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What causes worsening of anxiety attacks inspite of being on Cymbalta?

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Posted on Mon, 25 May 2015
Question: I have anxiety and to a lesser extent some depression I used to take paroxetine[paxil] but felt I no longer needed it ad stopped a few mo.s later I had some major anxiety and depression the physciatrist put me on Cymbalta and it seemed to be ok for a few mos. but now I'm feeling anxiety more than depression and when I awake in morn have it the worst I am also fighting the constant urination problem at nite even tho I take tamsulosin
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Answered by Dr. Ivo Ditah (57 minutes later)
Brief Answer:
How much Cymbalta do you take?

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about these symptoms that you have reported. Cymbalta is used mainly for depression and anxiety. I would have expected this medications to be helpful even with anxiety disorder. I am of the thinking that there is some disturbing issues going on in your life that need to be addressed. The fact that you seem not to sleep well at night because of the several times you need to urinate may be the cause of this. This also fits with the severe nature of these symptoms as the anxiety seems worse in the early hours of the morning.

What I will suggest is to first of all tackle the urination difficulty. Tamsulosin is a good drug but needs to be incorporated with lifestyle measures. Avoid drinking alcohol, tea or coffee and other fluids at night, and empty the bladder before going to bed. This would help make sure that you don't wake up several times at night.

If the above measures fail, I will recommend that we try other medications for frequent urination like terazosin, viagra, etc. At times, trying several different types helps to identify what works best for each individual as persons respond differently to them.

In all, increased anxiety could be caused by frequent urination that greatly disrupts sleep at night. Incorporating lifestyle changes and treatment review might help resolve this and solve the anxiety issues. If after correcting urination anxiety symptoms persist, then I will consider drug treatment at that time.

I hope this helps. I wish you well. Thanks for using our services and do feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Ivo Ditah (16 minutes later)
I take 60 m.g of Cynbalta
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Answered by Dr. Ivo Ditah (3 minutes later)
Brief Answer:
THis is the standard dose and okay!

Detailed Answer:
Hi and thanks for this follow up.

This is the maximum dose. This means that you are being well treated using this medication. I will lean towards improving the frequent urination as outlined above. I am positive this would help and would only consider further drugs for anxiety if this fails.

Let me know what you think. I wish you well.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ivo Ditah

Internal Medicine Specialist

Practicing since :2002

Answered : 3994 Questions

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What causes worsening of anxiety attacks inspite of being on Cymbalta?

Brief Answer: How much Cymbalta do you take? Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these symptoms that you have reported. Cymbalta is used mainly for depression and anxiety. I would have expected this medications to be helpful even with anxiety disorder. I am of the thinking that there is some disturbing issues going on in your life that need to be addressed. The fact that you seem not to sleep well at night because of the several times you need to urinate may be the cause of this. This also fits with the severe nature of these symptoms as the anxiety seems worse in the early hours of the morning. What I will suggest is to first of all tackle the urination difficulty. Tamsulosin is a good drug but needs to be incorporated with lifestyle measures. Avoid drinking alcohol, tea or coffee and other fluids at night, and empty the bladder before going to bed. This would help make sure that you don't wake up several times at night. If the above measures fail, I will recommend that we try other medications for frequent urination like terazosin, viagra, etc. At times, trying several different types helps to identify what works best for each individual as persons respond differently to them. In all, increased anxiety could be caused by frequent urination that greatly disrupts sleep at night. Incorporating lifestyle changes and treatment review might help resolve this and solve the anxiety issues. If after correcting urination anxiety symptoms persist, then I will consider drug treatment at that time. I hope this helps. I wish you well. Thanks for using our services and do feel free to ask for more information and clarifications if need be.