Woof: Cymbalta re-stabilization, after cold turkey withdrawal

[woof]

Thanks so much AliG,

 

I will hold at my current Cymbalta dose for at least for a few months.  After my CT I didn't realize I needed to become stabilized almost completely prior to making any further cuts. 

 

I needed to re-read the thread on stabilization after reinstatement or updosing. I think I may have gotten ahead of myself in terms of tapering. 

 

Now I believe that I just need to sit tight here at 14.5mg of Cymbalta for 3-4 months and then reassess.

 

As always, any comments, advice or confirmation of my plan/thoughts are greately  appreciated.

 

Thanks Woof

[woof]

Please help me out.

 

My insomnia is getting worse and truly beginning to get to me, I am begining to sleeping every other night.

 

Is it possible to stabilize (regain my sleep) while staying at the same dose? 

 

Thank you.

[apace41]

Please help me out.

 

My insomnia is getting worse and truly beginning to get to me, I am begining to sleeping every other night.

 

Is it possible to stabilize (regain my sleep) while staying at the same dose? 

 

Thank you.

 

Yes, Woof, definitely.  When I was in my worst insomnia phase I was doing the same thing -- sleeping every other day (after the worst which was 3 days in a row with no sleep), but it eventually normalized and stabilized as to sleep.

 

It can be frightening when you are going through it, but it WILL pass.

 

Best,

 

Andy

[woof]

Andy,

 

Thanks so much.  After reading through your tapering it appears that you have had some long holds (3 months or so) as well. 

 

I think I am going hold here for at least a few months and reasses at that point. 

 

This is also the first cut which has also resulted in some anhedonia. 

 

I wonder if this is my body telling me to slow down and hold on the cuts for a while?

 

I had no problems with the Cymbalta per se, I just thought it would be wise to get off of it.  It's just that the manner in which I did it (CT) was not wise at all.

 

Your support and wisdom are immensely appreciated,

Woof

[woof]

I plan to hold on any further cuts from my current 14.5 mg of Cymbalta for 3 months to a year or whatever it takes to reinstate, to a point where I can regain my sleep again. 

 

In consideration of the potential indefinite Cymbalta hold, I was considering tapering my 25mg Valium which I have been on for 5 months now. 

 

Can someone give me some guidance with my situation. 

 

Thanks Woof

[woof]

Will DHEA possibly help with my waking up at 2 or 3 AM?

[ChessieCat]

Hi Woof

 

Here are a couple of SA's links on DHEA:

 

dhea-dehydroepiandrosterone

 

waking-with-panic-or-anxiety-managing-cortisol-spikes

 

In the second topic, do a search (Control + F and type in DHEA).

 

To search for existing topics on SA I use Google and type in survivingantidepressants.org + topic.

[woof]

ChessieCat,

 

Thank you for the links and how to find other topics.

 

Woof

[woof]

Feeling not good

 

I had been doing fairly well prior to my last 10% cut on July 4 2016. 

 

I have been holding now for four weeks and over this period of time my symptoms have generally worsened; insomnia 4 hours, then 6 hours every other night and anhedonia. 

 

My understanding is that no two cuts have the same sx's.  

 

But given the time period of 4 weeks, is this a situation where a tiny (2-5 bead) updose may be considered?   My July 4th cut went from 16mg (158 beads) to 14.5mg (143 beads).

 

Also, when I started tapering 4 months after my CT and my pre CT full 20mg reinstatement 6 weeks after my CT, I was not close to stable in terms of my sleep and I think that after my first 10% cut to 175 beads (which eliminated my anxiety, although I had also started Valium) I should have held there for several months until my sleep cycle was restored. 

 

So I was thinking that this too might be a reason to try a tiny (3-5 beads) updose what do you think?

 

Or do I just hold.

 

Thanks so much,

Woof

[ChessieCat]

Hi woof

 

Many members find that as their dose gets lower during their taper the slower they have to go.  The decision on whether to updose and how much by is yours.  The question I asked myself when considering updosing was "can I live with the symptoms I am getting".  A couple of times the answer was no so I updosed a small amount.  In your case it may be worth trying an extra 3-5 beads and see if it helps with the symptoms.  It takes at least 4 days for the drug to get to steady state in the blood.  Keep notes on paper.  From Keep it Simple, Slow and Stable

 

2.c. Do not jump around in dosage. For most drugs, it takes about 4 days for the change to fully register in your system. Unless you have an IMMEDIATE bad reaction, wait at least 4-7 days to see how the change affects you. (If you have an immediate bad reaction, go back to the dosage you were taking before.)
 
Since withdrawal symptoms ordinarily fluctuate, you might have hours or days here and there when you don't feel well. One episode does not a pattern make. Do not panic and throw in another drug or supplement. Keep notes on paper of your daily symptom pattern. If you feel worse and worse over a week, the change was not a good one. It may be the decrease or increase was too large. Rather than jumping around in dosage, make an adjustment half-way.

[woof]

Keep it Simple, Slow and Stable

If you feel worse and worse over a week, the change was not a good one. It may be the decrease or increase was too large. Rather than jumping around in dosage, make an adjustment half-way.

 

ChessieCat, thank you for the advise. I just wanted to clarify that, "make an adjustment half-way"  would mean to make a very small adjustment; such as 3-5 beads since my last 10% cut was comprised of 15 beads?  With the understanding that half of 15 beads would be 7.5 beads, would be the half-way point for me, but to go a bit lower such as 3-5 beads would be safer.

 

Thanks Woof   

[scallywag]

Yes Woof, reducing by a lower % in the next step is recommended if the last cut resulted in symptoms.

 

Looking at your sig:

21-May  158 beads (17 bead reduction from 175)

04-Jul  143 beads (15 bead reduction from 158)

 

After your symptoms have reduced or stabilized, reducing by as little as 3-5 beads is a wise move.

[woof]

Hi Scally,

 

I totally agree that this last cut was too fast and or too much.

 

What's your thought on updosing by 3-5 beads at this point and see if it helps after a 7 day trial?

 

Or would you suggest I stay the course?

 

Sorry for all the questions, I am just not feeling good at all.

 

Thanks so much,

Woof,

[scallywag]

Woof: If you want to try an updose after 4 weeks at 143 beads, 3-5 beads is a sensible lower-risk increase.

[woof]

Thanks so much, I really appreciate having all of you here for me.   

 

My plan is to increase my dose by 5 beads and hold for a week and see if sx's improve.

 

I remember when I did my stupid CT, the symptoms did not hit me hard until 4 weeks after the CT.

 

I suppose that's how just how long it takes me to feel.  In fact right before I made this last cut, I did not feel as good as I did with just the initial cut down to 175 beads, which I was advised to do and my anxiety went completely away. 

 

I should have just held there until I had fully reinstated (no wd sx's) prior to any additional cuts. I want to state that the two subsequent cuts I made, I did so on my own without consulting any of you prior to my doing so. 

 

Hopefully, I will recover from all of my poor decisions and learn to ask for advise first before doing something and then asking all of you what do I do now that I have gotten myself into another mess.

 

Thanks again,

Most Sincerely,

Woof

[woof]

oops - ask for advice first

[brassmonkey]

Hi woof-- A 4 week hold after a drop is the absolute minimum length of time to wait. For many people it takes 6-8 weeks to settle down. One important question, How bad are the symptoms? Are they really uncomfortable or are you hiding under the covers in bed crying all day? Updosing should not be taken lightly as a way out for being very uncomfortable but as a way to alleviate not being able to function. An updose will take the same 6-8 weeks or more to full settle out that a drop would take, and leave you at a higher dost to taper from.  All things to take into consideration.

 

If your symptoms are tolerable, I would suggest waiting them out for a few more weeks.  Then the next time you taper I would suggest dropping 3 beads a week each week for 4 weeks (12 beads total) and then holding for another 2-3 weeks before doing it again. That should make the symptoms gentler.

Edited August 1, 2016 by apace41
Correct word "alliterative to alleviate"

[woof]

Tom, I really appreciate your compasion, advice, knowledge and wisdom.  With the past two cuts my symptoms seemed to resolve within 2 weeks. 

 

I don't plan on doing any tapering of Cymbalta in the future until my symptoms resolve.

 

Is this even possible without coming completely off of Cymbalta?

 

When I do resume tapering I absolutely plan on doing it in a manner consistent with the "Brassmonkey" taper - It just makes sense.

 

My current symptoms are an increase in: Insomnia and Tinnitus; and new (since tapering) anxiety, anhedonia these were the symptoms I had when I CTd the Cymbalta. 

 

These symptoms have gotten worse over the past week (week 4 of my hold), which was similar to the time it took my CT sx's to become severe. 

 

So if these new symptoms and degree of symptoms do not resolve with a full 6 to 8 week hold, would you then suggest a small, 5 bead, updose at that time?

 

Do you think the degree of my sx's may be partially suppressed by the 25mg of Valium I have been taking for the past 5 months to help me deal with the CT wd? 

If I was not taking my Valium I have a concern that these symptoms would possibly be much more severe.  My use of the Valium has really messed me up on knowing what to do.

 

 

Thanks so much,

Woof

[woof]

Tom, sorry for my rambling response above.

 

I am not incapacited, I just have the above described symptoms. 

 

Like many of us I have an extremely stressfull job, which I cannot take time off from.  Actually, currently I look forward to work as I need to be totally focused and this frequently takes my mind off of how cruddy I feel. 

 

What I really want to do is to stabilize and hold on any further cuts for at least 4-6 months or longer if that's what it takes to stabilize to a greater extent than I have in the past.  After my first cut I should have just held there, as I felt pretty good.  I was even socializing.  But that's all my fault.

 

If holding another 4 weeks is better for stabilization then that's what I will try to do.  It sounds to me like that is the more efficient route to stabilization.

 

Thanks so much,

Woof

[woof]

Does anyone know of any problems with me using Ashwagandha as a supplement to reduce anxiety and insomnia. It sort of sounds like a benzo to me in terms of actions. 

 

I have searched this site and on the web and I did not get much in terms of mechanism of action.

 

The one person on the SA site said it helped with anxiety and insomnia.

 

Thanks Woof

[apace41]

Woof,

 

Ashwaganda is like any number of other supplements that can be tried (see passionflower, holy basil, lavender, etc.) that all can have calming and mediating effects in some people.  The challenge is that for those of us with a compromised CNS it can sometimes be activating even though it is supposed to be calming.

 

I tried Ashwaganda and it made me more jittery.  I was in a bad wave when I tried it so that might not be the case if I tried it again, but... who knows.

 

If you try it do so in isolation (i.e., try only that) and see how you react.  Try it first at 1/2 or a 1/4 of the suggested dose.

 

Good luck if you do try it.

 

Best,

 

Andy

[woof]

Andy,

 

Thanks for the advce.

 

All the Best,

Woof

[woof]

If I hold on any further cuts of Cymbalta, is there any time frame at which I could hope to regain my normal sleep cycle? 

 

Or do I need to get completely off of Cymbalta to have a chance for my sleep cycle to return to normal.

 

Thanks Woof

[woof]

Tom, sorry for my rambling response above.

 

I am not incapacited, I just have the above described symptoms. 

 

Like many of us I have an extremely stressfull job, which I cannot take time off from.  Actually, currently I look forward to work as I need to be totally focused and this frequently takes my mind off of how cruddy I feel. 

 

What I really want to do is to stabilize and hold on any further cuts for at least 4-6 months or longer if that's what it takes to stabilize to a greater extent than I have in the past.  After my first cut I should have just held there, as I felt pretty good.  I was even socializing.  But that's all my fault.

 

If holding another 4 weeks is better for stabilization then that's what I will try to do.  It sounds to me like that is the more efficient route to stabilization.

 

Thanks so much,

Woof

I just wanted to clarify, that my underlining and embolding of the sentence above, was strictly directed at myself and my own mistakes at trying to get off of the Cymbalta as fast as possible; as I thought I had reinstated too high and that, that was a toxic dose for my brain to be on.  

 

Now my understanding is that I am reinstating at a good rate, I just need to wait a few months to fully stabilize after the destabilization I inflicted upon my CNS.  Is that correct?

 

All of you have been absolutely great in trying to help me out!

 

I am just scared and upset with myself.

 

Sincerely Woof

[woof]

Things have improved and I now I feel much better and more like my previous cuts; it just took a bit longer - just as you had said it would.

 

Thanks so much for all of your advice and patience.

Woof

[apace41]

Wow, Woof!  What a difference a few days make! 

 

Good to hear.  As hard as it can be, sometimes patience and doing nothing is the best approach.

 

Best,

 

Andy

[woof]

Generally speaking, if someone has had a CT, crash and burn in their history like I did in Dec 2015, does that mean that I should be holding for longer periods of time than 6-8 weeks, prior to making any additional cuts?

 

 

Thanks Woof

[woof]

Generally speaking, if someone has had a CT, crash and burn in their history like I did in Dec 2015, does that mean that I should be holding for longer periods of time than 6-8 weeks, prior to making any additional cuts?

 

 

Thanks Woof

 I think that I have just not held long enough at each cut?  On average I have held my cuts for 30 days.

 

Or is it more likely that I have reached a point on the exponential curve where I need to slow down on my cuts and hold for longer?

 

When I do resume cuts I think I am going to attempt the Brassmonkey taper; 3 beads per week for 4 weeks and hold for 6-8 weeks or longer.

[woof]

The coating on the little beads of Cymbalta is engineered to extend the half-life of the drug.

 

As scally said, it's unusual but you can take it twice a day. To do this, move part of the dose a few hours each day. Be very careful about keeping to a schedule, and keep notes of your dosing amounts and times and symptoms afterward.

 

Alto, I appreciate your advice on moving part of my dose a few hours each day and I will, as you suggested, keep good notes on dosing amounts, times of administration and any subsequent symptoms.

 

My question now is, do you have any suggestions as to how much of my current total dose I should move to my second dose of Cymbalta.  Since July 4, 2016,  just over 5 weeks ago, I have been taking 14.5mg (143 beads) of Cymbalta at 7 AM.

 

Your advice is greatly appreciated.

 

Thanks Again, Woof

[woof]

Does anyone know of any problems with post surgery pain med in the form of Vicodin (Lortab) while in withdrawal from Cymbalta; as I am experiencing quite a bit of post op pain, but don't want to mess things up now that I have been holding for 6 weeks and things are getting way more stable for me.

Thanks Woof

[Altostrata]

To answer your earlier question, I would move about a third of the Cymbalta dosage later.

 

Vicodin may or may not be destabilizing, but if you're in a lot of pain, you may wish to take the risk.

 

If you experiment with Vicodin, I would wait to change your Cymbalta dosing.

 

Be sure to keep notes on paper to see how any drug change affects you.

[woof]

Alto,

 

Your time, advice and caring are all greatly appreciated! 

 

Most Sincerely,

Woof

[woof]

Fortunately, I do not appear to be sensitive to Vicodin.  I took some last night and my pain went from 9/10 to 0/10. 

 

Interestingly, I slept great as well, but I don't understand why, as the pain had not been a sleep related issue - any thoughts?

 

Also, do you have any insight as to why 7 months ago when I initially CT'd and reinstated the Cymbalta, I was very sensitive to Vicodin and now I appear to have absolutely no negative affects whatsoever?

 

I plan to hold at this dose of Cymbalta dose for at least 3-4 months.

 

Thanks so much for all your help,

Woof

[apace41]

Also, do you have any insight as to why 7 months ago when I initially CT'd and reinstated the Cymbalta, I was very sensitive to Vicodin and now I appear to have absolutely no negative affects whatsoever?

 

Woof,

 

While it is tempting to chalk it up to the somewhat randomness of symptoms during this crazy process, perhaps the positive way to look at it is that in 7 months your CNS has done some healing and you can now tolerate something you couldn't back then.

 

That would be my best guess.

 

Andy

[woof]

Andy,

 

Thank you for your thoughts on the matter.  I was hopeful of this and needed to get an unbiased opinion on the topic.

 

Thanks Again,

Woof

[woof]

Wow, I slept great again last night (8 solid hours) and I appear to be totally over my Vicodin sensitivity.  I think that I should stay at this does of Cymbalta for at least 4 months, unless someone advises otherwise.  I finally feel happy again .