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.”