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Any contraindications with Cymbalta and Lithium, Lamictal, Levothyroxine, Risperdal, Prempro, Prevacid, and Prevastatin?

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Contraindications with Cymbalta and any of these drugs: Lithium, Lamictal, Levothyroxine, Risperdal, Prempro, Prevacid, Prevastatin? I know Cymbalta can cause mania in some people (especially those with bipolar disorder) but does it cause a problem with the drugs used to treat bipolar? Any other reason I can't try Cymbalta to manage pain based on my problem list?
Posted Mon, 12 Aug 2013 in Mental Health
 
 
Answered by Dr. Susanta Padhy 27 minutes later
Hi XXXX,

Thanks for the query

1. Cymbalta, contains duloxetine, effective for some pain conditions. Also it can treat bipolar disorder if used with mood stabilizer like Lamictal or lithium. But the dose of lamictal need to be kept on the lower side and one has to hike the dose of lamictar slowly.

2. Levothyroxine, Risperdal and prevastatin has no clinical significant interaction

3. Yes, Cymbalta can cause hypomania or mania in some; but the propensity is less than drugs like Imipramine / Fluoxetine etc

4. In short, yes, Cymbalta can be used in this circumstances. However before taking a decision, because you have plethora of medical conditions and you are on multiple medications, you must consult your doctor, discuss these issues with your doctor and then take a decision. Besides that, the dose of lamictal might need to be altered.

Hope this will help. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by
 
Follow-up: Any contraindications with Cymbalta and Lithium, Lamictal, Levothyroxine, Risperdal, Prempro, Prevacid, and Prevastatin? 45 minutes later
So if I understand, when used with Lithium &Lamictal, Cymbalta may actually assist in treating my bipolar. Or do you mean that it can be used with less risk of hypomania when lithium and/or lamicatal are on board? you mention the need to lower the Lamicatal dose, i am on a pretty low dose already (200mg) so will that be necessary? Sounds like Cymbaalta is a drug I should consider as it may treat my pain conditions as well as help with other problems. In follow up, as I am not currently working with a Rheumatologist, should I talk to my Psychiatrist about Cymbalta? Or should I consult with a Rheumatologist?
 
 
Answered by Dr. Susanta Padhy 3 hours later
When used with Lithium &Lamictal, Cymbalta may actually assist in treating my bipolar, particularly if the individual is "currently" in depressive episode of moderate to severity. Plus Cymbalta can be used with less risk of hypomania when lithium and/or lamicatal are on board; because Lithium and Lamictal are mood stabilizer and are the drugs primarily effective for bipolar disorder

Yes, Lamictal 200 mg is a low dose, if your doctor increases the dose of lamictal further, then he would consider a slow hike not a rapid hike of the dose

Because you have diagnosis of fibromyalgia, osteoarthritis and chronic radiculapathy, consulting a rheumatologist is important. As cymbalta helps in cases of fibromyalgia and some pain conditions, you can discuss about it with your rheumatologist.

You must also discuss this issues of cymbalta that we are discussing here with your psychiatrist. This will help your psychiatrist to take a better decision regarding drug selection

Hope this will be of help

Above answer was peer-reviewed by
 
Follow-up: Any contraindications with Cymbalta and Lithium, Lamictal, Levothyroxine, Risperdal, Prempro, Prevacid, and Prevastatin? 11 hours later
When seeking the help of a Rheumatologist what are some questions I should ask to be sure he/she is experienced with fibromyalgia?
 
 
Answered by Dr. Susanta Padhy 5 hours later
Fibromyalgia as a disease is very commonly encountered by Rheumatologist. They are expert and super-specialist for fibromyalgia.

If some one who have authentic qualification of a rheumatologist, I would say no need to test whether he is experienced in fibromyalgia. Still, if you are eager to ask, one can ask XXXXXXX do you often see such cases" ?

It is equally important to have faith and confidence in your doctor for your well being

Wish you good health
Above answer was peer-reviewed by
 
Follow-up: Any contraindications with Cymbalta and Lithium, Lamictal, Levothyroxine, Risperdal, Prempro, Prevacid, and Prevastatin? 56 minutes later
I asked about Cymbalta but are there other medications that I should consider or ask about for fibromyalgia and osteoarthritis pain?
 
 
Answered by Dr. Susanta Padhy 4 minutes later
For osteoarthritic pain there are number of medications starting fro NSAID group of drugs to Chondroitin sulphate etc. The right medication is individualized to suit a person's need.

However there are not many drugs to treat fibromyalgia - to name some alternatives, SSRI group of drugs are sometimes helpful. In some Cymbalta congener drug like Milnacipran are helpful.

Hope this helps. Let me know if you need clarifications.
If all your queries are addressed, please close this discussion.

Good luck
Above answer was peer-reviewed by
 
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