shurico: Help with tappering 4 drugs - Cymbalta CT and reinstated

[Altostrata]

On 9/4/2023 at 12:57 PM, shurico said:

Yes, I can really say the last few days have been better but still experiencing symptoms as you can see but honestly I am so used to feeling like crap that this is just pure happiness! I have also been feeling a bit more normalish, small glitches of motivation or joy…very small but better than totally numb.

 

This is good. Stabilizing is a process, there may be more to come. Don't be anxious about tapering, you can wait to do it.

 

Where is the neck pain? Have you had any examinations or tests for it?

 

[shurico]

Sept 5

7.30 - woke up

8 - ativan 0.5, not so intense pain in the neck, put on creams for inflamation and the cool feeling helps

9.40 - solpadeine (half), pain in the back of my head. I feel like my skull and scalp literally hurt and burn but intensity is less then before. It is tolerable

11 - lyrica 75mg

5 - solpadeine (half), light headache/head pressure

8.30pm - amitriptyline 12.5mg and ativan 0.5mg

9pm - cymbalta 30mg

11pm - lyrica 150mg
 

I was out and forgot to take the meds with me and took amitrip late, together with ativan. Lesson learned to never leave the house without meds. Plus I got so carried away with feeling normalish that I forgot 😔

[shurico]

7 hours ago, Altostrata said:

This is good. Stabilizing is a process, there may be more to come. Don't be anxious about tapering, you can wait to do it.

 

Where is the neck pain? Have you had any examinations or tests for it?

So the neck pain is right at the base of the skull, the soft spot between your skull and spine. The back of the head pain is literally like someone hit me with a baseball bat behind my head. 
i did not get any examination as I was/is sure that it was cymbalta withdrawl because it started 3 days after CT of cymbalta. I had extreme stiff neck and shoulders then. I had this kind of bad neck pain, kind of like when you sleep bad and wake up with a stiff neck also when going down from 60 to 30 but did not compare to how it hurt when I stopped completely. 

i went to acupuncture and that did not help, went to neurologist and said I have arnolds syndrom and wanted to give me some other drug I did not take (similar to anticonvulsants) but did not give me any tests to do.

I get pain relief from ointments and creams and I place a sock full of rice in the freezer then put it on my neck. It is such a relief for the moment. I saw a lot of people on the cymbalta hurts worse group with this syptom. The wierd thing is after I reinstated in May I still have it today. Not as bad but still very uncomfortable.

[Altostrata]

Suggest you look into physical therapy for the neck pain. Much pain that arises in withdrawal has to to with posture and repetitive stress, such as craning your neck to work on the computer or phone.

[shurico]

Sept 6

8 - woke up, took ativan 0.5mg, neck pain

9 - headache

9.30 - solpadeine half

10.40 - pain in the back of the head

11 - lyrica 75mg

3.45 pm - pain in the back of the head and neck

4- neck pain is still there

5 - solpadeine (half)

7 - amitriptyline 12.5mg, bad headache, paon behind the head like the scalp hurts

8 - ativan 0.5, excedrin migraine, feels like my brain hurts and is pounding

9-cymbalta 30

11.20 - lyrica 150

Bad headache/head pain in the afternoon and lasted all night untill i went to bed

 

Sep 7

8 - woke up, took ativan 0.5

9 - solpadeine (half), pain in the neck is starting

12 - lyrica 75

3 - headache like yesterday, pain in the back of the head and headache normal kind in the temples

4 - advil

5 - solpadeine half, headache still and neck pain, putting on creams every hour

7 - amitriptyline 12.5

8 - ativan 0.5

9 - cymbalta 30

11 - lyrica 150

Past few days i had bad neck pain again that went up the back of my head and gave me bad headaches after the first half of the day and lasted untill bedtime

[shurico]

Do you think i might be having adverse reactions to cymbalta? I did start feeling poorly after 1-2 weeks of reinstating - bad headaches, after going up to 50 i felt even worse. Very bad headaches and nausea started (for the first time since takings meds). After going down to 30 I immediately felt better but still having symptoms. I am afraid I am just waiting to stabilize but never will with these symptoms…:( 

[Altostrata]

In my opinion, you should focus on relieving the neck pain.

 

4 hours ago, Altostrata said:

Suggest you look into physical therapy for the neck pain. Much pain that arises in withdrawal has to to with posture and repetitive stress, such as craning your neck to work on the computer or phone.

 

Withdrawal can cause tight muscles and muscle pain, and exacerbate other physical problems that can be alleviated with stretching, physical therapy, chiropractic, osteopathic manual therapy, acupuncture, or massage.

[shurico]

Sept 8 - woke up at 1.30 with neck pain, fell back asleep at 4 after creams and ice packs

8 - woke up, took ativan 0.5

8.30 - headache and neck pain starting

9 - nausea starts, took 2 excedrin and solpadeine (half)

11 - lyrica 75mg, bad migraine, pins and needles all over my head, nausea, feeling sick all together

11.40 - took sumatriptan for migraine and ginger chews for nausea

1 - headache a little better but still neck pain

2- went to physical therapy, continue headache and nausea

4 - napped untill 6

6 - woke up with anxiety

7 - amitriptyline 12.5mg

8 - ativan 0.5mg, no more anxiety, headache and neck better

9 - cymbalta 30

11 - lyrica 150mg

Had a bad day with headache all day, nausea and neck pain

 

Sept 9

8 - slept better did not wake up, bad neck pain and headache, took ativan 0.5 (got my period, i remember last month I had bad headaches before my period but did not have these problems before)

9 - solpadeine half

11 - lyrica 75

12.30 - excedrin, bad migraine

3.20 - migraine still, solpadeine

7 - advil, still having a headache

8 - amitriptyline 12.5 and ativan 0.5mg

9.40 - cymbalta 30

11 - lyrica 150
 

past few days i just day excrustuating headaches that did not go away with any meds. Just felt horrible

i started physical therapy yesterday, the doctor there said I have occipital neuralgia and some symptoms such as nausea and headaches can come from there. I really hope that will help me.

[Altostrata]

It could be that you have had occipital neuralgia or a related medical condition all along and all the drugs you've been taking were unnecessary -- as they've already proven to be ineffective.

 

Please add solpadeine and sumatriptan to your signature.

[shurico]

But I never had this occipital neuralgia pain up untill I cold turkeyed cymbalta in april 2023. When I first started meds I took them for depression in 2021 and never had this kind of pain before which is unexplainable why I would get it now….after 3 days of being off cymbalta.

[shurico]

Only amitriptyline has been added for the neck pain and I could of totally went without it.

my neurologist recommends I start Tegretol. What do you think? I am starting to get desperate about this pain….:(

[Altostrata]

As explained before, severe antidepressant withdrawal syndrome can cause muscle tension and hypersensitivity in areas where there had been repetitive stress or poor body mechanics, e.g. craning over a computer compressing vertebrae in your neck.

 

We cannot comment on your taking additional drugs for the neck pain. You are already taking 5 drugs for the pain plus occasional sumatriptan (triptans should not be taken with serotonergics such as amitriptyline and duloxetine). If you want to keep adding drugs, that's your decision.

 

Please let us know when you want to reduce your drug burden.

[shurico]

12 hours ago, Altostrata said:

 

As explained before, severe antidepressant withdrawal syndrome can cause muscle tension and hypersensitivity in areas where there had been repetitive stress or poor body mechanics, e.g. craning over a computer compressing vertebrae in your neck.

 

We cannot comment on your taking additional drugs for the neck pain. You are already taking 5 drugs for the pain plus occasional sumatriptan (triptans should not be taken with serotonergics such as amitriptyline and duloxetine). If you want to keep adding drugs, that's your decision.

 

Please let us know when you want to reduce your drug burden.

 

 I definetly do not want to add other drugs and yes like you said, I am already taking so many for pain and they are not helping.

 

i want to start reducing. Can i slowly start now? Like very slowww while doing physical therapy for the neck pain.

i know i should not take triptans but I was just desperate

[shurico]

Sept 10

8 - woke up, took 0.5 mg ativan, neck pain anx no more headache

9 - solpadeine half for headache

11 - lyrica 75mg

12 - still neck pain and intense tingling/burning at the back of my head

5 - electrolytes

7 - amitriptyline 12.5

8 - ativan 0.5, bad nausea

9 - cymbalta 30mg, still numbness, pins and needles and pain in the scalp/back of the head and neck

11 - lyrica 150
 

yesterday i did not have the bad migraines, i can blame it on my menstrual cycle. But i did have all over head pain, probably caused by ON - occipital neuralgia. Also bad nausea in the evening.

[Altostrata]

It's not unusual for you to feel nausea in the evening, correct?

 

12 hours ago, shurico said:

i want to start reducing. Can i slowly start now? Like very slowww while doing physical therapy for the neck pain.

 

If I were you, I'd stop switching up your drugs for a while.

[shurico]

8 hours ago, Altostrata said:

 

It's not unusual for you to feel nausea in the evening, correct?

 

 

No, usually it get more intense for a couple hours in the evening

 

8 hours ago, Altostrata said:

 

If I were you, I'd stop switching up your drugs for a while.

Ok, that is what I will be doing. Should I keep daily journaling? For how long do you recommend I keep holding? I was thinking of tapering lyrica like 1% every 2 weeks, a couple ml. I really believe they are making me feel bad too but also I understand what you are saying regarding hold. I don t want to crash later like I have many times. Mentally I am ok, everything is just physical now.

thank you so much for your time and help!

 

[Altostrata]

We cannot interpret your symptom pattern if you are changing your drugs. Please continue to post daily notes, including when nausea feeling starts and goes away.

[shurico]

Sept 12

7.15 - woke up

8 - ativan 0.5, solpadeine half, pain at the top of my head, sore neck

9 - electrolytes

11 - sore neck, slight nausea, lyrica 75mg

12 - went to physio, slight headache and sore neck, nausea

3 - feeling a bit better

5 - nausea, tingling behind the head and headache, solpadeine quarter

7 - amitriptyline 12.5mg

8 - ativan 0.5mg

9 - cymbalta 30mg

Fell asleep and forgot to take lyrica at

11 :((

 

Sep 13 - did not sleep very well, kept on waking up every hour

7.20 - woke up, feeling anxious

8.20 - nausea, feeling unwell, took 75mg lyrica because of missed dose. Going to work and hopefully will feel better. Not so much pain in the neck. Stomach also hurts.

8.30 - nexium and ginger chews. Strong nausea

11.30 - no more nausea, slight tingling at the back of the head and slight head pressure

1.30pm- still no nausea, took 75mg lyrica now instead of my usual 11 because I already took one in the morning to cover the missing dose. Will get back to normal tomorrow. Tingling and less intense pain (as the past week) at the back of my head and neck. Solpadeine half

5 - thirsty, dry mouth, sore neck but not painful and no headache so far

6.30 - went to physio

7 - started getting a headache and pain starts in the neck, amitriptyline 12.5

7.30 - full on headache, in the temples especially right side, drank electrolytes

8 - ativan 0.5mg

9 - cymbalta 30mg

10.20 - lyrica 150 ( i will move my hours to 10 am and 10 pm since 11 pm is too late for my schedule - i would rather not forget it again)

 

Despite missing my lyrica dose last night i felt quite decent today. Headache started around 7pm and still have it now at 10.30 pm. Pain and burning in the back of the head/neck. Nausea just in the morning today and was gone by noon.

I intend to stop solpadeine as of tommorrow and limit as much as I can all pain meds (excedrin, triptans or anything else) since they do not work anyway.

[Altostrata]

Your Lyrica doses and solpadeine are moving around. 

 

It appears the physical therapy might be reducing the intensity of your symptoms. You might stop posting daily notes until further along in your physical therapy. We cannot interpret them anyway, because of your ad hoc dosing.

 

At any rate, it does not appear your drug regimen is causing the headache and neck pain, though you may be experiencing other adverse effects from it.

 

Please let us know when your course of physical therapy is ending and you can keep your drug schedule consistent from day to day.

[shurico]

Ok, I will keep journaling for myself just to see how physical therapy is helping. I will keep a strict schedule from now on and will not make anymore changes.

Thank you so much for your help and your dedicated time for me and everyone on this site. 

[shurico]

Hello Altostrata,

I have finished my PT sessions, I am feeling better neck and headache wise. Still getting headaches here and there but tolerable and still have some neck pain but they said effects of PT can take place up to 3 weeks later. 

I am still having nausea, almost daily, lately almost all day. Some days bad and some days better. I think it is linked to Lyrica, I either reached tolerance or maybe I am just having side effects. I have been dosing Lyrica 3 times a day to see if that helps (out of desperation). My schedule now is:

8 am - 0.5 ativan

10 am - lyrica 75

4pm - lyrica 75

7pm - amitriptyline 12.5mg

8pm - 0.5 ativan

9pm - cymbalta 30mg

10pm -lyrica 75

what a list!! 😕 

 

What is your advice? Can I start tapering one of them? what about tapering two at the same time, very slowly, like going 5%/2 weeks with Lyrica and maybe 1% with cymbalta at the same time?

 

Thank you so much!

[shurico]

I would like to add I no longer take solpadeine, I stopped ever since I stopped journaling. I take excedrin or aleeve for headaches.

[Altostrata]

How often do you get migraines now?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and any significant symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can help identify symptoms that are adverse effects from one or more of your drugs.

[shurico]

0ctober 5

8.15 - woke up, took ativan, feeling sick like, ativan 0.5

9 - bad nausea, took zofran

10 - lyrica 75

12 - still bad nausea, have no motivation to do anything

3pm - taking electrolytes and eating for the first time today, still nauseous, spiraling in thoughts that i cannot go on feeling so sick

4pm - lyrica 75mg, napped. Feeling a bit better after electrolytes

5pm - woke up with headache, took aleeve

6pm - bad nausea again

7pm - amitriptilyine 12.5mg

8pm - ativan 0.5mg

9pm - cymbalta 30

10pm - lyrica 75

Felt nauseous and sick untill i went to bed - stayed on the couch most of the night

[shurico]

On 10/5/2023 at 12:05 AM, Altostrata said:

 

How often do you get migraines now?

 

Maybe once a week, did not have one in about 2 weeks. Just slight headaches here and there

[shurico]

October 6

7.30 - woke up, slept well. As soon as I got out of bed nausea hit. Went back to bed

8.15 - 0.5 ativan and zofran

9 - nausea a little bit better

10 - lyrica 75

12 - feeling spacey and clumsy, overall nauseated but not as bad as this morning

4 - aleeve for neck pain, still getting pins and needles, burning and tight muscles at the neck. Lyrica 75

5 - drank electrolytes, ginger chews all day

7 - amitriptilyine, feeling less nauseous

8 - ativan 0.5

9 - cymbalta 30

10 - lyrica 75

[Altostrata]

What effects do you feel from a Lyrica dose?

 

Please show all drug dosages in your daily notes.

[shurico]

October 7

8.30 - woke up zombie like, ativan 0.5

9 - burning pain in the neck that goes down the spine

10 - lyrica 75. Feeling nausea coming on, took zofran (i noticed it works even though i know it s not a wise choice, it has interaction with other meds)

11 - burning in the neck continues, slight nausea

1- tingling, pins and needles in the head

3 - napped untill 5

5 - lyrica 75

5.30 - slight nausea

7 - amitriptyline 12.5

8 - ativan 0.5mg

9 - cymbalta 30

10 - lyrica 75

nausea is much better today, it does not compare to past days as I was just sick to my stomach the whole day.

i would like to add everyday i have strong  anhedonia, ever since starting meds and even before that. i am totally emotionless and careless. I only had small glimps of feelings here and there, mostly when i was not changing meds or when i was tapering something.

[shurico]

19 hours ago, Altostrata said:

 

What effects do you feel from a Lyrica dose?

 

Please show all drug dosages in your daily notes.

 

I feel:

-drowsy, sometimes sleepy

-clumsy, dropping and forgetting things

-trouble concentrating

-dry mouth

-feeling high and drugged

 

sorry about missing the dosages, they are always the same as I weigh my pills (ativan and amitriptyline) to make sure cutting in half gets me the right dose.

[shurico]

Could nausea be an adverse reaction to cymbalta? Or lyrica?

i will refresh the history:

-march 2023, before beginning to drop cymbalta my dr had me increase lyrica from 225 to 375, about a month prior to dropping cymb

-april 13th 2023 i dropped cymbalta from 30 to zero

-april 29th 2023 i reinstated to 30mg

-around may 20th 2023 i dropped lyrica to 300

-june i dropped again lyrica to 225

june is when nausea started and has only gotten worse since

maybe this will help figure things out…..i did try up dosing lyrica one time this summer to 300, nausea went away almost next day and came back a week later 😕 then i dropped back down to 225 as I didn t want to be stuck on a higher dose

[Altostrata]

What happens after your Lyrica dose at 10 p.m.? Please post 24 hours of daily notes.

[shurico]

October 8

8 - woke up, feeling drugged and zombie, 0.5 ativan

8.30 - nausea starts, took zofran

9 - feeling really tired, heavy body, don t feel like doing anything

10 - lyrica 75

12 - feeling a bit better, went shopping

4 - lyrica 75, head pressure and sore neck

7.30 - amitriptyline 12.5mg, feeling tired and worn out, slight headache

8 - ativan 0.5

9 - cymbalta 30

10 - lyrica 75, went to bed right after

[shurico]

8 hours ago, Altostrata said:

 

What happens after your Lyrica dose at 10 p.m.? Please post 24 hours of daily notes.

 

I usually go to bed right after. Some days I stay up later but did not notice anything in particular happening after my 10pm dose (like nausea going away or starting). Nausea is just so random during the day and I can seem to link it to anything. Past few days I had less nausea.

[Altostrata]

You may still be feeling ongoing benefits of the physical therapy, correct? Could the nausea be related to your postural issue?

 

You're taking a lot of drugs, it's not surprising you feel zombified, heavy, etc. Most of your drugs were to treat the neck pain and headaches, correct?

 

 

[shurico]

3 hours ago, Altostrata said:

 

You may still be feeling ongoing benefits of the physical therapy, correct? Could the nausea be related to your postural issue?

 

Yes, i may still feel ongoing benefits. I doubt nausea is related to postural issue, I never had this problem before taking meds.

 

3 hours ago, Altostrata said:

You're taking a lot of drugs, it's not surprising you feel zombified, heavy, etc. Most of your drugs were to treat the neck pain and headaches, correct?

Yes, I agree I feel zombified and heavy because of the drugs. 
No, I started antidepressants for depression in july 2021 which caused me headaches later on. Then Lyrica was added, to help headaches, but it didn t help and they kept on increasing my dose. Also my dr tried to replace benzo with Lyrica but that did not go well either. She had me switch from Ati to Klon and started decreasing Klon by a quarter a week. When I got to my last quarter I got really sick, I reinstated 0.5 Klon and later on switched back to Ati. Then after I quit cymbalta in april, neck pain started. Then my dr had me restart cymbalt and then wanted me to switch to amitriptilyne for the neck pain.

I strongly believe headaches and neck pain was cauzed by drugs and switching/quitting them. I feel like I was given one drug to treat what the other caused that is how I ended up on so many.

i was initially started on ativan and prozac in june 2021 for depression.

[shurico]

October 9

7.15 - woke up, feeling tired

7.45 - slight neck pain that goes down the spine

8 - nausea, took zofran and ativan 0.5

10 - lyrica 75

11.30 - headache in the back of the head, took aleeve

1.30 - sleepy and pulse is high(98), feeling sick, naussea

3.30 - nausea

4 - lyrica 75

6 - still nauseous

7.30 - amitriptyline 12.5

8.30 - ativan 0.5

9 - cymbalta 30

10 - lyrica 75