Two weeks after I’ve begun taking Cymbalta to help lessen the pain from fibromyalgia, I can certainly say that it’s working. I noticed the other day that certain motions and movements that used to cause a fair amount of tension and a stabbing sensation in my ribs I can now do freely, without wincing, without holding back. The odd sensations in my knee and foot are gone. I’m not cracking my neck first thing every morning.

What’s impressive is that since I’m no longer focusing on how much I hurt, I have the CPU available to consider other things that catch my attention more fully. This is nice because I do seem a bit more prone to staring these days. But at least my staring is leading to interesting ideas and thoughts, like wondering why a woman at the grocery store yesterday had obviously popped in whilst out for a jog, or noticing another woman heavily sigh as I went into the single-person restroom at work that I suspected she was gunning for.

I feel much more calm, which could be the result of having more serotonin and norepinephrine to go ’round. Or could be the result of not being in pain all the time. Or both. The net result is that my initial frustration-level is way lower than it’s been in years and I find myself feeling more satisfied with everything. I had no idea how restless I’d become. It must be nice for Ashley, for me to be able to chill the eff out for a change.

Reading is easier. Balancing my day is easier. Planning is easier. Thinking is easier. Focusing is easier. In short, my Cymblatered life is improved over my pre-SSNRI days.

And I feel so awake, even when I don’t sleep especially well. It’s a different kind of awake than before. It’s more…fundamental somehow. More like awake and aware. The consequence of this is that I’m barely drinking any coffee, maybe one to one-and-a-half cups per day as opposed to my previous three-cup minimum. This is sort of a good thing because coffee’s not really good for fibromyalgics, but I have a long-standing friendship with coffee that’s hard just to drop.

There are a couple of side-effects I’m dealing with constantly.

I can hear everything with a ridiculous clarity. Did you know that if you sit quietly enough you can hear paper? It makes a sound, presumably the slow sound of it biodegrading. You can also hear cat fur move, glass contract, water evaporate and snow fall. I had no idea there was so much going on in stasis, but I can hear it. It’s unreal.⁽¹⁾

I’m thirsty all the time. As in like I want a drink of water while I’m having a drink of water. And so also of course I’m in the bathroom more than before, which is impressive because even before I practically camped out in there. But there’s generally no harm in being thirsty as long as I stick to drinking water so I’ll just have to learn to get more done whilst sitting on the thunderbox.

The other side-effect is an inability to regulate my internal temperature. Or at least my personal thermostat seems to have been turned way down. I’m cold all the time now, even sitting in bed with my robe on over my pajamas and covered in blankets. This is weird because until two weeks ago I was always warm. I would sweat even if someone mentioned the word sweat. But even now, sitting inside wearing two shirts, a hoodie and a cap, I’m freezing.⁽²⁾

Also, I’m not really smelling anything anymore. It makes me a little sad, but I’ll be honest: the inability to catalog whatever I was smelling was way more annoying than the temporary ability to smell it. I’ve gone my whole life imagining what things smelled like and having no real idea how accurate I was. It’s something, I suppose, like a blind man who might have imagined his favorite chair and then suddenly was able to see how sort-of right and sort-of wrong he was. So, to be honest, I’m not missing it that much. Though I suppose if I were able to smell on a permanent basis, had time to learn how scents add to things, and then lost it, my opinion would be vastly different.

But, as far as potential side-effects go, these aren’t bad. If they’re still a problem when I visit my doctor in a few weeks I’ll bring them up. Otherwise, I’m not too worried about it. The benefits so far are greatly outweighing the negatives, so I’ll keep with it.

It’s nice, this not hurting all the time. It makes everything better. I laugh more, especially with Ashley who, while always hilarious, has really cracked me up in the last two weeks several times. I feel more connected with the world, less outside of it or detached from it. It’s hard to really describe how different I feel – the previous 800-ish words notwithstanding. But I can say that it’s nice. That I’m enjoying it, along with pretty much everything else.⁽⁴⁾

I can say that I feel better. The pain is way less intense than it’s been in years. Sometimes it’s barely even pain, more like just a bit of awkward tension no worse than watching Napoleon Dynamite.

I also feel more awake, generally speaking. This despite having consumed way less coffee than usual – less than half my normal amount, not because caffeine is bad for us fibromyalgics but simply because after about a cup-and-a-half I’m no longer interested. Coffee thinks I’m cheating on it with Cymbalta. I tried to tell it we’re just friends, that my relationship with coffee is too time-tested and too much a sure thing for me to ever even think about seeing someone else…but I suspect it’s right anyway.

Feeling awake is probably somewhat due to sleeping a bit more, but I think it’s more about just sleeping better. The only thing that woke me up these last few night was our cat, Gaz, who needs pet about once every two hours or so. The first couple of days were bad, sleep-wise. I kept waking up about once every hour or so, which gets old fast. But Tuesday night I started to feel like I was really sleeping during each 1.5-hour increment. And Wednesday night I slept better than I have since I was probably like four.

It’s a little easier to focus on things, too. That is an expected result of Cymbalta but it’s also a function of not hurting all the time. When you don’t have to focus on ignoring massive quantities of pain in your torso it frees your mind up for other tasks. Which is nice.

I also generally feel…not happier, exactly, but more satisfied. I suppose that should be expected from taking an anti-depressant, but it’s unfamiliar to me. The hardest part of this part week was taking it easy. Not that I’m an active person by any stretch, but I do like to keep myself busy. I’m not one to sit and watch TV for hours on end. I like to read and write and make music and clean the house and work on any of the numerous projects I always have going on. But this week I made myself chill out. Ashley and I watched a lot of TV, thanks to Hulu, and while I was somewhat disturbed to spend so much time in such a pointless pursuit, I also was satisfied to just relax and hang out with my lovely fiancée.

But there have been oddities as well. Nothing bad, and thankfully nothing really bad, just oddities. Much of time I feel as though I’m…suspended…within my own body, as though the real me begins, say, .25-inch below my skin. Consequently my skin often feels a bit numb, a bit far away. Even touching my tongue to the roof of my mouth is a surprise, because I forget that both my tongue and my palate exist. I’ve always been incredibly aware of my body – which might be a factor behind or resulting from the fibromyalgia – so this disconnect is surprising, though I’ll admit it’s welcome.

There are times in which I space out. Outwardly I know I look like I’m not even home but I’m thinking intensely about something. Maybe that’s part of being able to focus more, but it’s not generally acceptable to take a mental vacation whilst sitting at your desk.

The weirdest thing is that sometimes I can smell things. I’ve been anosmic my entire life, meaning that I’d never smelled anything ever. Until this week. It’s very odd that it happens and I wonder if anyone’s done any sort of research on SSNRIs and anosmia, but what’s even more odd is suddenly having a sense at 36 that I didn’t grow up with. I don’t have words for what I’m smelling. I don’t know what it is. I haven’t learned how to ignore it. I’ve never considered how important it is to grow up with a sense, how we learn to deal with it, and what it means if that process is skipped. It is certainly an unexpected result.

But despite the oddities, I feel better. So far, it’s worth it. It’ll take more time to assess the long-term benefits of course, but so far thing seem positive. Thanks to all of you who voiced concern, who offered comfort and prayers. I appreciate it all very much.

Yesterday was about the most neurologically strange day I’ve ever experienced. Yet everything was fine. The Cymbalta is reducing the amount of pain already, and hopefully it will continue to work.

But there were a few things that were odd. I couldn’t stop spacing out. Or, not exactly spacing out, more like spacing in. During lunch, for example, I sort-of checked-out of the conversation Ashley and her friend were having and instead paid attention to a lot of the details of the people around us. How people chewed. How they gripped their food. What kind of socks they wore. I noticed that two guys who seemed to have nothing to do with each other were wearing precisely the same pair of sweatpants and shoes.

There was about a minute-and-a-half during which I think I smelled stuff. My sandwich. Fries with vinegar. Lemonade. It’s hard to know for certain because when you’ve never smelled anything you don’t know what the sensation is. At first I just thought it was a taste leftover in my mount, but then I realized that that pretty much never happens while you’re eating. And as I brought my sandwich in for a bite I realized the sensation intensified. So I suppose maybe this was smell. But it’s gone now anyway.

I also noticed I just didn’t care about some things. Like being hungry. I was aware that I was hungry but the sensation held no real urgency. And later we were in a pretty crowded place and normally I don’t do very well in crowds. But I just didn’t care. It was odd…but also kinda nice. I probably worry too much about little things anyway.

Today so far time seems to just be moving slowly, at about half its usual speed. Other than that, though, I feel just fine except for being a bit tired and possibly coming down with a cold. No bad thoughts. In fact, my thoughts seems a bit more positive. So that’s good.

It’ll take a good month to six weeks to know how well the Cymbalta is working and how it’s affecting me. So far things are going fairly well, and I hope they continue to.

Name: Cymbalta (Duloxetine Hydrochloride)

Indications: Diabetic peripheral neuropathy; fibromyalgia; generalized anxiety disorder; major depressive disorder; musculoskeletal pain, chronic

Dosing: For fibromyalgia: 30 mg orally once daily for one week; increase to recommended dose of 60 mg once daily based on tolerability.⁽¹⁾

Black Box Warning:⁽²⁾ Increased risk of suicidal thinking and behavior in children, adolescents and young adults⁽³⁾ taking antidepressants for major depressive disorder and other psychiatric disorders.⁽⁴⁾ Short term⁽⁵⁾ studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24.⁽⁶⁾ This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior.

Contraindications: Concomitant use of MAOIs;⁽⁷⁾ narrow-angle glaucoma, uncontrolled – increased risk of mydriasis.⁽⁸⁾

Adverse effects: (Common) – Diaphoresis;⁽⁹⁾ Constipation; Decrease in appetite; Diarrhea; Nausea; Xerostomia;⁽¹⁰⁾ Dizziness; Headache; Insomnia;⁽¹¹⁾ Somnolence.⁽¹²⁾ (Serious) – Hypertensive crisis;⁽¹³⁾ Myocardial infarction;⁽¹⁴⁾ Stevens-Johnson syndrome;⁽¹⁵⁾ Gastrointestinal bleeding; Abnormal bleeding; Liver failure; Suicidal thoughts.⁽¹⁶⁾

Drug-Type: SSNRI: Selective Serotonin/Norepinephrine Reuptake Inhibitor

Mechanism of Action:⁽¹⁷⁾