nuvigil and cymbalta ???? Starting with theses ....

[nancihelp373]

Hello to all my MS family,

Another trip to MD today for the EMG. It was fine, turns out i was worrying for nothing. We discussed medications today and my neuro is not a big fan of interferons. He wants to try to treat the symptoms for now and I have to say at this point I agree because I am so cautious about meds. He started me on Nuvigil for the fatigue and cymbalta for the pain. Are any of you taking these and if so are they helping? I have another apt in a month to review how they are working for me. I will start them tomorrow. I have been told or read not sure which at this point that the nuvigil can keep u up all night. That is really one extreme to another. ( might be a good thing for a few days so I can catch up on my house cleaning .. LOL )
I would appreciate any thoughts as you all have been so helpful with my concerns.

Thank you in advance and I hope everyone is doing well ......

nanci

[twist330]

I have taken cymbalta at 60mg a day and it was very good for the burning in my legs and feet. I found after about 4 weeks or so I had a really bad taste in my mouth so my Dr changed the brand and reduced the dose to 40mg the taste subsided a bit to begin with but is now back and my pain level has risen.

I also take pregabain 400mg a day, I was taking quinne for cramp but it didn't do anything and so this will be review at my next appointment, & I have been recently been prescribed prozac as I struggle with an increase in symptoms 6 days before menstruation, this is a bit of experiment as no one really knows what to do about it.

Twist

[twopack]

Once you've taken drugs like this for more than a few weeks you should always taper the dose before totally discontinuing them.  Even a person with no previous depression can be thrown into depression if the drug is withdrawn too quickly.

Cymbalta is a SSRI.  It regulates levels of seratonin in the brain.  Few brains do well with abrupt chemistry changes.  Sometimes it's necessary to go off our meds for a while but not all docs consider what can happen after what seems like a small change.  I'm glad you did okay vidalouise.

Mary

[vidalouise]

I have been taking cymbalta for several years. I do find that it helps with pain to some extent. I've read that it changes the way your brain perceives pain. I never thought I was particularly depressed, but then I had to go off of it for a few weeks...let's just say my husband and kids were very happy when mommy got her "happy" pills back ;-)

[twopack]

Hi Nanci.  You might want to consider starting just one new drug at a time.  I know you are anxious to relieve as many symptoms as you can as soon as you can.  From past (bad) experience, I like to be established on one new drug at least a week or two before starting another new one.  

I'm thinking here about HVAC who just had a severe (and somewhat unusual) reaction to a new drug.  What if they had given her two new drugs to start at once?  She would have had to stop both and then wonder how safe it would be to re-start either one.  What an unpleasant choice when what you seek is relief.

Whenever you start two drugs or treatments at once you can never be sure which to credit with improvement or blame for problems.  You might want to ask your doctor what he thinks but I would want to start the one that targets the most pressing problem first.  I'm guessing that would be the Cymbalta because it is given for pain and mood and that always seems to be #1 priority.  Pain relief itself can give you a little extra zip.

Both of these drugs are often started at lower doses so your system can get accustomed to having them on board.  It the original dose works, great.  If not, the dose can be increased.

Nuvigil does need to be taken first thing in the morning so it doesn't keep you awake at night.  The last thing you want is to get into a cycle of a pill to wake up and another one to go to sleep.  If you take Nuvigil with food the absorption and action can be delayed.  It will still work well but it just takes a little longer to get in there, work and leave again.  

If you end up having trouble sleeping the doctor may consider a lower dose or switching you to Provigil.  It is an older version of the drug.  I used to take it and thought it didn't stay effective as long.  I work second shift and needed something that wasn't going to give out before my work shift.

One last caution.  In my opinion, it is never a good idea to think you can ever "catch up" when your body has thrown MS into the mix of your life.  On days you can do something, enjoy it.  On days you can't do so much, keep your mind occupied deciding what activities you will miss least if they are trimmed out of existence.

I hope these meds work for you.  Nuvigil keeps me functioning because I can remain alert without napping most days I take it.  It never produces bursts of energy for me but it was originally ordered to treat my sleep disorder rather than my MS.

Good luck in the AM.  I hope you get to see this before you dose up.
Mary

[nancihelp373]

He said I have PRMS and the drugs will not do much if anything for me at this point. It is not off the table. I think I am the one putting the hold on it really. He says it does not stop anything but it "possibly "can spread out the time between relapses. i don't seem to be getting a break anymore. He is big on their is no cure and managing symptoms is all he can do for me now with the progression. LuLu .. do u think he is wrong? Please tell me what you think.

Thanks

[Lulu54]

Be sure to take the nuvigil in the morning - never later in the day or evening from what I know.  

I am dumbfounded that the doctor wants you to wait to treat your MS. . Right now all he is doing is treating symptoms and nothing to slow the progression.

Good luck with the new drug combo
Lu

[nancihelp373]

OMG I am so sorry you ended up in the hospital. I think I will also go nuts with some energy. I will be very careful as you suggest. My MD thinks the combination he gave me is the best on the market at this time. I am taking my 1st dose of both tomorrow and will keep you posted. I am of course hoping for no side effects. I say I am not depressed but I am sure I am as all of you are. How can we not be at times.

Keep smiling and i will let you know. have a good night !!!

[grannyhotwheels]

I take Cymbalta for depression and pain... It helps in both aspects... Please let us know how this combination works out for you... I'm going to have to do something about my fatigue... It just keeps getting worse... Hope to hear from you soon....

I'll be praying,
Carol

[tripnstumble]

I just started taking Effexor which is pretty close to Cymbalta from what I understand. It's helped pretty much with my fatigue, I like an idiot had all this energy yesterday so like you I figured I'd catch up on my house cleaning (MUCH NEEDED I MIGHT ADD LOL) and landed in the ER last night lol I was having such terrible back spasms omg I thought my back was breaking lol

SOOOO please remember even with energy to take it very easy even if you feel you can move the house :)