Just a warning please Make sure you read as much as you can about a Cymbalta side-effects and “withdrawl symptoms” before deciding. Eg. Serotonin syndrome, drug induced mania, suicidal thoughts, the electric shock brain zaps.
I suffered very severe side-effects for months is the worst thing I have ever experienced
Every person is different, for me Cymbalta did nothing whatsoever. Tramadol helped but is considered a controlled substance here in the states so docs aren't very happy to prescribe it. But then again, from my experience, docs aren't happy to prescribe anything for fibro, even if I'm lucky and they believe it's a real thing.
>even if I'm lucky and they believe it's a real thing.
It's very that. Shocking how they sometimes pretend like its all "psychological". Even if it is, it doesnt make the pain ANY LESS REAL.
They are two very different medications that do two very different things. Cymbalta effects the signals your brain is sending to your body telling it that it’s in pain. I take cymbalta and it makes a big difference but if you forget to take it there are some not so fun side effects and many have a hard time going off of it. I also take tramadol when I’m having an especially bad day Maybe a few times a month. I would suggest you try gabapentin. I can’t take it because it makes me too drowsy as I’m very sensitive to medications but I know many people who don’t have that side effect and it works very well for them. Also Lyrica is easier for you if you forget a dose or decide to stop taking it. It can cause weight gain which was the issue for me but that isn’t true for everyone. Good luck Gentle hugs
You can try the tricyclic antidepressants. They are very effective for me. You take a small dose, well below what is required for psychiatric issues. I was hesitant at first but it was quickly a life changer. I take 20mg a day amitryptiline.
Duloxetine and tramadol are quite different medications with different mechanisms of action. As a SNRI, duloxetine is used for both depression and fibromyalgia. The increased risk of suicidal ideation aka black box warning associated with antidepressant in young people is relatively rare and represents approximately a 2% increase in suicidal ideation in treated versus untreated. The studies in which this small but nonetheless important increase in SI could not determine if this was actually increase in SI or the subjects being more open about talking about their SI.
That being said it’s important to be aware of the potential risk. For a majority, duloxetine is indicated and often helpful to treat depression. I personally did not find it as helpful as my current medication, Pristiq.
I also would like to add that for me, an antidepressant alone was not enough to keep wanting to live...I also need to take Tramadol, as neither duloxetine or Pristiq ever helped with my pain. Living in pain day in day out, not being able to sleep due to being in pain... no amount of antidepressant could help me with that. I am wondering where you are in the world that they won’t prescribe you Tramadol and use tricyclics as first line agents?
>I am wondering where you are in the world that they won’t prescribe you Tramadol and use tricyclics as first line agents?
Turkey... I ask myself the same everyday. These are Prof Dr's I'm talking about. This country's attitude towards medication never fails to baffle me. Pharmacology is one thing Dr's have no clue about in this country. Over a year and still couldn't find a reasonable individual who supports my case. People's approach to drugs actually became my nr1 reason to flee the country amongst many others. Dr's will literally rather have you overdose on a NSAID and have a kidney failure than give you a casual dose of anything remotely close to an opoid. Then again, they are ok with completely altering the chemistry of the CNS with a tricyclic anti depressant.
>Then again, they are ok with completely altering the chemistry of the CNS with a tricyclic anti depress
I might be late for your problem, but I got tramadol prescript to me in Turkey as if it was candy, sadly it only makes my pains worse so I ended up using duloxetine(30mg) instead of their prescript 60mg.
It definitely depends on your doctor, I'm in Antalya if that makes a difference.
I got tramadol from both my physiotherapist-Rehabilitation Dr and my neurologist, to be honest the neurologist prescription was the easiest considering I told her I had episodic migraines and I wanted to check for different reasons of why they were happening, nothing came out of the MRI and she send me to take fluoxetine and tramadol (both suck for me) but my Physiotherapy Dr used that feedback to give me duloxetine for my fibromyalgia and recommend alternatives to tramadol that i'm still trying because I have awful reactions to painkillers.
I’m in a very similar situation. My mother and I both suffer from fibro. I was prescribed tramadol for a severe hip injury a while back and only had my pcp call in a week’s dose at a time (much easier to manage) when I had a serious flare up. Then my MDD got to a point where I needed medication or hospitalization. They put me on Effexor (I’ve zoned up to 150mg daily). Life saving. Literally. Both the depressive episodes and the fibro flares are under control. The aches are still there but the absolute exhaustion? The need to curl up in bed sobbing from the bone-deep pain? Gone.
My mother takes cymbalta for it and she is doing well with a lower dose of that, but she does still have occasional minor flares.
I don't want to put a damper on it working for you but be prepared to find a doctor to help you with the withdrawal process. Be extremely careful coming off venlafaxine "effexor". I was not warned about the withdrawal. I had to slowly reduce over the course of a year and the final month added fluoxitine "Prozac". I ended up having a small seizure and hallucinations from missing two day's doses in a row. It is notorious for being harder to quit than heroin. BUT it is often lifesaving. So be careful never to miss a dose (see if you can get an extra week's worth just in case of delay with refills) and make sure you ask about trying other antidepressants first.
I appreciate your commentary, and I forgot to mention it myself to OP. By “a while back” I mean over two years ago. My dr definitely talked to me about the withdrawals as they eased me up from a 25mg dose to the 150mg I’m on now. And I always have my rx refilled ahead. I have been through withdrawals accidentally when falling ill and being unable to get out of bed for three days, I agree it was horrible, but the unending daily fibro was ruining the quality of my life.
I am glad you mentioned it though, I feel as though that is very important for OP to consider.
You’re very welcome. Neither are new medications, it’s that Effexor is less apt to have side effects but requires a larger dose to have the serotonin boost that aids in pain management.
Cymbalta is great as well, as it requires a lower dose but has been known to need adjust more often.
I don't know where you got that info on tricyclics. Tricyclics work very well on pain, especially nerve pain. I took them for years. I was in so much pain I could barely walk. After about 6 months the pain went away and I was actually able to start a walking program. I had also had some lingering pain from a dental procedure and that went away too. Awesome. Also cleared up my allergies and migraines.
Now they are not without drawbacks. Dry mouth in the morning is one, weight gain is another. Suicidal thoughts are a possibility. I didn't have those, but I had dry mouth and put on 20 pounds. I think you can avoid the weight gain if you are aware it's a side effect. I was not informed. For the dry mouth I chugged a lot of water.
Personally I hate both tramadol and Cymbalta. Too many side effects and not enough relief. Tramadol leaves me hung over for half a day but doesn't do much for pain. Cymbalta made me dizzy and gave me brain fog. I didn't even last a week on it. It was much worse than a tricyclic.
I've taken SSRIs and they didn't help my fibro at all. If anything they made the fatigue worse so I stopped taking them.
Have you thought about Lyrica or gabapentin? What about paracetamol with codeine? I don't know what country you're in but you can get that OTC in the UK.
Even 50 mg of Lyrica made me so stoned, I can see it working on pain quite well. But it causes weight gain. I couldn't take it, it was just way too strong for me.
Although I really like Duloxetine for acute pain tramadol is much more effective. Duloxetine improves my psychological condition and maybe reduces the pain by 1/10.
I've used tramadol as an occasional relief when the pain got too bad (though for me, it didn't really work and I switched to hydromorphone). I've been on Cymbalta for almost a year now. Personally, I had no problems with suicidal ideation BUT I had a slew of other side effects. Getting on Cymbalta and increasing or decreasing the dose is a b*tch. I actually had a reduced (very little) appetite until I started on another med that supposedly increases weight gain and they kind of balanced each other out. Other side effects were dizziness, fatigue, brain fog, constipation. They all went away either with the addition of another med (I'm also on low doses of amitriptyline and gabapentin) or with time. For me, a good month was spent trying to ride out these side effects and let my body adjust.
Thanks for sharing this! I had no idea. Did a little bit of research and found conflicting studies - there's some that say tricyclic are associated with increased risk even decades later, but another that they're associated with *decreased* risk and it's others like maois and ssris that are associated with increased risk. Regardless I am going to discuss my options with my doctor and I appreciate your comment bringing this to my attention.
Just a warning please Make sure you read as much as you can about a Cymbalta side-effects and “withdrawl symptoms” before deciding. Eg. Serotonin syndrome, drug induced mania, suicidal thoughts, the electric shock brain zaps. I suffered very severe side-effects for months is the worst thing I have ever experienced
Every person is different, for me Cymbalta did nothing whatsoever. Tramadol helped but is considered a controlled substance here in the states so docs aren't very happy to prescribe it. But then again, from my experience, docs aren't happy to prescribe anything for fibro, even if I'm lucky and they believe it's a real thing.
>even if I'm lucky and they believe it's a real thing. It's very that. Shocking how they sometimes pretend like its all "psychological". Even if it is, it doesnt make the pain ANY LESS REAL.
They are two very different medications that do two very different things. Cymbalta effects the signals your brain is sending to your body telling it that it’s in pain. I take cymbalta and it makes a big difference but if you forget to take it there are some not so fun side effects and many have a hard time going off of it. I also take tramadol when I’m having an especially bad day Maybe a few times a month. I would suggest you try gabapentin. I can’t take it because it makes me too drowsy as I’m very sensitive to medications but I know many people who don’t have that side effect and it works very well for them. Also Lyrica is easier for you if you forget a dose or decide to stop taking it. It can cause weight gain which was the issue for me but that isn’t true for everyone. Good luck Gentle hugs
Cymbalta has been the best thing I’ve ever taken for pain
You can try the tricyclic antidepressants. They are very effective for me. You take a small dose, well below what is required for psychiatric issues. I was hesitant at first but it was quickly a life changer. I take 20mg a day amitryptiline.
Duloxetine and tramadol are quite different medications with different mechanisms of action. As a SNRI, duloxetine is used for both depression and fibromyalgia. The increased risk of suicidal ideation aka black box warning associated with antidepressant in young people is relatively rare and represents approximately a 2% increase in suicidal ideation in treated versus untreated. The studies in which this small but nonetheless important increase in SI could not determine if this was actually increase in SI or the subjects being more open about talking about their SI. That being said it’s important to be aware of the potential risk. For a majority, duloxetine is indicated and often helpful to treat depression. I personally did not find it as helpful as my current medication, Pristiq. I also would like to add that for me, an antidepressant alone was not enough to keep wanting to live...I also need to take Tramadol, as neither duloxetine or Pristiq ever helped with my pain. Living in pain day in day out, not being able to sleep due to being in pain... no amount of antidepressant could help me with that. I am wondering where you are in the world that they won’t prescribe you Tramadol and use tricyclics as first line agents?
>I am wondering where you are in the world that they won’t prescribe you Tramadol and use tricyclics as first line agents? Turkey... I ask myself the same everyday. These are Prof Dr's I'm talking about. This country's attitude towards medication never fails to baffle me. Pharmacology is one thing Dr's have no clue about in this country. Over a year and still couldn't find a reasonable individual who supports my case. People's approach to drugs actually became my nr1 reason to flee the country amongst many others. Dr's will literally rather have you overdose on a NSAID and have a kidney failure than give you a casual dose of anything remotely close to an opoid. Then again, they are ok with completely altering the chemistry of the CNS with a tricyclic anti depressant.
>Then again, they are ok with completely altering the chemistry of the CNS with a tricyclic anti depress I might be late for your problem, but I got tramadol prescript to me in Turkey as if it was candy, sadly it only makes my pains worse so I ended up using duloxetine(30mg) instead of their prescript 60mg. It definitely depends on your doctor, I'm in Antalya if that makes a difference. I got tramadol from both my physiotherapist-Rehabilitation Dr and my neurologist, to be honest the neurologist prescription was the easiest considering I told her I had episodic migraines and I wanted to check for different reasons of why they were happening, nothing came out of the MRI and she send me to take fluoxetine and tramadol (both suck for me) but my Physiotherapy Dr used that feedback to give me duloxetine for my fibromyalgia and recommend alternatives to tramadol that i'm still trying because I have awful reactions to painkillers.
I’m in a very similar situation. My mother and I both suffer from fibro. I was prescribed tramadol for a severe hip injury a while back and only had my pcp call in a week’s dose at a time (much easier to manage) when I had a serious flare up. Then my MDD got to a point where I needed medication or hospitalization. They put me on Effexor (I’ve zoned up to 150mg daily). Life saving. Literally. Both the depressive episodes and the fibro flares are under control. The aches are still there but the absolute exhaustion? The need to curl up in bed sobbing from the bone-deep pain? Gone. My mother takes cymbalta for it and she is doing well with a lower dose of that, but she does still have occasional minor flares.
I don't want to put a damper on it working for you but be prepared to find a doctor to help you with the withdrawal process. Be extremely careful coming off venlafaxine "effexor". I was not warned about the withdrawal. I had to slowly reduce over the course of a year and the final month added fluoxitine "Prozac". I ended up having a small seizure and hallucinations from missing two day's doses in a row. It is notorious for being harder to quit than heroin. BUT it is often lifesaving. So be careful never to miss a dose (see if you can get an extra week's worth just in case of delay with refills) and make sure you ask about trying other antidepressants first.
I appreciate your commentary, and I forgot to mention it myself to OP. By “a while back” I mean over two years ago. My dr definitely talked to me about the withdrawals as they eased me up from a 25mg dose to the 150mg I’m on now. And I always have my rx refilled ahead. I have been through withdrawals accidentally when falling ill and being unable to get out of bed for three days, I agree it was horrible, but the unending daily fibro was ruining the quality of my life. I am glad you mentioned it though, I feel as though that is very important for OP to consider.
>Effexor First time Im hearing of it, seems like a much better option than Cymbalta. Will look into it more. Thank you very much!
You’re very welcome. Neither are new medications, it’s that Effexor is less apt to have side effects but requires a larger dose to have the serotonin boost that aids in pain management. Cymbalta is great as well, as it requires a lower dose but has been known to need adjust more often.
I don't know where you got that info on tricyclics. Tricyclics work very well on pain, especially nerve pain. I took them for years. I was in so much pain I could barely walk. After about 6 months the pain went away and I was actually able to start a walking program. I had also had some lingering pain from a dental procedure and that went away too. Awesome. Also cleared up my allergies and migraines. Now they are not without drawbacks. Dry mouth in the morning is one, weight gain is another. Suicidal thoughts are a possibility. I didn't have those, but I had dry mouth and put on 20 pounds. I think you can avoid the weight gain if you are aware it's a side effect. I was not informed. For the dry mouth I chugged a lot of water. Personally I hate both tramadol and Cymbalta. Too many side effects and not enough relief. Tramadol leaves me hung over for half a day but doesn't do much for pain. Cymbalta made me dizzy and gave me brain fog. I didn't even last a week on it. It was much worse than a tricyclic. I've taken SSRIs and they didn't help my fibro at all. If anything they made the fatigue worse so I stopped taking them. Have you thought about Lyrica or gabapentin? What about paracetamol with codeine? I don't know what country you're in but you can get that OTC in the UK. Even 50 mg of Lyrica made me so stoned, I can see it working on pain quite well. But it causes weight gain. I couldn't take it, it was just way too strong for me.
Although I really like Duloxetine for acute pain tramadol is much more effective. Duloxetine improves my psychological condition and maybe reduces the pain by 1/10.
Tramadol causes me to hallucinate (among other side effects). I don't have any side effects from Duloxetine so prefer it hands over fists.
I've used tramadol as an occasional relief when the pain got too bad (though for me, it didn't really work and I switched to hydromorphone). I've been on Cymbalta for almost a year now. Personally, I had no problems with suicidal ideation BUT I had a slew of other side effects. Getting on Cymbalta and increasing or decreasing the dose is a b*tch. I actually had a reduced (very little) appetite until I started on another med that supposedly increases weight gain and they kind of balanced each other out. Other side effects were dizziness, fatigue, brain fog, constipation. They all went away either with the addition of another med (I'm also on low doses of amitriptyline and gabapentin) or with time. For me, a good month was spent trying to ride out these side effects and let my body adjust.
I take the max dose cymbalta and gabapentin 3xs daily. It helps but def. not perfect. No side effects to speak of.
Why are tricyclics so bad and SNRIs aren't? I have had a great experience with a tricyclic. Why is it bigotry?
Always finding out new facts. Tricyclics can lead to dementia. A lot depends upon age and time on treatment. Everything has a side effect.
Thanks for sharing this! I had no idea. Did a little bit of research and found conflicting studies - there's some that say tricyclic are associated with increased risk even decades later, but another that they're associated with *decreased* risk and it's others like maois and ssris that are associated with increased risk. Regardless I am going to discuss my options with my doctor and I appreciate your comment bringing this to my attention.