Cymbalta

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@charley0419

I'm confused. Did the doctor start her on 30mg and then up the dose to 60mg? Was Cymbalta chosen to provide relief from chronic pain and depression/anxiety? Cymbalta can be a good option for pain from neuropathy, fibromyalgia, arthritis plus anxiety/depression.

If the increase in dosage was related to breakthrough pain alone or just an uptick in anxiety/depression, then it might be more prudent to explore adding an additional medication for that symptom alone.

If you have access to a geri psych, that would be your best option for medication management as they are the specialists in this kind of medication in the elderly. Often a cocktail of meds is prescribed to keep the doses of each low enough to minimize side effects while working together to manage symptoms.

Brain zaps are often related to the half-life of SSRIs; Cymbalta's is short (8-17 hrs compared to Prozac's 2-4 days. Effexor is even shorter) which makes weaning tricky. You'd need to go very slowly. Often geri psychs will wean one med while titrating up another of the same class to minimize withdrawal symptoms.

HB

60 mg twice a day sounds like a lot. I take 30 mg once a day for joint pain and anxiety. At one point my doctor upped my dose to 60 mg once a day. I didn't like it at all - I felt like I had no feelings about anything. I weaned myself back to 30 mg by taking the capsules apart and counting the little white beads inside and reducing them by a few a day. It took months, but at least I didn't have withdrawal symptoms. Before you increase it, I would run it by another doctor or at least read about it online. It works well for me, but I don't know about someone with dementia. Good luck!

Not as a first attempt for sure. There are a lot of others.