[Americano]

I have cymbalta and it’s one of the smoothest antidepressants for me initially. The liver warnings scared me away as liver failure and death is not good for depression lol. The thing is I’m taking both celexa 20 and Prozac 80 instead but for all I know this my be hard on my liver being on both. Any suggestions?

[still_crazy]

if you have insurance coverage, ask the prescriber about regular liver function tests. couldn't hurt.

the other thing...maybe effexor (wide dosing range) or Pristiq? Tofranil and the updated Tofranil, Tofranil-PM, worked better for me than Cymbalta, but...tca drugs aren't exactly the easiest to tolerate. On the plus side, Tofranil is dosed at bedtime, put me to sleep, and helped w/ anxiety, low mood, and concentration, w/o as much apathy as Cymbalta.

Some people w/ "treatment-resistant depression" respond well to a combination of Effexor and Remeron. A small study found results comparable to Parnate for some people, with far fewer (and far less dangerous) adverse effects.

[Americano]

I have Remeron and Effexor. I feel like that’s a hard combination on your body, but I may give it a shot on a low dose of Effexor I didn’t like either one of them separately.

[still_crazy]

hi. im -not- trying to tell you what to do...its just that the effexor+remeron combination (nickname: California Rocket Fuel) has been studied a bit, so there's a little more data available on that than most other combinations.

have you ever tried Symbyax? Its zyprexa and prozac, in one pill. the other option would be to try a (I would think, low) dose of zyprexa along side however much prozac the doctor wants to prescribe. zyprexa by itself reduces agitation, anxiety, etc., but isn't great for depression. with prozac on board, the combination can help stabilize Bipolar I and treat "treatment-resistant depression," for a lot of people. weight gain and metabolic issues are potential (serious) problems, of course.

low doses of other "atypical" tranquilizers have been used, with some success. abilify, low dose risperidone, of course...seroquel. Seroquel can sometimes be effective all by itself in some cases of depression.

remeron has been used to boost a number of other antidepressants. wellbutrin, ssri drugs, effexor, cymbalta. i even read a patent online that involved using remeron at night w/ ongoing amphetamine treatment for people w/ severe depression and/or add/adhd on top of mood problems.

i hope you and your doctor can find something that helps w/o too many adverse effects.

[Travelinglady]

I take Cymbalta and like it, but get liver function tests every so often.

[Guiness187055]

Almost all psych meds have dangerous side effects. I would not read to much into it and get the necessary tests when needed.

[Americano]

Thanks for the ideas crew!

[regretful]

An unsolicited thought about Cymbalta...took it for about a year - for some reason, I seemed to crave alcohol while I took it - had liver enzyme tests, everything was, and still is, fine...my only issue with Cymbalta is that getting off of it was rather rough as I quit it cold turkey. That took about two months to get back to somewhat normal. I knew I was playing with fire, drinking along side of meds - didn't seem to want to stop. When the cymbalta stopped, so did the alcohol craving. Maybe related, maybe not. Just consider that one day you may not want to be on that med, and the wind down from it, even medically supervised, is a long and complicated one. Best to you.

[WildcatVet]

Hepatic damage is very rare with Cymbalta...unless you have a history of prior liver disease:
"Hepatic
Cases of liver failure, including fatalities, have been reported. The majority of cases were reported in patients with past or current risk factors for liver injury, including alcohol abuse, hepatitis, or exposure to drugs with known adverse effects on the liver.[Ref]

Uncommon (0.1% to 1%): Acute liver injury, elevated liver enzymes (ALT, AST, GGT, alkaline phosphatase), hepatitis, increased blood bilirubin
Rare (less than 0.1%): Hepatic failure, jaundice[Ref]

Cymbalta:
"Hepatic
Common (1% to 10%): Increased alkaline phosphatase
Uncommon (0.1% to 1%): Increased ALT, GGT, and AST
Rare (less than 0.1%): Bilirubinemia, cholelithiasis, cholecystitis, hepatitis, jaundice
Frequency not reported: Abnormal liver function test
Postmarketing reports: Cholestatic hepatitis, hepatic necrosis[R"

Prozac
"Hepatic
Uncommon (0.1% to 1%): Abnormal liver function tests, cholelithiasis
Rare (less than 0.1%): Biliary pain, cholecystitis, hepatitis, idiosyncratic hepatitis, liver fatty deposits, transaminases increased, gamma glutamyltransferase increased
Frequency not reported: Abnormal hepatic function, aggravation of hepatic damage, cholestatic jaundice, hepatic failure/necrosis[Ref]"

[CobolCapsule]

Originally Posted by Americano

I have cymbalta and it’s one of the smoothest antidepressants for me initially. The liver warnings scared me away as liver failure and death is not good for depression lol. The thing is I’m taking both celexa 20 and Prozac 80 instead but for all I know this my be hard on my liver being on both. Any suggestions?

Abnormal or elevated liver function tests (ALT, AST levels) with antidepressants or any psych meds are considered rare. Your annual blood work will will show if you have any abnormalities or elevated levels. If so, then you can switch meds if their is a problem.
Good luck

[Americano]

Did that statistic he posted say there’s possibly a one and ten chance of liver abnormalities...that sounds like terrible odds lol

[Americano]

Cymbalta:
"Hepatic
Common (1% to 10%): Increased alkaline phosphatase

[Pasteles]

I have been worried about this too. I have been taking Cymbalta for about a month and a half (have been on Wellbutrin now for 5-6 years as well). I was sober for 5 months - a doctor advised me to after my liver enzymes (ALT/AST) were higher than usual. I have been told in the past they were "elevated". I have had a past of binge drinking - it is not near as bad anymore. I am drinking here and there now. I am trying to not let myself spin because of the potential. I am fortunate that I have health insurance, and my doc was agreeable when I asked for monthly liver blood tests. Did you end up taking Cymbalta?

[fille_folle]

I can't tell you what the best course of action is for you, but I have been taking Cymbalta for 12 years and my liver values are fine. I do have a small lesion that is likely indicative of nonalcoholic fatty liver. However, this most likely related to a course of accutane I had 5 years ago and/or being on an excessive dose of seroquel for years - either of which could have damaged my insulin resistance, which is related to fatty liver.

Just get your doc to monitor the situation. The first 1-6 months is when this side effect typically appears. Also, it's worth noting that elevated liver enzymes does not usually mean you have irrevocably injured your liver. I'm not sure where the 10% statistic came from, but the NIH reports that about 1% report elevated liver enzymes - but MOST of these were self-limiting and did not require discontinuation or adjustments in dosage.
https://livertox.nih.gov/Duloxetine.htm"]

[Americano]

The more we talk about it the more skeptical I become. You have a liver condition and your not sure what medication caused it but one of those is cymbalta.

....I’d be curios about pristiq though. That’s the other snri.