Think we finally found a replacement for my Cymbalta

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Jim1969
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Date Joined Jul 2009
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   Posted 5/3/2012 2:05 PM (GMT -6)   
As some may recall I had to stop taking Cymbalta due to insurance issues and that for quite some time my doctor has been trying to either find something that works for my diabetic nerve pain or to get it approved.

At my last visit she asked if I would try Effexor saying that it was closely related to Cymbalta. I agreed and have been taking one capsule a day for the past week and so far so good.

No side effects and a marked improvement in the nerve pain. I still get the occasional "electric shocks" in my feet but they are rare. 99% of the time what pain I still have in my feet is barely noticeable. It has been a long time since my feet felt as good as they do now.

I actually started noticing an improvement on the 2nd day but didn't want to say anything for fear of "jinxing" things.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.

crampygrammy
Regular Member


Date Joined Aug 2008
Total Posts : 85
   Posted 5/3/2012 2:33 PM (GMT -6)   
Jim I am new here, but let me say I am thrilled to hear your news. When I hear new like this, it gives me hope that someday everyone will be relieved of neuralgic pain.

I too have chronic nerve pain (not in my feet but in my upper left stomach from damage after an ischemic colitis attack). Right now my pain is bearable and I have refused to take medications for it at the moment. That may change depending on the level of my discomfort.

I wish you many days of feeling well :-)

straydog
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Date Joined Feb 2003
Total Posts : 11124
   Posted 5/3/2012 2:33 PM (GMT -6)   
Wow, Jim are you serious Effexor is helping your feet? I will have to tell my husband, he is having the same problems as you with the neuropathy in his feet and hands. He was put on Neurotin and has had increases in it but it just has not made a significant improvement. His hands are so bad he has trouble even holding onto a fork, he drops just about everything his hands touch. His feet are really bothering him. I think this is wonderful news for you and I sure hope it just keeps getting better and better for you.

I understand being afraid jinxing yourself. Its awful we get that way, but when so many other things have failed how can not help but feel that way.

Keep us posted on how you are doing please...Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Chartreux
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Date Joined Aug 2006
Total Posts : 8075
   Posted 5/3/2012 2:55 PM (GMT -6)   
Jim,
Good news indeed, glad to hear this... Sure hope it will
continue for you...many well wishes...
And keep us posted on how things go...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
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Monty's Mom
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Date Joined Aug 2010
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   Posted 5/3/2012 9:29 PM (GMT -6)   
Jim,
This is wonderful! I hope it works well for you for a long time. I remember how tough it was when your insurance would no longer allow Cymbalta. So glad you found something that works for your neuropathy.

Mindy
The worst sin towards our fellow creatures is not to hate them, but to be indifferent to them. That's the essence of inhumanity. George Bernard Shaw
Pelvic adhesive disease, IBS, SI dysfunction, arthritis, fibromyalgia, depression and anxiety, 11 pelvic surgeries for pain, adhesions, endometriosis, adenomyosis, ovarian cysts, and ovarian remnant syndrome.

Jim1969
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Date Joined Jul 2009
Total Posts : 2042
   Posted 5/4/2012 8:17 AM (GMT -6)   
I just checked the dosage of the Effexor and it is 37.5mg. Thought I would pass that on in case anyone is thinking about talking to their doctor about it.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11124
   Posted 5/4/2012 11:08 AM (GMT -6)   
Jim I think that is the standard dose the first two weeks then its bumped up. For neuropathy it may be different though. Will yours be increased?


Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 5/4/2012 11:55 AM (GMT -6)   
Yippee:)

This is wonderful to hear that it is working for you...I haven't heard of any Drs. using this off label for nerve pain so this could be pretty groundbreaking....

Definitely keep us posted on the dosage amounts and your progress.
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Betsey Ross
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Date Joined Mar 2011
Total Posts : 1056
   Posted 5/4/2012 9:19 PM (GMT -6)   
Jiim, that is wonderful news. I m so happy for you.

Keep us up to date on your health.

take Care
Betsey
Age to a woman is like krypronite to Superman.

grandmaroses
Veteran Member


Date Joined Jan 2011
Total Posts : 1355
   Posted 5/4/2012 11:41 PM (GMT -6)   
Jim I am so glad you have finally found something that works for you, I remember some of your previous posts you were gettig upset.
Take care
Rose



Insulin Dependant Diabetic, Fibromyalgia, Gerd, IBS, Sleep Apnea, COPD, Spondylolistesis, Diabetic Neuropathy, Fatty Liver, High Cholesterol

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 5/5/2012 6:59 AM (GMT -6)   
Glad to hear the effexor is helping. To my understanding, Cymbalta has a shorter half life and quicker "plasma" build, therefore its essentially quicker and more potent in effects. In this respect, its kind of like tramadol but with stronger SNRI properties but no Mu Opioid properties. However, Effexor is still a relatively potent SNRI anti depressant, so I can see it being both helpful for pain and that it helps with withdraw too.

I'm on Nucynta (tapentadol) which is a low end of moderate stregnth mu opioid receptor agonist (stronger than tramadol, weaker than oxycodone on THAT specific action) but its a moderately potent NRI. Less so than Cymbalta, but enough so that it makes a considerable contribution to pain relief so that the opioid properties can afford to be weaker.

The good thing with opioids with dual/tri action and anti depressants is that they build tolerance slower than traditional opioids and seem to work fairly well for nerve pain. Not exactly good agents for break through pain, but well suited for chronic around the clock relief. The biggest drawback is some of the side effects (like sleep issues) and that withdraw (especially with the dual/tri action opioids) can have some emotional related effects.

Also, not sure if you were aware of this Jim but Effexor has very mild Mu opioid agonist properties. Its chemically related to both tramadol and Nucynta (tapentadol) but has less opioid action than both, so its generally not viewed as being an opioid in that regard.
 
In my humble opinion and from what I've read up concerning the medication and their effects:
 
Effexor: very weak opioid, moderately strong SRI, moderately strong NRI, weak DRI
 
Tramadol: weak opioid, moderate SRI, moderate NRI, very weak DRI
 
Tapendtaol: moderate opioid, moderately strong NRI, weak SRI, no direct DRI action
 
 
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

Post Edited (grainofsalt) : 5/5/2012 6:05:49 AM (GMT-6)

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