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  1. Giulietta

    Giulietta

    Hello all, I am new to the forum after reviewing some of the posts intermittently since December 2018. I have posted my intro as a PDF (note: pasted below). When I tried to post it - the fonts and spacing were inconsistent and I couldn't edit it. This is my first online forum on any subject so please bear with me on the technical goofs I will make. 😉 Fortunately I did find the emoji and finally get the introduction written. Thank you! PDF information pasted below (CC manually reformatted as best as possible): Hello all, I am a new member and trying to liberate myself from duloxetine/Cymbalta 20 mg (compounded in a LIQUID). My goal is mood management without medication – and being able to cope positively with unwelcome (or sometimes welcome) events. I have been viewing information on the web site off and on since last December. My thanks and empathy to all of you on this site who are ridding themselves of Cymbalta and other ADs, benzos, etc. I remain optimistic that the light at the end of the tunnel is not that of an oncoming locomotive. J I am grateful for having found SurvivingAD and to the subject matter experts and people who administer it. I have been tapering duloxetine 20 mg (compounded) since December 15, 2018 under the care of an MD. I am at 10 mg (3.3 ml) as of July 20, 2019. I am decreasing by about 10% a month. I am also taking clonazepam 2 mg (my next taper goal) as well as meds for a childhood neurological illness (lamotrigine XR 600 mg and gabapentin 1000 mg). I have taken many medications since age 9 due to the latter. Because of my medical history and the many meds tried or used over the years to manage it, their efficacy, safety and side effects – I am anxious about medications. Anxiety exacerbates the neurological health issue. I was prescribed ADs about 15 years ago (and the clonazepam) to manage moods amid traumatic life events. I took Duloxetine for about the last 4 or 5 years; the highest dose was 60 mg. About my taper: The taper started in December 2018. However – before I knew better – I stopped cold turkey (per prescriber’s advice) in August 2018. I endured subsequent bouts of panic, elevated anxiety, auras and some agoraphobia - so I restarted the duloxetine and the symptoms went away. I figured out that cutting the medication maybe caused the symptoms. I found a new MD who reluctantly agreed to the taper. After learning I lack the fine motor skills to count beads, I found a compounding pharmacy and get the duloxetine in an oil-suspension. I decreased by 2 MG (10%) per his direction and I experienced 3 weeks of bad symptoms. Thereafter I tried a ‘micro-taper’ approach – a series of mini-cuts - per this website. This approach seems to have moderated many of the side effects– but the symptoms are still a problem a good proportion of the time. My process for the micro-taper is to reduce by about .5 mg a week (about 2 mg a month total) – with mini decrements across the week (in ml). I have symptoms for a few days, then a few days where I am feeling mostly OK, and then I make another mini-cut. This is fatiguing and difficult to manage. Some side effects I experience(d) on this medication at 20 mg– and they continue: • Hot flushing over head and torso and perspiration (in 70 F) and not attributable to endocrine function. • Blurry vision • Short-term memory impact • Focus and concentration and recall • Insomnia – awakening 2-3x night many nights…. • SSRI/SNRI sexual side –effects • And many more… Withdrawal effects Generally - the most consistent and prevalent withdrawal effects (thus far) have been: • Anxiety - which may often be markedly worse in mid to late afternoon and into the evening (about 7-8 hours after my dose). • Jitteriness/tremors/shakiness • Auras and other sensations (related to the neurological illness) which may be extremely uncomfortable • Tinnitus (hearing loss was ruled out as a cause) • Insomnia • Lower GI (one extreme or the other) • Appetite issues (one extreme or the other) • Maybe more sensitive to cloudy days – particulary when they cluster Less consistent: • Dizziness when quickly turning my head • Postural hypotension • Sinus headaches • Lightheadedness • Panic • Dysphoria • Short-term memory impact – worse at times during this taper than on the full dose • Focus and concentration and recall– worse at times during this taper than on the full dose June – July Withdrawal Symptoms Out of the blue in June I experienced additional and horrendous symptoms for 2-3 weeks (see ‘less consistent’ above). They were so acute I asked myself if this is worth it, whether I will ever get off this drug and so on with the nefarious what if’s. I have no idea what caused it but I made it through and I am now doing much better. Looking for another MD or NP The psych MD (started in December 2018) does not have my full confidence to taper me successfully off Duloxetine. I am looking for an MD or NP who sincerely wants to taper me off and take a holistic approach to mood management moving forward. Spending much time online and looking things up (like about ADs, tapering, etc.) elevates my anxiety to unhealthy levels. It’s therefore important to have an MD or NP on whom I may depend for this information. If it had not been for information I found on Surviving AD and other web sites – he would have tapered me to Viibryd or off duloxetine in 4 weeks. What I am doing to help myself • Joining Surviving AD and searching for an in person support group • Helping others through this and letting everyone I know about Cymbalta and AD withdrawal • (Re-) learning Cognitive Behavioral Therapy • Meditate (10 – 15 minutes a day I practice this – but 5 minutes are better than no minutes) – this may take me a while to learn…. • Exercise daily ( 45 minutes on the treadmill in the morning (and it would be good to do some walking in the afternoon). • Physical therapy and hand weight exercises most nights. • Eating plenty of protein, healthy (whole grain) carbohydrates, salad a day, nuts, and could do better with vegetables • Searching for a faith that aligns (mostly) with mine • Looking for a group to volunteer with • Write down (most days) what I am grateful for – even if I need to repeat things from one day to another J A few things I have learned – and wish I had known earlier – about exercise and diet and spending too much time online Maybe this may help someone out… 1. You may not want to start a ketogenic (or low carb) diet (depending on your medical circumstances). My personal experience with this: I was advised/told to restrict carbs (40%) to lower my a1c. I did 50% - and I suffered more anxiety, panic, etc. Ended up in ER with panic. No one told me about this and my MD wasn’t aware. Learn more about keto diets and psych meds: https://www.psychologytoday.com/us/blog/diagnosis-diet/201803/ketogenic-diets-andpsychiatric- medications. 2. Activate dopamine receptors and generate serotonin by EXERCISE (aerobic and/or weight lifting) and PROTEIN. Exercise releases endorphins and helps with dopamine receptor activation. Activating dopamine receptors is ‘critical’ to this process. A diet rich in protein helps with this. (this from the neuro RN) 3. A good snack in the mid to late afternoon – whole grains and protein - may help me with anxiety. It helps with blood glucose management –and a low BG will cause anxiety and a number of the symptoms that are also caused by AD withdrawal 4. To help cope with anxiety – I have found that doing something anything physical or with your hand (and focusing on it) can help (for example, clean the bathroom, knit, weed, etc.). I have a few questions, which I will post separately – and I would really appreciate your comments. Thank you Surviving AD Intro.pdf
  2. Hello. I am wanting some advice on withdrawing from the drugs I am currently on. I am taking 60 mg cymbalta, 5 mg zyprexa and 7.5 mg mirtazapine. I would like to withdraw from all 3 at the same time. Is this possible
  3. Hi, So I finally understood that it is strongly recommended to write a little something about my experiences here. I will just copy some parts of my posts I have shared in this forum to sum up. Recent developments: I myself have intolerable withdrawal symptoms even reducing 5% of the drug. They are unbearable, both physically and mentally. They totally incapacitate me for weeks (I sleep up to 15h a day, terrible brain fog and dizziness up to the point where I cannot walk, of course the brain zaps and lots of pains in different parts of the body etc) (I will not mention the mental effects, they are really bad...) and then on it is still bad but keeps stabilizing very slowly. At this point (after tapering for years) I am seriously considering coming off the 8,44 mg altogether because I am just unable to go through the symptoms that come after a reduction so many times any more. Because the withdrawal symptoms are extreme for me I am thinking it would be better to cut off the drug now at 8,44 mg and hope the nervous system will start balancing itself out than to go through this hell for at least another year (which is the very optimistic time frame). Note: I have decided to go with this idea - I am going from 8,44 to 1 mg in 8 days. (today being the 3rd day: April 3rd 2015 ). Before judging please read the history of my experiences to understand why I personally have decided to take this approach now in the very end of tapering. My experience: I have been tapering at different pace throughout the process. Since the beginning I have made the reductions by 10% or even 5 % when I realised that the symptoms were directly caused by the reductions. I was aware (theoretically) that my symptoms can be caused by the drug, its side effects and withdrawal, but I didn't really believe it for a long time. Or it would be more correct to say I always had doubts whether it was still more me being crazy and ill. So for a long time in the beginning (I have been tapering for over 2 years) I kept tapering with intervals that I now realise were not nearly enough for my brain to stabilize, but I was not fully aware that the withdrawal symptoms could be so severe and last for so long that I figured the reason had to be somewhere else. I just tapered according to the planned schedule, keeping aprox. 3 week intervals (and unfortunately, optimistically 2 week intervals). I also tried micro tapering every week, but needless to say that proved to be harsh on my nervous system and was keeping me in a constant state of agony. During the last 9 months or so I have had to keep longer periods between reductions in order to stabilize (I realised more and more that what I was experiencing was due to the reduction of the medication and the link got clearer by the day), but I cannot even estimate the stabilization point. For some of my friends it is perfectly clear - their withdrawal "cycle" is short and simple: they know that their symptoms will come 1-2 days after the reduction and last for about a week (max). This is not the case for me. One week for me is the extremely acute period (which would correspond to maybe the 1st 1-2 days of my friends' cycles) and as much as I would like to see a noticeable improvement during week 2, I can only say that it gets slightly better than the extreme, but not nearly enough to function to a standard that would/could be acceptable or tolerable. After recently having a 6 week and a 2 month gap between reductions I can say that during the 2 month gap I guess you cold say that I started to feel like the symptoms were starting to actually stabilize for the fist time for me subjectively. That enabled me to observe how the affects of withdrawal came about abruptly and directly connected to the reduction. In more detail: I'm having a hard time remembering exactly how long I have been taking certain drugs. Seems like forever. I was first prescribed Fluoxetine when I was 17. I am 30 now and for 13 years I have constantly been on and off different antidepressants - the whole spectrum of them. For a very short while I was even on antipsychotics (a month or so). I have always had awful side effects and have discontinued the drugs after a while, switched from one drug to another etc. It wasn't until a few years ago when I finally became aware and educated myself on the topic of antidepressant withdrawal and the harm they cause. (I would really suggest two books for a real eye-opening: Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime by Peter R. Breggin and Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker). When I think back on the years on these meds and realising now what they have done with me, it makes me indescribably angry and sad. I have had awful side effects for years and discontinuation effects that I only realise in retrospect for what they were. Last drug I discontinued before Cymbalta was Venlafaxine (Effexor) which is another nightmare next to Cymbalta. Unfortunately then I was not aware of the methods of slow tapering and the discontinuation symptoms literally almost killed me (the "brain zaps", disorientation and dizziness were so severe that I almost tumbled in front of a moving car one day). By then I was already google-smart on the discontinuation side effects these meds have but was still unaware how to slowly taper. I was very reluctant to start taking Cymbalta but was convinced it was necessary by mu doctor. I started with the idea that I would only be taking the drug for a few months. Well, months become a year before I started tapering. I was taking 60 mg of the drug. When I started tapering it was very difficult for me to distinguish between the effects of withdrawal symptoms and my usual symptoms. A lot of the time I did not believe that the drug could be causing all the mental and physical symptoms and was afraid that it was just me. By know (as I described in my previous post) I have realised that a lot of this has been the drug's effect, but I am still afraid whether these effects can be undone. I have no way of knowing whether the decade of these drugs has caused permanent damage on my nervous system. I have tapered using different strategies. I have never tapered more than 10% of the last dosage, but I did reduce very often for a long time (after making a schedule I tapered every 2-3 weeks). It was because I could not really believe that my symptoms were so severely caused by the withdrawal. Later when I tried longer stabilizing periods I experienced how the withdrawal effects were sudden and obvious and followed a certain pattern (for Cymbalta and for me it is 1st day - no different, 2nd day slightly lowered mood, mild brain zaps etc, 3rd day - hell!). Withdrawal symptoms: The first week, on day 3 I start to have terrible crying spells. Literally for days I keep crying. Well, of course not 24/7 but for most part of the first days I am in tears. I am not sure how long that lasts but at least half a week. At some point the crying is replaced by despair and major depressive feelings. This is the worst symptom and the best I know to describe it is that while having this I feel that I cannot bear living for another minute more. I just want the suffering to stop. And it doesn't. And that can get better for half a day or even an entire day, but still last for... well, an unknown amount of time. I know I could handle any kind of symptoms - all the pain and crying and everything, but this is unbearable. The only thing that helps is numbing the feelings with Xanax. I do not drink alcohol but I can totally understand why people would choose to numb their pain with it. I suppose it is not at all different from taking Xanax - they're both a sort of a poison for the body and the brain. From physical symptoms the strongest ones I have is exhaustion (up to the point where it is ridiculous even), I have strong neurological symptoms (brain fog, brain zaps - they are a sort of a mini seizure, extreme sleepiness - sleeping up to 15h a day, not being able to shake the drowsiness and fogginess for the most part of the day, I have strong neural pain in the left side of my body - in the left arm, shoulder, back of the head, behind the eye, vision problems, extreme sensitivity to sounds (!) and a general sensory oversensitivity, nausea of course. Oh, I remembered for some period during the tapering I sweated extremely. I usually sweat really little. I also sweat a lot during the night. The flu-like symptoms occur. Ohwell... the list is so long it is embarrassing. And these symptoms don't really seem to pass fast. They just last and last so that I get to thinking it is ridiculous. But it still keeps happening. Oh and from time to time comes the agitation and irritability. I can feel how my thinking gets impaired - it slows down, the memory gets really-really bad, I cannot remember words and names (I used to think it was just me or a symptom of depression, but now I have established a clear link between the symptoms and the reduction of the meds). Oh, and the restless legs of course. My method of tapering: I have developed a method for myself for tapering off Cymbalta that I have not encountered in this forum or any others so I thought I should share it. For the very reason that the beads inside a Cymbalta capsule are not the same size (two capsules might not contain the same amount of beads) and I do not have a scale to measure such small portions, I have come up with an alternative. What I did is I folded a paper in half from the middle, creating a void where I could pour the beads and they would stay in a straight line next to each other. In that way I created a measurable line of the contents of a capsule. Right now I use a 30 mg capsule which creates a 25,5 cm line (fits on a regular A4 paper), but when I was using a 60 mg capsule I had to devide the beads into portions and measure them all and calculate from there on. Now I am not particularly fond of mathematics, but with a few simple calculations and a lot of concentration ( ) I was able to calculate how many mg of the medicine was in a line of the medicine of a certain lenght. So when 30 mg of Cymbalta is 25,5 cm, that meas for example, that 15 mg of Cymbalta would be 12,75 cm etc. (This is specific to the capsules I use bought from Estonia, yours could be very different so you should always measure your own medication!) I use the same folded paper (with markings on it) every day to pour a certain amount of beads out from the capsule. So if I am using a 30 mg capsule and I am - let's say - at 20 mg daily dosage I would have to calculate how many (what lenght) beads I would have to extract from the capsule before taking the medicine. So I have established that 30 mg = 25,5 cm. That means 20 mg = 17 cm. I know that there is 25,5 cm of beads (30 mg) in the capsule so I have to pour out 10 mg = 8,5 cm. It really makes no difference, if you calculate it in cm or mg after you have established the relation between the two. So I have a marking on the paper and each day I pour out a 8,5 cm line. And if i reduce the dosage I just make another marking. It is actually very easy to do the reduction just visually, when you have drawn the lines beforehand and calculated what necessary. You also have the history of your reductions right there under your eyes. I always write the date of the reduction next to the specific line every time, so I have a good visual overview of what, when etc.
  4. Hello everyone. I had been on this forum many times before reading all the posts, usually in the dead of night when feeling so desperate and alone with insomnia but did not sign up until now as hoping I would be feeling a bit better by now. I don't. I came off Duloxetine/Cymbalta, 60mg,in June 2016 cold turkey, probably a huge mistake to do it this way but I had been in touch with my doctor and he suggested to change antidepressant to Citalopram 20mg which I tried for a week and felt strange so ended up ditching both. I went through a terrible time of adjustment for the first 100 days but then seemed to manage slightly better, although it was tough I had hope for a while apart from the no sleep. After another few weeks all kinds of symptoms came at me like an express train and these now remain. I feel generally unwell all the time, depressed, no interest, no zest for life and just not functioning very well. I do have Citalopram tablets, 20mg, here in the house and feel tempted to take them but unsure of what to do. I also have Diazepam which I have taken on and off for 8/9 years 2mg. The Diazepam does not help me sleep at all but does calm me down a little but I feel it is not helpful to my withdrawal off the anti depressents and may be making symptoms worse. Would like to ask advice as to whether or not to reinstate antidepressents for a while as struggling so badly with suicidal thoughts and of little hope in recovering. 8 months of feeling so ill everyday is such hard work and is like living less than half a life. All hope I had in feeling better has gone, I cant believe I can feel this bad and still continue to try and get on with the days activities. I keep thinking that I should be in a hospital being looked after but of course any doctor would just dose me up, seems appealing today. Any suggestions would be appreciated very much.
  5. I have been reading this forum for over a week and I need ADVISE! Let me introduce myself and give some background information. I am trying to be brief, so please feel free to ask questions. Seven years ago I was diagnosed with General Anxiety Disorder (GAD). After trying several antidepressants, Cymbalta seemed to help me dramatically after the start-up symptoms passed. Over a period of almost six years my prescription was gradually increased to the point I went out of my mind and could not take it anymore. I went to a treatment center where I abruptly discontinued Cymbalta (1 year ago) and roller-coasted thru almost every antidepressant there is with no joy. I took a genetics test that revealed Pristiq was one of the few antidepressants my body metabolizes as intended. I took 50mg per day for a month and then tapered to zero in 14 days. This was 2 months and a week ago. It did relieve the pain and anguish, but gave me a multitude of new undesirable symptoms. My current symptoms are: Vertigo for the last 7 weeks, Fibromyalgia type writhing pain since discontinuing Cymbalta (1 year), emotional distress, daily fits of anger and rage, and insomnia. I have been thru a million tests and have tried everything doctors have prescribed including Valium and high doses of Aleve which made my Peptic Ulcer flair up. I tried Tramadol with Acetaminophen two days last week which gave me some relief from both the Vertigo and pain. I know it works similar to antidepressants, so am cautious to continue taking. I have also been taking a regimen of amino acids and B vitamins for 2 weeks with no improvement and possibly worse conditions. After reading Mr. Anxious thread I am thinking of either reinstating Pristiq and tapering, or giving Tramadol a go and tapering off it. Please give me some insight.
  6. Hello, my name is Manny. I was diagnosed 0CD and schizophrenic in 2008, but I been taking benzos and amiptriptiline since 2005. Currently,taking abilify 20mg,risperidone 2mg,cymbalta 60mg,biperiden 4mg. I am tapering klonopin down to 0,27mg from a dose of 1,25mg. I went to see my doctor this week because a blood test that I did. He said my hepatic transaminases are high because of the medication that I take. I am assuming the APs that I take. What can I do to get my liver function well? I know, quitting the APs, but I can t cold turkey. Any advice,please.
  7. Hello, I am 41 years old. In 2011 I got Cymbalta because of a severe depressive episode. I started weaning in 2013 in a four weeks rhythm. I always reduced between 5 and 10% of the last dose. The last steps were a lot smaller. One bead every four weeks. (120mg to zero 2013 - 2018) Because of the slow weaning I was able to get my life well regulated. Sometimes there were bad withdrawal symptoms and sometimes a little less, there were windows and waves. I've been at zero for 16 months now.The first year after zero was mixed with windows and waves, but now I have only one wave to the next wave since eight month after zero. Nausea, Back pain, anxiety, itching, muscle pain, dizziness and many other things. I always read the story from Pug here. It is my anchor in this difficult time.
  8. Until July 2017 I was an active, healthy female (58). I'd been extremely fortunate in that, the only health problem I'd ever encountered had been anxiety/low grade depression. At least that's what the doctors diagnosed 20 years ago. I was put on Effexor 75mg and then, some years later, reduced the dosage to 37.5mg. In January 2017 I started tapering off my medication and by July was off Effexor. I did experience the odd brain zap but could easily go about my daily business. Suddenly at the end of July, I started having what I thought to be panic attacks (but which were, in actual fact, heart arrhythmias) and my then psychiatrist put me back on Effexor albeit 150mg/day. At 2am on August 12th, I had a sudden cardiac arrest. Thankfully one of our dogs wakened my husband and he and my daughter performed CPR until the ambulance arrived. My guardian angel was watching over me and after a week in the hospital, where I was fitted with an ICD and was put on 30mg Cymbalta, I returned home. Fast forward to three weeks later. My ICD fired. Off to hospital. In for observation for a week but no arrhythmias could be detected Returned home and 24 hours later the ICD fired again! In hospital for another 10 days, had a catheter ablation but no structural heart damage was found. What they did find was that one of the ICD leads had moved and pushed itself through one of the heart walls which could have explained the shocks. So another intervention to replace the lead. I was still on Cymbalta and an anti-arrhythmic drug. Just when I was beginning to think I was on the road to recovery, my ICD fired on the 12th of November. Off to hospital. In for ten days where I met a fascinating psychiatrist who thought that my SCA could have been induced by going back on Effexor as it's known to have a potential influence on cardiac rhythms. And since Cymbalta is also a SNRI, it would be advisable to stop taking it. Well since November 17th I'm Cymbalta-free and yes, I went cold turkey which I normally would not have done under other circumstances. Initially I experienced, brain zaps, anxiety and irritability. However, the symptoms were bearable. I’ve been taking vitamin D3, magnesium and Omega 3 supplements and trying to eat all the right foods. I walk my dogs every day so am getting exercise and fresh air on a regular basis and I go for acupressure treatments (suggested by my new psychiatrist). I was progressing quite well until March 2018 when I started experiencing severe anxiety, dizziness, muscle tension and headaches.The situation has improved every so slightly since then. Am I experiencing what is known as protracted withdrawal?
  9. 🙂 I'm new to the site. Couple of questions. Had a couple of bouts with GAD 18 years ago. Lexapro fixed the problem both times and stopped both times with no problems after a few months. June 2018 felt depressed. Doctor prescribed Lexapro for six months (Dec. 2018). Then quit over 11 days by skipping doses as he suggested. Some symptoms returned and we tried Zoloft the end of March 2019. Worked up to 100 mgs. by June 21 but having very loose stools. Quick 6 day taper August 22 with plans to begin Cymbalta. Just quit instead and contacted Doctor to advise her. It's now been 6 months off AD's and the first couple were ok. Began having some problems third month. Experiencing bad mornings (anxiety) and waking early. Also stomach ache and kind of dizzy sometimes. 1. Is anyone experiencing the same symptoms? 2. Can this be withdrawal after 6 months with no AD's 3. Could this be a relapse?
  10. Hello, I was put on Cymbalta about a year ago for PVC's along with a beta blocker. (no history of depression or anxiety diagnosis) The PVC's went away, but moderate, continuous, and unsettling dizziness seemed to take over. All diagnostic tests negative. We tried various different Beta blockers, but none took care of constant dizziness. About 2 months ago, my doctor told me to quit taking Cymbalta and gave me Lyrica instead "to see". After about a day or so, my dizziness was alittle better, but I got these wierd little "strikies" at the base of my skull with increased tinnitus..almost audible to me. ...especially later in day when I move my eyes or head. They got worse the next day so I took a Cymbalta 60mg if by chance it would help. They went away in about 6 hours and dizziness returned. I asked my doctor about the "brain zaps" (found out later that is what they were called) and he acted like I was crazy... "never heard of them" So, he has now referred me to a neurologist for "atypical migraines" which takes like 4 months to get into. In the mean time I have tried to get off of Cymbalta on my own. I have decreased dose (by removing beads) and spread doses out over a couple days for about the last month. Now it takes 2 to 3 days before these terrible brain zaps return. As far as I can tell I do not have any other symptoms of WD other than maybe difficulty to sleep. My questions are: 1. Can I expect to have more WD symptoms after the zaps go away? 2. When a person goes sorta fast or cold turkey, (Haven't taken a pill since Sunday) will the zaps get less soon....or are they with me for months? Thanks for any advice. I have found this site quite informative and really feel for the issues that these antidepressants have caused.
  11. Hello everyone My name is Eva, 20 years ago I gave my power to someone in lab coat and believed them that I have serotonin deficiency and need to take antidepressants. I was on one at the time on regular doses but don’t remember now. Over the years they would poop out and that’s when I would be changed to a different one always did really well with transition had no side effects either so I kept on taking them. Always was told by doctors that antidepressants are not addictive, never was advice to get off them even for years I did not have any symptoms of depression which was the reason I was put on them. I came to USA from Poland at age 23 in poursuit of American Dream ,was very home sick did not have friends, was working nights at dive bar, and studying in the morning, for two years I slept only 4 h at night and ate very poor diets that’s why I got depressed. In past 10 years I tried to get off twice with doctors help was tapered down too fast as doctors do, and as soon as I was on 0mg I would “relapse” now I know it was withdrawal. Second time it was the same story. For past 4 years I was in the best shape of my life i did yoga and other fitness at least 5 times a week I was very happy mother to my daughter and wife my husband is awesome and I love him dearly. I was in great shape mentally and physically. I kept asking myself this question why am I taking antidepressants I’m not depressed, I want to know who am I without this drug because I started to believe that I never should take them in first place. In February 2018 my cousin gave me medical marijuana ( i only smoke couple times in my life, never was attracted to it) i started to smoke and all the sudden i had that idea that I didn’t need to take antidepressants anymore so I stopped cold turkey in February 2018 from 60mg Cymbalta to nothing. Almost instantly i went into mania state, was euphoric and nothing was bothering me, i slept only couple of hours at night, i could not eat food that i ate my whole life, my tast became very sensitive, I lost appetite and had diarrhea for over month. Nothing was alarming me because I was in mania. That went on for 6 month it was starting to loose its high towards the end. And in the end of August I started to notice that I was crushing my memory was becoming very impaired, my cognitions too and I had anxiety that was scaring me because I had never had anxiety in my life. I was sure I’m relapsing and was very scared because my symptoms were much was then ever before. I started to take 60mg Cymbalta because I still had it in my house, that was August 2018, I called my doctor and she said I was relapsing , gave me Benzodiazapine for my anxiety 0.5 mg. My condition became worse I was not improving but getting worse. I could not sleep I couldn’t not eat, I could not think my cognitions was gone, I started to have sucidle ideation ( never in my life I had them before) I became dead a zombie. I had insomnia and sleeping pills were not helping ( never before in my life I had issues with sleeping) Between September 2018 and February 2019 I was switched to new antidepressant every two months. After Cymbalta it was , Effexor, then Remeron. I was in hell and totally in the hands of people who where making my condition worse but at that moment I didn’t know it I was sure I’m going crazy. In the January 2019 I did ketamine therapy but that made me worse. I was in hospital 5 times between September 2018 and February 2019. After ketamine I went to hospital again and agreed to have ECT at that time I did not care anymore I was devastated from smallest atom in my body I was broken chemically broken. After 4 session of ECT I felt better first time in 7 months I went home and was able to function some what. I got back my cognition to the point where I started to look back at what has happened to me and looking for answers, deep down inside of me I knew that it was not my body making me sick I knew that something was happening to me that was outside of my body control. That’s when I found this site SA which explained everything I was searching for, I was crying I was so relieved but also became so angry at doctors at whole system. I understood that after I started to take Cymbalta in August 2018 my body rejected it and it made me lot worse. After ECT my doctor put me on Zoloft first 25 mg and then up to 100 mg. It was March 2019 end i was saying to my husband I’m so scared i don’t know why because i know I’m safe but I’m scared. After I found S.A. I understood that the only way to heal for me is to be drug fee I understood that what has happened to me was severe withdrawal symptoms from Cymbalta. I realize that I will never trust doctor again I know that I have to heal my body and no doctor will help me to do this. I wean myself of Zoloft and have been drug free for 1 month, I also stopped taking Benzodiazapine I was only on 0,5 mg as needed but was very reluctant on taking them because deep inside I knew that this is not right. And it was not it was very wrong everything that has happened and the way we are being lied to about devastating withdrawal and addictives nature of antidepressants . So now I’m one month drug free. I have anxiety about doing basic things like grocery shopping and cooking it’s extremely difficult, my short term memory is very bad, my cognitions is better then between August 2018 and February 2019 but still not as normal, my appetite is still gone I have to force myself to eat I’m 16 Ib underweight, my sleep is broken but much better then it was before. I have tormenting thoughts like I cannot stop my brain from thinking, it’s usually related to what has happened in past year, I have depression very hopeless like a child very helpless like a child, I’m ashamed of myself for being in this condition even though i know it’s not my fault, I cannot enjoy enjoy anything that I loved in the past, I feel very disconnected from outside world and every human being. My daughter is my main reason I decided to get through it, but I feel so guilty for not being able to take care of her the way I would before withdrawal. My husband is been my biggest support and I’m worried that he will get tired of me being like this it’s must be so hard on him. I am totally different person now , I was highly functional and happy very social with everything organized. Now I’m like a child helpless hopeless afraid of my own shadow. Emotional suffering is beyond anything I have ever experienced, I cry every day for no reason other that the pain inside of me. Physically I only have problem eating and extreme blotting after I do eat. I know I’m very lucky compared to people who went through physical hell too. I’m not myself and I’m so scared that I will never be who I was before. I’m scared I not going to feel happiness and joy. I don’t even remember how it is to be happy. Please help me to get through it I feel so lost most of my friends think I’m crazy because I decided to take charge of my life and not to trust doctors but they don’t understand that trusting doctors are the main reason I’m suffering now. I feel so lonely Please help me to get through this hell Thank you Ps. This website gave me hope and probably saved my life, I do want to thank the man who created it , thank you from all my heart even though I cannot feel my heart Its still there because I’m alive.
  12. I started on Cymbalta 60 mg 4 years ago, (after 1-2 weeks @ 30 mg); the scrip was from a psychiatrist for major depressive disorder. My depression lifted significantly. After 1 year (+/-) the psychiatrist and I agreed that my family practitioner would handle the prescription and supervision. I was ready to go off the cymbalta and was planning to go of the meds until a couple of deaths close to me occurred. I agreed with my doc that it wasn't the time to make changes in the meds. About 15 years ago I was on Effexor XR and had a helluva time getting off it, even with bead counting. After having read the slow pace recommended here, I probably decreased too quickly. I remember the roller-coaster ride of symptoms (physical, emotional, and cognitive) but forgot about the bead counting. When I started both Effexor & Cymbalta, I had nausea for a couple of days. On my FP's advice, I started going off cymbalta in Feb. by taking 30 mg every other day for a few weeks, then every 3 days, etc. This last week I was starting with 30 mg every 4 days. Fortunately I was using a calendar reminder in my google calendar to keep the schedule. I say fortunately because on Tuesday I had nausea and on Saturday. When I looked at my calendar to mark the reminder as "done," I realized that the nausea was probably related to the cymbalta. Now that I think of it, I started having disrupted sleep and messed-up wake/sleep cycles in March. A web search (DuckDuckGo instead of the big G) led me here and reminded me that slow tapering and counting the granules worked better for me before. My plan now: I have 6 capsules leftover from 60 mg doses. I'll split each into 3 doses, approx. 20 mg, and try 20 mg/day for 18 days (to use them up), making adjustments if necessary. Based on how that goes, I'll either continue at 20 mg or start a 10% taper to 18 mg over 28-30 days.
  13. DavidfromTexas

    DavidfromTexas

    Hi, everybody. My name is David. I just discovered these forums a couple days ago as I was searching the internet for answers and hope. I'm in pretty bad shape right now, even as I am typing these first lines I am starting to cry. I feel better about asking other people who have been through the same issues as me, as opposed to a psychiatrist that just wants to put me on medication. Warning: this is going to be a long post, I apologize and thank you in advance for reading. LONG-TERM MEDS HISTORY: I am now 30 years old, and have been on Anti-Depressant medication for 20 years. I was diagnosed with pretty severe OCD/Anxiety around age 10 or 11, and immediately started on Anti-Depressant medication. (It was warranted, I was in such despair and largely unable to function even in everyday activities like school and doing normal kid things, and was never going to be able to get through any kind of Behavioral Therapy at that point in my life). SO we started with Zoloft (Sertraline), and it made a HUGE difference pretty immediately. I was able to be much more of a "normal" kid, though I did have setbacks here and there. After the better part of a decade, when the Zoloft seemed to not be working as well anymore, we switched to Cymbalta (Duloxetine), which I have been on for approximately the last decade. Which brings me to... SHORT-TERM MEDS HISTORY: Sometime in 2017 (I think), I decided I finally wanted to try going without my medication. I began a tapering with my prescribing psychiatrist that lasted 6+ months UNTIL the beginning of 2018 when I dropped COMPLETELY off of the medication. The tapering process was 90mg down to 60mg, then down to 30mg, then eventually down to nothing. I had NO physical withdrawal symptoms when I did this, and I remained off of the Medication for maybe around 3 months. The only REAL reason I decided to go back on the medication after those 3 months was because I had been feeling much more down/sad since being off of them, BUT I was unsure how much of that was normal (my 4-year first-love relationship finally died at the end of 2017) and how much of that was possibly a side-effect of being without the medication. SO, by April of 2018 I had decided to go back on Cymbalta, and I pretty quickly went all the way back up to 90mg. The plan was to be on it for a little while longer to give myself time to heal from the loss of this relationship. By the end of Oct. 2018 I had made it back down to 30mg, where I would stay for the next 5-6 months. (I think I tried dropping off the medication once during this period but went back on pretty quickly because I started feeling some physical withdrawal symptoms that I hadn't before. At this point, my memory is kinda blending it all together.) I tried dropping off again this April and felt the withdrawal effects worse than I did the previous time. So once again, I went right back on it. THEN I started seeing a different Dr (a nurse practitioner) who has experience helping people wean off of meds. Following her suggestions, THIS TIME I weaned from 30mg down to 20mg daily for 2 weeks, then started taking the 20mg ever other day for 2 weeks, then down to half of the 20mg pill every other day for 2 weeks (opening capsule and pouring out approximately half of the beads), and then finally taking half a 20mg pill every 4 days for a couple weeks. Doing it THIS way prevented the physical withdrawal symptoms I had experienced the couple times before. BUT now it's the emotional despair that I am worried about... WHERE I AM NOW: I have now been completely off of the medication since July 2nd. If I can just get through this depression and sadness, I just KNOW that I will be able to handle the issues that originally plagued me 20 years ago. I have lived through it all, and with the experience and memories and knowledge that I have now, I should be able to cope with it much better. I am just worried that it's the worst timing ever. Here we are, over a year and a half since my relationship was fully dead, and I am struggling with it worse than I have at any point since its death. I have only recently decided I need to do whatever I can to get past it because it is CERTAINLY not coming back (talked with her a few days ago). BUT what is now troubling me, is that I'm not sure if my current depression is due to the loss of the relationship OR if it's due to me being completely off of medication now and my brain having to re-wire itself and recover. OR if it's a really bad combination of both. I've never been through heartbreak like this before, but it seems to be getting progressively worse, where in normal circumstances it should be getting progressively better as time wears on. How can I tell the difference between true, natural depression and depression that's an effect of withdrawal? I assumed (maybe naively) that if I didn't have any physical withdrawal symptoms then I probably wouldn't have any emotional symptoms either. Just looking for some thoughts/insight from people with similar experiences. I am scared that I will have to remain on Anti-Depressants for the rest of my life, and who knows how THAT might even damage my health. I have been researching alternate, more natural forms of therapy for someone like me with Serotonin issues, the use of things like magnesium supplementation and whatnot. MY MAIN CONCERN IS BEING ABLE TO BE HAPPIER AGAIN, and I'm just hoping I can do that without Anti-Depressants. (I'm also dealing with other smaller physical issues like PE, which began as soon as I started weaning and gradually got worse the less amount of meds I took. But again, at this point, the more important thing to me is my mental health and mood. I don't want to feel heartbroken and hurt anymore.) Thanks for reading. I appreciate your time. David
  14. I have come off Strattera successfully and am now in the process of tapering off Latuda. I am down to 20mg from 60. It's taken a month and half. I know that's not super long. I have to taper off Cymbalta next which I am planning on doing alot more slowly. I've gone off it before and the withdrawal is quite intense. After the Cymbalta its LIthium and then I'm done. I'm nervous but determined. I'm taking supplements for my mind to help out.
  15. gardenlady

    gardenlady

    Moderator's note: Link to gardenlady's benzo thread I would like to taper off of 60 mg Cymbalta. However, I am in the middle of a taper off of Valium and am now at 11 mg/day. The horror stories I have heard about Cymbalta withdrawal terrify me. Should I cross over from Cymbalta to another AD and then taper off? And, should I wait until I finish my Valium taper? I cross tapered from 1.75 mg Ativan to 13 mg Valium and am now down to 11 mg. It's going to be a long time until I'm off of it. I am horribly depressed since switching to Valium, but the anxiety from interdose withdrawals on the Ativan were unbearable. I want off of ALL of these psychotropic drugs but realize I have to go slowly. I just want my life back. Any advice would be much appreciated.
  16. I stopped using Paxil someone abruptly back in March. By April I began to suffer from discontinuation symptoms however not one doctor told me to start taking Paxil again. At one point I even asked if my symptoms could be from the fact that I stopped taking axle and I was told no. There was a lot of ignorance on my part for thinking that the quick taper I did would be enough however it's how I stop years ago and how they had me stop my son years ago . I have not taken Paxil for months and have developed a sensitivity to all medications. Things I took in the past with no problem now have a terrible effect on me. Less than a month ago I tried taking 30 mg of Cymbalta which caused in credible stomach pain brains apps and severe pain and pressure in my right eye. I only took 30 mg for two days and had this reaction. About 2 1/2 yrs ago I was taking 120mg a day. At this point I am trying to get the liquid paxil approved by my insurance company, but to be honest I am not sure if it will help or hinder or help me. Not to mention I'm not particularly thrilled about putting that poison back in my body. I was wondering if anyone else could advise me One what would be the best thing for me to do at this point. I cannot even find a Doctor Who will admit my symptoms are from discontinuation syndrome O and try and help me be able to function again like a normal person. If anyone has been in a similar situation or know of others who have and could advise me it would be so greatly appreciated. Thank you, Antionette
  17. Hello, I am a caregiver. My patient is dealing with signs of a very serious neurological condition. He has no interest in doing any online research about his condition, which I think is wise, because we believe a positive attitude is a key to his recovery. It is not easy to maintain a positive attitude in the face of general information about his condition. So the online research is up to me. I notice that virtually all of the members here are the individuals tapering from meds themselves, rather than caregivers. However, I hope that I can be accepted as a participant here, under the circumstances. I'll leave off the medical details except what seems relevant to this website. He was given opioids last January (2019), for pain, and they didn't do much to help. So the opioids were increased gradually over some months, up to 120 mg. Embeda (time-release morphine) by (I think) last May/June. In (I think) May, he was also given 60 mg. duloxetine by our PCP, intended to help pain. He didn't notice any effects on the pain, but continued taking them. At the time, we were desperate for anything that might help with pain. I regret not doing more research at the time. Since then, he has also been given 50 mg. pregabalin/lyrica 2x/day, and we brought that down to 1x/day a few months ago. He has tapered his opioids from 120 down to 80 mg. over a couple of months. He is also taking many, many supplements. I know that some people don't advise doing supplements at the same time as a taper. However, we credit the supplements (among other things) for a very unexpected partial recovery with the neurological condition, so they are non-negotiable. Anyway, now, having reduced opioids while keeping duloxetin steady, instead of dealing with constipation (a common side effect of opioids), he's dealing with diarrhea (apparently a common side effect of duloxetin??). This makes me wonder if the two had been somewhat balancing each other out, and now that opioids are decreasing, the duloxetin is able to exert its influence on the gut, causing diarrhea. So we have pretty much decided to alternate reducing the Embeda (morphine, opioid) and reducing the duloxetin, in hopes that this will help with a certain sort of homeostasis. I have read on some website (sorry, I don't remember where) that while most people taper one drug at a time, sometimes reducing one drug can amplify the effects of another drug, so some people choose to alternate tapering one drug and then the other, back and forth, and have done this successfully. Anyway, we are also influenced by the information that apparently, tapering duloxetin has a better prognosis if started earlier rather than later, so we hate to put that off. I'm wondering if anyone else here has experience with tapering from both duloxetin and from opioids, and also if anyone here has experience with alternating a taper of two drugs. It seems that opioids act quite differently than SNRIs, although they both act on serotonin. My patient has no history with depression, but from what I've read, that doesn't mean he won't experience depression as a side effect of withdrawal. Anyway, I really appreciate this forum. I've already gotten a lot of great information. Thank you for your efforts. And my heart goes out to the many patients who are dealing with effects of withdrawing from these nasty drugs. FYI I've never been all that impressed with the pharmaceutical industry, but after doing online research, plus reading Anatomy of an Epidemic, I've concluded that the pharma industry is nearly identical to the mafia, except that they don't go around with machine guns. That's about the only difference I see. Things are much worse than I previously thought. Best wishes.
  18. 8 months ago I was on. Primidone 500mg Vraylar 6mg Cymbalta 120mg Zoloft 200mg Clonezapam 2mg My kidney function had dropped to 42% and a certain NP for a award winning psychologist continued treatment after noticing major muscle movement disorder. After a few months of this she stopped vraylar 6mg cold turkey. I had a reaction within days of cognitive impairment. I could not handle ANY external input. For a month I could only stare at the ceiling in total darkness and no sound. No TV and food had to be something I could grab and eat in bed in the dark. I lost 40lbs in 3mo because of stomach issues and me being unable to get food for myself. When I confronted her about my problems she informed me it could not be medicine related and sent me to see her friend a counceller who agreed with her and added that my condition was totally " behavioral " I was still on everything except vraylar. That is when I started doing some research and quit seeing both doctors. I had a genesight survey which NP had access to that listed 3 meds she had me on as a high risk and I am a poor drug metabolizer. In the drug interaction checker I showed her 5 serious interactions which she ignored. I was in a state of total apathy, did not care if I lived or died. I could not find any help in the psychologist field. I could not even manage to keep myself fed or handle phone or internet. I begged several times a Dr I had seen before her to help me but she would not accept me as a new patient. Finally after 50 calls my mom had to make...because no doctors were accepting new patients or they did not take my insurance....i got an appointment with an neurologist/psychologist I had seen before. He was amazed the amount of medications I was on and recommended I start coming off them. However he could not manage my taper but did recommended a taper that I followed. I finally got into see a local psychologist who agreed on taper....which was basically drop one at a time by half every 2 weeks. Way to fast I believe after reading your site. I cannot get anyone to answer what happened to me. It's now been 7mos and I can at least type and watch tv.....i still have crippling anxiety and depression. I have came off Cymbalta, vraylar, zoloft, and halfed clonezapam. But I'm still having horrible symptoms I never had before. I've been on at least 12 antidepressants and antipsychotic medications over the past 8yrs for bipolar. Before that I was on nothing for 10 years with no problems. I did have issues in my teens. But it's been downhill ever since I had a nervous breakdown due to extreme stress that lasted years 8 years ago and I started trusting doctors that I needed medication. I had to go on disability 5 years ago due to medication side effects. Before the pills started I had a successful career and ran half marathons. I am thinking about contacting a lawyer. Does anyone have experience with such a drug combo, how long this will last? What happened? Or if seeing a lawyer may be a good idea?
  19. I'm willing to travel for this one (hopefully within Washington state)....Can anyone recommend someone that can serve as an alternative to psychiatrists and mainstream doctors for help with withdrawal from an SSNRI? I've become frustrated with these people. They do not listen, assume what I am experiencing is simply the return of depression, and offer only to throw more dangerous meds my way. I need someone that has extensive knowledge of this subject along with compassion for the individuals afflicted.
  20. I'm currently taking 20 mg of Abilify, 40 mg of Paxil, 30 mg of Cymbalta. I am diagnosed with either Major Depression/Psychosis or Schizoaffective (depressive type). I have been on similar ones over the last 20+ years, always an antidepressant and antipsychotic. I have been reading about how they are obesogenic and would like to come off them cause of that, and also to see how I do now without them and try natural diet and treatments. I am thinking of starting by eliminating one antidepressant, maybe Paxil and see how I do with just Cymbalta and Abilify, before tapering slowly off those two together. I've tried to go off cold turkey and by tapering off all of them too quick before, and get suicidal depression and racing thoughts.Once I take the meds it goes right away.
  21. Hi! I read Robert Whitaker's anatomy of an epidemic in June 2019 which started me on my tapering journey. I originally assumed that the rate psychiatrists used to cross taper using the existing doses available was okay. As a result I did a fairly fast taper partly psychiatrist supervised from 160 mg of my ziprasidone to 120 to 80 to 60 mg. I also not at the same time of course, tapered off attarax 25 mg 3x daily to 25mg 25 mg and 20 mg. Than 25 20 20 mg, 20 20 20 mg and than 10 10 10 mg and than 0, 10 mg 10 mg and so on with minimal rebound anxiety which I waited for it to pass before tapering more, tapered off 100 mg of trazodone going from 100 to 75 to 50 to 25 to 0, and tapered down my cymbalta from 90 to 60 to 30 mg. This took me from June 2019 to the end of september 2019 which i understand is fast and im luckily i experienced little to no withdrawal symptoms. At the end of september I came across the withdrawal project, Links on Robert Whitakers website, and this site and realized I'd been going fast. Oct 8th I started a liquid titration of my ziprasidone going down to 50 mg. No problems yet. I am currently at 50 mg ziprasidone, 30 mg Cymbalta and 2 mg of Xanax which I take twice a day but am slowly shifting to spreading the dose to three and than four times a day (half a mg each). The plan if all goes well is to taper off my ziprasidone, wait 2 weeks, start tapering my cymbalta, wait two weeks and start tapering Xanax last. From my research the Lay tapering community reccomends 5 to 10% of the month's previous dose once a month if you are doing cut and hold and psychiatrists who specialize in tapering reccomend 10% of the original dose every 2 to 4 weeks doing cut and hold. I decided to go closer to 10 percent of the original dose for now every two weeks and if I run into any problems I will slow it down and do a smaller taper. So that's my introduction for now! Thank you for being here.
  22. I haven't been able to reduce my Cymbalta dose for two years because of the horrible withdrawal symptoms I have experienced with both attempts (a year apart). I spent three years dropping from 60 to 30 mg. I have pretty much given up the goal of eliminating Cymbalta - afraid to cause more damage by tapering the than that caused by continuing to take 30mg. I am unwilling to risk further trauma and drama, so I haven't tried the crossover either. Prozac was too "activating" for me in 1989. I don't think it's likely to be a solution in 2012. I still have restlessness, sweats, problems with balance, an incredibly trigger-happy startle reflex and frequent headaches. After feeling progressively less brain fog during my three year taper, my cognitive processes are really abysmal at this point. I can't keep track of simple stuff, can't handle financial transactions, have problems with noise, light, just stimulus in general. And I haven't changed doses in two years. I wonder, do SNRIs poop-out the way the SSRIs tend to?
  23. I’m actively slowly tapering off nasty cymbalta. I’m currently counting beads, taking 17.7mg / 93 beads. I also take 10mg of latuda. I haven’t had any problems dropping latuda from 20 to 15 or 15 to 10, but I’m wondering if staying on it for another two years before I’m off cymbalta completely is really a good idea. It’s also expensive which is a constant risk if insurance stops covering it. I know it’s a brake to the cymbalta and probably helps ease the cymbalta withdrawal... thoughts would be greatly appreciated! Not bipolar, if that matters - taking this cocktail for mostly situational depression that I’ve made life decisions to alleviate. Really don’t think I need these meds, and think the anxiety is a side effect from the AD. THANKS!
  24. Cymbalta comes in 20 mg, 30 mg, and 60 mg capsules. Full prescribing information: http://pi.lilly.com/us/cymbalta-pi.pdf Cymbalta is tricky to taper. It does not come in liquid form and cannot be compounded into a liquid. To protect the drug, each bead inside the gelatin capsule has an enteric coating to protect the drug from stomach acid, which would destroy the drug. (It is absorbed further down in the digestive tract.) The pellets cannot be dissolved in any liquid without destroying the active ingredient. You cannot crush the pellets (see http://survivingantidepressants.org/index.php?/topic/275-do-not-crush-list/page__view__findpost__p__3021 ) or dissolve them in a solution -- the drug would never get into your system, it would be destroyed in your stomach and you would have immediate cold-turkey withdrawal. Of course, the range of dosages from the manufacturer is inadequate for very gradual tapering. Like all psychiatric drugs, do not skip doses or alternate doses to taper Cymbalta. Its half-life is very short, about 12 hours. It is metabolized via the liver enzymes P450 1A2 (substrate, inhibitor) and 2D6 (inhibitor). This post has a chart that shows what happens with the level of Cymbalta in your bloodstream when skipping doses. See Doctor is shocked at severe Cymbalta withdrawal symptoms and testimony by Dr. Joseph Glenmullen regarding Cymbalta withdrawal syndrome: http://www.baumhedlundlaw.com/pdf/DrGlenmullenDeclarationSupportofCymbaltaClassCert.pdf (PDF) Reduce by 10% per month to start As with any neurologically active drug, a conservative taper is the safest way to go off Cymbalta. Some people find they can go faster and some people find they have to go slower -- they can only tolerate decreases of a fraction of a milligram at a time. A conservative taper for Cymbalta, like other psychiatric drugs is: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.) See Why taper by 10% of my dosage? Cymbalta CANNOT be crushed, compounded into a liquid, or dissolved in a liquid The pellets in the capsule cannot be dissolved in a liquid; this would destroy the active ingredient. High-dosage Cymbalta: Using different dosages to decrease to 40mg If you are taking as much as 120mg Cymbalta, see this topic for an example of how to taper to 40mg using existing capsule dosages and a few compounded prescriptions: http://survivingantidepressants.org/index.php?/topic/7060-razzlesf-off-abilify-tapering-cymbalta/?p=129252 To taper from a dosage of 40mg, you're going to have to either open up 20mg capsules and count beads, or get custom compounded dosages. The bead-counting method Like Effexor XR, some people have tapered by opening the Cymbalta capsule and taking out the beads to gradually reduce the dosage. (See http://survivingantidepressants.org/index.php?/topic/272-tapering-off-effexor-venlafaxine/page__view__findpost__p__2985 for the technique.) You can do this if you have brand-name Cymbalta or generic capsules containing hundreds of tiny beads rather than 4-12 "mini-tablets" (see below). The number of tiny beads in each Cymbalta capsule will vary within a given dosage, across dosages, and from different manufacturers. The capsules are filled by weight. To find an average number of beads per capsule, you will have to carefully count the beads in several capsules. Then you can estimate how many beads amount to 10% of the dosage and manage your taper accordingly by keeping notes on paper showing the number of beads removed and equivalent Cymbalta dosage. Take out 10% of the beads at each step of the taper. Put unused beads into a clean, dry, capped prescription bottle marked with the dosage of the original capsule and expiration date. You might want to use them later. Do NOT mix beads from capsules of different dosages, such as 30mg and 60mg. NOTE When you are taking loose beads, put them in an empty capsule to swallow them. Gelatin capsules and vegetarian capsules are available at health food store. The FDA reports here http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm103473.pdf there have been some instances of the beads causing throat irritation when swallowed without a capsule. Dividing Cymbalta beads into empty gelatin capsules To make counting of the beads easier, this technique may work with Cymbalta, see details at http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__3033 Opening capsules and weighing beads Eventually, as you remove more and more beads, it may become too confusing and time-consuming to count out them. You may wish to weigh them instead, see Using a digital scale to measure doses and Counting beads in a capsule versus weighing. Have a compounding pharmacy make up capsules of smaller dosages For precise dosing, a compounding pharmacy will accurately weigh the doses and put the right number of beads into capsules for you. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__3001 Dividing Cymbalta beads into apple juice or applesauce Follow the instructions above for dividing the beads in a capsule and put your reduced dose apple juice or applesauce. --------- It has been scientifically demonstrated that the Cymbalta pellets survive being put into apple juice or applesauce but NOT chocolate pudding: http://www.ncbi.nlm.nih.gov/pubmed/18691989 Clin Ther. 2008 Jul;30(7):1300-8. In vitro stability, potency, and dissolution of duloxetine enteric-coated pellets after exposure to applesauce, apple juice, and chocolate pudding. CONCLUSIONS: Results from this study found that the enteric coating of duloxetine pellets mixed with applesauce or apple juice was not negatively affected. The pellets were stable at room temperature for < or = 2 hours and should quantitatively allow delivery of the full capsule dose, provided that the pellet integrity is maintained (ie, not crushed, chewed, or otherwise broken). Therefore, mixing duloxetine pellets with applesauce or apple juice appears to be an acceptable vehicle for administration. However, exposing the pellets to chocolate pudding damaged the pellets' enteric coating, suggesting that pudding may be an unacceptable vehicle for administration. --------- Tapering generic Cymbalta (duloxetine) capsules containing "mini-tablets" The generic forms of Cymbalta may contain beads, like brand-name Cymbalta, or 4 to 12 "mini-tablets" rather than beads. From Lupin Pharmaceuticals http://medlibrary.org/lib/rx/meds/duloxetine-3/ The "mini-tablets" cannot be split or dissolved to make a liquid. Suggestions for gradual tapering: If you are taking 20mg, 30mg, or 40mg (two 20mg capsules) per day, switch to brand-name Cymbalta or a generic containing tiny beads rather than mini-tablets. Use the bead-counting method. If you are taking 50mg (20mg plus 30mg) per day, reduce by one mini-tablet from the 30mg capsule (5mg, or 10%) initially for a month, then switch to brand-name Cymbalta or a generic containing beads rather than mini-tablets. Use the bead-counting method. If you are taking one 60mg capsule per day, reduce by one mini-tablet (5mg) per month for 2 months until you are taking 50mg per day, then switch to brand-name Cymbalta or a generic containing beads rather than mini-tablets. Use the bead-counting method. If you are taking one 60mg capsule plus any of the other dosages per day (at least 80mg), reduce by one mini-tablet (5mg) from the 60mg capsule per month until you get to 45mg total daily dosage, then switch to brand-name Cymbalta or a generic containing beads rather than mini-tablets. Use the bead-counting method. You can combine brand-name Cymbalta or generic beads with generic duloxetine mini-tablets to taper. (This would cost less than using brand-name Cymbalta for your entire taper. A prescription for 60mg brand-name Cymbalta capsules will go further.) You could take part of your dosage in brand-name Cymbalta beads and the rest of your daily dosage in generic mini-tablets. For example: If your 30mg generic duloxetine capsules contain 6 mini-tablets, each mini-tablet contains about 5mg duloxetine. Let's say you want to reduce 10% from 30mg to 27mg. You can take 5 mini-tablets (25mg) and add 2mg in beads to it. If a 60mg capsule of brand-name Cymbalta contains 200 beads, each bead contains about 0.3mg duloxetine; you would take 7 beads (2.1mg) to total a daily dose of 27.1mg. (BE SURE TO COUNT THE TOTAL NUMBER OF BEADS IN YOUR CAPSULES -- THEY CAN VARY FROM THIS EXAMPLE.) When you are down to 5 mini-tablets (25mg) per day, take 4 mini-tablets and the rest in beads to reduce another 10%, and so forth. Reduce by micro-taper The very smallest dose of brand-name Cymbalta is one bead. Some people find they can better tolerate a reduction of one bead at a time rather than a 10% decrease. You may be able to make reductions of one bead more frequently; try reducing by one bead a week for a while to see what your tolerance is. See http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/ Do not reduce by one additional bead per day. This is too fast, you may develop withdrawal symptoms before you know what's happening. Here is an example of a micro-taper from cymbaltawithdrawal.com http://www.cymbaltawithdrawal.com/topic/8325-dose-down-bead-counting-chart-anywhere/?p=50499 Switch to Prozac Like its fellow SNRI Effexor, withdrawal from Cymbalta can be very difficult. Recently, I asked a knowledgeable doctor about how he switches patients to Prozac. He said if the dosage of Cymbalta is "normal" -- 30mg-40mg -- he would switch to 10mg Prozac with a week of overlap. In other words, take both medications for a week and then drop the Cymbalta. Later, taper off Prozac. He acknowledged Prozac can have its withdrawal problems, but given Prozac's long half-life, gradual tapering should be much easier than tapering off Cymbalta. And, at least Prozac comes in a liquid. He confirmed that Cymbalta cannot be compounded because the pellets are enteric-coated to get the medication past the stomach acid, which destroys it. Other than the Prozac switch, he said counting pellets is the only way to taper. See more about the Prozac switch http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/ Here is more discussion about switching from Cymbalta to Prozac: NOTE Also see 2009: FDA hears testimony about Cymbalta discontinuation syndrome Study finds some Cymbalta withdrawal "severe and persistant" Doctor is shocked at severe Cymbalta withdrawal symptoms Cymbalta Withdrawal Lawsuits Progressing in US
  25. Hello - I am about 7 days off of Cymbalta. I was only taking and only able to tolerate 20 mg and I slowly cut myself down to 10mg and then nothing. I get a few head swishes here and there, but nothing really bad expect I am severely up and down mood wise and fear I am going to end up in a psych ward. I was starting to feel like things were going to be ok and then I crashed hard. I've been on various psych meds for the last 30 years of my life and I just turned 47 and I've had enough of it all. I consulted a neuropsych who is an ECT doctor. My regular psych sent a referall to him from another state as I came to stay wtih my mother for a while to get some other health issues sorted out. His suggestion, since when I went there, I was in a better mood and thought my spring to mid-summer severe depressive episode was lifting or was going to lift, was to come off of cymbalta and see if I don't feel better. He said they are finding out these meds do a lot more than they thought and that they might not even be able to call them "seratonin reuptake inhibitors" anymore. He said some people do a lot worse on them over time. Well, I am doing worse yet and yet I don't want to go back on the stuff at all. I am really struggling. I have also been off of Adderall since the begining of July and felt better off due to not taking that, but now this added Cymbalta thing is throwing me for a loop. I am trying to figure out whether I should call the neuropsych back up and request ECT for sure and cancel a vacation with my family in September, or not. I am a 5 x a week yoga practicitioner, I meditate, I eat right, I do all kinds of things - been getting out socially, ect. and STILL I am plagued with severe bone crushing depression episodes that are causing me severe headaches of the type I cannot stand another minute of it. The depression headaches are so bad they don't even respond to migraine medication. They are different. Something is really wrong with my brain and I am scared I am going to not be able to handle it one day and commit suicide. I've had an MRI for the other regular migraines I get and they say it is all clear. Sometimes I feel like I spend all day trying to figure out what will make feel better - yoga, meditation, work, get out with someone, get out in nature - and still by the end of the day I end up in tears feeling suicidal. Is this par for the course? I am hoping someone can relate and let me know it gets better. I am so confused. I don't really think intuitively that my depression is going to get that much better and I should just call that neuropsych back and try to get ECT started. Things have been taking so damn long lately to get the help I need with doctors and that is frustrating too. Thank you.
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