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Is Cymbalta the right medicine for chronic pain?

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Posted on Mon, 30 May 2016
Question: I have been taking meloxicam (15 mg/day) for seven or eight years now, along with prozac (30 mg/day) with no obvious side effects (no nausea, cramping, intestinal bleeding, or diarrhea). Recently, I saw a rheumatologist and he recommended that I switch from prozac to cymbalta. I continued to take my 15 mg/day of meloxicam. After a week of 60 mg/day cymbalta I became constipated. This lasted for three weeks until I flushed my system with 2 ducolax and a couple of capfuls of mirilax. From that day on I have had incredible diarrhea, and ended up in the hospital with atrial flutter (because of dehydration I think). My doctor told me to get off meloxicam. I did so but the diarrhea has persisted, and my joints are killing me. I am ready to get off cymbalta and go back to the combination of prozac and meloxicam. What do you think?
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Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I agree, I think you should go back to what was working for you. The reason your doctor suggested Cymbalta was a good one -- Cymbalta is approved for the treatment of chronic pain. But in this case, you experienced constipation, an unfortunate but common side effect. It was a good try, but I recommend you go back to Prozac and Meloxicam.

Please remember to rate and close this answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe (3 hours later)
Thank you for your recommendation. Now as to trnasitioning from Cymbalta back to prozac, how long should I wait after stopping Cymbalta to begin prozac again, and do I have to start with 10 mg of prozac for a week, then 20 for a week, and then finally 30 mg, or can I just go full tilt tonight with 30 mg?
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Answered by Dr. Alexander H. Sheppe (5 minutes later)
Brief Answer:
Followup

Detailed Answer:
You need to slowly taper off Cymbalta by 20mg per week. Then start adding Prozac by 10mg a week.

Please remember to rate and close this answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers


Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2242 Questions

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Is Cymbalta the right medicine for chronic pain?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. I agree, I think you should go back to what was working for you. The reason your doctor suggested Cymbalta was a good one -- Cymbalta is approved for the treatment of chronic pain. But in this case, you experienced constipation, an unfortunate but common side effect. It was a good try, but I recommend you go back to Prozac and Meloxicam. Please remember to rate and close this answer when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers