105- Ali Handel and Cymbalta

[Bill W(not wilson)]

I used to take Cymbalta the way Ali did. She seemed to be dealing with some side effects I used to have of the severe energy loss. I was able to manage the side effects related to sleepiness and other energy loss by taking 1/2 my dose in the morning and 1/2 at lunch. My experience is that Cymbalta itself doesn't make you tired, but works as a stimulant. Without the stimulant, you crash. I've been on cymbalta for about 8 years and used the above dosing for the last 5. I have a hard time feeling alert enough to do anything before the first dose and I feel myself nodding off if I don't take the lunch dose by 2.

Before understanding Cymbalta was a stimulant, I took one 60 mg pill in the morning and one at night. with this schedule I was incapable of staying awake past 6 pm and routinely falling asleep at my desk around 4. I would regularly have coffee to stay awake in the late afternoon or early evening. The coffee and nightly stimulant took a horrible toll on my sleep patterns, thereby exacerbating my depression to the point my shrink sent me to a sleep doctor. The sleep doctor, a neurologist, told me about the stimulant-crash issue and that I obviously shouldn't be taking stimulants at bed time. Apparently Lilly (the manufacturer) did not do a good job spreading the word about the stimulant qualities to most doctors and pharmacists. Per my shrink, Cymbalta was (and is still advertised as) a pain management tool used primarily prescribed by neurologists. Accordingly,also per my shrink, the neurologists in general have a better understanding of it.

I'm still depressed and still have crappy sleep patterns, but the bad sleep is no longer directly caused by the cymbalta and too much caffeine too close to bed. For a variety of reasons and other medications I take (lamictal, and straterra) my doctor wants me to stay with the cymbalta instead of switching. I think the lilly rep just gives the best blow jobs, but I can be cynical.

Of course, to borrow and expand upon Paul's disclaimer, I'm not a doctor, just a lawyer who never had the cajones to step up to a mic and follow his dream of telling dick jokes.


I started a new topic b/c my thoughts deal specifically with Ali's used of medication and didn't want to derail the discussion in the other thread about that episode.

[Nevina]

That's fascinating, I had no idea Cymbalta was ... I guess I didn't know what it was (looked it up on Wiki due to your post). Sounds like maybe something I should ask my doctor about since I have chronic anxiety and intermittent depression and lower-back arthritis and some nerve pain. Weird that one med might be good for all of those - on the other hand, I am taking nortriptylene for the pain which may also help my other problems.