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Should Both Amitriptyline And Cymbalta Be Taken For Depression?

Posted on Tue, 15 Apr 2014

Question: My doctor just subscribed amitriptyline 10mg, can take 1-3 at night to help me sleep and she also subscribed cymbalta 20mg. Should I be taking both of these. They both say they are for depression and pain

Answered by Dr. Srikanth Reddy (3 hours later)

Brief Answer: Clarifications Detailed Answer: Hello, Thanks for using health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. However I would require a couple of more details to help you in answering your query in a better justified way. 1. Have you taken Amitriptyline ine the past? 2. Do you have any medical issues? 3. How long are you having depression? Hope to hear from you at your earliest convenience. Regards and wish you good health, Dr. Srikanth Reddy MD Neuro-Psychiatrist and Sexologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Srikanth Reddy (7 hours later)

I have never taken either one of the new meds before. I was taking St Johns Wart for depression. I have been suffering knee pain which is caused by bone spur under the knee cap. Also I am taking care of my elderly mother. Very stressful and has caused my depression. The only medical issues I have is high blood pressure which is under control by medicine and I have taken protinix for years for acid reflux. I also take cholesterol lower medicine. I also have a very stressful job especially right now I'm an accountant and in year end. Hope this helps. I just thought it was strange to be subscribed 2 anti depressant drugs. I thought she was subscribing the one you questioned to help me sleep.

Answered by Dr. Srikanth Reddy (24 hours later)

Brief Answer: I agree with your concerns Detailed Answer: Hello, Thanks for the add-on information. I totally agree with your concerns. You do need a course of anti-depressants , especially the one which has some sedating potential. But it makes no sense to start both of them together. Further there should be no option regarding the number of tab of amitriptyline you need to take as they are not sleeping pills. Infact you should start with one tab of 10 mg and then after a week increase it 2 and then to 3 after another week. You need to continue to take these medicines regularly. It will help in depression as well as sleep issues. I will not start cymbalta unless you have tried amitriptyline completely. A good dosage can go upto 150 mg or even more untill 200mg. Starting cymbalta will expose to a new set of side-effects which is not needed. You can discuss about my views with your treating doctor and get your treatment started. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Srikanth Reddy (16 hours later)

Thanks for the information. I did take 1 10mg tab of the amitriptyline the 1st night I got them then took the cymbalta the next morning. The next day my stomach didn't feel well and I had diareah. I have continued the cymbalta but didn't take anymore of the amitriptyline, do you think I did the wrong thing. What kind of side effects will I get from cymbalta.

Answered by Dr. Srikanth Reddy (6 hours later)

Brief Answer: You may continue the cymbalta Detailed Answer: Hello The fact was that you need not take two anti-depressants until needed in special circumstances. Now that you have started cymbalta, you may continue cymbalta. Use it for 2-4 weeks and then look for the improvement. In case if there is no improvement in 2 weeks then it would be wise to change the medication to amitriptyline. Nausea, somnolence, insomnia, and dizziness are the main side effects, reported by about 10% to 20% of patients. The other problem is the discontinuation syndrome. It should essesntially be withdrawn gradually. Otherwise it will again lead to anxiety and insomnia. Regards Dr. Srikanth Reddy MD

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj