A 49-year-old male asked:
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cymbalta (duloxetine) 60/tegretol 600/lamictal 100/klonopin 2.5..terrible racing thoughts..cannot take lithium and diabetic...any thoughts?

1 doctor answer
Dr. Donald Jacobson
39 years experience Psychiatry
Talk to your psych: I would personally stop the Cymbalta gradually while adding in saphris, (asenapine) latuda, depakote, or fanapt. Discuss with your psychiatrist first.
Answered on Jun 9, 2015
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3 comments
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Dr. Donald Jacobson
39 years experience Psychiatry
Provided original answer
Thanks for the additional info. My screen did not show the OCD part. I agree with you completely.
Jan 26, 2014
Dr. Jane Steiner
42 years experience Psychiatry
Most people will try to avoid antidepressant s in someone who is bipolar, but as you have OCD there should be a good reason why you are taking the Cymbalta. Is it helping your OCD? Have you tried all the more typical OCD drugs like the SSRI's and clomipramine? I think it depends whether the "racing thoughts" are related to worry or mania.
Jan 26, 2014
Dr. Donald Jacobson
39 years experience Psychiatry
Provided original answer
Your diabetic Dr should confer with your psychiatrist. Plenty of my bipolar disorder patients with diabetes are on atypicals and their diabetologists work with me on it. I would seriously consider a different diabetologist if he or she won't work around your bipolar meds. Bipolar disorder can be much more lethal and certainly more impairing than diabetes.best wishes.
Nov 29, 2013

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A 49-year-old male asked:
Dr. Donald Jacobson
39 years experience Psychiatry
Combo is safe: Cymbalta (duloxetine) 60 mg is the average dose, but can go up to 120 mg per day. Your doctor is juggling a lot of drug-drug interaction potentials, b ... Read More
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1 thank
A 49-year-old male asked:
Dr. Donald Jacobson
39 years experience Psychiatry
Cymbalta (duloxetine) hypo mania: This is not rare at all. We are learning to rely less on antidepressants in bipolar disorder because of this. Antidepressants, especially snri's like ... Read More
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Dr. Neil Kudler
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Yes: Yes. As long as you take this once daily treatment for high blood pressure everyday at approximately the same time, it will be effective.
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Dr. Douglas Bey
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Not necesstsartly: Your doc is trying to find a combination of meds to control your sx. Klonopin (clonazepam) is safe ; effective for anxiety ; also helps mood stabiliz ... Read More
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