Cymbalta for Anxiety?

July 2, 2016 10:01 AM

Tell me about your experience with Cymbalta, when prescribed for anxiety.

Doctor has prescribed me Cymbalta, to see if it will ease the anxiety side effects of Wellbutrin XR (300mg).

Before I pick up my prescription later today, I would like to hear about others' experiences taking Cymbalta for treatment of anxiety (generalized anxiety disorder, in my case) and depression.

Especially interested if you took it in combination with Wellbutrin; whether or not you took your Cymbalta in the morning vs at night; any and all side effects you experienced and how you managed the side effects; if you took it with Wellbutrin, did you continue with the two in combination, or ever make a switch off of Wellbutrin to just Cymbalta?

Some context on my situation:
- I've been on Wellbutrin for about 8 years.
- After taking a few months 'break' from Wellbutrin earlier this year, then going back on it, I learned that it was definitely playing a part in exacerbating my anxiety.
- SSRIs (Prozac, Lexapro, etc) have, historically, not worked for me when it comes to treating my depression (when I take them, I feel like a stoned robot), hence my insistence on sticking with Wellbutrin for now because I'd rather be "anxious but not depressed" than... a stoned robot? So I'm reluctant of SSRIs, but I'm open to seeing where an SNRI takes me.
- I'm also on stimulants for ADHD.
- I treat my anxiety with Ativan, as needed.
- This suggestion to try out Cymbalta came after my doctor and I discussed that my anxiety seems to be the root of most of my frustrations right now. He feels I should take my Ativan more often (I have a prescription for 1mg up to 3x daily, but I usually only take 1mg in the morning and occasionally another 1mg in the afternoon. I seem to do tremendously better if I take 2mg in the morning and 1-2mg again in the afternoon and before bed, but for now I'd like to see how the Cymbalta works. If the Cymbalta doesn't work out I will talk with my doctor more about increasing my Ativan dosage, or switching to Valium- we've discussed both possibilities in the past, but wants to see how an SNRI works for me first.)
- I do lots of non-medicinal activities to treat my anxiety (exercise, meditation, good sleep hygiene, nutritious diet, etc). I'm just curious to hear about Cymbalta experiences with regard to anxiety.

(Also: I have chronic nerve pain (L4-L5 herniation with impingement), joint inflammation since my mid-teens, and fatigue - still working with another physician on diagnosing the source of these symptoms - and am curious if anyone with both anxiety and chronic pain took Cymbalta and found it helped with both.)

posted by nightrecordings to Health & Fitness (7 answers total)

I've taken this combo with buspirone added, so take that as you will. Your body is different, etc.

I have pretty bad RSI from my wrist into my back because after finding out I had carpal tunnel in my wrist I let myself be talked into joining a bowling league, which if you have carpal tunnel is not something you should do. Okay. On top of the anxiety disorder I have clinical depression which comes with a lot of aching that just made the repetitive stress injury so bad that sometimes my entire right arm was just useless and frozen.

The Cymbalta was awesome for the pain. First, the general achy like it's about to rain feeling drained out of my body. Then the RSI became something that I could easily handle with an advil, there was that much of an improvement. Such an improvement that I was like, why don't they market this as something that helps with pain? And irrc my doctor told me it was often given to fibromyalgia patients. So you may see an improvement. I saw improvement after about two weeks of steady use. Also, my migraines were fewer and not as bad. Also a nice side effect.

When I first started it, Cymbalta knocked me out. I would take it and conk out somewhere for an hour. The doctor told me to take it at night, which helped. After a while it stops that. Your body gets used to it and then you can take it during the day. Eventually I had a small dose in the morning and a larger dose in the evening. But it took a good month or so for my body to adjust and every time you get a dose change you'll get a bit tired.

Take it on time. same time every day. If you don't you'll feel jittery and unsettled.

I want to tell you about a side effect I encountered that my doctor didn't know to warn about and isn't on the drug sheet. I thought it was just me until I started talking to other people taking Cymbalta and we all had that "HOLY SHIT, IT'S NOT JUST ME" moment.

You may develop what seems like a stutter. I'm going to try to explain this the best I can. It's like your brain is the office that makes up sentences and it puts each word in a manila folder. Each folder has three sheets of paper - 1) the written word, 2) an image of the word, and 3) a sound file of what the word sounds like as you say it. Your brain gathers all the folders, sends them to your mouth and you have a conversation.

After I started taking the Cymbalta sometimes the folders came with just the written word and a picture. Or just a picture. Just something was missing. I'd be talking and suddenly in my head I could see a picture of a fork. I could see the word fork. But the word as you say it wasn't there. Then I'd get anxious and my brain would send a bunch of pictures and words as context clues and I'd be playing charades with myself while someone stood there confused. "Can you hand me the... that...chair, no table. Chair, table, room. Dining room. Spoon. The spoon with the points!" Suddenly all the connections would hit and I'd yell fork like a demented 2 year old just learning the word.

This happened a lot at first. Then it tapered off. I no longer take this drug combo, but still every once in a while I can't say a word. Or I'll write the word down and it won't 'look' right even if it's spelled correctly. And like I said, my doctor and I thought it was just me until I talked to other people and they were like, "That happened to me!"

Hope this helps. It was hugely effective when I was taking it.
posted by 80 Cats in a Dog Suit at 12:42 PM on July 2, 2016 [1 favorite]

I have been trying to recover from a big b12 deficiency problem this year which gave me some whopping anxiety and depression at the start, and crazy nerve pain, for which I took Cymbalta. I think it kept me on a slightly more even keel depression-wise, but did nothing (or worse?) for anxiety. I might have stayed on it for the major nerve pain and minor depression help (and let benzos sort the anxiety) if not for two totally unexpected side effects, viz: debilitating headaches that didn't respond to anything (and I have never been headache-prone), and remarkably bad acne (backne, chest-ne? bloody everywhere, with cysts). It took the headaches and acne a month or two to subside after I went off it.

Sorry I don't have better news. On the plus side, I have a pretty robust collection of "~itises," and it certainly did not make my joint pain issues any worse, and it did not, I don't think, do anything fatigue-wise.
posted by kmennie at 1:13 PM on July 2, 2016

I don't know anything about Cymbalta, but if you're concerned about benzos (understandably), you might want to ask about Buspar if the Cymbalta doesn't help. It's an anti-anxiety drug that isn't habit-forming.
posted by mister pointy at 2:24 PM on July 2, 2016

I had a REALLY, REALLY, REALLY bad experience with Cymbalta. I was taking it for Anxiety and Chronic Pain, I didn't have any Depression.

I had side effects including:

trouble finding words when talking (aphasia)
losing my train of thought mid-sentence
trouble reading
trouble talking due to lack of brain
drowsiness/sleepiness/sedation
brain fog

severe balance problems so bad that I was holding onto walls as I walked around my house;

nightmares
trouble falling asleep
waking up at 2am or 3am
waking up at 4:30am or 5am and not being able to sleep anymore
a mouth so dry that it wakes me up

feeling like a zombie, emotionally disconnected from everything as though nothing is real;

feeling so excessively calm that I almost got hit by a car crossing the road because "Oh, I have plenty of time to cross before that car gets here";

loss of sex drive
loss of sexual response

my vulva getting so dry and irritable that I had to swap toilet paper for babywipes. "Everyone knows Cymbalta dries out mucous membranes" said the pharmacist finally. Um, not me. Not my Dr either.

aggravating my psoriasis

sweating like I've run a marathon when all I've been doing is sitting down

appetite suppressant effect so that I keep forgetting to eat until I feel tired or have a headache from low blood sugar

mood swings
posted by Sockpuppets 'R' Us at 8:51 PM on July 2, 2016 [1 favorite]

I have been taking Cymbalta for GAD and mild depression for 5 years now. I don't take any other medication. I was warned before taking it that some people have really bad side effects from it, and that if I felt awful after a week or suicidal at all, I should come back to see my doctor immediately. I had strong but manageable side effects for the first few months on 30mg, mostly tingliness and being clumsy - like a stutter for my hands and feet. I then went up to 60mg and hated it. At that time I had brain zaps, nausea and really disturbed sleep patterns.

So I went back to the 30, because the difference it made to my anxiety was amazing. All sorts of random little health problems (IBS, headaches, backaches) went away. I had energy I didn't realise I was capable of, and doing all the sensible health things like diet, exercise and sleep became much easier. And I preferred even a partial fix with some side effects to full fix with awful side effects or no fix and no side effects.

Two years later I tried to go off the 30, stepping down to 15mg for two weeks then nothing. Do not do this, I felt a full flood of anxiety plus nausea and crying and paranoia. Do it more slowly, take ages to do it. But after the withdrawal was over, I realised that the anxiety was not something I was prepared to live with anymore. I'd gotten my dream job and my marriage was awesome because I wasn't wasting all my time and energy on GAD anymore.

So I went back on the 30, and after 2 years I went up to 60 again just to see if I could manage the standard dose. This time I've had barely any increase in side effects and only feel anxiety when there's actually a stressful situation like a work deadline.

In short: it is worth a try, but take longer to shift through the doses than is recommended. Take it at the same time every day (I find morning better for my sleep patterns but your mileage may vary) or you will get withdrawal symptoms. And if you feel like shit for too long, don't hesitate to move on to something else. Cymbalta has been wonderful for me, it's changed my life. But so much depends on your own body chemistry and I assume the other medication you take as well. So if it's not for you, that's the end of the story.
posted by harriet vane at 3:31 AM on July 3, 2016

I took Cymbalta for GAD at some point. It helped a lot, but I believe it made me a big sluggish so my doctor added Wellbutrin on top of it.

The biggest problem was that Cymbalta gave me low-level acid reflux, and Wellbutrin on top of it created gut-stabbing pain. I toughed it out for a while, adding in Prilosec, and taking the meds on a full stomach, but I eventually switched. Unfortunatley, my GI tract never recovered and I've had stomach problems ever since.

YMMV, and this is just one experience. A lot of people love Cymbalta.
posted by radioamy at 8:20 PM on July 3, 2016

I took it for chronic pain and depression/anxiety. It definitely helped my pain. I was on 60 in the morning. I had no problems with sleepiness, though my brain seemed slowed down in strange ways. My doctor wanted to put me on 90, but the insurance company said hell no. She added in Wellbutrin, but at that time, it made me jittery. Right now I'm on Wellbutrin and Celexa. I want to go back to the Cymbalta for the pain relief aspect. I just need to talk the doctor into it.
posted by kathrynm at 9:19 AM on July 6, 2016