Jo09: Is it my reduced dose of Duloxetine that is giving me these symptoms?

[Jo09]

Hello everyone, I'm coming to you because I'm really lost... Let me explain, more or less 7 months ago I reduced my dose of duloxetine from 60 mg to 30 mg, just like that from one day to the next, and a few weeks later I started having very debilitating problems... In fact, I can't stand any computer screen or smartphone, I feel like my eyes can't stand artificial light any more, because the sun causes me absolutely no problems, after 10 minutes of using a screen I get a migraine that can last more than 2 days... Flickering also bothers me enormously, Oled screens and flickering lamps quickly give me a migraine and a heavy feeling in the middle of my face... I'm also very sensitive to sound, and certain sounds startle my eardrums on a daily basis... I've also had neck pain for 2 weeks now and it doesn't go away. I'm not sure if it's related to this or not, but I've been going through hell with it for some time now...

 

Do you think that all my problems are due to this much too rapid reduction in my dose? If so, what should I do? Resume the 60mg for a few weeks and reduce the dose little by little instead of going too fast? Honestly, I don't dare go back on 60mg because apart from these worries, I'm feeling much better mentally (that's the paradox) and I've already tried for 3 days to go back on 60mg and I was feeling really, really unwell to the point where I couldn't even get out of bed because I was so knocked out...

 

Thank you in advance for your answers.

 

 

 

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

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We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[Erimus]

23 hours ago, Jo09 said:

more or less 7 months ago I reduced my dose of duloxetine from 60 mg to 30 mg

That is likely to cause many problems. Duloxetine is a very challenging drug to taper, and requires micro cuts in order to allow the brain to undo the changes made in the presence of the drug. You've shocked your nervous system and the symptoms you're experiencing are the result of this.

 

23 hours ago, Jo09 said:

In fact, I can't stand any computer screen or smartphone, I feel like my eyes can't stand artificial light any more, because the sun causes me absolutely no problems

I had very debilitating visual symptoms from my disastrous taper attempt over 2 years ago. As well as the noise sensitivity you mentioned. Muscle pain, also a common problem.

 

On 4/1/2024 at 8:51 PM, Jo09 said:

If so, what should I do? Resume the 60mg for a few weeks and reduce the dose little by little instead of going too fast? Honestly, I don't dare go back on 60mg because apart from these worries, I'm feeling much better mentally (that's the paradox) and I've already tried for 3 days to go back on 60mg and I was feeling really, really unwell to the point where I couldn't even get out of bed because I was so knocked out...

If I were you I would keep holding on 30mg for the foreseeable future. If you can function and symptoms are manageable, keep holding for a few more months and allow things to settle out even more. You're much more likely to be succesful in tapering off completely if you hold now and allow things to smooth out.

[Jo09]

34 minutes ago, Erimus said:

That is likely to cause many problems. Duloxetine is a very challenging drug to taper, and requires micro cuts in order to allow the brain to undo the changes made in the presence of the drug. You've shocked your nervous system and the symptoms you're experiencing are the result of this.

 

I had very debilitating visual symptoms from my disastrous taper attempt over 2 years ago. As well as the noise sensitivity you mentioned. Muscle pain, also a common problem.

 

If I were you I would keep holding on 30mg for the foreseeable future. If you can function and symptoms are manageable, keep holding for a few more months and allow things to settle out even more. You're much more likely to be succesful in tapering off completely if you hold now and allow things to smooth out.

I'm so afraid that these symptoms will never go away, even though I know it can take years, is there a risk that these problems will never go away? it scares me... 

[Erimus]

22 hours ago, Jo09 said:

I'm so afraid that these symptoms will never go away, even though I know it can take years, is there a risk that these problems will never go away? it scares me... 

They will resolve with time. After reading your signature I can see you have been taking duloxetine since 2010. Suddenly dropping from 60mg to 30mg after 14 years is a huge shock to your brain and nervous system.

 

Going forward, whenever you make changes they need to be 10% of your current dose or less. Both increases and decreases.

 

Like I said, I would continue to hold on 30mg and see if the symptoms calm down somewhat. I don't think these symptoms will never go away, everyone here has that opinion at some point or another. Your brain has made hundreds to thousands of changes in the 14 years on 60mg, after dropping to 30mg it has to undo all these changes.

[Jo09]

I'm coming back to you because I can't take it anymore, I went to a restaurant again today with flickering lights and it completely ruined my day, even now, 10 hours later I still feel oppression... I feel like it's getting worse every month instead of better...

 

It's really handicapping me so much that I'm hesitating to go back on the 60mg... I have an appointment this April 29 with a new psychiatrist, because my old one, where I haven't been for 5 years, didn't please me anyway... I'm still waiting and enduring until the 29th...;

 

The worst thing is that I feel so much more pleasure in the little moments since I reduced my dose... And especially sexually, on 60mg I have difficulty getting an erection and it takes me a very long time to ejaculate, on 30mg it's so much better... I hate my situation, I don't know what to do anymore...

Ty again.

 

[FindRest]

1 hour ago, Jo09 said:

I have an appointment this April 29 with a new psychiatrist, because my old one, where I haven't been for 5 years, didn't please me anyway... I'm still waiting and enduring until the 29th...;

My educated guess is that your psychiatrist will want to either 1) put you back on your original dose, or 2) switch medications.  Either one would most likely cause things to get much worse. Not too many psychs out there know how to taper properly and most dismiss withdrawals as something fleeting that will be gone in a few weeks. They are in the business of prescribing psychiatric drugs; that’s their job and livelihood. 
 

Before your appointment, I would read up on the dangers of reinstating a drug too rapidly, especially after being on a lower dose for awhile. Your body is now sensitized to the drug, meaning it can’t handle it like it use to. If you do decide to increase your dose, it should be done VERY slowly and at fraction of the dose (as in 1 mg, not 30mg). 
 

Switching meds is not a good idea either, as it will NOT prevent the withdrawals you would get from stopping Duloxetine. 
 

That said, I agree with what Erimus said that it would be best if you could keep holding and allow your body to adjust to your 50% reduction. It’s been 8 months and reinstating this late can be risky.

 

Are you taking any other medications? Supplements? If so, please add them to your signature.

 

I was in very rough shape after my dr-led CT off Effexor. I experienced the WD symptoms you mention. The visual problems went away in that first year. You’re lucky the sexual problems improved for you. Mine have not. It’s a very good sign that your body is adapting to the lower dose and that your symptoms are reversible. The noise issues also resolved. I can’t tolerate loud noises, but do just fine with others. I can watch TV and read a book now. I couldn’t say that 4 years ago.

 

1 hour ago, Jo09 said:

The worst thing is that I feel so much more pleasure in the little moments since I reduced my dose

THIS! This right here is HUGE! I can’t tell you loudly enough what a good sign and blessing this is. Use this fact to help carry you on those terrible days. Many here cannot say this.
 

 

Edited April 8 by FindRest

[Jo09]

Thank you very much for taking the time to reply to my message.

I've added the complements in my signature as requested.

 

Otherwise, I hear what you're saying, but the problem is that right now I'm going through hell, I can't stand any more smartphones, and if I go into a store or restaurant with flickering lights, it puts me in such a state that cognitively I feel embarrassed... This weekend, I'm going to meet someone, I'm afraid, because the lights that flicker might make me feel bad, very bad... This Sunday, I went to eat at a restaurant with my brother, it was hell and I had an embarrassment in the middle of my face and cognitive throughout all the day... 

I'm really living a nightmare and I'm lost, I'm really handicapped by this story, even chatting with my date is complicated because my smartphone explodes my head... 

 

And I confess I'm afraid, very afraid of wasting my time, that these symptoms will never go away and that I'm just suffering for nothing... I'm also afraid, having reintroduced the 60mg for 4 days, that I've reset my progress since August 2022... 

 

I also really have the impression that it's getting worse and worse, until 2 weeks ago it wasn't that bad and I've talked about it again with my doctor who has never heard what I have and doesn't know what to give me because the painkillers and anti-inflammatories have no effect... The only thing he say is take your 60mg duloxetine back... 

 

Do you have any idea what could help me a little because it's a nightmare... I've been thinking about maybe eating more sardines? I already eat 1 sardine every 3 days, could a cure of omega 3 by eating sardines daily help?

 

I need help, even the doctors I've seen don't understand anything, it's once again a real nightmare.... :'(

 

BTW sorry if there is some error, i am using a translator because english is not my native language. 

Thanks again!

 

 

[FindRest]

Can you update your signature to include the dates you reinstated to 60mg then went back to 30mg? Keeping your signature updated helps moderators see exactly what you have done dose-wise, rather than having to read through the whole thread. Thanks. And thanks for adding the complements/supplements.

 

14 hours ago, Jo09 said:

because the painkillers and anti-inflammatories have no effect

Please include these medications in your signature as well, along with dates.

 

I too went through much of what you describe … not being able to go out in public because of the fluorescent lights, fear, panic, noise, etc.. It was the scariest time of my life. I ended up staying home and avoided all social life. I couldn’t handle it. 
 

This link might help you understand things more and might give you some clarity as to what is going on and offer some ideas of what may or may not help you:

Hypersensitivity and Kindling:
https://www.survivingantidepressants.org/forums/topic/27800-hypersensitivity-and-kindling/#comment-610557

 

Regarding supplements, I’d be careful about taking too many or too much. I had to stop all supplements when I was in your state. They caused me increased symptoms and anxiety. I was able to slowly reintroduce them later at very small amounts. Everyone is different , though. I think eating more sardines might be good, but if symptoms increase, then stop.

 

 

@Erimus gave you some good advice above.

 

Hang in there.

Edited April 10 by FindRest

[Jo09]

10 hours ago, FindRest said:

Regarding supplements, I’d be careful about taking too many or too much. I had to stop all supplements when I was in your state. They caused me increased symptoms and anxiety. I was able to slowly reintroduce them later at very small amounts. Everyone is different , though. I think eating more sardines might be good, but if symptoms increase, then stop.

Now that I think about it, it's more or less since I've been taking it that it's become hell... Maybe I should try not taking it for 2 weeks to see if I see a difference ?

[Erimus]

1 hour ago, Jo09 said:

Now that I think about it, it's more or less since I've been taking it that it's become hell... Maybe I should try not taking it for 2 weeks to see if I see a difference ?

You definitely could be over doing it on the vitamin D. I would stop everything except the Duloxetine, see how you feel.

[Jo09]

13 minutes ago, Erimus said:

1 hour ago, Jo09 said:

difference ?

You definitely could be over doing it on the vitamin D. I would stop everything except the Duloxetine, see how you feel.

I have done a blood panel 2 days ago and my result was fine 68 mmol 100 is the toxicity level from the lab.

[Erimus]

43 minutes ago, Jo09 said:

I have done a blood panel 2 days ago and my result was fine 68 mmol 100 is the toxicity level from the lab.

If your vitamin D levels are fine there's no need to be taking 10,000IU every other day. It can be over stimulating for many people. Worth stopping it for a few weeks.

[Jo09]

8 minutes ago, Erimus said:

If your vitamin D levels are fine there's no need to be taking 10,000IU every other day. It can be over stimulating for many people. Worth stopping it for a few weeks.

I've never read or heard anything about it, do you think it could make my symptoms worse? And the magnesium, I'm trying to stop taking it for a few days and see if I can see any difference?

It's really a big headache, I'm willing to try anything to reduce my symptoms...

[Erimus]

56 minutes ago, Jo09 said:

I've never read or heard anything about it, do you think it could make my symptoms worse? And the magnesium, I'm trying to stop taking it for a few days and see if I can see any difference?

It's really a big headache, I'm willing to try anything to reduce my symptoms...

There's only one way to find out. Stop the vitamin D, and keep everything else the same. See how you feel over the next week or so. 10,000IU is a really big dose, way beyond the recommended daily intake.

Edited April 10 by Erimus

[FindRest]

7 hours ago, Jo09 said:

And the magnesium, I'm trying to stop taking it for a few days and see if I can see any difference?

Just a word of caution regarding stopping the magnesium glycinate: I had surgery 2 weeks ago and to stop it for a week beforehand. Within a few days, I noticed my WD symptoms starting back up, ones that had been gone for quite awhile. About the 4th day, I decided to go ahead and take a capsule. The symptoms cleared right up within 24 hours. I don’t know if it was because it was helping those symptoms all along, or if there was some kind of minor withdrawal to the glycine part of it. Just something to be aware of. 
 

6 hours ago, Erimus said:

Stop the vitamin D, and keep everything else the same.

I like this advice. Stop one thing at a time for a week or so before stopping the next one. That way, if things get better or worsen, you know the likely culprit.

[FindRest]

Have you seen these links in the Symptoms part of the Forum? I think they could have some good ideas for you. For example, wearing my blue light (computer) glasses make a big difference when viewing my computer, iPad, phone, and television. I also have set all my electronic devices to the evening mode and whatever other options they have to reduce the amount of blue light.

 
 

HYPERSENSITIVITIES OR KINDLING

 

Post-withdrawal nervous system hypersensitivity or kindling 

 

Hypersensitivity to drugs, foods, and supplements? 

 

Increased sensitivity to light, noise, sound, exercise etc

 

Inactivity may make sympathetic nervous system hypersensitive...

 

Light-sensitive? Try blocking out blue light

 

Computer Program Adjusts Blue Light to Time of Day

 

Increased sensitivity to emotional content: TV, violent movies, music, conversations.

 

skin photosensitivity: a listed side effect

 

Light flashes made me sick?

 

Multiple Chemical Sensitivity vs hypersensitized nervous system

[Jo09]

Just a message to tell you that my anxiety is exploding, I'm passing a milestone I feel... This weekend I went to see a girl and I was hyper-anxious, like I've never been before, it was a nightmare between that and certain lamps in certain shops... I also find it harder and harder to get out of bed, no motivation to get out of bed because I have a depressing life with a terrible routine... I'm really lost, I also have psoriasis in my hair and I'm having an incredible crisis... 

 

I'm wondering, reading your post, if it wasn't stopping the magnesium that made everything worse... Maybe I should have waited until this weekend before trying...

 

[Jo09]

Honestly, I'm on the verge of breakdown and going back on the 60mg dose even though I know I'll be even worse for 2 to 4 weeks, what I'm feeling is such a huge handicap that I'm finding it hard to cope, I'm not a hermit, I like to get out and about and it's becoming a daily nightmare... What's more, I doubt I'll be able to live without these crappy drugs, given the state of anxiety I get whenever I'm stressed, and I'm a huge stressed guy...

 

The thing that frustrates me the most is that I want children, I want to start a family and I know that at 60mg I have trouble holding an erection and going to orgasm... How can I stay in a relationship with these drugs?... 

 

Now the other thing that makes me hesitate is waiting to go to the psychiatrist at the end of the month to get a new opinion and maybe another treatment (even though I know nothing will be better, these drugs are hell and I suspect he'll prescribe me paroxetine, which is worse than duloxetine...) 

 

I'm so lost... 

 

[Erimus]

2 hours ago, Jo09 said:

Honestly, I'm on the verge of breakdown and going back on the 60mg dose even though I know I'll be even worse for 2 to 4 weeks, what I'm feeling is such a huge handicap that I'm finding it hard to cope, I'm not a hermit, I like to get out and about and it's becoming a daily nightmare... What's more, I doubt I'll be able to live without these crappy drugs, given the state of anxiety I get whenever I'm stressed, and I'm a huge stressed guy...

 

The thing that frustrates me the most is that I want children, I want to start a family and I know that at 60mg I have trouble holding an erection and going to orgasm... How can I stay in a relationship with these drugs?... 

 

Now the other thing that makes me hesitate is waiting to go to the psychiatrist at the end of the month to get a new opinion and maybe another treatment (even though I know nothing will be better, these drugs are hell and I suspect he'll prescribe me paroxetine, which is worse than duloxetine...) 

 

I'm so lost... 

 

If you want to increase the dose I would suggest doing it in smaller increments, just try 33-35mg rather than jumping straight to 60mg. Duloxetine is easy to create unique doses because of the beads in the capsules.

Edited April 16 by Erimus

[Erimus]

42 minutes ago, Jo09 said:

The thing that frustrates me the most is that I want children, I want to start a family and I know that at 60mg I have trouble holding an erection and going to orgasm... How can I stay in a relationship with these drugs?... 

When you're stable again you will reach a point where you can taper off safely, following the guidelines here. I'm off the opinion that everyone can recover, no matter how many years they've been taking the medication.

 

44 minutes ago, Jo09 said:

Now the other thing that makes me hesitate is waiting to go to the psychiatrist at the end of the month to get a new opinion and maybe another treatment (even though I know nothing will be better, these drugs are hell and I suspect he'll prescribe me paroxetine, which is worse than duloxetine...) 

I wouldn't recommend that. Your body is adapted to duloxetine, so it's best to try and reach stability using the drug you already take.

[Jo09]

In fact, it's crazy, but I thought I was having neck pain, but in fact it's more like pain in the visual cortex at the back of my head... I'm sure that's it because I spent a weekend without using my computer screen or looking at my smartphone and I never had that sensation of neck pain again, whereas today it's there and very annoying because I'm using my computer screen... Isn't there anything that can relax or relieve this part of the brain? With Oled screens I don't have this problem, but I do get random tingling in my head and pressure in the middle of the face... It's really weird and very disabling... 

 

Otherwise thank you for the messages above and I would like to know if you have a guide page to help me increase my dose with advice on how to go up gradually? I'd like to test going up to 40mg, unfortunately where I live there are only 30 and 60 mg... If not, do you think that adding even a tiny bit more would help reduce my symptoms? Weeks?

 

Thank you so much.

 

[Erimus]

You will need to ask your doctor for 60mg capsules if you don't already have them. Then as follows:

 

Open a capsule and count the number of beads in it. Write it down, and then repeat for 4 further capsules. Total up the number of beads and divide by 5. This gives you the average number of beads in a 60mg capsule.

 

If you divide this number by 60 you have the number of beads that equals 1mg of duloxetine. With this number you can simply multiply by the dose you want to take (in milligrams). For example, mulitplying by 35 if you want to increase to 35mg.

 

Once you have the number of beads that equals 35mg you just need to make capsules with this number of beads in. I'd suggest giving it a good 4 weeks after increasing.

 

29 minutes ago, Jo09 said:

do you think that adding even a tiny bit more would help reduce my symptoms? Weeks?

The only way to find out is to test the waters with a small increase for a few weeks.

Edited April 16 by Erimus

[Jo09]

Thank you again for your incredible support, from the bottom of my heart, thank you.

 

I'd just like to know if you think that even by increasing to 35 mg, after 4 weeks I could already feel a minimal effect? Can such a small difference in dosage make a big difference?

 

[Erimus]

30 minutes ago, Jo09 said:

Thank you again for your incredible support, from the bottom of my heart, thank you.

 

I'd just like to know if you think that even by increasing to 35 mg, after 4 weeks I could already feel a minimal effect? Can such a small difference in dosage make a big difference?

 

Sometimes it can. The main thing is that increasing/decreasing in smaller amounts is less likely to shock your nervous system.