Antidepressant Duloxetine side effects tough, any suggestions?

Posted by mombo @mombo, Aug 19 5:08pm

I am a RA patient. I am in search of an antidepressant that can help with pain but not Duloxetine which had me very agitated. The charts of antidepressant side effects are overwhelming. I thought I would reach out here to see if anyone had antidepressant suggestions. I realize the result are quite varied but suggestions would be a good start for the next one. Thanks

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@thenazareneshul

I sit corrected. Thank you. As far as my chemical allergies go, first of all, it runs on both sides of my family. My mother was a nurse and the first to get them documents. She had the usual kind, to all fragrances, then later to peanuts. My Dad's allergies wasn't really talked about. My aunt, my Dad's sister had allergies to neuroleptics too, likely more prescriptions. My brother's son has more and worse ones than I have. My sister's is like my mother's. My brother is allergic to bone glue and he processes anesthesia's really fast. As do I, with a few ones too. Our cousins have some, one of them very bad ever since infancy. Both she and her sister.

I am convinced that one day, it will be found to be genetic. Some drugs I simply process totally different than what it's designed for. There is an antibiotic cream that actually causes me to have pimples. In my 30s and 40s I used to have really horrible migraines. So, when I got both the flu and a migraine one year, a friend convinced me to go to the local ER, which I did. There, I faithfully listed my known allergies at that time, all of which were to chemicals (then). Here's probably the best example. I told them at that ER (and another one later on) I could not ever take any neuroleptics, or despirimine. The despirimine, being a tri-cyclic drug, having sensitized me to both itself and all neuroleptics. At least, this was true then. New classes of both antidepressants and maybe neuroleptic's, also, have since been invented.

Anyway, the doctor kindly ordered a chemical cocktail IV, that was a mix of 3 drugs, for the migraine pain. The nurse put the needle in my arm, and I felt it...so horrible. I only had time to say "Oh God" and that was the end of that. Next thing I knew, another nurse was in my face trying to get me to check myself into the hospital for depression. I thought she was so out of order with that. I had come in for bad flu and a migraine. But the friend with me, she seemed to think I should stay at the hospital. Well, it was true I was going through a divorce I hadn't wanted, so I did as they wanted. Eight days later, I went home, recovered from the injection and my flu. Weeks later, my friend off handedly mentioned the seizure I'd had in the ER that day. It turns out, I'd gone straight into tonic clonic seizure, in the chair onto the floor, the whole bit. It was from the fact that Inapsine, a neuoleptic, was one of the 3 drugs in that chemical cocktail put into me. I have more stories of things like that. It got so bad in the 90's that just disclosing to a new doctor that I was allergic to such drugs knee-jerk caused the doctors to think I had a major MH illness. I never said I did. I was sitting there quietly. It doesn't happen much anymore, which is really good.

Eventually, I made it to a well respected Allergist, who kindly told me (like I was an idiot) that if I knew a drug would likely harm me, or gives me terrible side effects, I shouldn't take them! I just looked at him, trying to figure out how to tell him that sometimes I was extremely pressured (for no justifiable reason) to take drugs in classes I knew were mostly harmful for me. Suddenly, he just got it, and he wrote down a list of all the drugs his search of my medical records and exam had showed him that I was allergic to. He promised me that record of his would always remain in his records. Then, he gave me my own copy to have and told me to never lose it. As far as I am concerned, from that day to now, I believe he just plain saved my life and that of the infant daughter I had by that time.

Because of the permanent harm done to my nervous system by errors, prejudice, and misjudgments done to me, down through the years by doctors, I now must take several prescription drugs 3 times per day, for the rest of my life. There are specifically to treat the 24/7 pain I ended up in. It includes spasticsities, seizures, and repeated TIAs. I am blessed that my once infant is now in her late 20's and is the best live-in caregiver any 70 yr old woman could possibly want to have. She also has a "regular" job outside the home, good friends, is well balanced, and has a life outside our home too. A good friends of her's father recently lost a leg in a car accident, but survived, spending something like a week in ICU. My daughter amazed me at how she so naturally walked her friend through that whole experience. I am so blessed now.

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Thank you @thenazareneshul ! You have had a difficult life (at least from a medical standpoint).
I just don’t want you hurt in any way by saying something incorrect on the site. By any chance, did your daughter go to nursing school after doing her “mom” caregiving? Sounds like she has what it takes! I just did the math and I’ve been a nurse for 30+ years! I’m pleased that I got to meet you! What problem or issue can we help you with?

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Thank you. My daughter did not go to nursing school. At one time, I became paralyzed, she was 16 yrs old at the time. It later was diagnosed as a slipped cervical disc but we were living in Alaska at the time, and I wasn't able to get to doctors, even if we'd had specialists like that. I am a person of faith. I'd raised my daughter to be one too. The gist of our faith is "trust God." So, as I was on AK Medicaid and they do allow for family caregivers, I called them to come and get me approved for those programs. So, while they got around to fitting me into their visiting schedule, I paid for and sent her to some Red Cross classes. We barely had internet there, some days it wasn't much better than dial-up, but she was able to look up instructions online about how to lift someone much heavier than she. And I maxed out my credit card on taxi rides, to keep us in supplies. Eventually, I can out of it. The cervical disc moved back into place (sort of) and I was able to get up and learn to walk again. Right about the time the AK State nurses called me to schedule a visit to get the ball rolling for her to become my paid PCA (they call caregivers there). She declined their offer. She had her own income from the death of her father, not a lot, but enough that it gave her choices. She does what she does for me out of love. I can not argue with that. Only be grateful. She could make lots getting paid for the time and work she does for me, but declines. I have to respect that. It's our goal to raise our children to make their own decisions and to stand strong if they're sure they are right. She can change her mind. We live in Seattle and just moved out of its University District. I'm sure if she wanted to, she could take some college classes here. I've suggested it many times. Both my older kids have their college degrees but she declines.

As far as what Mayo online can do for me, this is helpful. Doing this right now. I get notices from the others in my email of "like" or "hug" and it does surprise me. Most of my life there was no feedback at all. Even your correction was something I value. There has been so little of that to me.

I have more "conditions" than I know what to do with. In reality, I barely even think of them. Each day, I deal with what is, and what plans I hope to fulfill. A lot of those have to do with checking out what options, or the opinions of specialists I now, for the first time, do have access to. I am also working on being kind to those who (in my opinion) break my trust. Which necessitates me having to change my plans. I am sorta good at that, having had to learn out of necessity. I am next to try out a new prescription, it could go very bad, or it might be as helpful as the doctors (several of them) believe it will be. And also, I am to see a neurosurgeon about a newly discovered rare condition in my L spine, along with stenosis and necrosis in one hip.

We moved recently into a much improved housing. That's as good as a good medicine for the attitude. Thanks for asking.

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@amkie

Cymbalta surprised me. My depression lifted almost immediately. I was taking it for neuropathy pain and did realize how depressed I was. It had just slowly started coming on since this life changing medical condition started in spring of 23. No real change in the pain aspect however. No side effects that I have observed.

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Interesting and my reaction was reversed to yours but we both discovered its benefits?!
I was taking it for depression and when I felt I wanted to try going without I weaned off it with MD instructions.
Imagine my surprise when, once I was off it for a few weeks, my pain from spinal problems greatly rebounded! Yikes! I ended up going back on it to help with radiculopathy and have remained on it.

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That is interesting. Goes to show how different people are and one answer is never right for everyone. It sure would be simpler if that were the case.

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@wisco50

Interesting and my reaction was reversed to yours but we both discovered its benefits?!
I was taking it for depression and when I felt I wanted to try going without I weaned off it with MD instructions.
Imagine my surprise when, once I was off it for a few weeks, my pain from spinal problems greatly rebounded! Yikes! I ended up going back on it to help with radiculopathy and have remained on it.

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Nothing is a straight line with RA. Thanks.

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There is St. John's Wort, an OTC supplement. It worked very well for me, even though it's not advertised for severe depression. Do inform your doctors though if you try it out. It's considered an MAOI type antidepressant, with mild anti-anxiety to it too.

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Thanks- it is a big project to sort through these medications.

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I have an undiagnosed autoimmune illness that causes pain. My GP thinks it's fibro, but the rheumies do not. In some ways, it behaves like that, but in other ways not. I get signficant pain, but it is months between and usually only lasts 24 hours, and has never been pinpointed in the ER or by any other tests. Just high ANA. All that to say, my dr originally put me on Dulox, and the pains increased, and I began having panic attacks, but over time they subdued. The only noticeable side effect I had was more sweating, a lot more. It did help with my general anxiety. The biggest problem I had was it made me crave wine, no kidding it's a thing. It got to a point where I was drinking too heavily and impacting my life negatively (which by the way is unsafe on Dulox due to enhanced effects on the liver), so I had to quit. I tapered down by taking out a few of the "balls" in each pill per day, and had zero side effects getting off (took a few months). Haven't touched wine since then (2020) and have no interest.

I went back to my doctor as the pains became more frequent and the anxiety went through the roof with routine panic attacks. I think I got used to being on the antidepressant. I am on gabapentin now, which helps with nerve pain and somewhat with anxiety. I still have higher anxiety than I would like in random situations (like getting an MRI, dental work, driving over a bridge, just random stuff that appeared out of nowhere after quitting dulox). But it's manageable. Anyway, that's a long way of saying maybe discuss gabapentin with your doctor. It might be an option.

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@supernat10

I have an undiagnosed autoimmune illness that causes pain. My GP thinks it's fibro, but the rheumies do not. In some ways, it behaves like that, but in other ways not. I get signficant pain, but it is months between and usually only lasts 24 hours, and has never been pinpointed in the ER or by any other tests. Just high ANA. All that to say, my dr originally put me on Dulox, and the pains increased, and I began having panic attacks, but over time they subdued. The only noticeable side effect I had was more sweating, a lot more. It did help with my general anxiety. The biggest problem I had was it made me crave wine, no kidding it's a thing. It got to a point where I was drinking too heavily and impacting my life negatively (which by the way is unsafe on Dulox due to enhanced effects on the liver), so I had to quit. I tapered down by taking out a few of the "balls" in each pill per day, and had zero side effects getting off (took a few months). Haven't touched wine since then (2020) and have no interest.

I went back to my doctor as the pains became more frequent and the anxiety went through the roof with routine panic attacks. I think I got used to being on the antidepressant. I am on gabapentin now, which helps with nerve pain and somewhat with anxiety. I still have higher anxiety than I would like in random situations (like getting an MRI, dental work, driving over a bridge, just random stuff that appeared out of nowhere after quitting dulox). But it's manageable. Anyway, that's a long way of saying maybe discuss gabapentin with your doctor. It might be an option.

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Crazy! Watch out for those bridges! Seriously I will look into gabapentin.

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I had arthritis like symptoms start about a year and a half before being diagnosed with another unrelated (?) issue called EPI. Not only did Duloxetine not help very much, if at all, I was very drowsy in the morning and would wet the bed. The doctors said this would go away. The drowsiness improved, and after about two weeks, the bedwetting stopped but was replaced with daily or nightly diarrhea. The doctor said the would improve but didn't. After I searched online and read several other peoples experience, I eventually stopped taking it, diarrhea improved but returned about a year and a half later, though not as bad. That led to the EPI diagnosis (basically my pancreas stopped making enzymes).

I have decided that I would rather have traditional pain killers than non-narcotic. I am suspicious of the long term and unknown side effects of these new fangled drugs that stop pain. My body is so screwed up that I dread making it any worse, and detoxing from some of these drugs is just too weird and difficult, especially after learning about the Lyrica scandal.

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