll see if it holds. So many other things are involved with thyroid and my sex hormones were very low according to a recent test. Very low progesterone cascades on down to low estrogen, low thyroid and low serotonin. I use a bio-identical hormone cream and had that adjusted as well.
The question becomes why are all these hormones fluctuating? To tell you the truth, I think it's mercury. I have a high mercury level and mercury likes to occupy all those hormone receptors. But that's another huge issue I'm dealing with that won't be gone right away and until it is I have to deal with the symptoms as they arise.
So these hormonal swings no doubt contributed to my recent crash but indeed I need a mood stabilizer also and lithium seems to be it. To let you know how wiggy my system is, I've been taking 3 little grains from my Cymbalta capsule and getting a response that is definitely a feeling of having taken Cymbalta. No wonder I was tripping my fanny off with 30mg.
It makes me really question the dosages of many of these meds. Perhaps some of us, especially bipolars, don't need the standard dosages of SSRIs and would benefit instead from minute amounts, as I seem to be doing. An interesting chemical soup we live in. Thanks for your response and ongoing support, Ravenwood. If I can ever return the favor... Barbara
>
> I think we know our bodies. If you have never done well on an SSRI or SNRI even while on lithium, then it probably isn't worth the risk. If all of your trials were WITHOUT a mood stabilizer, than you met have reason to rethink it.
>
> Hang in there!
Posted by ravenstorm on February 23, 2005, at 23:19:07
In reply to Re: Cymbalta to Barbaracat » ravenstorm, posted by barbaracat on February 23, 2005, at 19:05:22
Thanks Barb, I'm feeling a bit unhelpable at the moment. Have loads of tests run through a wholistic MD but I either have bizarre results that they haven't seen or I can't take the cure due to my stomach problems. Hormone test came back with elevated progesterone levels (like TWICE as much progesterone as I should have). They can't give me a hormone creme to take away too much progesterone now can they? The massive amounts of progesterone do explain why I am having the horrible/debilitating blood sugar swings on remeron. Too much progesterone=wacked blood sugar. Of course I suppose this could be reversed, that remeron is messing with my progesterone etc etc. It has definitely thrown my whole freakin' cycle off. I know I can't have a life until I get off the freakin' remeron and get rid of all of its horrible side effects but I can't even cut it in half without withdrawals and I don't know what the hell I would take next anyway.
Waiting to get some compounded remeron and start a slow descent off, which shouldn't be much fun since suppossedly I will get more side effects as I drop the dose. Don't you just want to get a new brain? Actually, I'd even settle for a new stomach. At least that way I could take the freakin' SSRI I need to get on with my life.
Posted by Phillipa on February 23, 2005, at 23:53:50
In reply to Re: Cymbalta to Barbaracat, posted by ravenstorm on February 23, 2005, at 23:19:07
I was told you couldn't test for individual hormone levels, only FSH. This was during menopause when I was using a compounded cream. I never heard of compounded remeron. Who is this MD,and where do you live? Fondly, Phillipa
Posted by ravenstorm on February 24, 2005, at 9:32:29
In reply to Re: Cymbalta to Barbaracat, posted by Phillipa on February 23, 2005, at 23:53:50
You can do extensive saliva testing for hormones. I collected samples on ten different days of my monthly cycle.
I will be getting smaller and smaller doses of remeron from a compounding pharmacy in Seatle.
Posted by iris2 on February 24, 2005, at 11:03:14
In reply to Re: Cymbalta (duloxetine) - report » iris2, posted by barbaracat on February 21, 2005, at 16:29:28
I started the cymbalta again and this time had no trouble at all. I was on it for about two weeks and had increased the dose to 60mg with no side effects at lal. I went off of it for now because my bladder desease is so bad that I am going on a very strict diet ( about ten foods) for three weeks and adding other foods gradually after that to see what food allergies I really do have. I did not want anything including drugs to interfere with the process. I plan on going back on the cybalta after several weeks on the diet. Good luck with your trial on it.
irene
Posted by ed_uk on February 24, 2005, at 12:03:59
In reply to Re: Cymbalta (duloxetine) - report, posted by iris2 on February 24, 2005, at 11:03:14
Hi Irene!
How are you doing? Are you still taking OxyContin?
Regards,
Ed.
Posted by barbaracat on February 25, 2005, at 21:10:50
In reply to Re: Cymbalta to Barbaracat, posted by ravenstorm on February 23, 2005, at 23:19:07
Oh, Remeron. Yes, I know the Rem well. The first two months were heavenly. That was 2 years ago and I'm still trying to lose the weight I packed on those many months I was hoping it would kick in again.
Too much progesterone - that is unusual as an ongoing problem but certainly plays a part in severe PMS. You must be younger than perimenopause age singe low progesterone is more typical for that age group. Actually, there is something that counteracts progesterone and that is estrogen, but it's best to get at the source. It's interesting that Remeron may screw with hormones. Mine have certainly been screwed the last few years.
I also have bad stomach problems, no so much pain or anything, but bad dysbiosis. That surely is contributing to our problems. Toxicity in the gut from whatever reason is going to take it's toll and in my experience, takes a while to resolve. What is your stomach problem? If you're going to a naturopath you've probably already looked at avoiding all the glutens and allergens. My allergy tests came back negative on everything but lately I've been on a very simply diet with no grains or dairy and feel like it's helping to relieve some of the digestive burden.
Good luck with the Remeron withdrawal. It's interesting, but that's the only AD I didn't have any trouble weaning off from. Amazingly, I'm still getting very good response from 4 little pellets of Cymbalta. At this rate my prescription of 30 capsules will last the rest of my life. It's something to consider while you're divorcing Remeron. Just don't let anyone talk you into the standard 30mg dose.
> Thanks Barb, I'm feeling a bit unhelpable at the moment. Have loads of tests run through a wholistic MD but I either have bizarre results that they haven't seen or I can't take the cure due to my stomach problems. Hormone test came back with elevated progesterone levels (like TWICE as much progesterone as I should have). They can't give me a hormone creme to take away too much progesterone now can they? The massive amounts of progesterone do explain why I am having the horrible/debilitating blood sugar swings on remeron. Too much progesterone=wacked blood sugar. Of course I suppose this could be reversed, that remeron is messing with my progesterone etc etc. It has definitely thrown my whole freakin' cycle off. I know I can't have a life until I get off the freakin' remeron and get rid of all of its horrible side effects but I can't even cut it in half without withdrawals and I don't know what the hell I would take next anyway.
>
> Waiting to get some compounded remeron and start a slow descent off, which shouldn't be much fun since suppossedly I will get more side effects as I drop the dose. Don't you just want to get a new brain? Actually, I'd even settle for a new stomach. At least that way I could take the freakin' SSRI I need to get on with my life.
Posted by iris2 on February 28, 2005, at 9:49:28
In reply to Re: Cymbalta (duloxetine) - report » iris2, posted by ed_uk on February 24, 2005, at 12:03:59
Ed,
I took Cymbalta for two weeks with no obvious side effects. I stopped taking it and almost everything else I was taking because my interstitial cystitis had gotten so bad I need to invest energy and diet towards getting that under control and most meds have some effect on it. When I get it under control I plan on starting the Cymbalta again.
irene
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