Cymbalta, Cerefolin/Deplin, and Nuvigil (oh my!)

Hi! So to summarize, I have atypical depression, anxiety, and social anxiety of varying degrees. I deal with derealization/depersonalization too, and I've been on, basically, a ***** ton of meds.

Right now I'm just on 250 mg Lamictal, and as of yesterday I'm starting Cymbalta. My doctor had originally put me on Viibryd, then after a few days I read about the common sleep paralysis problem and was scared away, which is unfortunate because I felt hopeful about it for some reason.

He also prescribed Cerefolin NAC, but my insurance turned it down and I'm not sure yet whether I'll be able to appeal and get it covered or not. But I'm thinking Deplin is really similar, isn't it? Is there any difference? If my insurance doesn't end up covering the Cerefolin I'm considering asking my doctor about Deplin and seeing if they'll cover that... So I'm wondering if Deplin would be more likely to be covered by insurance? I haven't even looked it up, but I just feel I've heard about Deplin more and somehow assume it's older and maybe more common? haha.

My doctor also gave me Nuvigil a couple of months ago when I asked about it, and after trying for a few days and having bad side effects I decided I'd just try it again after the holidays. My insurance had a problem with that, too, so I'm either going to have to go through the whole appeal thing or try with Provigil, but I'll worry about that later.

My problem is that I'm having startup side effects from Cymbalta already, and a big one of those is increased anxiety which I'd also experienced on Nuvigil. I'm torn because my depression and anxiety tend to get worse in the winter, and I do feel them getting worse (aside from having gone a while without a working med and worsening from that) so I really need to try to get things figured out quickly and not just take my time. I'm definitely starting the Cymbalta now and not waiting on that, because it should (if it works) do the most to help. But I also get very low energy in the winter, and that was part of my reason to try Nuvigil, only staying on it after winter if I felt that was best. I'm dealing with the fatigue now, worried it'll continue getting worse, and would really like to see if Nuvigil helps. I'm just worried because in a way I'd rather start both at the same time and just feel really crappy for a (hopefully) short amount of time and get it over with rather than spreading it out, also hopefully having them both kick in sooner then. But I also worry about it being too much, and, mainly, I'm worried about not being able to tell which side effects are coming from what and not knowing how each is actually helping. I'm also curious to see how Cymbalta affects me energy wise once it's stable and whether Nuvigil will be necessary, because despite desperately needing energy right now I actually don't typically respond well to too much stimulation.

So I guess my questions are:
-Should I try starting Cymbalta and Nuvigil at the same time, or will it just get too confusing?
-Has anyone tried Cerefolin NAC or Deplin, and what'd you think about it?
-Does anyone have any advice on dose timing with Cymbalta? It seems most people take it in the morning, but at least these first 2 days, I feel sleepy from it for about 4 hours, then get a shot of energy. I took it in the evening yesterday and had the worst insomnia, but if I take it in the morning I'll have that few hour crash every day. I've considered taking it right at bedtime, but I feel like the sleepiness would last a few hours then I'd wake up jittery in the middle of the night.

Thanks in advance!

Hi,

I take cymbalta at day time as well. did you start Deplin? how is it working for you?

Hi there! Unfortunately even after appealing my insurance company won't cover the Cerefolin, and I'm going to check if Deplin will be different but I'm doubting it. Have you tried Deplin?