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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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My wife is 51 and has been taking prozac or its generic for

Resolved Question:

My wife is 51 and has been taking prozac or it's generic for about 20 years. In more recent years she has also experienced a lot of overall pain in her body. While in Florida recently she went to her mothers doctor to discuss it and he suggested Cymbalta 60mg because that med addresses not only depression but also the pain symptoms she has experienced. It seems to help with the pain but the dosage was too high for starters. It did not do sufficiently well for the depression. My wife quickly felt that she was loosing ground in that area. Do you have any recommendations? Would it be permisable or advisable to to use 20mg of each at the same time? Also, Cymbalta is rather expensive and we have been told that it is not available in generic form in the U.S. but it is in Canada and certain other countries. We would consider ordering it via an online pharmacy. Any thoughts or experience with this avenue?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Did the new doctor determine why your wife was having this pain?

Elliott, LPCC, NCC :

Can you see my question?

Elliott, LPCC, NCC :

Cymbalta (duloxetine) is approved in the US to treat diabetic peripheral neuropathic pain and major depression. Is this the cause of her pain?

Elliott, LPCC, NCC :

It is usually not advisable to take both of these antidepressants together.

Elliott, LPCC, NCC :

Let me copy a portion of an article from www.drugs.com.

Elliott, LPCC, NCC :

 


Interactions between your selected drugs



fluoxetine ↔ duloxetine


Major Drug Interaction


Applies to: XXXXX XXXXX



Talk to your doctor before using FLUoxetine together with DULoxetine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Other drugs that your selected drugs interact with



Interactions between your selected drugs and food



duloxetine ↔ food


Moderate Drug Interaction


Applies to: duloxetine



DULoxetine may cause liver damage, and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with DULoxetine. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.



Drug Interaction Classification


The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

















MajorHighly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
ModerateModerately clinically significant. Usually avoid combinations; use it only under special circumstances.
MinorMinimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.


Elliott, LPCC, NCC :

 


You can find this on the link below:

Elliott, LPCC, NCC :

http://www.drugs.com/interactions-check.php?drug_list=949-0,1115-0

Elliott, LPCC, NCC :


If the Cymbalta is not addressing the depression then perhaps she should stick with the fluoxetine (Prozac) and further investigate the cause of her pain. Rather than just mask the symptoms it makes more sense to find out the cause and deal whatever is behind it.

Elliott, LPCC, NCC :

The patent has not yet run out on Cymbalta. Duloxetine is probably not available anywhere. Be careful of scams for this one.

Elliott, LPCC, NCC :

There are some places where you could help on this prescription, but it has side effects and is very difficult to get weaned off of as well.

Elliott, LPCC, NCC :

When using psychotropic drugs it is always safest and wisest to do so under the guidance of the foremost expert in that area - a psychiatrist.

Elliott, LPCC, NCC :

Here are some links for getting a break or possible limited free supply (or reduced cost) of Cymbalta:

Elliott, LPCC, NCC :

If her income is under $42k, then try this assistance program: www.myrxadvocate.com

Elliott, LPCC, NCC :

She may also be eligible for 12 month free supply from the manufacturer, Lily: www.Lillytruassist.com

Elliott, LPCC, NCC :


I know that this was a lot of information but hopefully will help you.

Elliott, LPCC, NCC :

I wish her the best of health and relief and will keep you family in my prayers.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and 3 other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
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