Dantegra: Cymbalta / duloxetine, reinstate and taper

[Dantegra]

Hi everyone. Need your advice and help. My story is simple: 2 years ago i have chronic pain and my doctor (neurologist) prescribed to me duloxetine for one month. I started from 30 mg - 10 days. My memory is very bad at now, so i hardly remember first days, but in 2 first day my libido and erection is crushed and probably was some strange state of mine with emotions. I continued to take, cause doctor said it's normal and adverse effects will go away. Next 60 mg - 20 days. I remember only one day, when i was very suicidal. And probably my most problems started while taking this dose. 

So, i took duloxetine for one month, without any relief for pain. I did cold turkey and hoped my symptoms will go away. At that moment i have pssd, anhedonia, chronic fatigue, cognitive impairment, emotional numbness, no desire, vision problems, dry skin/hair. Unfortunately, passed 1.5 years without any improvements. Besides, i didn't think it can be from duloxetine, cause doctors said it can't be. I was to many doctors, urologists, neurologists, cardiologists, but they didn't have any answers to my problems. I started to read about duloxetine and psychiatric drugs and understood, where is the problem. After that i tried supplements and drugs: dopa mucuna, bupropion, sjw, pram, selegiline, armodafinil. Also i take many different vitamins, like omega 3, zinc, magnesium threonate, vitamin b complex, lactoferrin, berberine. 

At this moment trying to treat lyme, cause i read it can give similar symptoms, but without results.

All my analysis is normal, mri and others too. 

My question is next: i read that is dangerously to reinstate drug after long time and understand the risk, but i don't have any other possible variant what to do in this situation, cause already it crushed my marriage, lose my job, and my life is completely ruined. If duloxetine did chemical imbalance to my neurotransmitters, so if i'll reinstate to 60 mg and for year or two will do taper, there is a chance my symptoms get relief for a little i hope? I read many successful stories at Facebook group Cymbalta hurts worse, but understand 2 years it's not 1 month. Thanks for any advice! 

 

P.S. sorry for my English, i am not native speaker.

 

[MrHappy]

Hi Dantegra

 

SA's tapering protocol is a harm reduction method and recommends that you reduce by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Jumping up and down in doses may cause issues and the nervous system may become sensitised.  Also, the effect of changing drugs and doses is cumulative.  What might have worked for you before might not work the next time you try the same/similar thing.

 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Post #1 of this topic has links to various drugs with information in the first post of those topics about ways to get non standard doses:

 

Important topics in the Tapering forum and FAQ

 

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

This is your own Introduction topic which is the place to ask questions about your situation and where you can journal your progress.  This keeps your history in one place.

[MrHappy]

Hi Dantegra

 

Your English is fine. No need to apologise.

 

I am sorry for your pain and emotional distress. Duloxetine has a wide range of effects and, in my experience, sadly, very few specialists have any idea how to prescribe or de-prescribe it. Doctors have no data to show that any reactions are normal. Often, adverse effects do not go away. Increasing the dose can make matters worse, rather than helping. This seems to be what happened to you.

 

Even after just a month, going cold turkey can make the symptoms far worse and can make it harder to manage other similar drugs. In some cases, it is reported that it takes years to recover. It seems to me, since you have been thoroughly checked by doctors, that it is likely to be a result of taking duloxetine. Doctors have no data - and therefore no right - to state that duloxetine can't be the problem.

 

It concerns me that you have been taking a range of drugs which may have made the situation worse. As I don't have the details from you yet, I can only comment on your question about reinstatement. If you have not taken it for 2 years, then I would not recommend reinstating it. Tapering off 60 mg would normally take 3-4 years, or longer, where patients have taken a range of drugs with interactions. Remember, the maximum reduction for Cymbalta / duloxetine is only 5% of the previous dose. There is no evidence anywhere that reinstatement after stopping, even for just a very short time - 2 or 3 weeks - necessarily helps. Certainly, after such a long time there would be no guarantees of anything except several years taking it and tapering.

 

Your focus on supplements is helpful, but you should always check them against any drugs you are taking, to see if there are interactions. It would be helpful to know whether you are following a careful diet, with good nutrition. If you were in Cymbalta Hurts Worse, I am sure you know their website Healing America Now has many, many suggestions on how to manage healthy nutrition. As it is a site specifically for people taking or coming off duloxetine, I would also look carefully at ways to manage withdrawal symptoms. 

 

 

[Dantegra]

Thanks for answer, MrHappy. I took drugs only for short periods, and, fortunately, without any negative effects. 

At this moment, I don't take any drugs, only supplements. I am on gluten free diet, 3-4 liters of water per day. 

Also trying to do some researching, cause i feel that my immune system is overactive and i didn't get ill since that time. Did analysis of b12, vitamin D, other chemical compounds and all is normal, b 12 is even slightly elevated. 

[MrHappy]

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

I had the impression you had tried a range of drugs. My experience is that the more drugs you have taken, the more difficult it is. Please complete your signature so we can see what you have been on and for how long. Then it is easier to comment. 

[Dantegra]

Did the signature

[MrHappy]

Thank you for completing the signature. What I don't really understand - and that may be because of the language problem - is why you keep trying different drugs for a short period of time.

 

Have you read about these drugs? The side effects that you may get? The harm they can do? 

https://www.drugs.com/mtm/pramipexole.html

https://www.drugs.com/sfx/armodafinil-side-effects.html

https://www.drugs.com/sfx/selegiline-side-effects.html

https://www.drugs.com/sfx/bupropion-side-effects.html

 

You don't seem to explain what chronic pain caused you to be put on duloxetine in the first place. I can see that your reaction to duloxetine can have caused you major long-term problems. This can happen, even after only a day or two on the drug. Cold turkey is never a good step to take and may have made your condition far worse, even after such a short time. 

 

As you have been tested by various doctors and they can find nothing wrong, I continue to think the solution lies in managing the condition through clean living, good nutrition, and not continuously trying new drugs to solve the problems of previous drugs. I am unable to see any other solution, from my own personal experience with this drug and with a specific duloxetine / Cymbalta support group. 

[MrHappy]

I do feel it would be worth your while trying some of the suggestions in these files: https://www.healingamericanow.com/chw-recovery-from-antidepressant-use/ and https://www.healingamericanow.com/chw-managing-withdrawal-symptoms/. There are so many alternatives to try which avoid experimenting with chemicals. 

 

[arbor]

Hello @Dantegra--How are you doing?

I send you best wishes,

Arbor

[Dantegra]

31 minutes ago, arbor said:

Hello @Dantegra--How are you doing?

I send you best wishes,

Arbor

Hi, thanks for question, unfortunately still bad

[arbor]

I'm sorry that you're suffering.  The SNRI's, like the SSRI's, are horrible to get off.  Have you tried supplements recommended by this site?  They can help with inflammation, though it's not my experience that they will reduce the suffering right away.  If you're having problems sleeping, melatonin is, in my opinion, very useful.

 

Melatonin for sleep - Symptoms and self-care

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

On 4/19/2022 at 1:23 AM, Dantegra said:

Also trying to do some researching, cause i feel that my immune system is overactive and i didn't get ill since that time. Did analysis of b12, vitamin D, other chemical compounds and all is normal, b 12 is even slightly elevated. 

Yes, your immune system may be overactive.  Mine has been.  There are several links here discussing immune and autoimmune issues which you may find useful.  For example: SSRI antidepressants may also affect human immune system

 

I encourage you to browse the Self Care section and to contact others on the site.  Above all, you are not alone.  I welcome you to the community @Dantegra

This suffering is unbelievable, but we know that no matter how slowly, healing will happen,

Thinking of you,

Arbor