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Cymbalta for Fibro

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I just had a question about the use of Cymbalta for Fibro... Has the bloom gone from the Lilly for the use of Cymbalta for this Dx? Is there anywhere I can be referred for info on this specifically?

Thanks so much for reading!

 

Georgie

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A number of antidepressants are approved for various pain conditions. Also PMS and menopausal hot flashes. And IBS. And whatever. All this means is that drug companies put some money into studies.

 

They need to show the FDA only two successful studies on a drug to get on-label approval for a specific condition. They may have conducted 98 studies that show the drug is a failure, but if they can somehow produce 2 favorable studies (for which statistics may have been manipulated), that's all the FDA needs to approve the drug for that condition.

 

The studies drug companies pay for (and get published) tend to support expanding use of the drug for some specific condition; they then use them in marketing campaigns to sell the drug to the general public and doctors so it will be prescribed to even more people.

 

Have you seen a commercial for Cymbalta lately? That should set off alarm bells. Does Cymbalta work for fibro? Does Prozac work for PMS? Does Effexor work for hot flashes? It's hard to know the truth.

 

What did happen is that the pharmaceutical industry expanded the use of drugs that were questionable in their original indication (depression) and made them into huge, huge moneymakers that primary care doctors could prescribe for just about anything women complain about. And while they expanded the markets for their drugs, pharma hid adverse effects, so it's impossible to tell whether the potential benefit of a drug outweighs its risk -- an essential criterion for medication.

 

It's too bad, Georgie, that you or I or any patient has to figure out the risk-benefit analysis for taking an antidepressant, but the medical literature for these drugs is so clouded by fraud of various types it's hard to say these drugs are "good" for any condition unless the patient is truly, truly desperate and is willing to try anything, even a drug that might be damaging, to get relief.

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After reading your post, I remb that several years ago I was put on Cymbalta for "possible" Fibro. Yes, you read that correctly... possible! I knew immediately I had made a stupid mistake. I stopped taking it around 2-3 weeks in and started the Celexa. Fortunately the switch worked for me.

 

When I see the commercials, I know I did the right thing by getting off it quickly. It's a very difficult AD to taper.... one of the more difficult ones.

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After reading your post, I remb that several years ago I was put on Cymbalta for "possible" Fibro. Yes, you read that correctly... possible! I knew immediately I had made a stupid mistake. I stopped taking it around 2-3 weeks in and started the Celexa. Fortunately the switch worked for me.

 

When I see the commercials, I know I did the right thing by getting off it quickly. It's a very difficult AD to taper.... one of the more difficult ones.

 

Hi Summer,

 

My former psychiatrist offered Cymbalta as an alternative to Wellbutrin XL when I had concerns about tinnitus. I declined because I was concerned that it would be a tough drug to get off of. It is one of the best decisions I made and thank my lucky star every day for that.

 

I am glad you escaped Cymbalta h-ll.

 

CS

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These polls of patients show:

 

- Cymbalta dead last among 85 treatments for fibromyalgia http://curetogether.com/blog/2011/08/10/patients-say-fibromyalgia-drugs-make-things-worse-rest-is-best/

- Cymbalta dead last among 35 treatments for neuropathy http://curetogether.com/blog/2011/08/16/neuropathy-study-results-800-people-rate-35-treatments/

- Cymbalta (and Wellbutrin) very mediocre among 83 treatments for depression (Effexor and Paxil barely effective) http://curetogether.com/blog/2011/05/03/23-surprisingly-effective-treatments-for-depression-one-year-later/ -- exercise, pets, art therapy, talk therapy rate much higher.

 

Low-dose naltrexone or LDN has a cult following among people suffering from various conditions -- see the results for fibromyalgia, neuropathy, rheumatoid arthritis . It may well be the sort of thing that doctors overlook because it's not promoted by pharma -- it's a very old generic drug. (I talked to a knowledgeable psychiatrist recently and he says he's used it successfully for OCD cutting and other self-harming conditions for many years. He didn't think it was appropriate for withdrawal syndrome.)

Edited by Altostrata
corrected link

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Alto... be sure to let the doctors in on the results of your last post! Apparently, they are unaware. :rolleyes:

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The doctors are influenced by TV ads just like everyone else. Cymbalta for fibro is a case of if you repeat a lie often enough, people believe it to be true.

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The doctors are influenced by TV ads just like everyone else.

 

This is so wrong on so many levels. Doctors shouldn't be "learning" or influenced by television commercials. It's bad enough that lay people do.

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Our gods have big stinky feet of clay, summer.

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Low-dose naltrexone or LDN has a cult following among people suffering from various conditions -- see the results for fibromyalgia, neuropathy, rheumatoid arthritis . It may well be the sort of thing that doctors overlook because it's not promoted by pharma -- it's a very old generic drug. (I talked to a knowledgeable psychiatrist recently and he says he's used it successfully for OCD cutting and other self-harming conditions for many years. He didn't think it was appropriate for withdrawal syndrome.)

 

Glad you mentioned that... GAPS suggests low-dose naltrexone, and I was curious about it because my dad and niece have an autoimmune disease that is supposed to get good results with that. What with everything being so connected I started wondering if it might not help with withdrawal (this dumb search for a solution).

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These polls of patients show:

 

- Cymbalta dead last among 85 treatments for fibromyalgia http://curetogether.com/blog/2011/08/10/patients-say-fibromyalgia-drugs-make-things-worse-rest-is-best/

 

- Cymbalta dead last among 35 treatments for neuropathy http://curetogether.com/blog/category/research-findings/

 

- Cymbalta (and Wellbutrin) very mediocre among 83 treatments for depression (Effexor and Paxil barely effective) http://curetogether.com/blog/category/research-findings/ -- exercise, pets, art therapy, talk therapy rate much higher.

 

 

Low-dose naltrexone or LDN has a cult following among people suffering from various conditions -- see the results for fibromyalgia, neuropathy, rheumatoid arthritis . It may well be the sort of thing that doctors overlook because it's not promoted by pharma -- it's a very old generic drug. (I talked to a knowledgeable psychiatrist recently and he says he's used it successfully for OCD cutting and other self-harming conditions for many years. He didn't think it was appropriate for withdrawal syndrome.)

I did some work on Naltrexone can be found here

http://www.topix.com/forum/drug/effexor/T2E0A0JG5NMQVJFQ3

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After reading your post, I remb that several years ago I was put on Cymbalta for "possible" Fibro. Yes, you read that correctly... possible! I knew immediately I had made a stupid mistake. I stopped taking it around 2-3 weeks in and started the Celexa. Fortunately the switch worked for me.

 

When I see the commercials, I know I did the right thing by getting off it quickly. It's a very difficult AD to taper.... one of the more difficult ones.

 

Summer had you been on an AD already? I have a theory that ADs cause fibro... not just mine.

fibro link here

http://www.topix.com/forum/drug/effexor/TTQ28JNPL3K5DVSLT

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Please keep sort of on-topic.

 

The off-topic posts were moved to their own topic.

 

Thank you.

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//http://www.therapeuticsdaily.com/news/article.cfm?contentValue=814507&contentType=newsarchive&channelID=26

 

Therapeutics Daily - Cymbalta (duloxetine)

 

I haven't found the full study/review yet. Sorry this is choppy.

 

Note the use of "chronic" and "long term" as it relates to the different indications/uses and 'lack of evidence that effect could be maintained over time', and repeated mention of benefits not outweighing risks.

 

They do say that GAD is "long term".

 

In reviewing for somatic pain, a long-term condition:

"There was also insufficient evidence that its effect could be maintained over time, which is important when treating a long-term condition."

 

 

 

Questions and answers on the refusal of a change to the marketing authorisations for Ariclaim, Cymbalta and Xeristar (duloxetine) - Outcome of re-examinationFrom the PharmaLive.com News Archive - Nov. 18, 2011

 

On 21 July 2011, the Committee for Medicinal Products for Human Use (CHMP) adopted a negative opinion, recommending the refusal of a change to the marketing authorisations for the duloxetine-containing medicines Ariclaim, Cymbalta and Xeristar. The change concerned the addition of a new indication, the treatment of moderate to severe chronic somatic pain in patients not taking NSAIDs regularly. The company that applied for the change to the authorisation is Eli Lilly.

 

The applicant requested a re-examination of the opinion. After considering the grounds for this request, the CHMP re examined the initial opinion, and confirmed the refusal of the change to the marketing authorisations on 17 November 2011.

 

Q:What are Ariclaim, Cymbalta and Xeristar?

 

Ariclaim, Cymbalta and Xeristar are medicines containing the active substance duloxetine. They are available as gastroresistant capsules.

 

Ariclaim is used to treat pain due to diabetic peripheral neuropathy (damage to the nerves in the extremities that can occur in patients with diabetes).

 

In addition to pain due to diabetic peripheral neuropathy, Cymbalta and Xeristar are also used in major depression and generalised anxiety disorder (long-term anxiety or nervousness about everyday matters).

 

Q: What were the medicines expected to be used for?

 

In addition to their approved uses, the three medicines were expected to be used to treat moderate to severe chronic (long-term) somatic pain in patients not regularly taking NSAID pain killers (non-steroidal anti-inflammatory drugs). Somatic pain is from the body surfaces (such as skin) or musculoskeletal tissues (such as skeletal muscles, bone and joints). It does not include pain from internal organs such as the stomach and intestines.

 

Q: How are they expected to work?

 

The medicines are expected to work in the same way they do in diabetic peripheral neuropathy. The active substance duloxetine, is a serotonin-noradrenaline re-uptake inhibitor. It works by preventing the neurotransmitters 5-hydroxytrypamine (also called serotonin) and noradrenaline from being taken back up into nerve cells in the brain and spinal cord. Neurotransmitters are chemicals that allow nerve cells to communicate with one another. By blocking their re-uptake, duloxetine increases the amount of these neurotransmitters in the spaces between these nerve cells, increasing the level of communication between the cells. Since these neurotransmitters are involved in reducing the sensation of pain, blocking their re-uptake into nerve cells may improve the symptoms of pain.

 

Q: What did the company present to support its application?

 

The company presented results of five main studies in 839 patients with chronic somatic pain: two studies in patients with knee pain caused by osteoarthritis (swelling and pain in the joints) and three in patients with chronic low back pain. Patients in the studies were treated with duloxetine or placebo (a dummy treatment) with some patients taking them in combination with NSAIDs. The main measure of effectiveness was the change in the severity of pain, as recorded by the patients on an 11-point scale after 12 or 13 weeks of treatment.

 

Q: What were the CHMP’s main concerns that led to the refusal of the change to the marketing authorisations?

 

The CHMP noted that the studies had not proven that duloxetine would provide a relevant benefit in the indication applied for. There was also insufficient evidence that its effect could be maintained over time, which is important when treating a long-term condition. In addition, more information was needed on the effects of duloxetine in elderly patients and its safety in the intended patients including the elderly. The CHMP therefore concluded that the benefits of duloxetine in the treatment of moderate to severe chronic somatic pain in patients not regularly taking NSAIDs had not been shown to outweigh its risks.During the re-examination, the Committee considered the use of duloxetine in a smaller group of patients: patients with chronic low back pain or osteoarthritis (swelling and pain in the joints) of at least moderate severity who cannot use NSAIDS. The Committee concluded however that its concerns had still not been adequately addressed and confirmed its initial negative opinion recommending the refusal of a change to the marketing authorisations. What consequences does this refusal have for patients in clinical trials or compassionate use programmes?

 

The company informed the CHMP that there are currently no ongoing clinical trials with Ariclaim, Cymbalta and Xeristar in chronic somatic pain patients in Europe.

 

Q: What is happening with Ariclaim, Cymbalta and Xeristar for in their approved indications?

 

There are no consequences on the use of these medicines in their approved indications, for which the balance of benefits and risks remains unchanged.

 

7 Westferry Circus - Canary Wharf - London E14 4HB - United Kingdom

Telephone +44 (0)20 7418 8400 Facsimile +44 (0)20 7418 8613 E-mail info@ema.europa.eu Website www.ema.europa.eu

 

 

 

 

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I have been on both Cymbalta and Savilla for Fibro. Neither worked and caused me nothing but pain.

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Yes, Cymbalta is one with wicked withdrawals. I was put on it also for Fibromyalgia and it didn't help me with that.

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The doctors are influenced by TV ads just like everyone else.

 

This is so wrong on so many levels. Doctors shouldn't be "learning" or influenced by television commercials. It's bad enough that lay people do.

 

However about MDs starring in drug commercials ~YIKES

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They may have conducted 98 studies that show the drug is a failure, but if they can somehow produce 2 favorable studies (for which statistics may have been manipulated), that's all the FDA needs to approve the drug for that condition.

Sick

 

Have you seen a commercial for Cymbalta lately? That should set off alarm bells.

Humph, I stay as far away from commercials as I can. I am a Netflix independent movie buff, so until the kill my Golden Goose, it's good deal.

 

Huge moneymakers that primary care doctors could prescribe for just about anything women complain about.

That is one place I'm fortunate with my doc, his wife is really neat.. she works in his one doc office, and it's always a joy to see her. There were mentions of Dr. Welby a while back. I often think of my doc in that way. I know his entire family, including his daughter who has a serious developmental disability. Really neat folks. In any case.. round the bend that, when I asked him about taking Cymbalta for fibro, a few years back, pre Whitaker, he told me I was on enough crap and did not need any more. He's far from perfect, but very much into learning mode. A good listener, and he does not believe drugs are what they are touted to be.

 

It's hard to say these drugs are "good" for any condition unless the patient is truly, truly desperate and is willing to try anything, even a drug that might be damaging, to get relief.

 

I got on Lyrica to help with fibro flares... it's the only drug on the market that really helps, and look at where that has gotten me. Oh, and the poop is if it helps, one then needs to stay on it. Also not true, as fibro waxes and wanes, but there are a lot of people that are now parked on it.

 

Thanks for your thoughtful reply,

Schuyler

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Georgie from three websites on AD Withdrawal, Cymbalta is up there with Effexor and Paxil for a miserable withdrawal from the posts I've read.

 

It is just not worth the chance that it might work IMO. I don't know anything about Lyrica, and was not surprised at how rotten a drug it is to get off of.

 

Is there anything holistically that may provide relief. Accupuncture, does massage help or cause more pain? I have never taken it, but Arnica is for pain.

 

Just had a thought. Epidural....I have had a few of them and they worked like a charm for back pain that radiates across hips and legs.

 

Hugs

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The doctors are influenced by TV ads just like everyone else.

This is so wrong on so many levels. Doctors shouldn't be "learning" or influenced by television commercials. It's bad enough that lay people do.

 

If you're having a bad day, summer, don't read this.

 

Doctors are required by state licensing boards to acquire a certain number of continuing education credits for every licensing period, which varies from state to state. In Pennsylvania, 100 credit hours are required every two years and there are certain requirements within those requirements to take certain categories of medical courses.

 

All well and good, but the part that may ruin your day is that a lot of these approved courses are free, sponsored and presented by Big Pharma, no doubt with lovely catered lunches thrown in. They are often located at an attractive resort, and because any continuing ed expense is tax deductible, these trips can amount to an inexpensive vacation. (Most doctors I know are cheapskates and will jump at a free lunch, a free course, or a tax deductible vacation.)

 

I spend several hundred every year to maintain my CPA license and I'm sure the PA Board of Accountancy would discipline any member who took free courses or other gifts from say, Country Wide Mortgage or MF Global. It's really sad that a governing body that protects people from unqualified Certified Public Accountants is more fierce and ethical than most state medical boards, but there it is. :(

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Is there anything holistically that may provide relief. Accupuncture, does massage help or cause more pain? I have never taken it, but Arnica is for pain.

 

Just had a thought. Epidural....I have had a few of them and they worked like a charm for back pain that radiates across hips and legs.

 

Hugs

 

My trusty occupational therapist is best now. Epidurals don't help because fibro is in the muscles, not the same as a nerve injury. I've had it for 35 long years. The first medication that worked was Lyrica. Obviously that is no longer a go.

 

Thanks for the suggestions,

 

Schuyler

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Not that you have a choice, now, Schuyler, but you can take Lyrica as needed, too. It's dosed in way too high an amount, as you're experiencing.

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Acupuncture can be very helpful for a myriad of health problems so it seems like a reasonable option for fibro -

Massage is very individual depending on the therapist and my type and level of pain which is musculoskeletal and not fibro - massage has increased my pain if too aggressive or if I need a chiro adjustment -

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I'm really uncomfortable with the whole need-to-take-med-daily-forever for chronic pain -

I've had chronic pain (musculoskeletal) for years and somedays it's there and other days it's not - I have my own algorithm depending on how the cycle started and when I catch it: chiro - massage - acupuncture - aspirin - Salon Pas patches or similar - ice - Imitrex (helps w tension in neck/head as well as migraine)- opiate -

I don't claim to understand difference btwn fibro and my musculoskeletal pain but have a negative gut feeling about prophylaxis treatment for symptoms that may wax and wane -

Same feelings w migraine prophylaxis-

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I'm really uncomfortable with the whole need-to-take-med-daily-forever for chronic pain -

I've had chronic pain (musculoskeletal) for years and somedays it's there and other days it's not - I have my own algorithm depending on how the cycle started and when I catch it: chiro - massage - acupuncture - aspirin - Salon Pas patches or similar - ice - Imitrex (helps w tension in neck/head as well as migraine)- opiate -

I don't claim to understand difference btwn fibro and my musculoskeletal pain but have a negative gut feeling about prophylaxis treatment for symptoms that may wax and wane -

Same feelings w migraine prophylaxis-

 

HI Barb.. just an fyi, fibro waxes and wanes but is present every day. The intensity and character vary, so when there is a flare, it is front and center most of the time, but otherwise, not as much. That said, Lyrica IS promoted for prophylaxis.. erroneously so. The pharmacist told me I needed to take it every day, as fibro is always there, but it only helps with the type of pain I have in flares, with the burning neuropathic pain that makes me feel like I'm on fire. From what Alto said, I may have been sold on needing more than I actually did. The party line is one needs 300 mgs for pain, and less may have worked almost as well? Duh... I did not realize I was on a high dose.. diabetics are told to take 600 mgs a day (sounds horrendous now)

 

Sorry to hear about the muscle pain you experience and glad you have found treatments that help, but still, never knowing when it will return must be draining.

 

Schuyler

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These polls of patients show:

 

- Cymbalta dead last among 85 treatments for fibromyalgia http://curetogether.com/blog/2011/08/10/patients-say-fibromyalgia-drugs-make-things-worse-rest-is-best/

 

- Cymbalta dead last among 35 treatments for neuropathy http://curetogether.com/blog/category/research-findings/

 

- Cymbalta (and Wellbutrin) very mediocre among 83 treatments for depression (Effexor and Paxil barely effective) http://curetogether.com/blog/category/research-findings/ -- exercise, pets, art therapy, talk therapy rate much higher.

 

 

Low-dose naltrexone or LDN has a cult following among people suffering from various conditions -- see the results for fibromyalgia, neuropathy, rheumatoid arthritis . It may well be the sort of thing that doctors overlook because it's not promoted by pharma -- it's a very old generic drug. (I talked to a knowledgeable psychiatrist recently and he says he's used it successfully for OCD cutting and other self-harming conditions for many years. He didn't think it was appropriate for withdrawal syndrome.)

I did some work on Naltrexone can be found here

http://www.topix.com/forum/drug/effexor/T2E0A0JG5NMQVJFQ3

 

Since the site is gone now you can find this here on wayback

 

https://web.archive.org/web/20101202091319/http://www.topix.com/forum/drug/effexor/T2E0A0JG5NMQVJFQ3

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