Reprinted with the kind permission of Margaret B. Schroeder
It took my doctor a year to convince me to “take something” for fibromyalgia and about two months for me to decide to never do it again. I’ve grappled with whether or not to blog about this because maybe it’s TMI. This is an older post that I deleted, but after talking with a few Fibromytees, I decided to re-post it this week. Maybe this will help some of you who are wondering about Cymbalta for fibromyalgia.
The unprecedented volatility in the North Texas barometric pressure caused me a great deal of pain in the first half of 2015. After living through a severe migraine for three days, I gave in and asked my doctor to go over her medication plan one more time. “It’s a very low dose of Cymbalta, much lower than what you were probably on when you were taking it for depression,” she said. Actually, because of my body weight and higher sensitivity to medications, I was on a low dose even when I was at the height of my treatment for depression. But I let her continue. “There are no side effects at this dosage,” she reassured me.
I don’t remember a whole lot about the side effects when I was taking it for depression because there was so much else going on at the time. What I do remember, though, was the strange feeling I had while driving during the first two weeks. Everything on the freeway seemed extra-sparkly and kind of swimmy. I lived alone at that time and I had to get myself to the outpatient clinic every day, so I pushed through it. Looking back at that experience, I’d advise anyone else to find help with the driving for the first two weeks on Cymbalta.
This time, I decided to start it after a major family weekend event was over so I could hunker down on the couch if necessary. The first thing I noticed was an amazing clarity of pain perception. No longer could I feel the heavy burden of that all-over body throb. Now I could really feel the other sources of pain in my body. Now I felt what physical therapists describe as a “toothache-like throb” in my pulled hamstring. I could specifically feel my golfer’s elbow. I don’t think I could ever get excited about the arthritis pain in my neck or the stiffness in my shoulders, but I will tell you that it’s exciting to know that it doesn’t necessarily have to radiate all over your body. That’s probably not an accurate medical description of arthritis pain, but it’s a decent way to describe fibromyalgia on a good day.
The best news is, fibromyalgia pain relief came immediately upon starting the minimum dose of Cymbalta. The little aches I felt from my other problems seemed tiny in comparison to the load I’d just dropped. I was elated.
And then the side effects started kicking in. During my two-week ramp-up, my husband noticed a little bobble here and there in my steps. Vertigo is my come-and-go companion, so I didn’t notice it that much but it was getting worse. Within two weeks, I started having difficulty urinating. Now this is not a topic I like talking about but it’s a part of life. I would sit on the toilet, my bladder bursting for relief and I’d say aloud, “release, release, release.” Sometimes it could take as much as five minutes before I could start to pee. The process was so frustrating I found myself putting it off, which made matters worse.
Not long after I noticed the peeing problem, I started noticing that I was also constipated. I increased my fruit and vegetable intake and drank a lot more water. It helped a little, but when you’re as uncomfortable as I was, a big dietary effort for just a little effect makes no sense. My diet was never the thing that needed fixing anyway, having adhered to low carbs, clean protein, and lots of fruits and vegetables for a long time already.
Right about this time in my Cymbalta treatment, my husband and I both noticed a marked improvement in my clarity of thought. It was amazing, and I loved being able to hold discussions where I didn’t have to make people wait for me to come up with the words I was visualizing. Fibro fog is something I’ve been fighting for a long time. The ability to talk without struggling was beautiful, and it reminded me of the good ol’ days in the corporate world when I had a fast mind and a sharp tongue. It was fun to relive for a while.
Here comes the TMI part. All of the selective serotonin reuptake inhibitors (SSRIs), including Cymbalta, have the potential to negatively affect sexual function. Some people have reduced libido and others cannot reach orgasm. In my case, libido wasn’t the problem. Let’s just say that within a few weeks, my husband was the only one enjoying our intimacy. This was a really big deal for us. We lost our pillow talk time and our cuddling, things that contribute to a healthy, intimate relationship. “That could wreck a marriage,” a friend said. Yes, it could. Without ever being able to have an orgasm, I really didn’t need the rest of it either. I could see the future of this and decided to draw my boundaries. At that point, I’d been taking Cymbalta for less than three months.
There’s so much going on in the body with fibromyalgia – the constant aches and pains, the occasional migraines, the exhaustion, the brain fog. Why would I give up the one experience I can have that creates all-over body pleasure and makes me forget everything else? Even if the effects of an orgasm are temporary, it just can’t be overrated for someone who’s in pain all the time. So with my husband’s support, I went back to my couch for a couple of weeks to endure the weaning-off period, which sometimes comes with nasty withdrawal symptoms. Gradually over that two weeks, the brain fog returned and my general pain returned. It took another couple of weeks for my sexual function to return to normal.
For some people, the side effects might be a fair trade for cessation of symptoms. And not everyone reacts to Cymbalta the same way I did. I like how one of my friends got to the point of the problem: “If you can’t pee, poo, or c**, where’s your quality of life?” I snorted coffee through my nose when she said that. A few seconds later, I admitted she was right. “You’re so crude,” I teased, and she said, “I know.” Her smile came through the phone. The point she was making, and I agree, is that we can’t give up too much just because someone with a lot of education and the license to write prescriptions makes a suggestion. What I learned from this experience is, I can live with pain but I can’t live without intimacy in my marriage.
Last week, I was trying to hold up my end of a conversation with my husband. I just looked at him and said, “Oh, hell, just read my mind. At least I can have an orgasm.” He looked over at me in a moment of disbelief. Then he laughed, held out his hand and said, “You’re a nut.” I put my hand in his and thought to myself, “I can’t live without this.”
Margaret B. Schroeder writes about neuroscience, fibromyalgia, fitness, and yoga. She is the President of the DFW Fibromyalgia Support Group and staff writer for the Dallas Area Parkinsonism Society Newsletter.