Jamtin - Cymbalta needs to go

[Jamtin]

I was prescribed Lyrica and Cymbalta for what a lazy rheumatologist decided was fibromyalgia - that is as an off-label pain mediator. I managed to get through the initial side effects - which were fairly innocuous: I'd take the capsule at 10pm and wake at 2am with diarrhoea every night for just over a week. That was it - no other effects and no pain reduction ... ever.
Sacked the lazy rheumy and coasted for some years. Then gathered myself again and found a bright energetic interested researching rheumy and an equally good integrative physician.

While waiting for my first rheumy appointment I weaned off Lyrica. Have some liver damage partially due to medications but also possibly due to a big dose of Epstein-Barr at 20yo with hepatitis.

Energetic rheumy found ... Ta da! ... Psoriatic arthritis, ankylosing spondylitis and other enthesites - with fibro as a secondary artefact of having had significant joint pain since teen years. Hmmm
She is a researcher so I agreed to start a clinical trial of secukinumab which is not currently licensed for use in Australia. During the trial I wasn't allowed to change my drug regime so I've been sitting on it for 12mths.
Sadly, I am one of the unlucky small percentage of people that are not helped by secukinumab, so I've been released from the trial after only one year - relief and sadness all at once!

BUT now's my chance to have a go at weaning off Cymbalta which I plan to do with the help of both the rheumy and integrative physician. I have a lot of concerns as I am still in considerable pain, use buprenorphine patches which ease the muscular pain but without something to reduce the inflammation in my entheses I'm in trouble.

During all this I've worked part time with small children then full time when they grew up.
I recently requested a medical assessment for work and have recently reduced to half hours which has provided some relief from fatigue.

So I have some obvious problems with the concept of weaning - I'm still in considerable pain, I need to look at other biologic drugs to sort out my joints, I'm still working ... I'm keen but also concerned that I'll end up in a mess and I've just climbed out of the last one by reducing my hours.

I can afford to leave work on medical grounds as I have income protection but again - am I ready.

So lots of questions and lots of friends needed.

Jamtin
Dx: Psoriatic arthritis, ankylosing spondylitis, other enthesites, fibromyalgia, Sjögren's syndrome, peri-glaucoma, hypertension
Rx: meloxicam, Cymbalta, melatonin, diazepam, telmisartin, buprenorphine, med cann

[JanCarol]

Hey Jamtin - welcome to SA!

 

It sounds like you have been through a lot, and I'm so glad you found us before you start you Cymbalta taper.  More about that in a moment.

 

Please put your current drug history into your signature.  What we are looking for is date started, dosage, date discontinued for at least the last year.  Like - how long were you on Lyrica?  When did you come off? Did you taper or CT?  Please Put Your WIthdrawal History Into your Signature  How long have you been on Cymbalta?  At what dose?  Has your dose changed any during that time?

 

Also list the other drugs & dosages you are on - those arthritis drugs can be complicated, but it may help you if you put them into our http://www.drugs.com/drug_interactions.html interactions checker.  Please copy and paste your results here, in this thread (not in your signature, it wouldn't fit!).

 

When you've completed your signature, it will be easier to "track" you wherever you post, without having to go through your whole history (which is, sadly, substantial).

 

Cymbalta and Lyrica are the doctor's "go-to" for pain alternatives.  Honestly?  I think opoids are less dangerous, but try telling that to a doctor.  Anytime a drug has "addictive potential" they become afraid of it.  When really - they are completely unaware of how deep the psych drug hooks go.

 

How did your Lyrica discontinuation go for you?  Did you have withdrawals?  Did you CT or taper?  How slow or fast of a taper? 

 

(NOTE:  Here in SA, we consider a slow taper to be 10% per month or slower, see: Why taper by 10% of my dosage?)

 

We'll be happy to help you come down off of the Cymbalta.  It has a reputation for being a bear, but if you take it slowly, gently, and avoid the urge to impulsively decrease doses (see the 10% thing again) - you can do this with the minimum of symptoms.

 

It's called "harm reduction."  We want you to come off as safely as possible - and since we know that the worst possible case scenario is really awful, we try to prevent that at all costs.  Tapering does not eliminate all side effects, but it can minimise them.  Additionally, you can be in control - you can decide to hold, if you have some stress to deal with, or a cold, or just dealing with too many symptoms.  Holding is where the healing takes place.  And you can choose WHEN to have your tapers, and plan your tapers around your life, instead of the other way around.

 

OK.  Withdrawal.  Our Rhi, says it best, here:   Rhi's description of healing the brain , and Our Founder, AltoStrata, has a more technical (but rewarding article here):  Intro to Antidepressant Withdrawal Syndrome  or, perhaps you'd like the short version in a video:  Healing from Antidepressants - Patterns of Recovery (by Toxic Antidepressants)

 

You are in an excellent position to plan this out - now is the time to start learning alternatives for maintaining your mood and pain, Non Drug Techniques for Coping with Emotional Symptoms and Non-Drug Techniques for Dealing wth Physical Pain.

 

You can learn about the best ways to taper your drug, here:

Tips for tapering off Cymbalta

Cymbalta taperers are "bead counters," you taper by removing beads from the capsule, as it cannot be crushed or made into liquid.  But read the link, and ask your questions here.  This thread is for your questions, and to track your progress, and for people to chime in with help and support.

 

Post scattered elsewhere on the site risk being lost - but here, in your thread, we can usually find them.  You can click on "follow," the upper right hand corner, a gray box, and you can teach SA to send you an email anytime someone posts here.

 

Okay - the big one:  arthritis pain.  I have a mate here who is a sufferer of that awful one, young adult Rheumatoid Arthritis.  She is tapering off of her antidepressant, too.  BUT - here's the big one - we have lots of suggestions for pain, but I will give you hers, first.  She is a huge fan of Omega-3 fish oil.  But not just any oil - you can read the thread, but she takes the Nordic Naturals because of the specific ratio of EPA / DHA.  She's tried to find cheaper versions of this ratio worldwide.  She's tried different ratios - but she takes (I seem to recall 8000-9000 IU total per day) this one, and because of fish oil, she can walk, she can drive, she can look "normal."

 

We are also big fans of Magnesium and Epsom Salts - Another Way to Relax with Magnesium as ways to work with pain.  I have a lot of pain myself (but it's not officially arthritis, other than normal, aging, osteo-arthritis) and time in the mag bath is life saving.

 

The Medical Cannabis - I have to address - only because it may interfere with your taper.  There have been excellent results in pain control with medical cannabis, but I know you live in a state which does not have an array of medical strains to choose from.  If you were in California, and could choose the exact strain for your pain, and lower the THC and raise the CBD of the strain - I would encourage this natural alternative.  But there are a few things which may work against you:  1.  Street cannabis, you cannot control the mix, and is often very high THC - this could be quite crazy making as you start your taper, as it is hitting the same receptors as the antidepressants, 2. Like most cannabis users, you are probably heating the THC, which combusts it and makes it psychoactive - again - counterproductive for trying to come off a psych drug.  3.  Vaping is better, but still heats the THC.  The "high" is NOT desirable while tapering.

 

In a perfect world, you could grow plants outside your doorstep and plop a plant into your blender every day and juice the whole, raw plant.  That seems to be miraculous for inflammatory, autoimmune, and pain disorders.  Unfortunately, there are few places in the world where this is acceptable, legal, or encouraged.  Unfortunately, the black market still reigns in Australia.  Some of us are getting around this by using THC-free CBD oil (which is still officially illegal in Australia, but there seems to be a blind eye being turned at the moment - personally I have da fear of getting caught with this one and have been afraid to try it, but others have.).

 

In my research, the THC is important too, but only if it is raw.  Read more, here (whups, I talked about that just a little too much!)  http://survivingantidepressants.org/index.php?/topic/5030-cannabis-thc-or-marijuana-to-ease-withdrawal-symptoms/

 

One last thing - you're in a special position to actually prepare for your taper.  Many of us weren't able to do that (I'm one of the rare ones who did).  Some get ripped around with cold turkeys, fast tapers and switches by their doctor, and are forced into tapering to get out from under the rollercoaster ride.  

 

Since you can prepare, I suggest these two articles:

Psych Central 6 Ways to Prepare for Antidepressant Withdrawal

and

Preparing to Taper

 

Welcome to SA - oh (I said I'd quit, but - ) there are a lot of Aussies here, too: http://survivingantidepressants.org/index.php?/topic/6284-australia-members-please-check-in-here/

 

I don't know any offhand in Tassie (beautiful beautiful land that it is), but come visit the rest of us and say hello!

 

Again, welcome!  I hope you find something useful, helpful and healing here.