The Side Effects At All Stages


Like any mental health med, there are of course a collection of side effects. Risk verses benefits. I want to talk about that.

Savella is in the anti-depressant family. While it isn’t used to treat depression, as it has a slightly different formula, it has the same chemical basis.

As such, any anti-depressant has one big  possible (and surprising to many) side effect, especially for those not necessarily depressed: Suicidal thoughts.

This is hard to write because that phrase raises to many red flags. Makes people anxious. Makes those who care nervous. But let’s talk this out.

I am otherwise stable. Very, fully stable. So the way this takes shape is occasionally when I’m too tired, stressed, or frustrated I start thinking that I wish I wouldn’t wake up or it would be better off if I didn’t. No. None. Absolutely not. I do not have any ideas about taking matters in my own hands. What I do have thoughts on are how ridiculous it is to think these things.

Dear Karen, you are tired and stressed but generally very happy with life. You don’t really think you’d be better off dead. This is the meds and stress talking. Now. What are you going to do to fix this so that you are excited for tomorrow?

It’s weird.  It’s new and exciting. I talk myself down so rationally and calmly. That’s how I know I’m OK. It’s just the meds. And there isn’t anything to worry and fret over.

I also think I’m really just too tired. This I fully blame the meds on. They are psyche meds and psyche meds do make me tired. And I have to take them twice a day so there is no relief. I’m able to function. But I’m able to function just enough to get done what I have to get done, but nothing extra curricular.

I do want my energy back. I’ll talk to the good doctor about that. (I’ll tell my psychiatrist about the bad thoughts. Not because she needs to worry, but because things need documented.)

And maybe, just maybe, as the days get longer and I can become more physically active, I can get my energy back.


Luke, standing on scale: What number did I turn momma?
Me: 43.6!  You’re getting so big and strong!
Luke: I know!  It’s because I poop all the time now!

Ok.  Wait.  Pooping creates weight gain now?  About as logical as the doctor’s insistence that it wasn’t the beta-blocker.  And no, apparently I’m not over that yet.  Especially since in the 3 weeks I’ve been off it, I’ve lost 8 pounds.  Yes I’m aware that in the past week I’ve started counting calories.  But, I’ve also been cheating and counting sex, and 5 minutes a day of stretching, as exercise.  So…


I have a hard decision I have to face.  What would be cut and dry with any other doctor is complicated by the fact that my current doctor works for the same company as my mom and that company has a really great reputation.  However, he is riding on their shirt tails.  I’ve seen the best of their best, my children’s pediatrician for starters, and it looks like I’m seeing the sub par now.

It started great.  He spoke English natively.  I’m not going to lie, that is huge.  He recognized my husband’s health wasn’t fully caused by his weight, but in fact his weight was a byproduct of his health.  That is amazing.  Unique, and amazing.  He himself is no tiny dancer so he gets it isn’t always easy.

I/we have spent 9 years trying to find a general practice doctor that we were willing to return to time and time again.  We/I really thought he was the one.

This whole beta blocker thing has be questioning that, though.  And it’s dragging up things from a year ago.

I was given every possible reason that I gained so much weight so fast but he refused to even entertain the idea it was the med he put me on right before my weight began to rise.  He blamed my already born baby, but it couldn’t be the beta blocker.  It was my diet, that had improved drastically.  He was so fast to draw my labs because surely they explained my weight gain.


I got my labs today.  They are perfect.  Phenomenal.  Obscenely beautiful.  People are going “Hot damn how the hell does a fat girl have labs like that?!?!”  Be jealous, bitches, my blood work is beautiful.  And strangely, does not hold the secrets to sudden 10 pound weight gain.  In fact, they might even explain sudden 10 pound weight loss, if that were the case.  Jealous yet?

And my lovely friend Luna, in all of 5 minutes with her amazing access to uncharted documents was able to pull up and send me 4 amazing scientific research studies, some dating back to 1990, all agreeing without a shadow of a doubt that oh hey, beta blockers cause weight gain.

Her words summarizing the studies:

“According to the 1990 study in the British Medical Journal, patients on propranolol gained an average of 2 to 3 pounds compared to control patients. This figure of 2 to 3 pounds is the 95% confidence interval. These researchers are 95% certain that weight gain of this magnitude did occur, due to the effects of propranolol.

The more recent 2005 study in the Journal of Headache Pain found that while fewer patients on propranolol gained weight than on some other beta blockers, the weight gain seen was of a greater magnitude when it occurred, up to 13 pounds in their sample.”

So was I left wondering what did I want to do with this knowledge?  Is my immature need to have the last word and be proven right going to drive me to losing a “great doctor”.

My views of last summer are changing.  Where I was obscenely pregnant.  In the most pain I had ever been in.  And faced with the decision of trying to work through that pain or admit I couldn’t, and go one leave without any sort of pay since Sciatica isn’t means for short term disability.

I get that last part.  I really do.  But with my well and carefully established for his records history of BPD, depression, and hospital admittance due to suicidal idealization, desire, and intents…  It wasn’t just my life in danger last June, it was the life of my Sammy as well.  I flat out said things were turning south.  I had a clear short term disability out due to my depression I was in.  I didn’t have gun/knife/razor/pills in hand but it was clear where things were headed.  No?

I mean my psychiatrists within 30 seconds of talking to me, over the phone not even in person, was ready to do what she had to do to get me on medical leave.  And the doctor who I sat in front of wasn’t willing to consider signing the paper in hand.

Ok, I had a psychiatrist.  My life, Sammy’s life wasn’t in his hands.  Thank God, because he expressed doubt my meds doctor would even be willing to sign the papers.

Seems he is not an overly well informed doctor.

And flat out?  I’m stable right now.  We are cutting back on my therapy and meds appointment visits because I’m stable. I refer to it as remission. 

But not unlike remission for cancer, there are no guarantees this is gone for good.  I may spend years stable.  I may spend the rest of my life stable.  Or things may go to hell in a hand basket in a few years and I won’t be able to get in as quickly as needed with my psyche team and my life may very well be in his hands.

Am I’m no longer convinced those are capable hands.

I mean, if he can’t even admit that maybe, just maybe, a medication known for causing weight gain could have caused me to gain 10-20 pounds (the exact number is up for debate) in 2 months, or sign a stupid paper saying I’m currently a danger to myself and unborn child, then how can he face the bigger task of damage control, I’m on the path to taking my own life and I don’t have a psychiatrist on ready back-up?

After all, I was on that path last summer and he did nothing.

Maybe not having my meds doc at my beck and call will make a difference.  But can I count on that?

Because sciatica was not life threatening to me or the baby.  Yes, sir, I understand that.  However, what it was doing to my mental health very much was.


A commenter on One Thousand Percent has mentioned they have access to Harvard’s medical databases and they like a challenge.

If just once before I die someday, I can say the following words to a medical doctor, I’ll die happy.

Well according to the Harvard medical database, which I’m sure you have access to, (right?) xxxx has been known to cause xxxx in a significant number of patients.  About xx percent of them, actually.  But that’s according to the most recent documented study.

I think this could be the time.  With this med.  And this doctor.

And to think, I was simply debating the pros and cons of sending a fax of the side effects listed on the bag from the pharmacy.  Sadly, that would involve the work fax machine and that’s probably misuse.


Look, I know you have to take what you read on the internet with a grain of salt.  I also know, after years of taking various meds and years of internet journeys, when to start putting belief in what the internet says.  What sites.  How many testimonials at what percent all saying the same damn thing.  Plus, I have offline sources of info.  Like a nurses guide to medication.  And a pharmacy.

So I went in to the doctor’s appointment yesterday hoping to request a blood pressure med that would A) be more effective and B) wouldn’t cause me to gain 5-10 pounds a week.

I was instead greeted with the knowledge my blood pressure has risen 10 points and the doctoral insistence that it is “1000% impossible for a beta blocker like Propranolol to cause weight gain”.  Really?  1000%?  That seems a tad excessive even if it were accurate.  I mean, I myself usually choose to stop at 150% that way if and when I’m proven wrong, I’m only 150% moronic and not 1000%.  That’s a percentage of wrong that’s hard to recover from.

You just need to work on diet.
I’ve cut out pop and way the back on sweets.  I’m eating 10 times more veggies than I ever have, enough fruits for the nutrients but not so much to get fat off them and a lot more quality meats verses the crap I usually consume.

You did just had a baby 7 months ago, your body is evening out.
Pretty sure once the baby is out of the womb the body evens out by losing weight not gaining almost more than it did in the entire 9 months of pregnancy.

Some people are just predisposed to be heavy.
Did you seriously just go there?  I mean really?

Yes well this med has been around as long as I have and beta blockers don’t cause weight gain.
Alright then, let’s get me off it anyway, it isn’t helping my headaches and my blood pressure is rising.

Well you shouldn’t worry about the fact your blood pressure is up.
Yes but aren’t I on this med to lower my blood pressure to reduce headaches?

Well how many migraines are you having?
A few migraines a month and tension/stress headache after tension/stress headache.

Well, nothing is going to do anything about the tension headaches…
We. Put. Me. On. This. With. The. Mutual. Understanding. That. It’s. The Tension. Headaches. I. Need. To. Treat.  It even helped for 2 weeks straight of glorious headache free life immediately after I started it.

Yes, well nothing will help with those.
Actually, lying with a full can of pop under the base of my skull helps quite a bit for awhile.

I thought you gave up pop?
I did.  That’s why I’m using cans of pop as pillows instead of as a beverage…

Well nothing else will help tension headaches…
Yes so then we agree to get me off the med that isn’t helping my BP and is causing me to balloon up…

It is impossible for the beta blocker to be doing that…  It’s psyche meds that do that…
Yes, well I’m not ON any psyche meds and now let’s get me off this med.

Well, you can’t just stop it, you have to taper down.
Yes.  Actually, my psychiatrist was very careful to tell me the dangers of missing a dose of the med you put me on.

Well, while you are here do you need a refill of the Ibuprofen?
To treat the headaches you said can’t be treated?  I’m good…


And then I got a tetanus shot and a blood draw to check my thyroid because clearly something is causing me to balloon up with all this water weight. If only we could figure out what that something is.  I mean, everyone else in the medical field will tell you beta blockers cause water weight.  But he is 1000% certain so he can’t possible be wrong.

“Coincidences” are an asshole.

And yet, still better than the doctor I walked out on mid exam a little over a year ago.


My body and I have a love/hate relationship.  I have never been a small girl.  Even as a child I wasn’t small.  It took me 27 years, but I finally got to where I could look at myself in the mirror and instead of seeing fat and sloth, I saw a body that held 3 babies and spent a decade pumped with mental health meds.

I’m not going to be skinny.

That said, my biggest fear going into my 3rd pregnancy, body wise, was based on the fact I finally had a full wardrobe that fit me, for the first time in my adult life, and I wasn’t ready to give that up.  I knew replacing it would be a long drawn out process.  So I was pleased to fit most of it, and all of it that mattered, within a month of birthing Sammy.

Let’s face it.  I struggled to gain much during my pregnancy and Cymbalta immediately after delivery killed my apatite and I went with it knowing I was safe to let it do it’s thing.

This pregnancy didn’t kill my, admittedly already ravaged, body.

So imagine my horror when 2 weeks ago I went to put on a skirt, I had worn at 9 months pregnant, and I was too fat for it to fit.  Out of the blue.

What the what?

Major changes in diet?  Not really?  My diet has never been awesome, but it certainly hasn’t been any worse and has maybe even better in many ways.

Major changes in exercise routine?  No…

Mental health meds?  I’m off them all.  Cymbalta wasn’t making me skinnier.  So this is the opposite of the expected change, one would think.

What the what?

Hey, I am taking a blood pressure med.  Would that?  But surely my doctor would let me know if weight gain is a common side effect.

Yeah.  See my psychiatrist is AMAZING in that she tells me every possible side effect of a med.  But then, my psychiatrist is also weird that she does that.  Most doctors, I find, don’t bother.  In fact, it was my psychiatrist that warned me what would happen if I just stopped taking the same BP med cold turkey.  And it was a fellow patient who warned me that BP meds can cause slight depression.

So, hello Google.

Yes, well, not only is weight gain a possible side effect of my new BP med, but MASSIVE and RAPID is how the internet describes it.  Yeah, you have to take the internet with a grain of salt.  But, I’ve also gained 20 pounds in the 2 months I’ve been on it.  Which is almost the exact amount I gained in the full 9 months of being pregnant with Sammy.

I’m already seeing my doctor Wednesday for a follow up anyway, so it looks like I’m going to have to request to be taken off this med.

But where do I go from here?

It was mostly helping with my headaches.  Do I request something different that won’t cause me to gain 10 pounds a month?  Or do I spend the rest of my life just riding out these headaches?


Before pregnancy, my anti-depressant was at 90mg of Cymbalta.  After Sammy was born, we started at 60 knowing we could up it at any time.  I’m officially put in the request for it to go back to the 90.  I’m not in bad shape, by any means, I just feel I could be doing better.  I’ll be fine a few days and then I’ll have a low.  It’s almost playing out like rapid-cycling bi-polar, though my lows and highs are way too close to baseline for it to be that.  That’s just the best way to explain it.  And when I’m up, I think I’m crazy for wanting that extra something.  But when I’m down I’m well aware that while yes, I’m still ok, I’m very capable of being better, and I’m also very capable of a sudden crash that these ups and downs are sometimes a prelude to.  So since, it’s a simple matter of increasing something that’s already in my system, back to my original dose, might as well.  And my mental health team agreed.


However, I’m currently enjoying a healthy, natural sex life with my husband that my meds usually kill all interest in.  I’m even, apparently, a cuddler atm.  Should this increase lead to any signs of that disappearing, well, I’d rather the enjoyment of my husband than the extra 30 of Cymbalta.  No second thoughts.


Anyway, still a long ways off of needing anything else.  This extra Cymbalta should do the trick, and if it doesn’t I’m at healthy enough of a place to just leave it be.  There really is a comfortable point of good enough, if you’ve given better an honest try and it simply doesn’t work out.

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