The woes of adding a new ingredient to my medicine cocktail

Note: This column describes the author’s own experiences with Cymbalta (duloxetine). Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

Every morning, my caregivers present me with a bouquet of drugs. What started as a measly two syringes has become a literal gut ache: a twice-daily dose of Zyrtec (cetirizine), liquid protein, multivitamins, my beloved caffeine pill, supplementary vitamin D depending on the time of year, and now two Cymbalta (duloxetine) pills, courtesy of my neurologist. Taken together, the drugs give me a pretty significant hangover, to the point where I have to stop moving and stare at the ceiling until my stomach stops spasming.

For the most part, my medicinal experiences have been fairly straightforward. So when my neurologist sent me home with a prescription for Cymbalta, and my friend Sherry told me to prepare for some side effects, I shrugged it off. I’ve never had a problem with new medications. Why would my luck change with Cymbalta? It was just a serotonin and norepinephrine reuptake inhibitor, or SNRI, after all, not much different than the Prozac (fluoxetine) I’d been taking for depression since 2019.

Boy, was I wrong.

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Why I started Cymbalta in the first place

Last fall, I was diagnosed with Eustachian tube dysfunction. I was dealing with, among other things, ear fullness, tinnitus, and vertigo. I’d hoped the change in seasons would address my symptoms, and while they improved, I was still struggling with dizziness. I’d also started experiencing some minor head twitching, which I assumed — thanks to copious amounts of Googling — was due to the vertigo.

My neurologist wasn’t entirely sure what was causing the dizziness and head twitching. He wasn’t concerned, but given my history of migraines, we decided to start with treating those. I opted against migraine drugs as they’ve been known to cause kidney stones (another thing I have a history of). At an earlier appointment, my palliative care doctor suggested switching from Prozac to something that could tackle more than one of my symptoms at the same time.

Enter Cymbalta, a medicine that could address my anxiety and depression as well as my migraines and muscle tension. I was aghast. Agog! Where had this miracle drug been all my life?

The grass is greener?

I noticed a difference a few days after starting Cymbalta. For one thing, I was far less anxious. That could’ve been due to my neurologist looking me in the eye and telling me he wasn’t concerned. But my dizziness and twitching were also improving. They weren’t gone completely, but to my understanding, migraines are never really “gone”; you treat them as best you can in the hopes of minimizing the frequency. My neck was also significantly less sore, which I chalked up to the drug’s “muscle tension relief” effect.

I knew better than to hope my problems were solved. When are things that easy? But I had a bit of a spring to my step for the first time since October.

Then the bloating started, which was so bad that I actually had to take over-the-counter medication for it. According to Google, it was all part of the “adjusting to Cymbalta” process, along with some other, even more annoying gastrointestinal (GI) symptoms that cropped up. Suddenly, my miracle drug became a lot less miraculous.

My neurologist was surprised when I finally broke down and told him about the side effects. I tried not to sound like a kicked dog, but I’m sure my portal message had at least some “please put me out of my misery” undertones. Still, I agreed to give it another two weeks. I wasn’t excited about it, but I also wasn’t thrilled by the idea of going off this drug only to start another; with my luck, the new one would probably have even worse side effects.

Since then, the bloating has lessened significantly, as have the other GI unmentionables. The dizziness isn’t completely gone, and my ears are acting up a little, but my allergies are in full swing (yay, spring?), so who knows what the culprit is. I’m just enjoying the anxiety lull. I wouldn’t call it “numb to the world” so much as “less inclined to crash out over small, inconsequential things.”

Of course, side effects of Cymbalta include — you guessed it — dizziness, headaches, and itching, so who knows what my drug future holds.

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Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.