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Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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I suffered a major depression in 2002 and was hospitalized

Customer Question

I suffered a major depression in 2002 and was hospitalized many times between 2002 and 2005, underwent ECT and am now on Cymbalta. recently i had a surgery and it upset the balance, and the anxiety returned and so did the depression. the cymbalta was increased to 40 mg QD, but this proved too much, so i am back on 30 mg. My biggest issues are sleep and a "flat"feeling. I have never been the same sexually since this whole thing started. I have no desires, and this morning my husband pointed out that I had no desires period. I feel rather robotic if you will. Will this pass? How can I get back to my "old self"? Is this ever going to be possible?
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Steve replied 7 years ago.

Hmmm. The Cymbalta should not "flatten" you out like that - in fact, it tends to give folks a bit of engery, if anything. I wonder if the ECT may be creating some long-term effects... although you mentioned that the recent surgery upset the balance, implying that everything was fine on the 30 mg of Cymbalta. I am also going to assume there are no other medicaitons in play.

I'm not sure I have a good answer for you, but these are the avenues I would explore first:

(1) hormonal balance. You did not mention what the recent surgery was, but if may have unbalanced your thyroid or estrogen/progesterone (or if you are near menopausal or recently changed birth control methods), then hormonal fluctuations could account for flat affect and impaired sex drive.

(2) Either add Wellbutrin to your Cymbalta (which will counteract some fo the sexual side-effects and add to the effect of the Cymbalta), or change medications altogether. For some people, the SNRIs have a bit of a "shelf life." For some, they can take an anti-depressant and it works forever - for others (of which you may be one), the medicine has a good period, but then begins to lose effectiveness. A change to Effexor or Paxil may be in order.

(3) Consult with the neurologist regarding long-term effects of the ECT. There is much that is NOT known about the effects of ECT, and something may be amiss regarding your recovery from the procedure in '05.

Sorry I could not give you a definitive answer, but a more thorough evaluation is in order.

If you are satisfied with your answer, please hit “ACCEPT” so that I may receive credit. Feedback is also appreciated.


Dr. Steve

Customer: replied 7 years ago.
As noted in my original question, this has been a long term problem. Everything was not fine, I have been having sexual difficulties since the illness began. Unfortunately, Welbuterin, Paxil and Effexor were not well tolerated by me. Many medications were tried during many different hospitalizations and Cymbalta has been the only thing that helped, but I am just not returning to "my old self". I used to be very sexually active, I would dress up for my husband and even initiate things. I have no interest whatsoever anymore, and no one can seem to help me figure this out. My question was, will I ever be like 'My old self" again? ECT ended in 2005, how can this be the source of the problem?
Expert:  Dr. Steve replied 7 years ago.
whoops.... I just posted an answer but it must have gotten wiped out when I opted out. I'll repeat the highlights:

Thanks for the additional info. Unfortunately, I cannot find anything in your descriptions that would lead me to knowing what is going on with your recovery. Without knowing the root of the problem, I have nothing to help me formulate an opinion about whether you will return to your old self, or how that may be accomplished. I will opt out and throw the question to the other experts on Just Answer. Perhaps one of them will see something that I have not.
Best of luck to you:
Dr. Steve
Customer: replied 7 years ago.
thanks, anyway.
Expert:  Dr. Steve replied 7 years ago.
My apologies. Hopefully, this will be resolved soon.
Dr. Steve
Expert:  Dr. Ed Wilfong replied 7 years ago.
Steve asked me to look in on this.
I doubt ECT is causing problems. It is beoming more accepted as safe and effective.
Sometimes on cymbalta, as well as most antidepressant, some people do feel a little emotionally dulled. We don't know why, but it may mean your moods, hopeflly the depression, is not so intense.
Cymbalta can cause some decline in sexual interest, to put it mildly. Basically, I agree with Steve's recommendation of Well butrin or different med and thyroid tests.
I know you want to know if you will ever get back to old self. I wish I had that kind of predictive power. Only Dr. Phil does Tongue out.

A final theory, which may be more relevent, but I did want to discuss the usual options.
You mention that you don't tolerate many medications well (anti-depressants). I see three possibilities
  1. You may not need antidepressants
  2. A mood stabilzor may be more helpful
  3. You need to make sure another medical problem is not causing some of this.
I hope I gave you a couple ideas to look into.
Customer: replied 7 years ago.
Guess I should not have tried to ask the questions, there doesn't seem to be an answer for me. Thanks anyway
Expert:  Dr. Ed Wilfong replied 7 years ago.
There is an answer, you will just have to wait and see what it is. Sorry Steve and I couldn't find it.

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