experiences with duloxetine (Cymbalta) for PN?

It can be taken permanently for a chronic condition, but with these kinds of medications, everyone responds differently, so it’s not unusual for someone to have side effects that cause them to want to discontinue the medication. Or if it’s not as effective as they hoped, they may want to try a different, but similar medication that shouldn’t be taken at the same time. Others may take Cymbalta for depression and when their depression improves, they may want to stop it to see if they can maintain remission without it or need to switch medications.

But the most common thing I hear of is people who don’t tolerate the medication and want to stop it, only to find they can’t stop it immediately or as quickly as they want to, or the act of stopping it causes even worse side effects.

I don’t want to scare anyone off taking it. Everyone is different and also has a different tolerance to risk, but it’s something I’d want someone to tell me while I was considering my options, just like my NP told me, not to scare me, but to make sure I had all the information.

I’d want to know I before I took something if it would be difficult to stop taking immediately if I wanted to. I don’t like having to give up that much control, and I’m not comfortable with that risk because of my underlying condition. And historically, discontinuation syndrome from neuromodulators/antidepressants hasn’t gotten much recognition from doctors in the past; some minimize it or repeat what they’ve been taught, which is that it takes a few weeks to taper (which is true for some, but not everyone), minimize it, or even don’t believe it’s true. I think that’s less common now…at least since that one study came out a few years ago showing how high the rate of discontinuation syndrome is, but even that study was done by a physician if I recall correctly because they had personal experience and wanted to know more.

If you’ve been diagnosed with B12 deficiency, has the neuropathy not improved as your B12 level has gone up?

That’s a good question. I feel my body is better in some ways, but not in others, but my symptoms are intermittent….so it’s difficult to gauge. I’ve read a lot and even read that loading up on the doses, as I’m doing with sublingual, not injection, can cause a sudden worsening of symptoms, which I did have within 3 days of starting the mega doses. Neurologist told me it would take months, if not years to restore.

I started sleeping with my arms on pillows. Don’t know if that has brought me relief from arm and hand tingling or the B12. ?

So, I’m not positive what I’m dealing with. …………Even wonder if I have TIND. (Type 1 diabetic with recent substantial lowering of blood sugar level with new pump/cgm.)

Of course, I read here and see all kinds of potential explanations. Several, I will ask my neurologist about.

I’m seeing my primary later this week to confirm my nutrition and muscles are on track.

For now, I’m following Neurologist and PC. If I take something that mask symptoms, is that helpful? Idk. I guess I’ll monitor any burning this week.

Thanks for your input about Cymbalta. It’s quite helpful.

That's so hard when the symptoms and causes and treatment can all get blurred together. Wow, I didn't realize it could take months to recover from B12 deficiency-related neuropathy. It sounds like you're taking B12 (since I recall that being sublingual?) but just a head's up that excess amounts of B6 can cause neuropathy--I learned that the hard way when trying to supplement my way out of neuropathy (spoiler alert, it didn't work because I don't have a deficiency).

It sounds like a good plan to follow w/ your neurologist and PCP. If the Cymbalta or another medication improves your quality of life, I do think it's worth considering. But if you have concerns about the Cymbalta, you could consider trying gabapentin or Lyrica first, something a little easier to taper down from if need be.

PT might also help give you some strategies for the pain. My PT was able to assess my neuropathy and we did find that some of my burning pain (actually, it was the worst of the burning) was related to disc compression in my spine, which was easily addressed by learning about positional changes and stretches. If only everything were that easy. I've had burning pain in my arms that was referred by disc compression in my neck. I still have neuropathy but getting rid of some of the burning pain still helped a lot. It might be worth looking int.

Wishing you the best of luck.

I’m requesting PT and Gabapentin caused me blurry vision. Insurance says I must try Cymbalta generic, before they pay for Lyrica. Oh, I’m fighting them for my insulin too. ……man, the fun never stops. Lol

Yikes! Sadly, I believe it since Cymbalta has a generic and Lyrica does not. ::eye roll:: But since it’s a newer medication, my doctor said it tends to have fewer or milder side effects. So frustrating.

At least, I’ve almost always come away with something helpful from PT, when I have thoughtful ones. So I hope that helps!