Posted by: Anonymous | 2009-05-15


my gp took me off Sandoz Paroxetine 20mg p/day and placed me on Cymbalta 30mg p/day. why such a strong dose and how does one eventually wean off them if its a capsule and not tablet? Sandoz Paroxetine was clear about what it was prescibed for e.g. panic attacks, social phobia, depression, etc. but the Cymbalta leaflet it not as clear. Can you please give me some info on what it should be helping me with - I know it' s for depression but I also need for social phobia.

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Our expert says:
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Obviously, you should have asked HIM these questions, especially about why he made the change --- it's part of his job to explain such things to you, and make sure you understand whatever he tells you. Cymbalta is a newer antidepressant, used for exatly the same uses as Paroxetine. It is more expensive than the semi-generic Sandoz Paroxetine. ( Generics are drugs made by other companies than the original one, identical chemically but cheaper ). With an antidepressant, it costs companies an enormous amount of money doing the necessary research to enable them to get it registered to sue for Depression. They are, in return, given a period of exclusive copyright, during which time no other company mayh make and sell that drug. After some years, that copyright runds out. Although specialists know that any of the major antidepressants is likely to also be useful for social phobia, panic, etc., it is usually late in the cucyle when a company is about to lose it's exclusive rights to sell the drug, that they go to the expense of proving that it is effective and safe for these other uses, as it can then get sole rights to sell the drug FOR THAT USE, for some more years, even while other companies can then sell it for Depression.
I suspect that Cymbalta, which has been very heavily promoted, may be in the phase of not yet registered formally for these other uses, though probably just as effective in them, so you should do fine. How do we know it should also work for those uses ? Because we know HOW it works, what chemical changes it produces, and thus what else it is likely to work for

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Our users say:
Posted by: Liza | 2009-05-15

The mg dose of one medication cannot be compared to the mg dose of another. Thus the fact that you now drink 30mg Cymbalta doesn' t mean that it is stronger than 20mg Paroxetine.

If you have doubts about the medication that you are on, go and see a specialist psychiatrist instead of just a GP.

CBT is also a better option for social anxiety than medication. I' m not even using rescue tablets anymore for my anxiety (never mind the strong tranquillizers I used to use) due to CBT.

Good Luck

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