a bottle of Cymbalta 20 mg

Q. Over the last 10 years I have been on various antidepressants, including Prozac (fluoxetine), Zoloft (sertraline), Effexor (venlafaxine), Lexapro (escitalopram) and Cymbalta (duloxetine). I have experienced weight gain, blurred vision, dry mouth and sexual side effects (low libido and no orgasms). None of these drugs worked all that well against my depression.

Cymbalta had the fewest sexual side effects, but whenever I missed a dose I would be nauseated, get brain zaps, feel dizzy and disoriented, experience night sweats and have crazy dreams. I am concerned about the long-term side effects of these medications, especially for my brain. Are there any other options?

A. The side effects you describe are not uncommon. Stopping a drug like Cymbalta suddenly can be devastating. Gradual tapering off this medicine may take months.

We are sending you our Guide to Dealing with Depression for more information on side effects and withdrawal. It also describes other treatment approaches.

Researchers are investigating the anesthetic ketamine as a rapid option for hard-to-treat depression (American Journal of Psychiatry, Oct. 1, 2013). Light therapy, vigorous exercise and cognitive behavioral therapy may also be helpful.

Staying in touch with friends, in person or on the phone, can also boost spirits, as Helen described on our site: “I don’t know if it is a sign of the times, the advance of technology for communication, but in these waning years of my life, I find that most of my friends are telephone friends from different parts of the country. We usually met thru an online support group/list. Last Sunday, I had a horrible loneliness attack in the middle of a busy store, where it seemed to me that friends were greeting friends all around me. Forget that I myself had just met a friend that I had not seen for a long time at the previous store I went to.

“I went home and called a friend who had told me she suffered loneliness attacks and confirmed that indeed they were what I had just been thru. I told her to call me, don’t worry about disturbing my rest, that’s what friends are for. Later another of my telephone friends called and we had a long chat. The next day I spend three hours on the phone with two more.

“We used to hear “reach out and touch someone”, remember? Well, it is very true and with or without therapy, communicating on the phone with friends and family can be therapeutic, chase away the “blues”. Keep us feeling connected. Especially when you are older and have been thru loss of loved ones.”

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  1. Jasmine

    I was on zoloft (200 mg) for 8 years, cymbalta for 6 months (60mgs for 4 months then to 30mg’s). then after the refill was emptied I chose not to fill this prescription any longer. I have been using 5-htp in the morning & evening for about 3 weeks now. Usually I have been feeling better, cheerier and at peace, but some days I am just beside myself with anger & ugliness. I’m hoping this will disappear soon. I wish you continued success with your journey.

  2. Matt

    I have heard of a few people having a living hell coming off of these and also antipsychotic meds.
    The odd part is I have been taking Dexedrine for hyperactivity since I was 5 and I am 33 now and I get treated like a junkie at the pharmacy but I just get loud and hyper if I don’t take it.

  3. Dr. Rodrigues

    In my last conference it was stressed that if you have had a few episodes of depression you are a candidate for long term meds. There are many so many meds now that you should be able to find combination that help without the side effects. They also need to double check for a different diagnosis like bipolar or Adult ADD.

  4. Sha

    Hope this is correct. Mayo clinic does DNA before Rx for psycho Tropic drugs. My doc did DNA for drug sensitivity for a few things. It was some help. Had DNA done at 23&me; and, volunteered info for research. Sensitivities to more drugs showed up.
    I believe re-actions that some of us have are genetic; I had my own horror show with Prozac, 25 years age. I had been over medicated with hormones, after hyst. as well. Pain control is vital; do not be ashamed to ask for help.
    Fibromyalgia has been found to have extra pain receptors in skin. I believe many more of the problems people suffer will prove, “Not in Their Heads”.

  5. Cindy M. B.

    In the last few years I’ve had more anxiety and depression than usual, due to some extra stressors. Due to the side effects, I simply cannot take any of the Rx antidepressants. But recently I started using a med called “5-HTP,” an over-the-counter med I’d heard of for years but never tried. The label says to take up to 4 tablets per day, but I only take one at bedtime… I am sleeping SO much better, and during the day I seem to be calmer and more cheerful too! I think anyone with mild to moderate depression, especially with poor sleep, should definitely try this med. I haven’t been able to find any negatives so far. (Would PP have any opinion on 5-HTP??)

  6. DP

    A phone visit is the next best thing to being with the person. The sound of the voice of someone you know is a comforting thing. E-mailing is NOT the same. The connection is not there, and one can’t really know if what they are saying is being interpreted the way it was intended without feed-back. It is so much fun to phone a loved one and have a shared laugh. Don’t get talked into using texting and e-mail only. Conversations are what connect us.

  7. Stephen T.

    Rhodiola Rosea really helped my depression as well as increasing my B vitamin intake and exercising.

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