Kicking Cymbalta is painful

Q. My doctor prescribed Cymbalta for the pain of fibromyalgia, but it did not alleviate the pain at all. Instead, it made me feel like a zombie. I had no energy or motivation, but I did have insomnia. The worst thing was stopping the drug. I had anxiety, panic, awful dizziness, increased pain and even more insomnia for weeks.

A. Duloxetine (Cymbalta) was originally approved as an antidepressant. More recently, however, it has been promoted for chronic pain associated with osteoarthritis, fibromyalgia, neuropathy and lower-back problems.

The Medical Letter on Drugs and Therapeutics (May 2, 2011) concluded, “Duloxetine’s [Cymbalta] superiority over placebo for treatment of chronic low back pain and osteoarthritis appears to be modest at best.”

Other readers also report difficulty stopping Cymbalta. One woman wrote: “Our daughter’s life has almost been ruined in her attempt to withdraw from that drug. She is almost an invalid as a result. Kindly send me your Guide to Dealing With Depression and any information on withdrawing from Cymbalta.”

Suddenly stopping drugs such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), paroxetine (Paxil), sertraline (Zoloft) and venlafaxine (Effexor) can lead to disorientation, dizziness, nausea, insomnia, headaches and other symptoms of withdrawal. We discuss this problem in our guide. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (64 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. E-7, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q. I had hiccups every 10 seconds by the clock. I tried all the tricks, but the hiccups just would not stop.

I saw the doctor on the second day, and he pulled out his reference book. The cure was benzonatate. Within two days, I had no more hiccups. This drug really did the job. My home drug book says it works on the cough center of the brain.

A. Thanks for sharing your experience. When hiccups last that long, they can be extremely painful and disruptive. It is important for a physician to make sure nothing serious is causing the problem.

Benzonatate (Tessalon) is a nonnarcotic prescription cough medicine. It is thought to work through a local anesthetic action, suppressing the cough reflex.

Q. I read in your newsletter that a study confirms that blood-pressure readings at home are more reliable than those in the doctor’s office. I’ve been through this and can tell you why. Once diagnosed with hypertension, every trip to the doctor’s office is like being called in to the boss to be told whether you will be promoted or terminated. I have more dread of a blood-pressure reading than going to my retinal specialist. My BP can be 150/85 at the doctor’s office; it is 112/60 at home.

A. The research was published in the Annals of Internal Medicine (June 21, 2011). In the course of 18 months, more than 400 veterans had their blood pressure monitored at home, in a research setting and in the clinic. Clinic readings were highest. Home blood-pressure readings are a more accurate reflection of fluctuating blood pressure and should be shared with the doctor.

2011 King Features Syndicate, Inc.