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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ben on October 29, 2005, at 10:30:04
Hi
I was taking up to 600mg/d of Effexor with moderate benefit. This summer I switched very slowly to Cymbalta without serious problems. Now I have still 150mg Effexor ER along with 80 mg of Cymbalta per day. I read of possible interactions between this two drugs. It could be the CYP2D6 enzyme which is inhibited by Cymbalta and it is the pathway of elimination from Effexor.
Since about 4 weeks I am having severe (tension?) headache coming from my neck (my doctors thoughts). I don`t know if it `s from the Effexor which could be araised in the blood?! I remember when I increased Effexor I was having very similar headache. I tried most of all pain killers and only tramadol gave me some relief (beside ibuprofen in high doses).
Now I went to a doctor which is specialized in pain (don`t if it the correct word) and he made me injections of lidocaine in the neck (near the ears --> occipital nerves). In a few hours the headache was gone but it went back the next day and increased to the same level. Asecon time he used bupivacaine and the effect wasn`t such good but lasted longer.
Is there a possible connection to the drugs or it is an other "story" ?
Do you have some inputs, thoughts, comments ore experiences?many thanks for your help
ben
Posted by ed_uk on October 29, 2005, at 13:52:24
In reply to Interaction between Effexor and Cymbalta?!, posted by ben on October 29, 2005, at 10:30:04
Hi Ben,
Some people do develop headache/neckache while taking serotonergic drugs, especially at high doses. Some people have reported muscle tension in the neck and upper back.
Is your blood pressure normal?
Kind regards
~ed
Posted by ben on October 29, 2005, at 14:35:27
In reply to Re: Interaction between Effexor and Cymbalta?! » ben, posted by ed_uk on October 29, 2005, at 13:52:24
Hi Ed
My blood pressure is okay - a lilttle bit low but this is in our family. I wonder if it could be the Lamictal in my cocktail (125 mg/d) but I am taking it since summer without any side effects. Can headache occur weeks later? I don`t think so but who knows. Perhaps I have to wean completly oFF Effexor and then considering something else if it doen`t work. But what do you think of the CYP2D6 inhibition causing something like cumulation?!
Do you know if Lyrica differs a lot from Neurontin? I think Neurontin is loosing its effectiveness except to make me forgetting a lot (memory probs).
Perhaps I should try a tricyclic AD but I can`t bear amitryptilin or trimipramine - they make me drowsy the hole day!
Sorry I have too many questions but having headache each they without any success makes you unpatient.best regards
ben
Posted by ed_uk on October 29, 2005, at 15:23:45
In reply to Re: Interaction between Effexor and Cymbalta?! » ed_uk, posted by ben on October 29, 2005, at 14:35:27
Hi Ben
>I wonder if it could be the Lamictal in my cocktail (125 mg/d) but I am taking it since summer without any side effects. Can headache occur weeks later? I don`t think so but who knows.
It seems unlikely. I suspect that your headache is due to taking too high a dose of Effexor and Cymbalta. I'm not sure about the interaction. Could you reduce the dose of Effexor?
>Do you know if Lyrica differs a lot from Neurontin?
No, I don't think so.
>Perhaps I should try a tricyclic AD but I can`t bear amitryptilin or trimipramine - they make me drowsy the hole day!
Is depression your main diagnosis? Some tricyclics are much less sedating than amitriptyline. Have you tried any TCAs so far?
Best regards
Ed
Posted by ben on October 30, 2005, at 1:20:49
In reply to Re: Interaction between Effexor and Cymbalta?! » ben, posted by ed_uk on October 29, 2005, at 15:23:45
> Hi Ben
>
> >I wonder if it could be the Lamictal in my cocktail (125 mg/d) but I am taking it since summer without any side effects. Can headache occur weeks later? I don`t think so but who knows.
>
> It seems unlikely. I suspect that your headache is due to taking too high a dose of Effexor and Cymbalta. I'm not sure about the interaction. Could you reduce the dose of Effexor?
>
> >Do you know if Lyrica differs a lot from Neurontin?
>
> No, I don't think so.
>
> >Perhaps I should try a tricyclic AD but I can`t bear amitryptilin or trimipramine - they make me drowsy the hole day!
>
> Is depression your main diagnosis? Some tricyclics are much less sedating than amitriptyline. Have you tried any TCAs so far?
>
> Best regards
>
> EdEd
I tried trimipramine up to 100mg but it was too sedating and I gained weight. Amitryptiline was the same thing. Lofepramine made me very nervous and agitated. What about clomipramine - but together with my cocktail it could be dangerous ?! I think the main problem is pain, but my pdoc sees it from depression!? Nefazodone was very good but no more available. Trazodone is much more sedating. I dont know what to do.
best wishes
ben
Posted by ed_uk on October 30, 2005, at 10:24:33
In reply to Re: Interaction between Effexor and Cymbalta?!, posted by ben on October 30, 2005, at 1:20:49
Hi Ben,
>What about clomipramine - but together with my cocktail it could be dangerous?!
Clomipramine is less sedating that amitriptyline or trimipramine. Still, it can be sedating. If you want to try clomipramine, you'll have to come off your current meds first, or at least reduce the doses substantially!
Kind regards
Ed
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