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Cymbalta Affecting My Sleep?

Quick history - have been taking Imrest 7.5mg (also known as Zopiclone, Zolpidem and Immovane (I'm in Australia) for the past 9 years. Just wasn't able to go to sleep as my mind kept racing and thinking about what I have to do tomorrow.  9 years later I got diagnosed with major depression and anxiety.  I'm assuming it was the anxiety that was making my mind race at bed time.  Since being diagnosed I'm now taking Cymbalta (Duloxetine) 30mg anti-depressant and that side of things is a lot better.  It still didn't help my sleep, although my anxiety is way better.  Three weeks ago I increased the AD to 60mg and ever since then I've had to take extra sleeping pills to get to sleep.  When I say extra - I was able to take 1.5 pill to get to sleep, now I need 4-5!  Has anybody had any experience with Imrest?  The doctor I'm seeing now doesn't agree with me taking it, but it's the only sleeping pill that works for me.  All the benzodiazepines like Diazapam and Temazepam don't work for me.  I literally cannot get to sleep on my own.  Without any sleep I can't function.  I'm menopausal as well, so when the hot flushes hit me like a Mack truck the pills come in handy so I can sleep through the flushes.  I don't know if I need to see a sleep doctor regarding insomnia or what.  I just know that it's only a matter of time before the pharmacists won't fill my scripts because I'm churning through them so quickly.  Anybody got anything for me?
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This is why the class of antidepressants Cymbalta is in, the SNRIs, aren't usually the first choice for anxiety sufferers.  Usually you'd start off with either the tricyclics or more likely the SSRIs.  I do have a preliminary question, though, which is, those of us who suffer from anxiety and depression pretty much know it.  You describe it as someone just diagnosed you with it, but you don't say what your thinking was like and your life was like, only that you've long had a problem sleeping.  So here's the thing with sleeping pills -- used occasionally they are probably fine, but used regularly the body gets used to them and that can cause something called rebound insomnia, which can be worse that your original problem.  In short, you get so used to taking the pills you can't sleep anymore without them, and often you have to keep taking a higher and higher dose to get the same results.  Apparently, this didn't happen to you, so it's possible you don't have that problem, but it's also possible the med was acting more like a placebo in that if you took it, you relaxed and could sleep.  A lot of the meds we use don't actually work but they can still have a profound placebo response.  Which means, insomnia is something you have to try to fix without medication at some point because the meds will eventually not work for most people.  Okay, Cymbalta is in a class of meds that work on serotonin and something called norepeniphrine, also called noradrenaline.  Just be that latter name tells you this is an intentionally stimulating medication and depressed people often respond very well to that, but anxious people and even those who weren't anxious to begin with can just get overstimulated by amping up this neurotransmitter.  That might explain what's happening to you.  It's very hard to tell someone for whom the drug is working for the anxiety that it still might not be the right med for you because of the stimulation issue, but that's one of the difficult aspects of taking medication for anything -- they almost never cure anything but offer symptomatic relief, whereas if you were to successfully undergo therapy or lifestyle changes and that worked you'd have actually solved the problem.  But that isn't easy and so meds are often the only things that work but you still have to find a med you are able to tolerate.  This is something to discuss with whoever prescribed you the Cymbalta, and your two questions would be, first, was the problem so bad you couldn't function and therefore couldn't just try therapy and meditation and dietary changes and exercise and the usual suspects to try to fix the problem, and second, is this perhaps turning out to be the wrong med for you.  Whatever you do, don't stop the Cymbalta abruptly.  It will take a slow taper off to prevent withdrawals and so make sure if you do choose to stop it your psychiatrist knows how to do this in a way that is tailored to you, not everyone else.  Again, though, this is a balancing act because another med might not work as well for the anxiety so it's a hard choice to make.  But you're right, you gotta sleep.  That's why make sure your doc knows how to taper you off any meds you take, most docs don't know how to properly do this, because not being able to sleep is a common problem for those who stop at a pace that doesn't suit them individually.  Whatever you do, you have to work on that insomnia in a way that fixes it or at least doesn't use sleeping pills and antidepressants and benzos, which really shouldn't be used for that purpose for very long.  Ever tried anything natural, such as melatonin or homeopathy or herbal medicine or just changing when you go to bed or when you eat or how you live your life?  Peace.
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Yes, I do believe the sleeping pills were acting like a placebo as 10mins after taking one I could feel my eyes stop flickering and my mind stop racing.  Life was pretty stressful.  I was so anxious and full of adrenaline that I simply didn't stop.  I was tired.  And at my worst, 1 - 1.5 pills was all I needed to get to sleep.  So I see what you mean about Cymbalta being stimulating.  I have noticed that it has taken the depression away, but the anxiety is still there in the background.  And I'm my own worst enemy when it comes to overthinking things and thinking the worst.  I will say that the first doctor I saw put me on Zoloft and from the minute I took that first pill I was not me.  It nearly pushed me over the edge.  Same with Prozac.  And they're both SSRIs….  Thank you so much for sharing your info with me.  I'll definitely speak to my GP regarding a more non-stimulating AD.
973741 tn?1342342773
Unfortunately, that drug is completely banned in the United States.  It became known to create an issue with addiction. Addiction includes having to take more and more for effect. Sadly, you may be at that point. This isn't really about your cymbalta in my opinion.  I would consider if your sleep aid is actually problematic to your life.  That's a hard thing to talk about.  I am sorry to say that.  Sleep is a tricky thing for a lot of people. SSRI's can be activating for some people (one can be for one person, not the next and just because one causes you to be activated, doesn't mean the next one you try will).  Sometimes switching the time of day you take it can help.  My son takes prozac at about 8 pm every night.  It is not activating for him.  Although it is considered a more activating of the SSRI's.  He also has taken melatonin for about 2 years now and he takes hydroxyzine.  All lead to his getting 8 hours of sleep minimum a night which is what he needs.  Before, he would not sleep.  But that's what has worked for HIM and everyone is different. However, your doctor may be correct that it is time to give imrest a rest.  Sorry to say.
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SSRI's are first line agents for anxiety and depression.  https://emedicine.medscape.com/article/286227-medication  That's not really your issue. It's the sleep aid that you have become dependent on and developed tolerance.
I'm a bit confused, Mom.  Did you mean to say SNRIs can be activating?  Cymbalta is an SNRI, not an SSRI.  Most SSRIs are sedating, and Prozac is the only one thought to be agitating, although anyone can suffer pretty much anything on anything that affects brain function.  It's the SNRIs that are intentionally stimulating.  Just wondering.
I was giving an example.  Of the SSRI's, prozac is considered one of the more activating. But it is not for my son. When someone has a bit of activation or a bit of tiredness on an SSRI, they recommend switching time of day to see if it is better and to try a new one if it is not. I wasn't talking about classification of Cymbalta.  Norepinphrine is considered stimulating but with serotonin involved, these work well for anxiety. For anyone reading:  SNRIs work to influence both serotonin and norepinephrine by preventing a person’s brain cells from rapidly absorbing these neurotransmitters. By stabilizing these neurotransmitters, SNRIs can help improve a person’s mood, reduce feelings of anxiety, and help alleviate panic attacks.  
*serotonin involved and norepinphrine, it balances things out. For some.  Not everyone.  Everyone has such individual reactions to medication. We're moving to a serotonin agonist tonight, weaning off prozac while starting this newer class of medication.  
Not to get technical, but no, that's not how these meds work.  They work by preventing the normal breakdown of the enzyme that would normally flush out the used and bring in the new.  By nature the body prefers fresh serotonin and norepinephrine and only uses as much as the brain needs.  These meds do two things or one thing depending on the med:  the first is to prevent the natural breakdown of the serotonin, say, so it washes longer in the receptors the drug selects for it to do that, which is the second thing.  Other receptors are bypassed and therefore stop functioning and that is believed to cause the brain zaps and other withdrawal symptoms when the drug is stopped as these receptors have to attempt to start working again.  Now, some meds don't do anything other than block the enzyme.  So in essence, these drugs attempt to put more of the neurotransmitter into the system for a longer period of time at a selected point where the effect is though to be stronger.  Obviously it's complicated, but the basic point is to alter the natural way the brain works so it theoretically works better so it's a lot more than simply not absorbing them as quickly, they are absorbed quickly but for a longer period of time as the enzyme that would otherwise get rid of the used stuff has been disabled.  The only reason this is important is it explains why it's so hard for so many to stop taking these meds, why they have so many side effects, and why they can alter personality.  As for serotonin offsetting norepinephrine, if that were true there wouldn't be so many people having problems with anxiety and sleep from the SNRIs and Wellbutrin as compared to the SSRIs, which are much more often sedating.  Again, only putting this in so folks who are considering meds know to try to fix the problem without meds first to be cautious because evolution knows us a lot better than pharmaceutical companies.  Peace, all.
To the poster, The main thing is your issue with Imrest.  Unfortunately it does sound like you may have developed dependence on this based on needing more to work which is what it is known for and why the United States no longer prescribes it.  I know this is hard but I'd consider all your options in eliminating that medication.
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