Antidepressants???

[KBear]

Hey everyone,
I had been on Cymbalta for over 3 years and had received some good pain reduction from it. I also suffer from depression, and it helped with that too. As some of you may know, my husband and I would really like to have another child in the next year or two. I had weaned off all of my medications, other than Cymbalta. I was feeling really good and only taking OTC medications for the pain. I then started to wean off of Cymbalta, as it is class 3 and it is unknown if it is safe in pregnancy. It was pure hell getting off of it, felt like I had the flu for weeks, my entire body hurt and it was worse than morphine or vicodin withdrawals. I finally finished my weaning about 7 weeks ago. I was in more pan, but figured this would get better as my body adjusted to not having the Cymbalta. Within 3 weeks of being off of it, I went into another bad depression. I then started Wellbutrin (which is safe in pregnancy). This has helped my depression, though I think I need a higher dose. However, the pain remains at a higher level than before.

On Friday, I saw my pain management doctor and informed them that I was now taking 3 Vicodin a day. I told them that I didn't want to be on the Cymbalta since it is unknown how it affects a developing baby. They want me to talk with my OBGYN and ask them how they feel about me being on Cymbalta during pregnancy. They said basically it's a lesser of 2 evils kind of thing, a) I take Vicodin during pregnancy (proven safe in pregnancy, risk of child being addicted, but pediatrician says it wouldn't be a big deal to wean them off of it) or b) take Cymbalta during pregnancy and not Vicodin (which is gambling, will it affect a developing baby or not).

So, my question is, do any of you know of an antidepressant that works like Cymbalta and helps with pain too? Do any of you know if there is any kind of research out there about Cymbalta and pregnancy? Any help or insight would be appreciated.
Thanks,
Kathy

[linda]

K,
I am sorry you are dealing with these med issues. I think I've read that ultram(trammadol) does have some seratonin properties as well as some narcoctic properties according to my ENT even though it claims to be non narcotic. However, I do not know its effect on a fetus and it did not help that much with my pain. I almost started a thread(imagine that) about depression and back pain. I was just on a cure back pain site that was mostly about how all this pain is psycosamatic and is linked to unresolved issues from depression. I definitely have unresolved issues with my past and have been in denial about this back thing and could it be all in my head. It seemed like my pain worsened when I saw my MRI and also it did not seem as bad before I started taking pain meds.

I don't know about Cymbalta and pregnancy but if you are the least bit unsure I would not take it. I will read up on it. Maybe we could find out why we are so depressed and go from there. You seem to have the perfect life with a great husband and beautiful kids. You are so lucky to have this. I know why I am depressed. I've had a lot of loss in my life and have a tragic past but don't seem to do anything about it. I do know that I have a lot to be grateful for. I have Cymbalta, Zooloft and a prescription for Effexor but for some reason won't take them. I guess I just don't understand them - like they scare me a bit. I'm used to the old timey drugs that work in 20 minutes not weeks...
Take care for now my friend.
Linda

[KBear]

I don't know about Cymbalta and pregnancy but if you are the least bit unsure I would not take it. I will read up on it.

I completely agree, I don't think I could live with myself if I knew that something I did caused something to be wrong with my child.

Maybe we could find out why we are so depressed and go from there. You seem to have the perfect life with a great husband and beautiful kids. You are so lucky to have this. I know why I am depressed. I've had a lot of loss in my life and have a tragic past but don't seem to do anything about it. I do know that I have a lot to be grateful for.

I had thought for a long time that my depression was caused by my pain. I had never really been depressed prior to the chronic pain, other than a bit of postpartum depression after my first daughter (though I had attributed that to her being a really hard colicky baby). I have always been a very happy person and outgoing, pain has changed me alot. I have everything I ever wanted, so it makes no since why I get so depressed. My dream was to grow up, get married, buy a house, have kids and be a stay at home mom and I have done all that. I am starting to realize that my depression has very little to do with outside factors (other than pain, because lets face it, pain is depressing... I have yet to meet a spiney who has not battled depression). I think it is mostly chemical and a disease, just like diabetes. Depression runs in my family, I had 2 great uncles who committed suicide, my grandmother and father, as well as cousins and siblings have battled depression. I think I need to just accept that i have a genetic tendency to be depressed and that I will need to take medication for it.

I just read a really awesome book about depression that was written by a lady in Dallas, it's called Struck By Living She talks about her depression, her suicide attempts, her family history of depression and how she overcame it. She had everything by anyones standards, literally a millionaire, boy and girl child, husband, etc., yet still suffered major depression. It was a great read, I read it cover to cover in 2 days.

[KBear]

I almost forgot the other dilemma of going back onto Cymbalta. My insurance, BCBS of TX (an individual plan) will not pay for antidepressants in the State of Texas. I am stuck with them, because of the pre-existing back issues. I was on Unicare and they paid for all my medications; but they left Texas at the end of December and BCBS took over all of their customers without putting in any pre-existing clauses. There is not a generic for Cymbalta that I know of, and it is $200+ for my script, as I was taking 2-60mg pills a day (double the 'theraputic' dose). So, ideally, I would love to find an antidepressant that comes in generic, helps with pain and is safe during pregnancy (alot to ask apparently)

[linda]

K,
Cymbalta as you probably know is a ssnri - has both seratonin and norephorin (sp) uptake or whatever in it. Effexor also has this. However, Effexor XR does not have a generic but regular effexor does according to the first website I looked at when I typed in Antidepressant like Cymbalta. Unfortunately my gp gave me a script for Effexor XR and the pharmacy said it would be around $60 with my BCBS. She also gave me a month supply of samples of Cymbalta slow release 30 mg so that would probably be costly too. I haven't gotten to pregnacy part yet. I guess my depression deal is that I was somewhat depressed before the pain and the pain now has caused me to be way more depressed. I'm also nervous about mixing these meds with my short acting oxycone that I take - 40 mg a day (8 pills) a lot in my book and not working that good anymore. I originally got the Cymbalta several months ago because of your statement of how it completely took you pain away in the beginning. What is the best time of the day to take it?
Linda

[linda]

K,
Read that Paxil, Cymbalta and Effexor maybe should be avoided. This is as far as I got. I just don't know about taking them and being pregnant. One stated that it may depend on the severity of the depression whether or not they should be taken and if the depression is not too severe to go the therapy route. Justin is probably going to get on us for talking about drugs on the site. Good luck with your search.
Linda

[KBear]

I read a lot of different research and stuff today too. It is pretty mixed opinions on the matter. I think I am just going to make an appointment with my OB and see what he says. Maybe I need to just not have another baby, because being of the meds is not an option for me. I get way depressed, can hardly get out of bed, sleep all the time and quit eating (the upside is I lose a lot of weight when I'm that depressed). The positive of the research was that why there 'may' be a link to an increase in birth defects, it is still less than 1%. On the Mayo clinic site and had a few that should not be taken and the rest (including Cymbalta) were in the consider taking. Basically, everything said to discuss with your dr and see if the benefits outweigh the risks. The other side of this is that depression left untreated during pregnancy can cause harm to the baby as well. So, there is no clear answer, other than just don't get pregnant. The thought of not having another is more depressing than anything else. Going to have a pity party now......

[linda]

K,
Maybe since you were on those antid's so long that you could still be having some withdrawals? I don't know but I am so sorry you are struggling with this. You are young and if you want to have another kid you should. I really understand this depression thing. I get way down on the weekends sometimes never leaving the house just moping around about getting older and losing what little looks I had, being alone, the pain, low self esteem and the list goes on. How could I be good for anybody when I just feel so dead inside? I'm like you - can hardly eat, lay around all day in total gloom and doom. However, the withdrawals from Cymbalta you talked about sounded horrible. Makes me not want to start these things and everytime I try I have stange side effects and give up before they can even start to work. I'm tired of feeling this way though. Life is too short and at 48 mine is getting shorter. I am just before hitting that cabinet and taking one of those 30mg Cymbaltas. Can you take it at night?

So do you feel like you are feeling a little better each day or is the depression staying about the same? I'm worried about you because your family needs all of you not just a piece of you. My mother was crazy depressed but would never do anything about it except take a valium every once in awhile. She would stay in bed all the time, have crying fits that would take her to the floor and there was no getting her up. We just had to let her ride it out. Our wildness caused a lot of it though which I still feel so much guilt about - may she rest in peace.
Linda

[KBear]

I had a big long reply typed out, then I shrunk the page to do something else, forgot about it and accidentally closed the dang page! Ughh..... If I only had a brain! LOL

Yes, you can take them at night. I have started taking all new medications at night, then moving them to the mornings if need be. From what I read yesterday, sounds like there are withdrawals for all antidepressants. Not sure if it is as severe as Cymbalta or not. I hate getting back on it for that reason, but I guess if I need it forever then I won't need to go through withdrawals. Sounds like you also have a family history of depression too. The relief is worth the withdrawals too, feel so much better and have energy to do things and I'm not so grouchy.

Think I am going to call my OB today and ask about what antidepressants are safe. May need to make an appointment and talk to them in person, guess we will see. I also am going to go see my family doctor (which I am getting a new one, because mine is a quack- I think). I definitely can tell I need a med increase; but don't want to do it until I know if I should just get back on the Cymbalta or not. I'm also going to find out if there is a way to make my insurer pay for it. Seems like crap that they can just decide to not pay for certain drugs, especially since they are prescribed for a dual purpose.

disclaimer: Oh, and don't worry, I'm not taking this, or anything else I find on the internet as medical advice. I know it is just opinions and that I should see a doctor before changing, increasing or decreasing any meds. It just helps me to discuss it out and gather information before I go into the doctor. That way I know what to ask, know about the topic I am discussing, ect. Thanks for brainstorming with me, feel better about it already.
Kathy

[linda]

hey Kathy,
Glad to hear you were feeling better aleady about your dilema. I love researching stuff. You have always been so much help to me and I admire you strength for all you have been through. I can't imagine how frightening it was when you had your accident. You've really come a long way. You know you could also be having some lingering withdrawals for lowering your pain meds. I can't really remember when you reduced and how much you were on before but just a thought. Since I am the big researcher (I was a History major in college) I have spent way too much time reading about these pills that I don't seem to tolerate very well. I feel bad on the and bad without them. It is the damndest thing I've ever seen.
Linda