A question about Cymbalta from our Lyme Forum memeber...

[Johnnny off Paxil]

Folks I need your help and input here , one of our members has a question about using this "new SSRI" called Cymbalta"......I'll let her do the speaking....your responses would be greatly appreciated..

I'm newish to the forum but have a thread Husband's Lyme in1989, me now. I want to talk to you about this antidepressant thing.
I've been clinic. diagnosed with Lyme going back to1989 too. A few yrs ago I started having stabbing/burning pain on the surface of my feet & shins. My endocronogist who I had been seeing for a few yrs at that point to treat Hashimotos thyroid said I now had Peripheral Neuropathy. To make a long story short, he started treated me for PN - Gabapentin, then Lyrica,then added a Nitro Glycerin patch on my leg at night.
Then, a few months ago, he said a new treatment had arrived in Canada called Cymbalta (duloxetine hydrochloride) & that it had been used in the US for yrs. successfully for PN. He prescribed it for me. This med is used mainly as an antidpressant, but it even says on the info sheet you get with meds that it is also used for PN. It was after being on this for a few months I started having the nausea/weakness attacks that led me to my LD diagnosis. I am wondering if there is a connection. When I had my first attack & wanted to talk to him he refused to talk to me. Haven't seen him since & won't see him.

So Doc is essentially treating her Peripheral Neuropathy with an SSRI..........comments please...

Regards, Johnny

[rubbyducky]

Prescribing antidepressants for neuropathy is par for the course. Other avenues include painkillers, but doctors are of course leery about using those long term .... so antidepressants it is.

I have peripheral neuropathy from a sympathectomy that I had in '02 and the only course of treatment offered was antidepressants ... I don't think that there is a sinister motive behind this practice -- there are just no truly safe alternatives for long term, chronic pain problems, especially when it comes down to misfiring / damaged nerves.

Obviously I doubt that the nausea/weakness is anyway related to LD. I would assume that it is related to cymbalta, because when I had my (rather short) stint with cymbalta, I felt like vomiting half of the time too.

[rubbyducky]

And for the record, the SNRIs ARE good for pain management -- I got numerous piercings without ever feeling a thing, and it did take care of my own neuropathy, but of course the cost was high. Your friend has to weigh the pros and cons and decide for herself whether or not its worth it.

If the pain is moderate then I wouldn't bother with it, I would just focus on swimming exercises, hot baths, and massages to cope.

[LCrawford67]

Cymbalta is very commonly prescribed for neuropathy. My step father is a diabetic and Cymbalta is drug of choice for diabetics w/neuropathy. It's either SSRIs or pain killers, as Rubbyducky mentioned. Pain killers for this kind of chronic pain, can actually be a lot more harmful than Cymbalta. It's a lesser of two evils situation.

I'm a little confused though - she says she was diagnosed with Lyme back in 1989, but then says that the nausea/weakness is what led to her Lyme diagnosis.

[leo79]

Cymbalta is garbage though. There are lesser evils.

[westeewoman]

I would have to agree with Leo about the size of evils here. Cymbalta has so many side effects that they outweigh the pain management piece. That's just my opinion.

[LCrawford67]

Originally Posted by westeewoman

I would have to agree with Leo about the size of evils here. Cymbalta has so many side effects that they outweigh the pain management piece. That's just my opinion.

Oh, I agree. But, I also know what my SD has goes through and how he was with pain killers. For some, in this situation, this is their only option.

He did try alternatives, but none worked. Believe me, we had the SSRI discussion, but this works for him and me not being in his shoes, but knowing what he's been through, I can understand his position and for him, the side have been few and he's done much better than with narcotics. So, to say the side effects outweigh the pain management, just isn't true in some cases.

[leo79]

I agree. I didn't mean to say that an SSRI is not an option as I do believe they can help here, just that I think there are safer SSRIs than Cymbalta if you look at the overall picture ( basically because it is associated with a high rate of suicidality compared with some of the others ).

[LCrawford67]

Originally Posted by leo79

I agree. I didn't mean to say that an SSRI is not an option as I do believe they can help here, just that I think there are safer SSRIs than Cymbalta if you look at the overall picture ( basically because it is associated with a high rate of suicidality compared with some of the others ).

I knew what you were saying, Leo.

Believe me, I wasn't happy with the choice of Cymbalta either, but this seems to be the drug of choice for diabetic pain. In fact, the FDA approved it for that specific reason a few years ago. However, how it's any better than any other SSRI for pain, escapes me. I've never found a "real" answer for that.

[leo79]

yeah it is strange. it must have some opiod receptor that it targets or something otherwise it will just be marketing.

[Johnnny off Paxil]

Thank you folks...I will pass this info on to her....... your input is greatly appreciated.


Just a note, Lyme disease is so horrible, especially the nerve pain and inflammation caused by it, couple that with the fact that for thew most part unless you connect with a Lyme Literate doctor... either will not be treated at all or treated but poorly. The record here in Canada for treating those infected with Lyme is absolutely abyssmal or should I say it borders on medical criminal negligeance . According to the majority of Canadian doctors..there is no such thing as Lyme disease in Canada..and of course..its all in your head
If you are interested in seeing a real "eye opener" just go to Google video and look up " Under our skin"....warning..the imagery and stories are heart wrenching and shocking.

Regards, Johnny