Cymbalta: Can it be used for bipolar disorder?
I ask because I was put on it earlier in the year, and had some horrible, horrible side effects. While I was on it, in my third week of taking 50mg twice a day (I believe it was 50, but I'm not 100% sure), I attempted suicide. I wasn't taking it for manic depression or depression by itself, I've got fibromyalgia and was taking it to see if it would give me any relief. I haven't been diagnosed with manic depression, though I am going to start seeing a psychiatrist sometime after the new year (kind of scared to, but that's neither here nor there), but every woman (no joke) on my Mother's side of the family has one type of bipolar or another. Some are mild, some are in full blown mania for months and years at a time. I think I am as well, because I've had scattered weeks of mania, but I haven't had any extended periods of major depression. Let me clearly state that I'm not looking for a diagnosis here, just giving backround information.
Cymbalta is an antidepressant, and aren't antidepressants generally not a good idea to give to people who suffer from bipolar mania? Aren't mood stabilizers and (when necessary) antipsychotics the route to take? I've found conflicting info googling around.
Thanks!
Also, I was (and still am) quite young. I was seventeen when I was taking Cymbalta, though I am eighteen now.
Public Comments
1. I am Bi-Polar. Been diagnosed for at least 10 years, I'm 24 now. My medications that I have been on just about that long are Depakote(Valproic Acid)- Mood Stabilizer, Cymbalta- Anti-Depressant, Ativan(Lorazepam)- Anti-Anxiety, and Buspar- Anti-Anxiety/Anti-Depressant. As long as I take these medications on a regular basis I am fine, as soon as I stop them I'm back at the craziness again. It has been stated both ways, that anti-depressants are generally a good way of handling the "downs", and they say that anti-depressants can very well make you feel down in certain situations. I personally believe that even though they say that anti-depressants may be used for several issues, unless you are actually clinically depressed they should be left alone at all costs. Anti-Depressants CAN and in some cases WILL intice you to have suicidal thoughts. The FDA warning in the phamplet that comes with the medication even states that. I would say if you are not depressed, STAY AWAY FROM ANTI-DEPRESSANTS! OF ALL KINDS! But yes, if indeed you are Bi-Polar I think the good from taking them by far out weighs the bad.2. Cymbalta is an antidepressant. If there is a chance that you do have bipolar, you SHOULD NOT be on an antidepressant without mood stabalizer. AD's in people with bipolar trigger manic episodes. You should see a psychiatrist if you think you may have bipolar. You cant say ADs should not be used at all for someone with bipolar, but they should be used carefully and only with a mood stabalizer.
One severe side effect with AD's is causing suicidal thoughts and behaviors. That is a known side effect, that is most common in teens and young adults. You are a teen, you need to be careful going on to any AD, especially since you already know you have had this side effect on one. It doesnt mean you will on all, but you have to be careful, be aware and contact your Dr ASAP if it pops up. Those side effects do not mean you have bipolar though.
3. A recent large-scale study conducted by the US National Institute of Mental Health (NIMH, part of the National Institute of Health) called the STEP-II study, found that antidepressants confer NO benefit when added to a mood stabilizer, so there is no point in doing that, and still have the risk of switching you into mania, or inducing rapid cycling. From what I can see in recent info, bipolar experts do not want bipolar patients taking antidepressants in most cases. They are way overprescribed by psychiatrists in the community. Bipolar experts also think antipsychotics are way overprescribed for bipolar, and people should be weaned off them when a crisis is over, if possible. Antipsychotics are killing tens of thousands of people worldwide due to diabetes, severe obesity, heart attack risk 3x higher or so, neuroleptic malignant syndrome, etc. So avoid them unless you really need them. Some people do, don't get me wrong, I'm not anti antipsychotics. But hell, they're pushing Abilify on people with moderate depression in TV ads, and you know that 5 years down the road, it will turn out thousands were killed by that drug, just like the people on Celebrex. Resist trying a drug until it's been on the market for 7 years so you aren't a guinea pig - that's the rule of thumb (unless you have no other options or the drug is a tremendous improvement over older drugs).
Cymbalta made me aggressive & gave me terrible nightmares and panic attacks. It also destroyed my ability to have an orgasm, without blunting my sex drive, so I was extremely upset over that, because I'm married. All the drugs that affect serotonin will do that, and it is a serious strain on relationships.
If you have mostly pure manias, lithium is good for that. If you mostly have depressions, lamictal/lamotrigine is the drug of choice. For mixed moods and I think rapid cycling also (not sure) depakote is the one. Lithium is the only drug that prevents suicide, so if you have a lot of suicidal ideation, do try to take it, even if it doesn't make you feel better - I think it reduces your risk of suicide like 80%, if I remember right, and no other drug, even if you are successfully treated, does that. Lithium is thought to be underprescribed for bipolar, because it has no drug reps pushing it.
Good luck! Do get treatment if it's bipolar - it often gets worse without treatment, and it could disable you and spoil your chance to be a mother (I couldn't have kids because I would have been an unfit mother).
Google Dr. Phelps. He's currently a Harvard researcher specializing in bipolar. He has a whole book online you can read for free (or you can buy it at amazon). Read up on the STEP-II studies at NIMH too - they are government funded with no profit motives. Much of the other research is funded by drug companies & thus very biased.
