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CaliCowboy

CaliCowboy: so about that Cymbalta...

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CaliCowboy

Howdy folks! 

 

I've been on cymbalta for a little over a year now, and out of the list of antidepressants I've taken (prozac, zoloft, wellbutrin, amitriptyline, trazodone) it's been the most successful at treating both my anxiety and depression. Unfortunately, it's also been incredibly successful at making me immune to this thing called "falling asleep" and has jacked up my blood pressure to heights of hilarity that are not countered by increasing my blood pressure medication. Oh yeah, and weight gain. Ugh.

 

I first thought I'd go cold turkey, as I had with most of my previous antidepressants, and just suffer through it.

 

Woah, was that a learning experience! Two days of trying to survive that had me back on my dose in no time. 

 

I met with my psychiatrist and discussed it all in detail, and he's having me taper down 20mg at a time per month. I started at 60mg, so I'm at 40mg right now. I felt like I was doing kinda alright, but one week in and I'm miserable. My emotions are all over the place, from waking up bawling like someone just passed away to feeling like I'm "Joe Cool". I'm nauseas all the time, sometimes to the point of wanting to throw up. My head feels like a constant migraine, I'm exhausted all the time, and best of all, I have the most vivid slasher horror movie nightmares each and every night.

 

Joy! I can't wait to find out what dropping to 20mg feels like next month!

 

On the plus side, I'm sleeping more than 2 hours a night and my blood pressure has dropped over 40 points! Unreal...

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ChessieCat

Hi Cali,

 

Welcome to SA.  Looks like you've arrived just in time.  SA recommends a slow taper of 10% of the previous dose with a 4-6 weeks holding period to stabilise and allow the brain to adapt to not getting as much of the drug.  Dropping at the rate your psych has suggested is way too fast and will most likely only land you in lots of trouble.  You have already had a taste of it.  But if you slow down you should be able to get back on track.

 

The first thing we request all new members to do is to Please put your Withdrawal History in Signature.  Please make this a SUMMARY and include ALL drugs, doses, and how you decreased/increased.  This will allow your drug history to be seen at a glance.  Please also remember to update it with date and dose as you change you drop your dose so it remains current.  Thank you.

 

If you are finding that your withdrawal symptoms are unbearable you could try a small updose and see if that helps.  DO NOT go back to your previous dose because you have already been at the lower dose for 3 or 4 weeks and the brain will have already started adapting.  The lower the dose  that you can get symptom relief the better.  It takes 4 days for the drug to get to full state in the blood but you may start to feel some relief within a few hours.  Once you have held for a while, maybe 1 or 2 months, you can then start tapering by 10%.  I'll ask the other staff what dose they think would be a reasonable updose.

 

I'm going to give you some links to read and then come back to your Intro/Update topic to ask questions and to journal your progress.  Click FOLLOW (top right) and you will be notified when someone responds.  You can also save it as a Favourite in your browser.

 

Introduction to AD Withdrawal Syndrome

Why taper by 10% of my dosage?

 

Tips for tapering off Cymbalta (duloxetine)

 

Brain Remodelling (Rhi's Description of Brain Healing)

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Dr Joseph Glenmullen's Symptoms Checklist

 

What should I expect from my doctor about withdrawal symptoms?


How do you talk to a doctor about tapering and withdrawal?

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Petunia

Welcome from me too Cali, I'm glad you found us. I'm sorry you are feeling unwell after dropping your Cymbalta dose. As Chessie noted, that cut was too big and its no wonder you are feeling awful. Most doctors don't have a clue about withdrawal or how to safely taper these kinds of drugs. For most of us, if we want to avoid a very unpleasant withdrawal experience and the risk being put back on more or different drugs, we have to take control of our own taper.

 

Thank you for adding your signature. Am I right that you dropped from 60mg down to 40mg a week ago? When did you start experiencing bad symptoms? Are they getting worse each day or are you having better days and worse days?

 

Stabilization after a cut or discontinuing drugs usually happens in a non-linear pattern, with good days and bad days, with slow, general improvement, have a look at this topic to find out more and to see if you think you are starting to stabilize: The Windows and Waves Pattern of Stabilization 

 

If your symptoms are generally getting worse and basically intolerable, you might want to consider updosing a little. If you decided to try this, if I'm right that its been a week, I would suggest adding back between 5mg to 10mg, taking you back up to either 45mg to 50mg. It really depends on how bad you feel and if you are starting to improve or not. You may actually be able to stabilize at 40mg but it might take a month or two. Make notes of your symptoms on paper so you can get a clear understanding of your pattern.

 

This topic will give you an idea of what to expect if you decide to updose:  About reinstating and stabilizing to stop withdrawal symptoms 

Most important to note is that it takes 4 days for the drug to reach a steady state in your system and then several weeks to possibly several months for your symptoms to stabilize completely. This works the same way when your are reducing and increasing.

 

Whether you updose or not, if I were you I would hold for at least 2 months before making any more cuts, and when you do, no more than 10%. The links will give you information about how to make small cuts from your dose.

 

Please read through the links Chessie posted and ask any questions here in your thread. Do stay in touch and let us know what you decide.

 

Petunia.

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scallywag

Welcome CaliCowboy! I'm tapering off Cymbalta as well and wanted to say hi. I'm currently at 20 mg and holding there for another 2 weeks (4 weeks total) before I cut by 10% to 18 mg. I hope you'll *consider* what ChessieCat and Petunia have written about gently tapering your dose and about the possibility of reinstating to a slightly higher dose than 40 mg. 

 

Are you taking the brand-name Cymbalta (Eli LIlly) or a generic duloxetine? Adding that to your signature will help the moderators and others guide you with any dose reductions. The brand-name capsules have hundreds of tiny beads, the generics typically have fewer larger beads (usually 5mg).

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CaliCowboy

Am I right that you dropped from 60mg down to 40mg a week ago? When did you start experiencing bad symptoms? Are they getting worse each day or are you having better days and worse days?

 

That's right, yeah. I'd say 3 days in things started to feel a bit weird (foggy thinking, tired, migraine) and it's been gradually worse each day with added issues until today, which has been fairly tolerable, like I'm back at day 3. I find that really weird, honestly. I'd swear it was because I drank a bunch of coffee today and I read somewhere that caffeine intake increases the effectiveness of duloxetine uptake, but that could just be wishful thinking there. 

 

Of course, the two days I tried cold turkey I pretty much had a nightmare experience from brain zaps and tingling hands to just generally being unable to do much of anything within about 18 hours so, yeah...

 

 

Are you taking the brand-name Cymbalta (Eli LIlly) or a generic duloxetine? Adding that to your signature will help the moderators and others guide you with any dose reductions. The brand-name capsules have hundreds of tiny beads, the generics typically have fewer larger beads (usually 5mg).

 

I'm taking the generic. I still have a couple (about 7 or so, would have to count) 60mg capsules, but now my prescription has been modified for these really tiny 20mg capsules that have correspondingly really tiny beads in them. I take two a day. 

 

Am I understanding correctly that updosing would involve adding in X amount of beads into an empty capsule, and that only certain capsules will work for this? Is there an alternative form (food or otherwise) besides capsules that would work for updosing? Not saying I want to go that route just yet, but how that works would also be handy to know for decreasing my dose slower in the future.

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CaliCowboy

So yesterday's feeling better did not carry over to today. Spent the first half in bed, forcing myself out and about to do things but I could seriously just sleep all day long. Feel like I'm burning up and sweating like a hog. Non-stop headaches. Ugh.

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purcy51

Hey Cali! Welcome to SA. I'm tapering Cymbalta as well. Regarding your post about alternatives to capsules..first you can usually find gel-caps at health food stores and they are generally pretty cheap. However, I think I read somewhere on this site that somebody was putting the beads in apple sauce. Each bead apparently is enteric coated so as long as it is eaten right away the beads don't dissolve until they are in your stomach. Before you try this let me look around and see if I can find the link. Personally, I purchased a digital jeweler's scale and use that to weigh out my doses. I'll find that link and get back to you soon.

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scallywag

Cali, Sorry today wasn't a great one.  Sounds like a wave phase; did you read the thread that Petunia posted above (post #3)?

 

Name-brand capsules make it easier to adjust dosage by bead counting at the very end of the taper if you need to step slowly down from 1 mg. Bead counting name brand at higher dosages can be a pain because there are approx. 585 in my 60 mg capsules and approx. 290 in my 30 mg capsules. There's a thread specifically about tapering from cymbalta.  I bead count for my 20 mg doses because 20 mg capsules aren't available in Canada, or maybe it's just Ontario.

 

purcy: Altostrata's first post in the tapering cymbalta thread includes a citation of a study that found that cymbalta/duloxetine beads are stable in applesauce and apple juice. I've decided to take my beads with applesauce (a tablespoon or more).

 

When you're ready to taper, you've got a few choices to do a slow taper (10% reduction from 40 mg to 36 mg): opening the capsule and counting beads; or, opening the capsule and weighing the beads. Threads containing information about those methods are in the Tapering Forum

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purcy51

Found it. It's in the very first post of the topic "Tips for tapering Cymbalta" that was shared with you earlier by Chessie. (Having trouble copying & pasting the link on my tablet)

 

In the very first post of this topic, it says putting the beads in Apple juice or applesauce will not destroy the enteric coating. So it seems you may be able to take the extra small dose that way instead of in a gel cap. Hope that helps!

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purcy51

Lol!looks like scallywag beat me to it!

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