Has anyone had experience using cymbala for pain relief?
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Hi @AlwaysHopeful, the following info should be useful and might help others on this thread, too.
Whether or not Cymbalta (duloxetine) helps a person depends on several factors, including how the person’s body metabolizes the medication.
Most medications are metabolized by the body’s cytochrome P450 liver enzyme system. This system contains a ton of different enzymes that are basically genes. Whether or not your body metabolizes a medication properly can depend on three things…
1. Whether or not you are taking a medication that inhibits/induces an enzyme that your body uses to metabolize another medication (or even the same medication). (For example, duloxetine is a substrate of the enzymes CYP1A2 and CYP2D6, which means that these two enzymes metabolize duloxetine in your body. But if you take a medication that inhibits (i.e., slows down) those two enzymes, it will cause you to too-slowly metabolize duloxetine, which means that you will not receive the intended effects. Interestingly, duloxetine actually inhibits CYP2D6. Many medications inhibit P450 enzymes; fewer medications induce them.)
2. Whether or not you have P450 liver enzyme polymorphisms, which means that you posses an enzyme or enzymes that are mutated and make you, organically, metabolize some medications too slowly or too quickly. These polymorphisms are not rare. After years of taking duloxetine, Mayo performed pharmacogenomic testing on me and figured out that I was born with CYP1A2 and CYP2D6 polymorphisms, which explained why I never received the pain relief effects from taking it. (The official diagnosis for this is called CYP450 Deficiency.)
3. A combination of numbers 1 and 2 above. Because I was also taking other medications that inhibited my CYP2D6 enzyme, it made the above situation even worse.
Unfortunately, most doctors only have very rudimentary knowledge of the P450 system, and they don’t know enough about drug-drug interactions via these enzymes to recognize of suspect these issues. If you suspect this may be an issue for you, you may be best off talking to your pharmacist first.
Here’s where you can look at substrate, inhibitor, and inducer medication info: http://www.mayomedicallaboratories.com/it-mmfiles/Pharmacogenomic_Associations_Tables.pdf
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@kdubois It would be wonderful if more doctors and insurance companies ordered and paid for pharmacogenomic testing. I think that we must be mindful that for the majority of us, it simply is not an option.
Recently in Business Insider, I read an article stating doctors spend 13-16 minutes average with each patient. When I go in to my doctor and tell him X drug is giving me side effects or doesn’t give me relief, the Dr. goes on to the next drug in the arsenal used for the particular condition.
Next you have the cost of the testing. When medicine became a business, rather than old fashioned patient care, we the patient got lost in the equation. I hope as newer, younger doctors emerge this technology that we have at our fingertips take hold.
It’s wonderful that you were able to get this testing. Thanks for making us aware of it.
Agreed, availability and costs are probably the biggest reasons why these aren’t more well-known. Hopefully with places like OneOme/Mayo lowering their prices the way they have, pricing will go down across the industry.
Hi, I feel quite privileged to live in Sweden and don’t worry about the medicin costs neither doctor or hospitals. Everything is included and if you pay more than 1200 Swedish crowns a year for medicines or for your medical needs, doctors, specialists, massage, any kind of service offered by a medical center, then the rest of the year is free of charge. My Falsodex shots costs 5000:- Swedish crowns each Month. So I pay 1200 Swedish Crowns the first time and then for a year from my purchase every medication written on a recept is free of charge. I really feel for you that the politicians, the insurance companies must decide what kind of medicine you may use. I wish there was another way for you all.. Here, my oncology team try to give me the best regardless of the costs. I wish I could share it with you. Cymbalta has reduced my depression and my anxiety before my death which would be in a year or so. Good luck people!
@saltis, it’s just nice to know that it’s like this somewhere on Earth!
Thank you so much! This is exciting information! I appreciate your help!
I wish I could help you all. Please understand and accept that I really feel for you. In our struggle to fight back cancer, we don’t need to worry about costs or company profits on medication we need to survive. A real big hug!
I am taking cymbalta & not sure if it helps with fibromyalgia or not- had a major flare up yesterday with the cold damp weather & wondering if weather change flares are common for fibro folks-
I take cymbalta 60 mg daily for crps from bilateral total knee surgery. I’m not sure it helps with the pain, but it has helped with the anxiety & some depression that sometimes goes along with chronic pain. I’m still constantly searching for an answer for my pain.
Yes, my Neurologist prescribed this medication to me for Chronic Pain. The medication has helped me more than any other Antidepressants. My mood has improved tremendously. My physician stated that the high amount of pain my body endures is the reason for my depression. I need a left knee replacement, both hips , and Cervical Surgery for a crushed bone lying on my nerves that inhibits my ability to move my hands and arms. I am not complaining, I have been injured in numerous auto accidents, and at a few points came out of surgery on a respirator. This was when my back was broken.
I had a successful right knee replacement 8 years ago. This was the best surgery I had. Now, as I was informed, this knee needs revision . I am not having the surgery . My sister has had failed knee replacement surgery three times. Our genetics has degenerated bone disease. She was never in auto accidents. They failed due to disease.
I have made the decision to not have any surgery. The most prominent problem that could cause me severe paralysis is my Cervival Spine. I have chosen to wait it out. I have had so many spinal surgeries that I feel my body and immune system could not take the toll it would put on me. I also have come to a time in My Life that I am Self Supporting. I can not take this great amount of time out with no income. Yes, I get SS disability, however I have to work the allotted amount of time and earnings allowed to pay for myself to live.
One really never thinks that this can really happen to you. One point in my Life money was never a worry. I had all the money for the best of care. Help in the home, Nurses coming to my home to administer medication, therapy. A loving Family that was always there. Today, they are all gone. Passed away. I have only one living sister who is terribly disabled.
I will say the difference between us is that she lives on Narcotics. I refuse to live my Life so medicated I do not feel Life. This is a Personal Choice. I do not judge how anyone chooses to handle chronic pain. There is no measuring stick to say truly how to handle your chronic pain. I will say that with the help of my great Neurologist, who listens to me, does not judge my decision to resist surgery as long as possible. He respects my knowledge of my body and just how much pain I can take before I ask for Help. This leads me to Cymbolta. In a honest review of my medications, I told him this is no way to live. Any which way I look, surgery no surgery I am faced with pain every day of my life.
Yes, we all get depressed. We see others living life, smiling, going about their day in a normal routine. They have no physical pain to stop them. I envy them! Yet, I realize that I can have a life with pain if I mentally feel better. This medication has seemed to help. I have been on for only less than a month.
I have an appointment with my Neurologist at the end of the month. We will discuss how I am doing physically and mentally. I wish to continue on this medication, perhaps up the dose. He has elimated all the Neds I felt were not doing anything. I have survived . Although, I must have my Arthritis medication Diclofenac Sodium 100mg ER tablets 1 daily. In closing, I hope I have helped anyone who is going through pain and the different medications.
I can say I have had most narcotics prescribed, and I am happy to report I do not take any narcotics. For now I am doing well on this new regiment of medication! I would say to you, if your doctor feels you may benefit, take the chance! Yes, there are a few side effects I am adjusting to, yet I have been in such a good mood;(and I have wanted this feeling for a very long time) ; This is the least of my
Problems. I can see more clearly that I can make a life for Myself. I can ask for help and not feel guilty. I can also try to help anyone who has felt as badly at times as I have. There is a road , you have to find which one works for you. We are not alone; Chronic Pain is hard to explain to people who have no pain. Yet, we are strong and know how to fight the battle.
One day the friend you have who leeps through life, and does not comprehend what you are going through; may need your help one day . For we only have today, tomorrow is not a given and provides no promises. I choose to live Day to Day and always let my Loved Ones know I love them. Why, because one day I was driving, doing everything right, yet a Semi Truck did not see me . That day changed my Life.
I use it for Fibromyalgia pain & post surgical neuropathy pain.
@dande I appreciate your sharing so much of what is and has been going on with you. I have recently decided to stop taking the Gabapentin 300 mg capsules my pain doctor prescribed, as well as my Baclofen 10 mg pills. I just took my final Gabapentin. When I told my pain doctor I wanted to stop taking both medications, his reaction seemed to me to be negative. He told me to just stop the Gabapentin cold turkey. I said I had read that people who stop taking it suddenly have withdrawal reactions. He said he’s never had a patient have a problem going cold turkey. When I got home I counted the capsules and realized I only had enough left to cut to one every night, down from 2/day. I called the pharmacy to get a 1/2 refill and found out the doctor had already canceled my prescription. I was surprised he did that, but decided to go with what I had and take 1 pill a day for 6 nights and then go off totally. Tonight was the last capsule. So, I’ll see how I feel in a few days.
An interesting thing is that when I cut back on the Gabapentin, my right hip, leg, and back stopped having the deep pain I have had for the last year. It has been at a 6-7 level constantly for a year with a few days of 8-9 levels. Suddenly, it is much better and down to the 3-4 level. I also cut back on the Baclofen from 3 a day (24 hours) to 2 a day now. After I’m sure I’m not having withdrawal from the Gabapentin, I will withdraw to 1 a day for 7 days, then off. I don’t know if taking less of both pills actually helped my pain decrease, but it surely a coincidence I continue to question.
I am considering stopping the 4 daily Tramadol 50mg I am taking for pain and going to Marijuana instead. I know if I do that my pain doctor won’t prescribe for me again. I think Marijuana is safer than the meds I have been taking. Since it’s legal in California, I’m OK with using it orally and the cream on the areas that hurt. I won’t have to take it everyday, like I am required to do with the meds I take now, which I think is good. That means I will have to feel my pain level daily and decide whether or not I need pain assistance. I won’t become addicted to pot; I have smoked it before and was fine. I don’t plan to smoke any pot, but instead use the tincture and topical kind that won’t make me high. I am seriously considering this option for my remaining arthritis and sciatic pain on my right side that may require spinal surgery at some point. I have degenerative disk disease, as do my 2 older brothers, and scoliosis, ankalyzing spondylitis, and herniated disks at L4 and L5.
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