Documenting my journey with therapy/medication

[pitzy272]

Gosh, I wouldn't personally recommend Cymbalta, especially if your primary issue is anxiety; but I certainly don't want to interfere with anything. But I'll give my reasons, if it interests you. (For the record, I work in family medicine as a PA)

Cymbalta increases serotonin levels, but it also increases norepinephrine (adrenaline). It can give you more energy, but that can often come at the cost of more adverse effects, and, the biggest reason I have a distaste for the class, the potential for severe withdrawal symptoms if you try to come off the med (or miss a dose). Effexor (venlafaxine) and pristiq are in the same class. Anxiety and depression are the number 1 most common diagnoses I see. I have spoken with some of my patients who tried to come off of meds like Effexor and Cymbalta, and many of them described the withdrawal symptoms as quite horrible. So, I personally try to avoid that class whenever possible.

The absolute most common med I use for anxiety is Zoloft (sertraline). I use this bc it's very effective in treating a wide variety of anxiety disorders, as well as depression; but also bc it is a very clean drug with minimal adverse effects. I try to put people on meds only when absolutely necessary, so I always look for the safest options (note: Zoloft is the main go-to anti-depressant to treat depression/anxiety in a pregnant woman, which is further affirmation of its safety).

I start Zoloft at the lowest possible dose at 25mg. Lower doses of antidepressants are better for anxiety, while higher doses are typically required for primary-depressive symptoms. A lot of times, patients have great success just on Zoloft 25mg, which is good, bc the lower the dose, the less the chance for adverse effects. It's uncommon for a patient to require more than 50mg for primarily anxiety.

You restarting therapy is excellent. Pretty much all research on anxiety and depression conclude that a patient will not get maximum treatment efficacy unless they have BOTH medication and therapy (best form is called cognitive behaviorial therapy) on board. But therapy is only as good as the therapist, so make sure u find a good one that is teaching you things. The last thing that I recommend for all my anxiety and depression patients is exercise. Research consistently shows that exercise elevates mood, stabilizes mood, and reduces stress and anxiety.

Good luck! And keep us updated with your progress.