# cymbalta 60mg vs 120mg



## fineline (Oct 21, 2011)

Any noticeable improvements from 60mg to 120mg? I see my doctor tomorrow and am going to ask him to increase to 120mg.

I was wondering others experiences at either of these doses, for both GAD and depression.

Thanks.


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## Willowg (Mar 16, 2014)

120 was too high for me. I went back to 60.


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## fineline (Oct 21, 2011)

Willowg said:


> 120 was too high for me. I went back to 60.


what symptoms did you have that made you feel like the dose was too high?


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## UltraShy (Nov 8, 2003)

You might as well try 120mg. If it doesn't help or causes intolerable side effects it's real easy to drop back to 60mg.

Cymbalta didn't help me. I don't specifically remember my dosage as it's been years, but if 120mg is the max recommended then you can be sure I tried it as I always go at least that high.


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## fineline (Oct 21, 2011)

UltraShy said:


> You might as well try 120mg. If it doesn't help or causes intolerable side effects it's real easy to drop back to 60mg.
> 
> Cymbalta didn't help me. I don't specifically remember my dosage as it's been years, but if 120mg is the max recommended then you can be sure I tried it as I always go at least that high.


yes. I read that there is not evidence that doses over 120mg have a greater effect and that 120mg is considered the maximum does.

I honestly don't think he will have an issue prescribing it to me. I still have about half or so of the depression I did before the cymbalta. And also, it is approved for GAD, which can't hurt. Whether or not it helps with GAD, is anybodies guess, I suppose.

I'll let you all know how it went tomorrow when i get home.


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## UltraShy (Nov 8, 2003)

Do you get sexual side effects from Cymbalta? I'm curious since that's all I ever got from SSRIs/SNRIs.

As for there being no evidence that doses over 120mg have a greater effect that just means the drug company didn't bother to test it. Max recommended doses aren't carved in stone. They're just recommendations or suggestions. Example: the suggested dose of Ambien is one 10mg pill. Reality: not everyone responds to that recommended dose. I can take 1 or 6 or 8 pills and be fully awake. I thought Ambien didn't work at any dose till one day I decided to see how many it would actually take. The answer: 23 Ambien produce a wonderful 8 hour nap from which I awake feeling fully refreshed just like normal folks get from a single pill. I think you can see why I don't put much faith in max recommended dosages. Right now I'm trying Parnate and I got my dosage raised to the max recommended dose of 60mg. I'd like to go much higher. It's been tested in refractory depression cases at doses of 100-170mg safely & effectively, though I doubt my doctor would be brave enough to push my dose to such levels. Instead preferring to leave me disabled by SA. Gotta play it safe even if playing it safe means not effectively treating a patient.

Good luck with your appointment tomorrow. Hope you get the dosage increase in Cymbalta + the Lyrica.


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## fineline (Oct 21, 2011)

UltraShy said:


> Do you get sexual side effects from Cymbalta? I'm curious since that's all I ever got from SSRIs/SNRIs.
> 
> As for there being no evidence that doses over 120mg have a greater effect that just means the drug company didn't bother to test it. Max recommended doses aren't carved in stone. They're just recommendations or suggestions. Example: the suggested dose of Ambien is one 10mg pill. Reality: not everyone responds to that recommended dose. I can take 1 or 6 or 8 pills and be fully awake. I thought Ambien didn't work at any dose till one day I decided to see how many it would actually take. The answer: 23 Ambien produce a wonderful 8 hour nap from which I awake feeling fully refreshed just like normal folks get from a single pill. I think you can see why I don't put much faith in max recommended dosages. Right now I'm trying Parnate and I got my dosage raised to the max recommended dose of 60mg. I'd like to go much higher. It's been tested in refractory depression cases at doses of 100-170mg safely & effectively, though I doubt my doctor would be brave enough to push my dose to such levels. Instead preferring to leave me disabled by SA. Gotta play it safe even if playing it safe means not effectively treating a patient.
> 
> Good luck with your appointment tomorrow. Hope you get the dosage increase in Cymbalta + the Lyrica.


Effexor XR gave me sexual side effects. Made it difficult to ejaculate. But since cymbalta, my sex drive is at a average level. Am able to "take care of myself" as needed, with no issues.

And I agree that the drug companies just don't test the higher doses once they find that certain doses work, I bet they figure why bother further testing.

And thanks. Doc is tomorrow for the cymbalta, and psychiatrist is the 20th..but I'm torn on what I want to ask him about. The lyrica, I read good with anxiety, but weight gain... Or increase of trileptal, no weight gain, but I've read not as good for anxiety as lyrica.

Im leaning toward at least trying the lyrica. Ok, just now, I've made my decision lol. Gonna give the lyrica a go, on a as needed basis. And just see what happens. If helps with anxiety and no weight gain, then great! I'll stick with it!


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## UltraShy (Nov 8, 2003)

fineline said:


> And thanks. Doc is tomorrow for the cymbalta, and psychiatrist is the 20th..


You get your Cymbalta from a GP? My GP didn't want to refill my psych meds any more since I got a pdoc recently, feeling that the job now belongs to my pdoc. And if you're getting psych meds from a GP then what's your pdoc for?:stu Oh, yeah, I guess you'd need the pdoc for benzos, since you're on a high dose and I don't imagine that any GP would be willing to write scripts that big. Even a lot of pdocs wouldn't be willing to go that high. To get Xanax by the truckload was my reason for getting a pdoc in 2003.



fineline said:


> ...but I'm torn on what I want to ask him about. The lyrica, I read good with anxiety, but weight gain... Or increase of trileptal, no weight gain, but I've read not as good for anxiety as lyrica.
> 
> Im leaning toward at least trying the lyrica. Ok, just now, I've made my decision lol. Gonna give the lyrica a go, on a as needed basis. And just see what happens. If helps with anxiety and no weight gain, then great! I'll stick with it!


I know your said your doc doesn't like making more than one change at a time, which certainly makes sense. But adding Lyrica & increasing trileptal arguably isn't really two changes if Lyrica is being used on a PRN basis. After all, on days when you're off Lyrica you can accurately assess how the new higher dose of trileptal is working without Lyrica clouding the results. I'd say go for both if you can talk him into it.

Yeah, Lyrica's weight gain is a real turn off. 9% of patients gaining at least 7% of starting body mass is hard to ignore (2% of placebo patients gained that much). I'd really much rather have meprobamate or phenobarbital, though doctors look at you like you're f'ing crazy when you ask for tranquilizers that haven't been in common use since the 1960s. They have no problem with Lyrica, of course, since they don't care if you get fat. Drugs that make you fat are fine. They act as if that's not a serious health concern. They magically forget it causes my high blood pressure, high cholesterol, high blood sugar, negative body image, etc.


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## fineline (Oct 21, 2011)

UltraShy said:


> You get your Cymbalta from a GP? My GP didn't want to refill my psych meds any more since I got a pdoc recently, feeling that the job now belongs to my pdoc. And if you're getting psych meds from a GP then what's your pdoc for?:stu Oh, yeah, I guess you'd need the pdoc for benzos, since you're on a high dose and I don't imagine that any GP would be willing to write scripts that big. Even a lot of pdocs wouldn't be willing to go that high. To get Xanax by the truckload was my reason for getting a pdoc in 2003.
> 
> I know your said your doc doesn't like making more than one change at a time, which certainly makes sense. But adding Lyrica & increasing trileptal arguably isn't really two changes if Lyrica is being used on a PRN basis. After all, on days when you're off Lyrica you can accurately assess how the new higher dose of trileptal is working without Lyrica clouding the results. I'd say go for both if you can talk him into it.
> 
> Yeah, Lyrica's weight gain is a real turn off. 9% of patients gaining at least 7% of starting body mass is hard to ignore (2% of placebo patients gained that much). I'd really much rather have meprobamate or phenobarbital, though doctors look at you like you're f'ing crazy when you ask for tranquilizers that haven't been in common use since the 1960s. They have no problem with Lyrica, of course, since they don't care if you get fat. Drugs that make you fat are fine. They act as if that's not a serious health concern. They magically forget it causes my high blood pressure, high cholesterol, high blood sugar, negative body image, etc.


I dont have a GP anymore, I have a real doctor. He prescribes the medicine for my depression and anxiety. My psychiatrist prescribes meds for my bipolar.

And yes thats a good idea! Cus the trileptal would be just a dose increase, and he could maybe start me at a low dose of lyrica to take as needed to see how I react to it. I will ask him to see if he can do that. Cus I know I am not on a high enough dose of trileptal. I can barely feel it doing anything. I'll have a long talk with my psych about my options, and i'll try to go with what I think will be best, that he agrees with.

And yea, I am very scared of gaining anymore weight. Zyprexa made me gain 20 and depakote made me gain another 10. Thankfully, the weight gain has stopped, and im trying hard to get back down to my original weight, before the zyprexa.

And you are right, they dont really care if you get fat. :bah


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## UltraShy (Nov 8, 2003)

fineline said:


> *I dont have a GP anymore, I have a real doctor.* He prescribes the medicine for my depression and anxiety. My psychiatrist prescribes meds for my bipolar.


So what's a "real doctor" who's not a GP and not a psychiatrist? I didn't realize there was a third possibility.



fineline said:


> And yea, I am very scared of gaining anymore weight. Zyprexa made me gain 20 and depakote made me gain another 10. Thankfully, the weight gain has stopped, and im trying hard to get back down to my original weight, before the zyprexa.
> 
> And you are right, they dont really care if you get fat. :bah


Zyprexa is the drug from hell. I gained 25# in 6 weeks. My GP, who's in love with antipsychotics, put me on Zyprexa in 2003. It was his first choice. Even before benzos. I had a starting weight of 246#. That certainly sounds like the kind of patient where you damn well ought to be concerned about weight -- obese with an obesity-related condition: high blood pressure. I expressed my concern about weight gain, having read a Wall Street Journal article about how Zypexa causes extreme weight gain. His response was "Not everyone gains weight on it." Yeah, and not everyone dies playing Russian Roulette, but I still wouldn't recommend it. I'd note that there's also no valid reason to have me on Zyprexa as I'm neither psychotic nor bipolar (there's never been any question of that). He wanted to used it exclusively as a treatment for my SA, even though no antipsychotic has ever been FDA approved for the treatment of any anxiety disorder (because they don't f'ing work on anxiety!). At least you're bipolar, so there's actually a valid reason to have you on some antipsychotic, though still you should be on one that's weight neutral. And I can personally confirm that the Saphris you now use is that.

Good luck shedding those extra pounds. I know how hard weight loss is. I'm currently 211# and trying to lose. It's a long slow process.


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## fineline (Oct 21, 2011)

UltraShy said:


> So what's a "real doctor" who's not a GP and not a psychiatrist? I didn't realize there was a third possibility.
> 
> Zyprexa is the drug from hell. I gained 25# in 6 weeks. My GP, who's in love with antipsychotics, put me on Zyprexa in 2003. It was his first choice. Even before benzos. I had a starting weight of 246#. That certainly sounds like the kind of patient where you damn well ought to be concerned about weight -- obese with an obesity-related condition: high blood pressure. I expressed my concern about weight gain, having read a Wall Street Journal article about how Zypexa causes extreme weight gain. His response was "Not everyone gains weight on it." Yeah, and not everyone dies playing Russian Roulette, but I still wouldn't recommend it. I'd note that there's also no valid reason to have me on Zyprexa as I'm neither psychotic nor bipolar (there's never been any question of that). He wanted to used it exclusively as a treatment for my SA, even though no antipsychotic has ever been FDA approved for the treatment of any anxiety disorder (because they don't f'ing work on anxiety!). At least you're bipolar, so there's actually a valid reason to have you on some antipsychotic, though still you should be on one that's weight neutral. And I can personally confirm that the Saphris you now use is that.
> 
> Good luck shedding those extra pounds. I know how hard weight loss is. I'm currently 211# and trying to lose. It's a long slow process.


Oh. I think i was thinking of a NURSE practitioner. A GP is what I have, which is a "real doctor". lol I got a bit confused.

and yea i would only recommend zyprexa to anorexics. saphris is weight neutral. its a good drug.


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## UltraShy (Nov 8, 2003)

fineline said:


> and yea i would only recommend zyprexa to anorexics.


We actually have a member, Noca, who used to use Zyprexa exclusively for its weight gain effect. He was a rarity as very few people are in need of something to help them gain weight.

I think Zyprexa may well be the #1 weight gaining drug on Earth. I'd love to see a study of how it compares to Marinol. Zyprexa would be a godsend for cancer patients who are wasting away.

I thought my 25# in 6 weeks was stunning but there was a woman on SAS who managed to beat me with 40# in 6 weeks.

BTW, why don't you just ask for Lyrica from tomorrow's doctor?


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## fineline (Oct 21, 2011)

UltraShy said:


> We actually have a member, Noca, who used to use Zyprexa exclusively for its weight gain effect. He was a rarity as very few people are in need of something to help them gain weight.
> 
> I think Zyprexa may well be the #1 weight gaining drug on Earth. I'd love to see a study of how it compares to Marinol. Zyprexa would be a godsend for cancer patients who are wasting away.
> 
> ...


Ugh, my doctor appt. got pushed back to tomorrow lol.

The reason I probably wont ask my doctor for lyrica, is because lyrica is used mainly for fibromyalgia. And its use for anxiety may not be known by many doctors. Psychiatrists are much more likely to know of its used for anxiety. So I don't even want to go down that road with my doctor lol. Arguing with him and such. What if he doesn't know about its off label uses? Then I will be coming off as smarter than him...and doctors don't like that. They like to have their ego's stroked, not to be made to feel like there is something that they don't know about medicine. 

Plus, he is my new doctor. Only had 1 appt. with him so far, so I want to build a good doctor patient relationship with him.


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## UltraShy (Nov 8, 2003)

fineline said:


> They like to have their ego's stroked, not to be made to feel like there is something that they don't know about medicine.


I'd just ask for Lyrica and if he doesn't know about its off-label use for anxiety then drop it. It's possible he knows and no big deal if he doesn't.

Seems not all doctors are know-it-alls. When writing scripts for Parnate my poc has to look up the dosing in a book as I sit there. He doesn't even do it beforehand to keep alive the illusion that he knows what he's doing. He makes no attempt to hide his ignorance of MAOIs after 28 years of practice. As they looked it up, I sat there knowing the max recommended dose was 60mg because I can read and I read it long before my appointment unlike he who waits till the appointment. It doesn't exactly inspire confidence.


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## fineline (Oct 21, 2011)

yea my old nurse practitioner had to look up everything i asked him about too. that was one reason why I sought out a real doctor.

hows that parnate working for you? I doubt I will every try it, but it seems the forums have mixed reviews on it.


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## UltraShy (Nov 8, 2003)

fineline said:


> yea my old nurse practitioner had to look up everything i asked him about too. that was one reason why I sought out a real doctor.


You could bring in a printout about how Lyrica is approved for GAD in Europe if you wanted to get it tomorrow. A doctor doesn't have to feel foolish for not knowing what's going on in Europe, after all. And it shows that you're a patient who does his homework. At least some doctors appreciate that.

I've never had a NP. I've always had MDs. I'd feel more comfortable with somebody who graduated med school, even though the term Dr. Dumba** still applies to quite a few of them.



fineline said:


> hows that parnate working for you? I doubt I will every try it, but it seems the forums have mixed reviews on it.


You can read all about my Parnate experience in this post: http://www.socialanxietysupport.com/forum/f30/karls-parnate-report-917121/

Sure, reviews are mixed, but every drug has mixed reviews. You want Lyrica even though plenty of people say it's useless. With Parnate you have very few reviews to go on because it's far less popular than Nardil. You'd likely appreciate that Parnate doesn't cause weight gain the way Nardil does. The side effect profile is quite attractive.


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## fineline (Oct 21, 2011)

yea the printout idea is a good idea, i may do that.

and as for parnate or nardil, i will prolly never try them. unless things get really bad, and i run out of options.

i hope the parnate works out for you


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