Monday, September 26, 2005

Journal: Next, please.

So long, Cymbalta, and don't let the door hit you in the butt on the way out. Hello, Zonegran.

A few months back, I saw a neurologist at the pain clinic. My regular neurologist had suggested the pain clinic might have more success in dealing with the burning pain in my legs. After a really good visit with the pain clinic neuro, I started on Cymbalta, which is an antidepressant that works on both serotonin and norepinephrine. Almost immediately, I started having increased bladder trouble: harder to go during the daytime, then either having to pee or having to change the bed pad like half a dozen times every nite. (This is kind of odd because Cymbalta is sometimes used off-label to treat stress urinary incontinence.) After a while I noticed an improvement in the pain and in my mood, but I started to feel pretty sleep deprived.

Eventually, it became clear that on balance Cymbalta was not helping me. I called the pain clinic to let them know that I wanted to stop. The message I got back on a Friday was OK, fine, but you should probably taper off rather than quit cold turkey, to avoid withdrawal. Tapering required picking up some low-strength pills at the pharmacy, but I didn't bother to pick them up until Monday, by which time I'd realized that, yes, one should not quit Cymbalta cold turkey. Suffice it to say that Cymbalta withdrawal makes one a real asshole. Taking the low-strength pill on Monday morning restored me to my usual self.

Now, I'm starting an anti-seizure drug called Zonegran. This is on top of the 3000 daily mgs of Neurontin that I'm already taking. Zonegran's got side effects similar to those of Neurontin (makes me a bit sleeeeeepy, slightly stooooopid), so we'll see what happens. I'm tapering up to a full dose of 200 mg by ramping up 25 mg per week, meaning I won't be at full dose for a couple months. Wish I didn't have to wait that long. And I remain concerned that effective pain treatment will leave me too dopey to keep doing my geeky, thought-intensive job.

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mdmhvonpa said...

"Taper off to avoid withdrawl" ... great. Gotta love drugs like that.

Doug Lee-Knowles said...

Yeah, although I had the same experience several years ago when I switched from Zoloft to another antidepressant. That time, nobody warned me, and for a week and a half I was kind of a maniac.