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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
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Experience:  Psychiatrist
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i have been on cymbalta 60 mgs for 37 days and prior to that

Customer Question

i have been on cymbalta 60 mg's for 37 days and prior to that I was slowly starting cymbalta 30mg's for 44 days for a total of 81 days. I am very dizzy in the afternoons and I tried taking in morning then night now back to mid mornings. Is this dizziness from cymbalta? I have tried every other anxiety med on the market and was hoping this would work for my panic attacks. Zoloft used to work but it poops out. Should I continue on with it or taper off. Not sure what to do or is this another issue in my body?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 2 years ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear friend,

I am sorry for your difficulty in controlling your anxiety. You mentioned that you had panic attacks which is a strong form of anxiety, but not one that is generally treated by Cymbalta or any of the other drugs you mentioned. You have said that you tried every other anxiety med on the market but there were none on your list, only antidepressants that are sometimes used for General Anxiety Disorder.

The most common side effects of Cymbalta (duloxetine) are: Nausea, somnolence, insomnia, and dizziness, said to affect about 10% to 20% of users. If you decide to wean off of it, do it slowly. Consult with your pharmacist or doctor for the best regimen.

The best medication for panic attacks is a true antianxiety medication, a benzodiazepine called alprazolam (Xanax), which can be used in low doses on an AS NEEDED basis to prevent any kind of addiction. This drug can stop a panic attack if you feel it coming on. Some people call it amazing.

Talk to your physician and ask him to try this.

I wish you great success in getting the relief you need and deserve, and which is quite obtainable.

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
Customer: replied 2 years ago.
I take Xanax too when needed but is the dizziness from cymbalta? also are you suggesting that I just use Xanax the doc said to take it every day and with the low dose of 1mg I won't become addicted but back to cymbalta I do suffer from depression from the anxiety that I will suddenly die. What's your professional advise give cymbta more time or get off slowly
Customer: replied 2 years ago.
Relist: Incomplete answer.
Expert:  Dr_Anderson replied 2 years ago.
Greetings, and thank you for your question. My colleague began the answer thread, and I'm certain he'd be happy to answer your follow-on questions, but I see you have the question re-listed. Do you still need an answer to your question? I will of course opt-out if you prefer Elliott continue assisting.

Regards,

Dr. Anderson
Customer: replied 2 years ago.
Yes I would like a more thorough answer please
Expert:  Dr_Anderson replied 2 years ago.
Greetings!

I note that you have been on a number of different medications for anxiety, so a side question is whether each of these prior medications were tried at higher doses. For example, say Zoloft worked well for you at 100 mg, but it stopped. That is actually a common problem, and the typical solution is to increase the Zoloft. The reason for increasing instead of switching is that the medicine was helpful. So, it is possible the symptoms have overwhelmed the ability of the medication to work, or your metabolism is clearing it more quickly, or some combination or other reason. Increasing the dose would set the threshold of symptoms higher, providing relief again.

Also, when a medicine stops working, it may be necessary to augment instead of changing it - this means more than one medicine being used at the same time. It is also important to make sure nothing else is going on that may be rendering the medication ineffective, such as medical illness, other drugs, etc.

As for the specifics of your symptoms, unless you had the dizziness before the Cymbalta, it is likely the Cymbalta is the culprit. This is a known side effect. There are several ways to handle it, and of course tapering off is always an option if these don't work. One option is to split the dose up into 2 30 mg pills, taken separately, instead of 1 60 mg pill. This may give you more even coverage rather than high peaks. Another option is to "gut through it" and see if the symptoms go away, as many times they will if a person can sand it long enough. If you try this option, though, I'd only give it a week tops before calling it off. It is not worth your safety and health (falling from being dizzy, for example). A third option is to go to a lower dose and try to go up more slowly. They make 20 mg size, so you could go to 40 mg (2 20 mg pills) or 50 mg (a 20 mg plus 30 mg pill). I echo Elliott's advice, though that you ought to let your doctor know what you are experiencing.

Hope this helps! Please let me know if I may be of further service.

Regards,

Dr. Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
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