Hello again! Antidepressant question.

[abbygirl]

Hi everyone,
I haven't been posting much for the past couple of months. I thought I would try taking a break for awhile to see if that would help me keep my mind off of my eye issues. I was becoming rather obsessed with my eyes!
I have come to the realization that I need help with my anxiety/depression. I thought I could overcome this myself and I can't.. It's been over 3 years now and I have decided to try a medication. My doctor prescribed Cymbalta. Of course I am researching all the meds and am so anxious this will make things worse. I also have Glaucoma. Anyone have a good experience with Cymbalta or any other antidepressant?

[lizlou29]

Hi abbygirl

Earlier this year I started on Cymbalta and got a dry mouth from it so I decided to stop it as I was worried that it would make my eyes even drier as well. I have heard it is one of the best ones to treat both depression and anxiety though. Turned out my anxiety and depression was caused by the sleeping pills I was taking (as they wore off I would suddenly feel really down with a pounding heart) so at the moment I don't need to take anything. I've read on here that Wellbutrin is the least drying for some. I know it's a difficult decision deciding whether to start antidepressants when they may cause drier eyes but I am in the camp that believe mental health comes first. I'm seeing a pain management therapist at the end of this month.

Good luck with this and I hope others who have more experience than me with antidepressants will chime in.

[DCRdryeye]

Cymbalta is the "Effexor" without the nasty side effects. I wouldn't worry so much about it causing dry eyes, those were mainly due to the older tricyclic antidepressants (anti-cholinergic). If you can't find any resources on the internet linking Cymbalta to dry eyes, then feel safe to take it. However, since we all react differently, especially to anti-depressants, please do monitor your eyes whilst on it. If they get drier, then wean off the drug and try another.

[buntbean]

I've been on Cymbalta for over 8 years now. I would warn you that there is (apparently) a law suit against the company because people trying to get off of it have found it close to impossible. I actually just found this information out because I am seriously considering going off of it myself. There is a website: http://www.cymbaltawithdrawal.com/

I was put on so many medications that I'm weaning myself off of them one by one to try and figure out what works and what doesn't. I still have anxiety issues and I still get depressed when the pain is bad, even on the Cymbalta. I would have to say 'talk therapy' and learning how to deal with panic attacks, etc as well as a good support system have helped the most for me. It's so hard to try and figure out what the right thing to do is. I make myself crazy trying to make sense of all the medications, therapies. Good luck with your decision and God bless!

[buntbean]

I thought I'd quickly look up Cymbalta and dry eye for you. It does appear that Cymbalta 'could' make dry eye worse but if you're seriously depressed than it might be worth the risk. I spent my first 3 months refusing any medications because I feared the dryness from them but I became so suicidal that I needed something.

http://www.revoptom.com/continuing_e...ssonid/105930/
Medications: Several types of medications increase a patient’s risk of dry eye. Among them: selective serotonin reuptake inhibitors, which are used to treat depression and anxiety disorders.7 These medications include Prozac (fluoxetine, Eli Lilly), Paxil (paroxetine, GlaxoSmithKline), Zoloft (sertraline, Pfizer) and Lexapro (excitalopram oxalate, Forest Pharmaceuticals). A newer drug, Cymbalta (duloxetine, Eli Lilly), a reuptake inhibitor of both serotonin and norepinephrine, also falls into this category of potential drying agents.

[Faith1989]

Buntbean, were you depressed before your eye problems started happening? I was but now am even more, somehow i manage to hide it from people but deep down can't even think about how many restrictions i have now. For example, can only go shopping if i am having a good eye day, and even then they will probably flare before i am done. I don't even go out anymore unless i have to!

[abbygirl]

Thank-you all for the advice. This has been quite a journey! After 3 weeks of researching and analyzing Cymbalta I decided to take 1/2 the starting dose yesterday. I really have hit rock bottom. Well, I actually felt some relief just making the decision to take it! Then about 5 hours later I was shopping in Target and noticed I was having a hard time focusing my eyes. When I got home my pupils were twice their normal size. So, that made me anxious because I also have Glaucoma and blurry vision is a sign of high eye pressure! What next?? Plus, my eye was beet red when I woke up. Needless to say, I am afraid to take it again. Maybe you are right buntbean and I should try talk therapy. I need something!

[DCRdryeye]

Haven't you already tried talk therapy? I did that for months from the stress/depression my severe dry eyes caused me when I first got the disease. It did nothing. The only thing that worked was anti-depressants, but you need to find the correct med. I've had one antidepressant give me heart attack symptoms and I went to emergency. Another caused 20kg of weight, and raised liver enzymes. Then I did some research and found one that is well tolerated and often used in the elderly. My doctor said he doesn't normally prescribe it and I'll get the shakes on it. It was up to me, so I went on it and no shakes, no symptoms hardly at all. I already had dry eyes and so it has done nothing there. I've been on it for about 6 yrs now.

Regarding withdrawing, some are easier than others but it can be done - but slowly and under medical supervision. My current antidpressant has a short half life, so it's out of my system within 2-3 days. I went off it for 3 days once and got upset and teary for absolutely no reason at all...so strange how these chemicals can affect us. A friend has been on Paxil for 11 yrs and cannot withdraw, even chipping a small piece off with a razor blade and he'll notice it.

There is a new antidepressant, and a member in the Sjogren's group said she takes half or a quarter of this new med and it INCREASES her tear production. Not sure if I'm allowed to mention medication names on this forum.

[abbygirl]

Thanks DCR dryeye.. Yes, I have tried talk therapy when all of my eye problems started. It did help somewhat but I don't think she really "got it." I had alot more hope back then that this would resolve and now the reality has set in that I will be dealing with this the rest of my life. I have had 7 eye procedures in 5 years for retina tears, IOL implants etc. plus the dry eye.

Anyway!! I would be interested in the med you are taking and also you mentioned another one that might work for me. I mentioned Cymbalta so I hope that wasn't a problem. I would still have to get my doctors approval. At this point he is not sure what to do for me either!

[karensumner]

i am not sure about the glaucoma but i do take wellbutrin 150 and i use it for depression and anxiety.. even tho it can sometimes cause anxiety it can also help it (it is for an off lablel use to help it and it does in my case)// i really have stopped obsessing about my eyes and it doesnt dry me out at all. I tried about 3 other anti depressants and they all dried my mouth and eyes so bad-i have sjogrens and take meds to make saliva and my mouth was like cotton..so bad.and eyes worse too

let us know what u decide.. good luck

[DCRdryeye]

Karensummer - Yes you exactly explained my point earlier about trying the different anti-depressants out. Even people without dry eyes have to do this since we all react differently to anti-depressants. It's frustrating because depression is bad enough, then comes a roller coaster ride of basically being a guinea pig and 'trialling' the correct drug that will suit you best. You may get lucky and find the first med (or combination) works fine, but it's rarely the case with anti-depressants.

Anti-depressants have a scale measure of anxiety, so it's from which will make you the most relaxed to the most anxious. And then there are drugs in between. The two anti-depressants at the extremes are, for relaxation, insomnia, to relax is Mirtazapine and at the other end of the scale the one to provide energy and motivation (but can also exacerbate anxiety if it's already there) is Wellbutrin. Some people use Wellbutrin to get them fired up and going in the morning. So a depressed person whom is the lethargic, no energy, over sleeping type will do well with Wellbutrin. The depressed person who is hyper anxious, serious insomnia, etc will do best with Mirtazapine.

However, I've learned than Mirtazapine uses an anti-histamanic effect for it's relaxation and sleeping effect. So it may exacerbate dry eyes? I've been on it and it helped a lot. I didn't have dry eyes back then.

[lizlou29]

I know we are all different but Mirtazapine was a killer for my eyes. I took it for insomnia and my eyes went from mild-moderate dryness to severely dry. There may have been other factors that contributed to the dryness of course but as DCRdryeye said it acts as a strong anti-histamine to cause drowsiness. Was a shame as it was good for sleep initially and it really relaxed me.

[alisonW]

Ditto to what karensumner said. (The only difference is that I haven't yet been diagnosed with Sjogren's although I've had a dry mouth ever since my second child was born.)

[Katewest]

I was on Paxil at the age of 18 ish I think. I was on it for maybe a year...tops? Sometimes I wonder if that was the trigger. I really need an anti-anxiety med but I just have not been able to find one. I tried xanax but its not really a daily option. I am thinking about one of the non-SSRIs like Cymbalta. Oh I was on Lyrica for only 2 weeks and it made me super drowsy and unmotivated. I stopped too abruptly though and got super emotional/down. I'm weening myself off now. I also tried neurontin but that gave me Horrible headaches. I was on tegretol for about a week but then read about the side effects (SJS) and got off because I was really paranoid of having the cure being worse than the cause. I'm trying to do bio-feedback/talk therapy but its so expensive! Funny how these pain meds/anti depressant generics cost like $7.00 and therapy, with insurance is $70.00 an hour. UGH!!! I get so angry thinking of people making money off our disabilities. I'm considering Lipiflow now but I feel like it will be another waste of money. IPL was a total waste for me. I'm going for the lipiview test on Monday.

[DCRdryeye]

I hear so many stories at how IPL does not help. I believe they are doing it on the Meibomian Glands now too (it may be a different machine). Keep trying researchers, I'm sure you'll get it right some day, maybe not in our life times!

Katewest, have you tried simple diazepam for anxiety? It has a long half life and is easier to withdraw than the others. Many other options exist and should be utilized and that's "natural therapies" - Meditation is the most important (never underestimate it), exercise, massage, spa, sauna, yoga, tai chi, etc. Secondly, there are powerful herbs and specific nutrients that can immensely assist with anxiety with no side effects. Mixing the lifestyle strategies with the herbs/nutrients works wonders.