mak456: will withdrawal ever end?

[mak456]

I have been on antidepressants since i was 16 for anxiety and depression, I am 35 now. Doctors have bounced me back and forth between medications due to worsening feelings of anxiety and depressed or the medication just crapping out. I just want to preface this by saying I have struggled with drug addiction since I was a teenager. After seeing many psychologists and psychiatrists and Dr's I was started on antidepressants probably at age 15 or 16. In hindsight I believe most of my issues with anxiety and depression were due to me being a drug addict. I have been clean since 2012.

 

I don't really remember what drugs I took when and the dosages prior to 2013- 2014. At that time I was 30mg of Cymbalta.  I did well on this drug but it was very expensive with my high deductible health Insurance.  I decided to switch to Effexor because it was cheap and I did well on it in the past. I was only taken off of the Effexor in the past because i had high blood pressure when I was in a rehab, go figure... I remember being on the effexor at 150 mg for awhile. At some point, I was having severe anxiety and my Dr. bumped me up to 225mg. I was aright for awhile and then began have issues with anxiety again. My Dr. sent me to a psychiatrist who bumped me up to 300mg. I was feeling better and stayed at this dosage for awhile. After a few years I began to feel numb to life and my emotions. I wanted to be able to feel again, for better or for worse. I decided I didn't want to be on antidepressants anymore. I could not successfully reduce the dosage without feeling withdrawal symptoms and I did not know  to do a slow taper at that time. The Dr's did not understand when I told them I was having withdrawal symptoms. Their answer was to increase the dose or switch drugs. After reading about how hard it was to get off this drug i decided to try lexapro. After researching cross tapering I successfully switched to 20mg of lexapro.  I felt fine after a few months although I was having some side effects such as excessive hunger and tiredness. I manged to get down to 15mg and these side effects went away. I then tried to go to 10 mg, this is where my withdrawal problems started. I tried to go back up to 15mgs and then 20 mg, but it did not really work. I still did not not really understand withdrawal from these drugs and thought it just crapped out. In the past I did well on cymbalta but i could not afford it with my insurance. I have new insurance now and decided to try this drug again. My Dr. started me at the lowest dose on Cymballta of 20 mg. I felt fine after a few weeks except for a little agitation and decided to stay on this dosage instead of increasing as initially discussed with my Dr. My Dr. agreed since i was feeling okay. After about a month the withdrawal symptoms hit me. I thought i needed to increase the dose because I was having relapse symptoms of anxiety and depression. This is when I found this site and learned a lot about tapering and the withdrawal symptoms and process. I realized all of my symptoms were withdrawal and not relapse. I basically went from a high dose of effexor/ lexapro to the lowest dose of Cymbalta, without counting beads ect. I have managed to stay at this dosage of 20mg on Cymbalta for the last 5 months although it has been hell. My plan is to stabilize on this dosage and then make small reductions (10% or less) by counting beads until finished. The biggest symtoms I have by far are akathesia, agitation and adehonia and a fibromyalgia type feeling in hands. My symptoms were slowly improving with small windows and long waves until the last week or so. The akathesia has really spiked and been bothering me, feeling almost unbearable at times. I think being stuck at home due to COVID-19 has a little to do with it. It has been 5 months since I have been taking the 20mg of Cymbalta. The only supplement I take is a magnesium spay, which does give some relief. I have tried other supplements but they all make with the withdrawal symptoms worse. I guess I don't know what to do at this point. I think the best course of action is probably to just stay the course until I stabilize at this dosage. I understand they may take along time. I'm just curious if any of the other members had any feedback? I have thought about trying to start tapering the rest of the Cymbalta I'm on, but fear that might make matters worse. At one point I thought about upping the dosage of the Cymbalta to stabilize, although it's probably too late for that. I also really do not want to increase the dosage. These last 5 months have been hell and I don't want that to be for nothing and lose any progress I've made. After reading some of the other members posts and seeing that these symptoms can last for years is a bit discouraging. I am grateful this site exists because the medical community has no clue when it comes to this. I have read some success stories on here and do have hope that I can one day get through this. I would appreciate it if anyone has any feedback.

 

Thank you,

[Gridley]

Welcome to SA, mak456.

 

When we switch from one antidepressant to another, the new drug doesn't necessarily replace what the old drug was doing (they all work differently), so the withdrawal you're experiencing could be from one or all of the drug switches and dosage changes you made.  I think you're right that the best course of action is to stabilize at 20mg Cymbalta.  This may take several more months.  I wouldn't increase and I wouldn't taper.  After all the changes, what your system needs now is stability.  It's very encouraging that, at least until last week, you were slowly improving.  There are going to be a lot of ups and downs along the way (see the link below on waves and windows) , and it's important to ride these out and not try to tinker with dosage/drug changes to try to "fix" the problem.  

 

So that you have a better idea of what you're experiencing here is some information on withdrawal and the healing process.  The symptoms you describe are typical withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

When the time come for you to taper the Cymbalta, we recommend tapering no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Cymbalta, including using the bead-counting method you mentioned.

 

Tips for tapering off Cymbalta (duloxetine)

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

[WiggleIt]

Hi mak465,

 

I just want to say it’s awesome you’ve been clean since 2012 😊

 

Welcome to SA. We’re glad you found us; it’s a great support system! 

[mak456]

Thank you for your replies and the insight.  I have been feeling better the last day or so. I’m going to just wait it out and hopefully I will stabilize on this dosage soon. It Is nice to have a forum like this to vent because nobody else understands what I’m going though.

[mak456]

The akathisia has really been bothering me the last week or so and it was becoming more and more difficult to function in my daily life. It has really been taking a toll on my mental health. I have been reading that antidepressants cause also cause this, in addition to it being a withdrawal symptom. I was thinking maybe it is tardive akathisia and I decided i was going to try taking out some beads to see what happened. I find it very difficult to count them and even harder to handle them without losing them. The capsule is also very small and hard to work with. I counted about 150 beads in the 20mg cymbalta capsule, which is slightly less than other numbers I have seen on here, but i probably lost a few in the process. Today I decided to take 20 beads out of the 20mg cymbalta capsule to see what happened. Well the akathisia was greatly improved, withing an hour or 2, but i was feeling nauseous and my head hurt along with a kind of a spaced out feeling in my head. I was surprised that i'd felt these effects in such a short time after adjusting the dose. I probably should of only taken out 15 beads, that would be a 10% reduction. I didn't think a matter of 5 beads would make that much of a difference but maybe I'm wrong. Tomorrow I will try to just take out 15 beads  and see how it goes.  I plan to weigh them in the future, I ordered a scale, small measuring spoons and clear gelatin capsules so hopefully that will make things easier.