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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are There Any Side Effects Of Taking Endep For Fibromyalgia?

I have been using endep for fibromyalgia, half 25 tab nightly, but have had long term issue with low mood. tried to treat it with an SSRI, low dose, but I m pretty sure it interacted and caused anxiety, although my doctor didn t anticipate it would. Therefore I had only continued with the endep because it did ease the soreness. However, the mood issue was constant so I am trying St. John s Wort, 3xday. Because I understood there may be issues, I stopped the endep. My question is, does the endep affect the STW effectiveness (I think it did help after a couple of weeks)? I also notice that my sleep is a lot more shallow without the endep and I tend to wake feeling more anxious. Any more that the half 25 endep I took caused me to be more tired during the day. Without the endep it seemed I was less tired and my head was clearer, but my tiredness varies, probably due to the fibromyalgia and changing mood. So, do you have any thoughts?
Tue, 19 Jan 2016
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Addiction Medicine Specialist,  's  Response
oh... I use endep a LOT in my patients with fibromyalgia. It is a weak anti-depressant but has some significant pain effects. Too many antidepressants together can cause problems (mental funniness--generally sedation or confusion, gut hyperactivity). St John's might be the worst interaction because it also lowers liver metabolism of the endep. On the other hand it is very UNreliable--most bottles saying St Johns don't have much of anything useful in them.
Exercise, cyclobenzepine, amitryptiline are quite good. CYmbalta has slight antidepressant and slight pain effects like amitryptiline but far less likely to cause mental clouding.
It's not that rare for people to have a genetic lack of metabolism of these drugs (up to 10%). The treatment is to take about a quarter to a half of the usual doses. Could happen.
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Are There Any Side Effects Of Taking Endep For Fibromyalgia?

oh... I use endep a LOT in my patients with fibromyalgia. It is a weak anti-depressant but has some significant pain effects. Too many antidepressants together can cause problems (mental funniness--generally sedation or confusion, gut hyperactivity). St John s might be the worst interaction because it also lowers liver metabolism of the endep. On the other hand it is very UNreliable--most bottles saying St Johns don t have much of anything useful in them. Exercise, cyclobenzepine, amitryptiline are quite good. CYmbalta has slight antidepressant and slight pain effects like amitryptiline but far less likely to cause mental clouding. It s not that rare for people to have a genetic lack of metabolism of these drugs (up to 10%). The treatment is to take about a quarter to a half of the usual doses. Could happen.