Serenyd: Cymbalta w/d after CT in April 2023

[Serenyd]

18 hours ago, Altostrata said:

@Serenyd in your daily notes, be sure to indicate the time o'clock of every drug dose and its dosage.

 

It appears that you do not take your drugs on a set schedule. We can't tell anything from daily notes when dosing is inconsistent. Please choose a drug dosing schedule and follow it consistently. Thank you.

I'm trying to be more consistent. Thanks for your feedback. 

[Serenyd]

My GP is willing to write for 1 month of Flexeril 7.5 mg, and then decrease to 5 mg for month 2. Then I need to come see him. I really hope that this works out. It isn't the 3 months that Horowitz recommended, but I suppose it's better than nothing. Thankful that I seem to be stabilizing quickly on the Flexeril 7.5 mg. This morning I had some arm prickles but it wasn't the intense burning I've been having. I feel like this is a good sign. I feel more like myself, too. 

Last week trying to go from Flexeril 10 mg to 5 mg was disastrous. I found out my beloved grandmother has gone from having mild dementia to being on her deathbed and my 20-year-old son dropped out of college. Normally I would have been very sad about my grandmother and very annoyed at my son but because of the rebound in withdrawal symptoms, I just had a bunch of panic attacks instead. 

 

A little worried that the coming time change is going to mess with my recovery, any tips on how to handle that? 

 

 

[Altostrata]

We can't tell anything from your prior history of potentially drug-related symptoms. You may have been making some of your own problems, including panic attacks, by taking your drugs inconsistently, as well as spontaneously increasing and decreasing the dosages and adding drugs.

 

The drug changes must stop for us to offer you peer support. Please let us know when you have been taking your drugs on a consistent schedule for a week.

[manymoretodays]

Hi Serenyd,

Yes..........Do try for consistency.  You know, drugs taken, same dosage, and same time of day taken.

Try for a set of NOTES too then.

 

Time change!  You're right, it can be a tough one.  Get things shifted to the same time taken.  Maybe take a day and adjust your time by 1/2 hour and then the other 1/2 hour the next day.  This is the one where we lose an hour.  And here's a topic even:

Adjusting doses for different time zones or daylight savings time

 

I've been thrown some falls and some springs as well.  No rhyme or reason or even consistency with that.......maybe that's a good thing.

 

You can do it, get through it.  I mean look what you have gotten through to date Serenyd.  I do have faith you'll go the distance.  When you feel ready.

 

I look forward to your next post.  And again, my sympathy and hugs.

 

L, P, H, and G,

mmt

[manymoretodays]

On 11/2/2023 at 8:45 PM, manymoretodays said:

This is the one where we lose an hour. 

 

Oops......I think we gain an hour this time change.  I just set my clocks back.......most of them anyway.

[Serenyd]

On 11/4/2023 at 6:39 PM, manymoretodays said:

 

Oops......I think we gain an hour this time change.  I just set my clocks back.......most of them anyway.

This one isn't as bad. 

 

I'm still taking propanolol 20 mg and Flexeril 7.5 mg daily. Unfortunately I haven't been taking notes. The time change has me a bit discombobulated. 

 

I'm really concerned that my doctor's plan for me to drop to 5 mg of Flexeril in a month is going to completely destabilize me again. I emailed Horowitz and he wants me to stay on it for 3 months at 7.5 mg. But if I can't get a prescription I'm not sure what I can do. Is there any chance I'll be ok doing that? I'm definitely still having symptoms. Sometimes I feel like my hair is standing on end, or that I have goosebumps over my whole body. I'm having some burning on my arms, face, and neck today also. Anxiety and intrusive thoughts are still there but are more manageable. 

 

Horowitz also gave me the option of gradually reinstating Cymbalta to 5 mg while slowly tapering off Flexeril. He doesn't think adding in Prozac is a good idea. I've really only talked to one person who was able to use Prozac to stabilize after going off Cymbalta CT. She's off the Prozac now too, after tapering.

 

Do I need to be setting alarms to take my meds by? Like does it need to be that consistent? What about my non-psych meds?  

[Altostrata]

On 11/7/2023 at 10:22 AM, Serenyd said:

Do I need to be setting alarms to take my meds by? Like does it need to be that consistent? What about my non-psych meds?  

 

You take more drugs than appear in your signature? Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.

 

For us to understand your symptom pattern, you will need to take all your drugs on a regular schedule.

[Serenyd]

I've currently tapered the Flexeril to 5 mg. I am going to hold at this dose until after we get back from the cruise - end of January. 

I was cutting the tablets into eighths which was tricky. I put myself on Vitex for my PMS symptoms which are greatly exaggerated and continued through ovulation. I experienced flushing with ovulation and anxiety after ovulation when I usually feel more calm in this part of my cycle. I'm working with a naturopath now to try and balance my hormones. 

 

Wondering if switching to a liquid formulation of Flexeril would make my taper easier? My doctor thinks I shouldn't have withdrawal symptoms from Flexeril but I do experience symptoms when I drop down in dose. Any suggestions? Flexeril is in the same family as tricyclic antidepressants. 

[Serenyd]

Is it common to have hormone issues after antidepressants? I went off because I had a miscarriage with the intention to conceive again, since experiencing wd I haven't been able to get pregnant at all! I've experienced miscarriages before but have never lost the ability to conceive completely. I'm very distressed about this. I never expected to have wd symptoms like this either since I have gotten off other medications without issue. 

[LotusRising]

My hormones were all over the place while I was tapering. It was hard to know what was causing what, but for sure these drugs mess with our hormones, and since our bodies are under a fair amount of stress while tapering, this will also contribute to hormone fluctuations. 

 

4 hours ago, Serenyd said:

I've experienced miscarriages before but have never lost the ability to conceive completely. I'm very distressed about this.

I'm sorry to hear this, it must be very upsetting, but I'm glad you've started vitex. I just started this for low progesterone. I'm assuming your naturopath checked your p levels?

 

4 hours ago, Serenyd said:

My doctor thinks I shouldn't have withdrawal symptoms from Flexeril but I do experience symptoms when I drop down in dose

If you're experiencing symptoms, then your doctor is wrong. I don't see a lot of information on our website about flexeril. Have you spoken with a pharmacist to see if it could be compounded? This would certainly make it easier to make smaller reductions.

[Serenyd]

20 hours ago, LotusRising said:

My hormones were all over the place while I was tapering. It was hard to know what was causing what, but for sure these drugs mess with our hormones, and since our bodies are under a fair amount of stress while tapering, this will also contribute to hormone fluctuations. 

 

I'm sorry to hear this, it must be very upsetting, but I'm glad you've started vitex. I just started this for low progesterone. I'm assuming your naturopath checked your p levels?

 

If you're experiencing symptoms, then your doctor is wrong. I don't see a lot of information on our website about flexeril. Have you spoken with a pharmacist to see if it could be compounded? This would certainly make it easier to make smaller reductions.

My progesterone is actually fine currently, but it has fluctuated a lot since I went off Cymbalta. I started the Vitex on the advice of a midwife friend of mine. I also had a DUTCH test done. I'm working with the naturopath to balance my hormones. She thinks my thyroid is causing my issues. I have Hashimoto's hypothyroidism. My TSH has been suppressed for a long time, but I don't really pay attention to it because my doctor said it's the Free T4 level and reverse T3 that tells him if I'm on the right amount of medication. Looking back, I was having fertility issues in 2015/2016 and my TSH was also almost undetectable. After that I gained weight and my levels were more balanced. I had 2 more kids with zero issues. So maybe I don't need the Vitex after all. Naturopath said to see an endocrinologist but I can't get in for months. I haven't been on this low a dose of Tirosint (levothyroxine) since I was first diagnosed. Praying this is it and it's not too late for me. 

 

Definitely feel like I need a smoother transition off the Flexeril. I'm going to call a compounding pharmacy on Monday and ask for help. There is one that my GP works with. I can't take my T3 right now because it is too activating and it worsens my anxiety. When I was on Cymbalta I was SO EXHAUSTED and I didn't know it was the medication. I asked to have my thyroid medication increased thinking that would help. I'm getting my levels checked every 6 weeks until they straighten out. I think stress increases reverse T3 and mine is higher than it has ever been (36!). That was after a dose decrease. 

 

Thanks for replying to me. This feels very lonely sometimes. 

[LotusRising]

I'm glad to hear you're working with a naturopath. Did you have your 4-pt cortisol level checked with the DUTCH?

 

1 hour ago, Serenyd said:

think stress increases reverse T3 and mine is higher than it has ever been (36!).

Yikes, yes, I've read that stress can for sure increase production of reverse T3. Has your naturopath been looking at your gut/liver health?

 

1 hour ago, Serenyd said:

When I was on Cymbalta I was SO EXHAUSTED and I didn't know it was the medication.

Has your exhaustion improved?

 

1 hour ago, Serenyd said:

Definitely feel like I need a smoother transition off the Flexeril. I'm going to call a compounding pharmacy on Monday and ask for help. There is one that my GP works with.

This is great to hear! I definitely think it will help with easing you off. It sounds like your GP is being a little more flexible now with the prescription?

 

1 hour ago, Serenyd said:

Thanks for replying to me. This feels very lonely sometimes. 

Of course, you're welcome! It can definitely be a lonely journey, especially when our symptoms aren't validated, or we're made to feel that it should be easier than it is. I hope you have some luck with the compounding pharmacist 💖

[Serenyd]

I accidentally took Flexeril this morning instead of my thyroid pill. Tried to make myself throw up but no luck. Should I just skip it tonight then? 

[Serenyd]

On 1/15/2024 at 9:54 AM, LotusRising said:

I'm glad to hear you're working with a naturopath. Did you have your 4-pt cortisol level checked with the DUTCH?

 

Yes, I did. My morning cortisol is high.  

[Serenyd]

On 1/15/2024 at 9:54 AM, LotusRising said:

Yikes, yes, I've read that stress can for sure increase production of reverse T3. Has your naturopath been looking at your gut/liver health?

Yes, we are looking into it. 

 

On 1/15/2024 at 9:54 AM, LotusRising said:

 

Has your exhaustion improved?

Yes, I still get pretty exhausted by the end of the day, but I think that is because my anxiety is so high now. 

On 1/15/2024 at 9:54 AM, LotusRising said:

 

This is great to hear! I definitely think it will help with easing you off. It sounds like your GP is being a little more flexible now with the prescription?

Last time I talked to him I told him I was tapering off a quarter tablet at a time. That's prooved to be a bit much for me. I hope he's open to me using a liquid to taper. The compounding pharmacy was helpful. They also said I could make my own by crushing the pills. 

On 1/15/2024 at 9:54 AM, LotusRising said:

 

Of course, you're welcome! It can definitely be a lonely journey, especially when our symptoms aren't validated, or we're made to feel that it should be easier than it is. I hope you have some luck with the compounding pharmacist 💖

I still don't feel like any of my practitioners really believe that I'm still having issues from CT off Cymbalta. They think I have run of the mill anxiety. Which I have always had a bit of anxiety but I never felt like I needed medication for it. If anything I was busy pouring coffee down my throat trying to feel a bit of energy. That was pre-Cymbalta too.  

[LotusRising]

4 hours ago, Serenyd said:

I accidentally took Flexeril this morning instead of my thyroid pill. Tried to make myself throw up but no luck. Should I just skip it tonight then? 

That's what I would do.

[Serenyd]

I have been able to taper the flexeril from 7.5 mg to 5 mg over a month's time. It was hard but I've been at 5 mg for over a week and I'm doing OK. I plan to stay at this dose until at least the end of the month. 

 

Any pointers on tapering off? I don't want to take a year to get off 5 mg. My doctor wanted me on 5 mg that's why I tapered from 7.5 mg so quickly. But as I'm getting lower I feel it is getting harder. 

 

[manymoretodays]

Hi Serenyd,

2 hours ago, Serenyd said:

But as I'm getting lower I feel it is getting harder. 

How so is it getting harder?  I think you can do hard. 

Gosh, looking through your thread I see you are on a boatload of drugs for a 42/43 year old working Mom, with 6 kids.  Have you taken your cruise yet or vacation?  Can you make it through that on just 5 mg of Flexeril.   Then I see a variety of herbs-supplements likely off and on at will. 

I do see interactions done on 3 of them.

 

You could start empowering yourself by doing a interaction check on all of them, including flexeril, immunosupressants, and thyroid meds, and any present supplements/herbs that you take.  You'll likely have to sign in and do an account at Drugs.com  No worries, they won't haunt you or email you or anything.

Then get familiar with them all.   You can begin that process at drugs.com too.  I don't imagine you have much time but it's time to make time to get more familiar with what you put into your body and why.

Do like you did before and once interactions are done, post the link so we can see too.

 

Is your thyroid in good shape at this point?  Are you a positive for Hashimoto's?(thought I read that)

 

Have you remembered to take each and every one of your prescription drugs at the same time, same dose,  each and every day?

I do spy your Flexeril med oops of this week.  How would you manage to manage the meds if it was one of your kids, say?  Say one of them needed daily medications for a long time.  Pretend you are taking care of your own little self better.  You sure sound like a giver.  Anyway.........that oops should level off........give it a little more time.  Gosh, don't make yourself vomit........you are hard on yourself.  You were taking 10 mg at some point.  Just remember, you can do hard stuff.  You have been.

 

Can you make a list of each and every drug and other you presently take.

Note the time.  Full drug or other substance name.  Dosage.  And why you take it?  Then post that.  Just do tomorrow say.

 

Any psychotropic drugs prior to 2017?

Is the ativan now a daily thing since October?

 

Since you are holding anyway and maybe taking some relax time I'm hoping you'll get into caring more for yourself. 

Likely you can and will go faster off the Flexeril, I always thought of it as a muscle relaxant.  Where did you read it's the same class as amitriptyline?  A tricyclic antidepressant?.......??Flexeril.......I don't know much but I don't think so.  And then why is this the drug that you want off first?  Help us understand your logic.

 

It's very hard to give advice on any one medication, when a member is on a boatload.  And hats off on your functioning so tiptop or so it sounds........while I'm sure it's been freaking hard.  That is why I know you can do hard stuff.

 

Sure, there is some withdrawal, and likely drug interactions as well.  What non- drug coping skills do you have now?  Simple stuff, non ingested for pain(physical and emotional) and anxiety/panic when it happens? 

 

Whoosh, this all takes time sweetie.......no quick fixes.   Overall, are you feeling pretty stable after the holidays and just mildly anxious about a vacation and routine change? ..........I'm hoping so.

 

L, P, H, and G,

mmt

 

Edited January 19 by manymoretodays

[Serenyd]

 

19 hours ago, manymoretodays said:

Hi Serenyd,

How so is it getting harder?  I think you can do hard. 

Gosh, looking through your thread I see you are on a boatload of drugs for a 42/43 year old working Mom, with 6 kids.  Have you taken your cruise yet or vacation?  Can you make it through that on just 5 mg of Flexeril.   Then I see a variety of herbs-supplements likely off and on at will. 

I do see interactions done on 3 of them.

I'm leaving soon. Not going to try and taper anymore while on the cruise. I took Vitex last month because my PMS symptoms have been so awful and out of control. Ended up causing me more issues. Naturopath wants me to start 2 new supplements KL-Support and HomocysteX Plus. I have them but I'm not risking starting anything new. The supplements I take daily right now are Dr. Brighten's Prenatal Plus, Life Extension Gamma E, Thorne B-Complex #6, and Natrol Acai Berry. I was taking ALA but I'm taking a break from it. I think it possibly did help with some of the nerve issues like burning skin and over-active goosebump response. I am drinking herbal teas, dandelion root and a hormone balance tea that has red raspberry leaf and nettle in it. The dandelion root is an ok substitute for coffee and the naturopath wants me on it for my liver. I'm going to have to look into those interactions. 

I've had bad reactions to stuff that other people seem to have no trouble taking, like fish oil, vitamin D, and magnesium. I even switched to more expensive brand of fish oil to see if that was the problem. Nope. 

19 hours ago, manymoretodays said:

 

You could start empowering yourself by doing a interaction check on all of them, including flexeril, immunosupressants, and thyroid meds, and any present supplements/herbs that you take.  You'll likely have to sign in and do an account at Drugs.com  No worries, they won't haunt you or email you or anything.

Then get familiar with them all.   You can begin that process at drugs.com too.  I don't imagine you have much time but it's time to make time to get more familiar with what you put into your body and why.

Do like you did before and once interactions are done, post the link so we can see too.

https://www.drugs.com/interactions-check.php?drug_list=3186-14316,1488-899,296-0,758-386,1956-0,1463-3519&professional=1

 

19 hours ago, manymoretodays said:

 

Is your thyroid in good shape at this point?  Are you a positive for Hashimoto's?(thought I read that)

Yes, I have Hashimoto's. No, it's been awful ever since I went off Cymbalta. My doctor just had to do a second, more drastic, dose decrease to try and stabilize me. I had to stop taking the T3 that I usually take to give me energy because it is too activating now and triggers my anxiety so I'm just on T4 (Tirosint). My reverse T3 is 36 and it's never been this high before. 

19 hours ago, manymoretodays said:

 

Have you remembered to take each and every one of your prescription drugs at the same time, same dose,  each and every day?

I do spy your Flexeril med oops of this week.  How would you manage to manage the meds if it was one of your kids, say?  Say one of them needed daily medications for a long time.  Pretend you are taking care of your own little self better.  You sure sound like a giver.  Anyway.........that oops should level off........give it a little more time.  Gosh, don't make yourself vomit........you are hard on yourself.  You were taking 10 mg at some point.  Just remember, you can do hard stuff.  You have been.

I've been fairly consistent. Still not perfect on timing. My daughter who died was on seizure meds twice a day and we did set alarms for her meds. 

 

So you think it's ok to wean faster than 10% per month on the Flexeril if I'm handling it ok? 

 

 

 

 

19 hours ago, manymoretodays said:

 

Can you make a list of each and every drug and other you presently take.

Note the time.  Full drug or other substance name.  Dosage.  And why you take it?  Then post that.  Just do tomorrow say.

I'll try. We're getting ready to go out of town and celebrate my daughter's birthday so today is going to be crazy. Of course I haven't started packing yet. 

 

19 hours ago, manymoretodays said:

 

Any psychotropic drugs prior to 2017?

Is the ativan now a daily thing since October?

Nope. I remember being in nursing school in early 2000's wondering why so many of my classmates were on drugs for anxiety and depression. 

Ativan, no. I've only taken it a few times as a rescue med. I'm supposed to take it for anxiety related to the menstrual cycle specifically around ovulation since that is when I started having panic attacks. I don't have a history of panic attacks prior to d/c Cymbalta. I'm not a big fan of benzos, they seem to take a fair amount of time to kick in and the effects are subtle. But they do take the edge off when needed. I'd prefer to avoid taking them. 

I took Klonopin after my daughter died and then went on Cymbalta but I never felt like Klonopin did much for me besides making me sleepy. 

 

19 hours ago, manymoretodays said:

 

Since you are holding anyway and maybe taking some relax time I'm hoping you'll get into caring more for yourself. 

Likely you can and will go faster off the Flexeril, I always thought of it as a muscle relaxant.  Where did you read it's the same class as amitriptyline?  A tricyclic antidepressant?.......??Flexeril.......I don't know much but I don't think so.  And then why is this the drug that you want off first?  Help us understand your logic.

https://www.ncbi.nlm.nih.gov/books/NBK513362/ - talks about tricyclics

 

I started taking the Flexeril to stop a panic attack caused by the Cymbalta withdrawals because I knew it would put me to sleep. The next day I noticed my withdrawal symptoms were diminished significantly. I tried going from 10 mg to 5 mg and had a really awful recurrence of symptoms. I have PAWS from the Cymbalta that took about 2 months to kick in so I didn't realize what was happening for a long while. I had also taken Clomid which is a fertility drug as we were trying for a baby. I stopped the Cymbalta because I had a miscarriage while on it. 

 

Anyway, I had a consult with Horowitz and he said the Flexeril was covering up Cymbalta w/d symptoms. I was on 7.5 mg by then and slowly stabilizing. I stayed on that dose for 2.5 months, then started to reduce because my doctor wanted me to drop from 7.5 mg to 5 mg. I did, but over a month's time. I found the drops a little more difficult than I expected and I've had to go slower than I would like. 

 

Anyway, Flexeril and Propanolol are the only drugs I'm worried about weaning. I don't take Ativan enough to be dependent on it (knock on wood). My real issue is the PAWS I have from going off Cymbalta without tapering properly. I don't want to aggravate my symptoms. I wasn't on any of the above drugs before seeking treatment for PAWS. I figured Propanolol can be saved for last as it helps ease the symptoms I have when weaning. 

 

 

 

19 hours ago, manymoretodays said:

 

It's very hard to give advice on any one medication, when a member is on a boatload.  And hats off on your functioning so tiptop or so it sounds........while I'm sure it's been freaking hard.  That is why I know you can do hard stuff.

 

Sure, there is some withdrawal, and likely drug interactions as well.  What non- drug coping skills do you have now?  Simple stuff, non ingested for pain(physical and emotional) and anxiety/panic when it happens? 

I've been doing some vagus nerve stuff to try and deal with the palpitations and feelings of doom and gloom I get first thing in the morning. For anxiety I usually go for a walk, if I can. Distracting myself by talking on the phone to friends. Or cleaning. I haven't found much else that works. 

 

19 hours ago, manymoretodays said:

 

Whoosh, this all takes time sweetie.......no quick fixes.   Overall, are you feeling pretty stable after the holidays and just mildly anxious about a vacation and routine change? ..........I'm hoping so.

 

L, P, H, and G,

mmt

 

I think so. Last week was rough as I dropped my Flexeril dose down and also quit Vitex but I feel more stable now. A little anxious about being trapped on a boat with so many people. Crowds don't bother me per se, but I'm still a bit noise-sensitive. Might need to bring some earplugs. This will be the longest I've ever been away from my kids and my oldest is 20. I'm not really happy about that. I'm really impatient with how long this is all taking. It's been 10 months since I went off Cymbalta and that seems like a life-time. I can't believe I'm still having problems from going off one drug - or that I'm taking 3 more in its place. It's surreal. Thanks for your help! 

[manymoretodays]

On 1/20/2024 at 10:02 AM, Serenyd said:

Anyway, I had a consult with Horowitz and he said the Flexeril was covering up Cymbalta w/d symptoms. I was on 7.5 mg by then and slowly stabilizing. I stayed on that dose for 2.5 months, then started to reduce because my doctor wanted me to drop from 7.5 mg to 5 mg. I did, but over a month's time. I found the drops a little more difficult than I expected and I've had to go slower than I would like. 

What were you dropping by?  And were you taking the Flexeril dose all at once, or splitting it into 3, or every 8 hours.

 

And okay, I had no idea it was a tricyclic.  Thanks for that link.

And so.......any further tapering should be done by 10% of each previous dose. 

If you split your dose into 3(I'm just seeing it's short action and is usually dosed every 8 hours, or 3 times a day, take 10% off each dose, once you start tapering)  I just have to wonder if some of your morning symptoms might be secondary at the flexeril wearing off, or interdose withdrawal.

You've been on it long enough that I'd sure expect physiologic dependency to have set in, and in my opinion........a judicious taper is in order. 

Why taper by 10% of my dosage?

Gosh, if it helped get you out of the depths of symptoms, I'd stay with it, consider dosing it as it is meant to be, and sit tight a little longer.

 

Getting regular with the propranolol might make a difference too, and regular with your doses, and dosing schedules.  Consistent.

 

Here's the topic on amitriptyline tapering, closest I could find to flexeril:

Tips for tapering off amitriptyline 

 

.........and any doctor can prescribe for you more Flexeril........it's not controlled or anything.  Then you can liquify it if you want, or use your scale, and get prepared for a long taper, when you are ready to start that.  There really are not short cuts to this.

 

I don't know if you found these yet, so will also link you to the propranolol and tapering beta blockers topics:

Tips for tapering off propranolol

Tapering beta blockers or alpha blockers

 

Before any tapering occurs, do get consistent with your present meds., same dose, same time, each and every day excluding the Ativan, which you stated you use sparingly, and never regularly.

Gosh, I sure wouldn't get into expectations that excess supplementation is going to make it smoother.  I'd pick just one new substance to trial at any given time, and even then........only when you've made no other changes for ............I'm going to say weeks.

 

And then the extremes of life happenings and losses since the Cymbalta CT.  It can't be easy.  And expect mini grief waves continuing ad infinitum.....sometimes hard to distinguish from your drug/medication problems.

 

I'm glad you are taking a break, and then when back keeping busy.  Just take time too, to plan out your next taper really well.  And stabilize first, including getting consistent doses and times with your meds/drugs.  Try and just do that first for a couple of weeks to a month even.

 

You'll see an indexed list to Tapering FAQ's and topics here:  Important topics in the Tapering forum and FAQ's

 

There are forums too, from the Home page on managing symptoms, finding meaning, etc you can always go to for support too, for it all......the whole. 

 

Please don't lose hope.  I am pretty sporadic these days, but will keep an eye out when I pop in for your posts.  Maybe the propranolol is a better first choice to taper?  As the Flexeril might have helped as per your own observations and Dr. Horowitz input.

 

You are my heroine.  Sending comfort.  Hope. 

 

Keep us updated, okay?

 

Love, peace, healing, and growth,

manymoretoday(mmt)

 

 

Edited January 22 by manymoretodays

[Serenyd]

On 1/22/2024 at 2:49 PM, manymoretodays said:

What were you dropping by?  And were you taking the Flexeril dose all at once, or splitting it into 3, or every 8 hours.

I started with a quarter of a tablet which is 1.25 mg. That was a bit too much. After that, I split them into eightths which is 0.625 mg. Holding each drop for 2 weeks. I take Flexeril at bedtime only. I read an article that advised against splitting Flexeril tablets. Splitting is unreliable because the active medication may not be mixed uniformly throughout the tablet, so there's no way of knowing how much you're really getting. I thought about taking it more than once a day but it helps me sleep so I take it at bedtime. I've only ever taken it once per day. 

 

 

On 1/22/2024 at 2:49 PM, manymoretodays said:

 

And okay, I had no idea it was a tricyclic.  Thanks for that link.

And so.......any further tapering should be done by 10% of each previous dose. 

If you split your dose into 3(I'm just seeing it's short action and is usually dosed every 8 hours, or 3 times a day, take 10% off each dose, once you start tapering)  I just have to wonder if some of your morning symptoms might be secondary at the flexeril wearing off, or interdose withdrawal.

I don't think so, because I had bad morning symptoms before I started the Flexeril. 

 

On 1/22/2024 at 2:49 PM, manymoretodays said:

You've been on it long enough that I'd sure expect physiologic dependency to have set in, and in my opinion........a judicious taper is in order. 

Why taper by 10% of my dosage?

Gosh, if it helped get you out of the depths of symptoms, I'd stay with it, consider dosing it as it is meant to be, and sit tight a little longer.

 

Getting regular with the propranolol might make a difference too, and regular with your doses, and dosing schedules.  Consistent.

I'm trying. My sleep/wake schedules aren't perfect and it messes with when I take my medication. 

On 1/22/2024 at 2:49 PM, manymoretodays said:

 

Here's the topic on amitriptyline tapering, closest I could find to flexeril:

Tips for tapering off amitriptyline 

 

.........and any doctor can prescribe for you more Flexeril........it's not controlled or anything.  Then you can liquify it if you want, or use your scale, and get prepared for a long taper, when you are ready to start that.  There really are not short cuts to this.

 

I don't know if you found these yet, so will also link you to the propranolol and tapering beta blockers topics:

Tips for tapering off propranolol

Tapering beta blockers or alpha blockers

 

Before any tapering occurs, do get consistent with your present meds., same dose, same time, each and every day excluding the Ativan, which you stated you use sparingly, and never regularly.

Gosh, I sure wouldn't get into expectations that excess supplementation is going to make it smoother.  I'd pick just one new substance to trial at any given time, and even then........only when you've made no other changes for ............I'm going to say weeks.

 

And then the extremes of life happenings and losses since the Cymbalta CT.  It can't be easy.  And expect mini grief waves continuing ad infinitum.....sometimes hard to distinguish from your drug/medication problems.

I'm having a lot of symptoms now that I'm home. I think it's a mixture of dealing with my daughter's death anniversary, the half of a margarita I finally caved in and drank, and the letdown of coming home to the same old issues after being away. 

 

On 1/22/2024 at 2:49 PM, manymoretodays said:

 

I'm glad you are taking a break, and then when back keeping busy.  Just take time too, to plan out your next taper really well.  And stabilize first, including getting consistent doses and times with your meds/drugs.  Try and just do that first for a couple of weeks to a month even.

Ok. 

On 1/22/2024 at 2:49 PM, manymoretodays said:

 

You'll see an indexed list to Tapering FAQ's and topics here:  Important topics in the Tapering forum and FAQ's

 

There are forums too, from the Home page on managing symptoms, finding meaning, etc you can always go to for support too, for it all......the whole. 

 

Please don't lose hope.  I am pretty sporadic these days, but will keep an eye out when I pop in for your posts.  Maybe the propranolol is a better first choice to taper?  As the Flexeril might have helped as per your own observations and Dr. Horowitz input.

I'm not super happy about being on something as toxic as Flexeril for an extended amount of time. But that IS what helped me stabilize after the Cymbalta CT. I went off Cymbalta to try for another baby after my miscarriage last year. I rushed the taper because I expected to conceive again quickly as I've become pregnant the month following a miscarriage twice before. Anyway, I want this stuff out of my body. I'm not sure how toxic propanolol is compared to Flexeril. I assume it is less so as beta blockers are commonly used during pregnancy. Propanolol helps me with the increased symptoms I have when tapering the Flexeril so I wanted to stay on it while doing that. I'd prefer a slower taper on the Flexeril but I don't know if I can handle the hyperbolic tapering. It's just so confusing. The compounding pharmacy I talked to here said they could do a Flexeril suspension in oil which would be good for 180 days. Not sure who I could get to order this if my doctor doesn't want to, but he works with this compounding pharmacy. 

 

He keeps lowering my thyroid medication thinking it's causing my wd symptoms. It's not. I think I'm going to have to add back in the T3 (Cytomel) because of the extreme fatigue I'm now experiencing. Yay. I'm supposed to take 5 mg a day, but it's a very activating medication. 

 

On 1/22/2024 at 2:49 PM, manymoretodays said:

 

You are my heroine.  Sending comfort.  Hope. 

 

Keep us updated, okay?

I'll try. Thanks so much. 

 

 

[Serenyd]

I found a 10% tapering calculator online. How does this look?

 

1	cyclobenzaprine	4.50mg	Daily	7 days
2	cyclobenzaprine	4.50mg	Daily	7 days
3	cyclobenzaprine	4.00mg	Daily	7 days
4	cyclobenzaprine	4.00mg	Daily	7 days
5	cyclobenzaprine	3.50mg	Daily	7 days
6	cyclobenzaprine	3.50mg	Daily	7 days
7	cyclobenzaprine	3.00mg	Daily	7 days
8	cyclobenzaprine	3.00mg	Daily	7 days
9	cyclobenzaprine	2.50mg	Daily	7 days
10	cyclobenzaprine	2.50mg	Daily	7 days
11	cyclobenzaprine	2.00mg	Daily	7 days
12	cyclobenzaprine	2.00mg	Daily	7 days
13	cyclobenzaprine	1.50mg	Daily	7 days
14	cyclobenzaprine	1.50mg	Daily	7 days
15	cyclobenzaprine	1.00mg	Daily	7 days
16	cyclobenzaprine	1.00mg	Daily	7 days
17	cyclobenzaprine	0.50mg	Daily	7 days
18	cyclobenzaprine	0.50mg	Daily	7 days
19	cyclobenzaprine	0.25mg	Daily	7 days
20	cyclobenzaprine	0.25mg	Daily	7 days

[Serenyd]

I think the taper from 7.5 mg to 5 mg that I did over a month is catching up with me. I'm suddenly having trouble sleeping again and waking up with a pounding heart and horrible depression/anxiety. Is there anything I can do to make this more bearable? Holding for now. 

[manymoretodays]

Oh Serenyd........

I might updose a bit, if it was me,  10% off of your starting dose of 7.5 mg would have been just 6.75 mg.

About reinstating and stabilizing to reduce withdrawal symptoms

I'd try 6.75 mg if you are certain recent symptoms ARE withdrawal.  I honestly would have expected withdrawal symptoms to set in fairly quickly after you got to 5 mg or even before though.  Has it been a whole month on 5 mg now?  And just now the insomnia and anxious/depressed feelings?  Hmmm.  I'd do it as a tester, if it did help then I'd stay put on the dose........with great relief, and wait months before beginning to taper again.

 

Acceptance, that this is likely to be a longer haul than you wished.

 

That Flexeril helped, at 7.5 mg is something you can be grateful for too........and it isn't something that us moderators usually deal with here.

It's interesting and also good that it helped.  I can't blame you for testing the waters of doing a 25% reduction, and now you know.  This isn't going to be quick and easy.  And afterall, it's been 4 months now on the Flexeril........good chance that you are going to need to go more slowly from here on in.

 

A follow up with Dr. Horowitz might be order as well.......sounds like you have the means to do so.

 

Your schedule that you posted was too fast, and very linear.  I did learn with a simple google search that Flexeril is water soluble, which for future purposes may be the way to go.  Making your own liquid and then going slow as you transition from solid to liquid, taking into account that you will have to adjust to the more sudden absorption.  Trying that transition when stabilized again on a set dose.

Gather supplies.  Get a calculator.  To figure out a 10% drop from each previous dose, you just multiply current dose by .90 and the result is your next 10% dosage.

 

For example:  7.5 mg X .90= 6.75 mg.

 

For future reference, later:

Cross over from tablet to liquid OR changing the brand

and:  How to make a liquid from tablets or capsules

 

If it was me, I'd updose to 6.75 mg as soon as possible.  I wouldn't liquify until you've stabilized and then do as you had been told to, stay put for at least a couple of months, if the updose does give relief. 

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

Acceptance and Hope

 

Please do let me know if you decide to updose to 6.75 mg using your solid cyclobenzaprine and if it helps.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

[Serenyd]

18 hours ago, manymoretodays said:

Oh Serenyd........

I might updose a bit, if it was me,  10% off of your starting dose of 7.5 mg would have been just 6.75 mg.

About reinstating and stabilizing to reduce withdrawal symptoms

I'd try 6.75 mg if you are certain recent symptoms ARE withdrawal.  I honestly would have expected withdrawal symptoms to set in fairly quickly after you got to 5 mg or even before though.  Has it been a whole month on 5 mg now?  And just now the insomnia and anxious/depressed feelings?  Hmmm.  I'd do it as a tester, if it did help then I'd stay put on the dose........with great relief, and wait months before beginning to taper again.

No, I'm not sure that they are withdrawal symptoms. I guess I thought it could be a delayed withdrawal but it might not be that at all. Sometimes I think maybe I'm taking too many herbal teas and vitamins. It could also be hormones. I have a rough time before, during, and for a couple days after ovulation and I decided to skip the Ativan this month. Ovulation is when I have the worst anxiety and restlessness and I was prescribed the Ativan for that reason. So it could be related to that. Does taking something like Ativan set back recovery? I figured it was better if I could do without it. 

 

18 hours ago, manymoretodays said:

 

Acceptance, that this is likely to be a longer haul than you wished.

 

That Flexeril helped, at 7.5 mg is something you can be grateful for too........and it isn't something that us moderators usually deal with here.

It's interesting and also good that it helped.  I can't blame you for testing the waters of doing a 25% reduction, and now you know.  This isn't going to be quick and easy.  And afterall, it's been 4 months now on the Flexeril........good chance that you are going to need to go more slowly from here on in.

 

A follow up with Dr. Horowitz might be order as well.......sounds like you have the means to do so.

I might. It didn't seem he was super familiar with Flexeril either. 

18 hours ago, manymoretodays said:

 

Your schedule that you posted was too fast, and very linear.  I did learn with a simple google search that Flexeril is water soluble, which for future purposes may be the way to go.  Making your own liquid and then going slow as you transition from solid to liquid, taking into account that you will have to adjust to the more sudden absorption.  Trying that transition when stabilized again on a set dose.

Gather supplies.  Get a calculator.  To figure out a 10% drop from each previous dose, you just multiply current dose by .90 and the result is your next 10% dosage.

 

For example:  7.5 mg X .90= 6.75 mg.

 

For future reference, later:

Cross over from tablet to liquid OR changing the brand

and:  How to make a liquid from tablets or capsules

 

If it was me, I'd updose to 6.75 mg as soon as possible.  I wouldn't liquify until you've stabilized and then do as you had been told to, stay put for at least a couple of months, if the updose does give relief. 

I think I'm going to stay here at 5 mg as I'm feeling a bit better today. Maybe it was just my hormones and I'll be ok until PMS hits. It was kind of a stressful week too. I started a new part-time job and I haven't told my therapist yet that I need to change my therapy time. I'm worried she won't have a spot for me. Also really wish my doctor would stop changing my thyroid medication. My labs have been SO CRAZY since I went off Cymbalta. He was convinced all my symptoms were thyroid related but I really think I'm probably undermedicated at this point. I haven't been on this low of a dose in YEARS. I wish it were that easy.  I also didn't realize I was supposed to be off biotin before having labs drawn so they could be skewed. So who knows what part that is playing in my symptoms? My friend who CT Lyrica and Cymbalta during Covid says it is soup. I'm soup. All this stuff just blends together and it's hard to what symptoms is from what cause. And I keep adding things to the soup, because I'm stubborn and want to do it my way. Then I have my OB, my psychiatrist, my GP, my rheumatologist, my orthopedic doctor, and my naturopath throwing meds and opinions my way. I've also seen a functional medicine OB, a natural healer who muscle-tested me, my partner's PMHNP, and Horowitz. I've had so many labs done including the DUTCH test that showed high morning cortisol. Some visits are covered by my insurance but I've wasted a lot of money that could have been used better elsewhere. Unsure where to go from here as far as my health goes.  

 

Next month will make a year since my miscarriage and I haven't even seen a hint of a pink line. I also turn 43. I think I may have to face the fact that I'm not going to be able to have a rainbow baby this time. This has caused me a lot of distress and tears. I really wanted one more baby. My girls were fascinated by the babies at the park this week and kept wanting to play with them. It broke my heart that I won't be able to give them a little brother or sister to play with and love. I'm sure that my upset over not being able to conceive is probably slowing down my recovery. My friend (who DID have a surprise rainbow baby at 43) told me that it's just one more thing to grieve. So no doubt if I did manage to have one more, I'd still have to go through the grieving process knowing that there wouldn't be any more babies. Can't help but wonder if I hadn't taken Cymbalta if I would have lost the baby. I have compound heterozygous MTHFR and supposedly my ability to rid my body of toxins is much lower than normal. 

 

 

18 hours ago, manymoretodays said:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

Acceptance and Hope

 

Please do let me know if you decide to updose to 6.75 mg using your solid cyclobenzaprine and if it helps.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

Thanks, I will look at these. Insomnia is awful and the thought of not being able to sleep makes me feel even more anxious. 

[Serenyd]

PS. I usually have about a week of increased restlessness/anxiety after I drop my Flexeril dose. I don't drop right before my period or before ovulation. After the first drop I was overly irritable and wanted to slow my taper that's why I started cutting the pills into eighths - however, I read online that splitting Flexeril pills is not recommended because of the medication not being evenly distributed in the tablet. Mornings have become more difficult too, but the last drop I also quit taking Vitex at the same time and I think that really messed me up. I probably need to just hold here until things improve. I also sent an email to Horowitz asking for help with a tapering plan. We'll see what he says. 

[Serenyd]

Have been in touch with Horowitz. He said I can taper as fast as I can tolerate. We're going to work on a plan. I am tapering the propanolol now to see how my body reacts to me going off it. 

I really think that I need to hold the Flexeril at 5 mg until after I finish this part-time job. It's for Feb/March and way more stressful than I anticipated. I had hoped it would just be a good distraction. Hopefully, it will be once I get into the swing of things. 

[Serenyd]

On 2/2/2024 at 4:47 PM, Serenyd said:

I think the taper from 7.5 mg to 5 mg that I did over a month is catching up with me. I'm suddenly having trouble sleeping again and waking up with a pounding heart and horrible depression/anxiety. Is there anything I can do to make this more bearable? Holding for now. 

Is it possible this could have been from the stress of starting a new job? And not withdrawals? 

[Serenyd]

My symptoms get so much worse on my period and with ovulation. I feel like I'm on a rollercoaster all month long. Depression and anxiety with restlessness. I can't relax. I'm just so very tired. It feels like I'm never going to get better. 

[Serenyd]

Would it be safe to try l-theanine instead of Ativan for the anxiety around ovulation? I was on it before but I stopped.

[Serenyd]

Weaning propanolol off currently. Halved 20 mg to 10 mg then held for 1 month per Horowitz. Am now trying 5 mg. I'm about 5 days on this dose. Have been having irritability and pounding heart in the mornings. Also ran out of my B complex vitamins and I think that's been causing me issues as well. Still holding at 5 mg Flexeril at bedtime. I'm going to restart the B complex when it comes tomorrow. Hoping that helps. Unsure if I should hold at 5 mg for another month or just stop. 

[LotusRising]

4 hours ago, Serenyd said:

Unsure if I should hold at 5 mg for another month or just stop. 

How long did you hold with your other reductions? Are you able to split it in half again?

[Serenyd]

3 hours ago, LotusRising said:

How long did you hold with your other reductions? Are you able to split it in half again?

I was on 20 mg in the mornings for morning palpitations. I had no issue going from 20 mg to 10 mg and held that dose for a month. I had been planning to hold for 2 weeks only but was advised by Dr. Horowitz to hold the dose longer. 

I need to get off it so I can start weaning off the Flexeril. I'm going on 6 months on that and he said the longer I'm on it the harder it will be for me to wean. 

 

I can split the 10 mg into quarters. I specifically asked for 10 mg tablets so I could split them into smaller chunks. I'm trying to time my drops around my menstrual cycle since the week of my period is so awful for me, I definitely don't want to try weaning anything that week. 

[LotusRising]

If it were me, I would cut it in half again.

 

Why do you think stopping the B vitamins is causing issues?

[Serenyd]

15 hours ago, LotusRising said:

If it were me, I would cut it in half again.

 

Why do you think stopping the B vitamins is causing issues?

Because last time I stopped them I had issues. 

 

And B vitamins raise neurotransmitters. I read on here that someone said they felt a bunch better after taking them and I did see improvement when I started them. I just didn't know I wouldn't be able to stop them, that I would go through a withdrawal from stopping them. That's aggravating. 

 

So you think cut the dose again, then hold for another month? Or do you think 2 weeks is enough?   ManyMoreTodays suggested trying to taper the propanolol before tapering Flexeril again. I wasn't open to it at first, but the more I thought about it, the more it made sense. Just not sure I want to wait 2 more months to taper the Flexeril (or maybe I do, I'm terrified). 

 

[LotusRising]

43 minutes ago, Serenyd said:

Because last time I stopped them I had issues. 

 

And B vitamins raise neurotransmitters. I read on here that someone said they felt a bunch better after taking them and I did see improvement when I started them. I just didn't know I wouldn't be able to stop them, that I would go through a withdrawal from stopping them. That's aggravating. 

I haven't heard of withdrawal from vitamins. I wonder if maybe you are just deficient? But yes, they can influence neurotransmitter pathways for sure. What symptoms did you get when you stopped them?

 

44 minutes ago, Serenyd said:

So you think cut the dose again, then hold for another month? Or do you think 2 weeks is enough?

If it were me, I would cut the dose again and see how I felt after two weeks. Did symptoms settle out after two weeks with your last reduction? - that might be your guide.

 

I hear you about being terrified, but one step at a time. What was the reason for tapering the propanolol first?