InNeedOfHope: Cymbalta hell - is it impossible for some people?

[Altostrata]

InNeed, I am very sorry you are having such a bad time.

 

I'm glad you checked in here. I have thought about you every day and sent healing thoughts your way.

 

I'm afraid there are no easy answers.

 

Please consider the switch to Savella http://survivingantidepressants.org/index.php?/topic/1420-inneedofhope-cymbalta-hell-is-it-impossible-for-some-people/page__view__findpost__p__17792

 

It is more similar to Cymbalta than an SSRI like Prozac or Celexa.

[Barbarannamated]

InNeed,

Are the specialists acknowledging the role that ciprofloxacin may be playing? If I recall correctly, it was the addition of ciprofloxacin to Cymbalta/duloxetine that dramatically effected you. Please correct me if wrong.

 

What type of treatment are they proposing and what type of specialist would be directing your treatment? As I mentioned previously, your symptoms (to me) seem to be in the domain of Neurology with possible Infectious Disease and Toxicology. I dont know your system in the UK, but have access to a few Medical Toxicologists and know of a physician who does work with legal cases involving quinolones and psychiatric drugs. I know you have been fighting for so long and must limit your exposure to input. Please send me a private message if you'd like me to ask these people on your behalf. I dont want to push it on you but if there is any way I can help, I want to do so.

 

I care about you.

 

B

[InNeedOfHope]

They sweep Ciprofloxacin under the carpet. (Even though it is contraindicated on my patient info leaflet, I was in hospital so didnt have it with me) My problems got worse after that but to be honest the majority I think are because it removed so much Cymbalta from my system that it was like going CT and then I had to wait for it to stabilise (which it never did) and I got progressively worse. So I attempted a 2 bead reduction and all hell let loose, being stabbed, shocked and burned.

 

The GP referred me back to the neurologist but he said that he didn't think there was any more he could do.

 

So she referred me back to psychiatry (not for a diagnosis) but an onward referral to a more specialist hospital perhaps in London. But it came back they said they would or could not do that and I should be admitted into the psych unit to have it removed overnight. The GP said maybe it would not be as bad as I think. I could scream. If losing 2 beads does this to me what do they expect losing 124 will do? I would be under the care of the originall psychiatrist who does not believe in discontinuation syndrome at all and said he took people off these drugs in two weeks all the time. He was the doctor who said my symptoms at the start where either a) me somatising them due to something else and I should see a pain specialist.

 

This is despite reductions inducing paralysis and loss of hearing, bleeding from the ears and soles of my feet etc ....after a while the paralysis lifts, I reduce and it comes back. How is that in any way related to anything other than the medicine??? But now the paralysis is not lifting, it is getting more severe. it is spreading to my right side.

 

What happens is, i drop and get paralysis , I move on and it goes, in fact the slower I go the worse it gets. But at times I have to slow it down due to other pain in the body such as crushing chest, the inability to urinate because of constriction etc. But slowing it down brings paralysis and the loss of feeling in my left side in conjuntion with pain.

 

I react to any drop within an hour. Symptoms change completely from week to week.

 

I kept thinking my body wanted me to go faster (because I sometimes get relief dropping) and I did a series of 4 and 5 and 3 day drops. I felt almost crushed internally doing this so I slowed it down to 7 day drops with the help of Valium. So in effect the distance between losing a gram of this stuff has gone from around 24 days to 37 or 38 and is now speeding up to 35 again as each 7 day drop sinks into a pattern. It is this slight speeding up that is causing this pain right now I think. But slowing it down does as much damage almost as going fast.

 

 

 

I am terrified of going in. I am terrified of continuing on in this way.

 

CITA think I may possibly be not breaking down this drug properly and maybe this is true because it is the same with Valium it has little effect now, so I don t really take it except in an emergency. As I have diarrohea all the time maybe I am not absorbing Cymbalta as much I dont know.

 

All I know is there seems to be no patterns. I think sometimes that when I slow it down and it becomes excruciating that is just severe WD. Kind of like when people quit and feel ok for a while and then it hits them later on. So I worry about going too fast. But then I think maybe as I am in tolerance I am making it worse going so slow and I should somehow try to get rid, with the help of muscle relaxants and worry about getting off them at a later date. But I worry I wont be able to break them down or get off them and then I will have nothing to help with the constriction.

 

I am again sorry to drone on, it's just we can't find any solution and my husband and I think I am just dying a slow painful death. It is hard to get through each day with such horrific pain when you are awake for around 22 of those hours. Only removing this stuff will I ever see any kind of improvement but I can't get to that place.

 

I don't want to die. I don't want to end up paralysed with a stroke permanently.

[InNeedOfHope]

I have got myself in a state and can't calm down, I read the discontinuation journal reference papers on here and saw the stuff on stroke, liver disease and parkinson's and I can't stop worrying that this is what will become of me as I can't move my left side properly. I will drop again on Friday and I am scared to death. I need somone to help me figure out how to do this and get off in one piece.

 

When I took the extra tablet last February I became paralysed in my head, left face, lost hearing and my left shoulder and back of head. As I began to withdraw this largely went away only to begin to catch up when I slowed it down and reduced by 0.2mg a week. When I keep going this left numbness went away, but if ever I had to slow down it came back worse, spreading into my arm and side. So every time I slow it down now at lower levels the paralysis gets worse and worse as does the pain. Am I going to have a stroke?

 

Then I just got the call my friend passed away this morning. One week ago she was on a week end away, now she is gone. I just feel on top of the pain severe grief and anxiety and the pain is excruciating.

 

It is all just too much. I really need help but don't know where to turn. I have some questions about Valium but I can't think right now.

[Barbarannamated]

InNeed,

 

I'm so sorry about your friend.

 

It sounds like CITA is thinking along the same lines as I am... the shared metabolic pathways causing induction of metabolism/clearance.

 

I will send a pm with my contact info. I am not a medical professional but have access to some who may be able to look at your case from a different perspective.

 

Please don't read anymore about possible health complications, ok?

 

Love, Barb

[Altostrata]

InNeed, if you go to the hospital, you must insist upon seeing another doctor.

 

Can you make an appeal for a neurologist again?

[Skyler]

InNeed,

 

I'm so sorry about your friend.

 

It sounds like CITA is thinking along the same lines as I am... the shared metabolic pathways causing induction of metabolism/clearance.

 

I will send a pm with my contact info. I am not a medical professional but have access to some who may be able to look at your case from a different perspective.

 

Please don't read anymore about possible health complications, ok?

 

Love, Barb

 

 

InNeed, if you go to the hospital, you must insist upon seeing another doctor.

 

Can you make an appeal for a neurologist again?

 

I agree with both Barb and Alto.. insist on seeing a different doc. Are you in a metro area, so you have wider choices for docs?

 

You know, I quibble and obsess about my taper (I'm kinda stuck with me.. can't change that). and your journey humbles me, because I really don't have it so bad. InNeedofHope,my heart goes out to you. ~S

[InNeedOfHope]

Thank you for your kind replies at least some people understand, someone once told me only people having done this get it, and they were right.

 

The GP did refer me back to the neurologist but they refused to help said they didn't see what they could do.

 

My GP referred me to the psych dept hoping for an onward referral to a more specialist hospital. There is one called The Maudsley in London, but they refused to forward anything. I got the same psych who does not believe in wd and said my problems 'must be down to something else' to remove the med and seek a pain clinic. How do you do that when you are paralysed down the left side of your head and shoulder and keep losing the use of your arm?

 

I haven't digested food properly for over a year now.

 

I'm sorry I don't know what The Metro Area is, I live in the UK.

 

I am waiting for an app with the GP to arrange a face to face visit with the psych, but my last visit with him left me traumatised last year in May, when I kept talking about wd and he kept shaking his head, saying it was just some quacks opinion - not his.

 

My problems stem from ON the drug, so I suppose all this tolerance talk does not apply strictly to me, but that is how I feel I deal with this medicine as I couldn't tolerate it in the first place.

 

I need to ask a question about diazapam.

 

I have only taken 2mg here and 2mg there maybe three times a month or so. Then six weeks ago I hit severe breathing problems and I took a range of 8mg dropping down to 1mg over the course of 2 weeks. CITA made sure I did not go past two weeks and enter the addiction phase. But now when I took 2mg last week it had zero effect. Can I not break that down either? I don't think it hurt any, I just didnt feel anything.

 

I thought diazapam was like alcohol, abstain for quite a while and when you take it again it is effective again. I must be wrong. It was supposed to be my safety net, if I couldn't breathe or was made to get off this faster I thought I could use that then get off that, but now I am scared if they take me in hospital and remove it there will be nothing to relax the airways or slow the heart down. Can't take beta blockers as I have asthma.

 

I get a fast heart beat at times, sometimes very slow, but the lower number on my BP keeps going low and onlly moving brings it back up. About 4 weeks ago I went through a stage of only an hour and a half of sleep a night and if I didnt keep moving I lost all feeling in my upper body.This went on for around 10days and sccared me to death. All the GP would say is everyones bp drops at night and did my feeling come back? Well, yes it did, but now it is sticking.

 

Sorry to go on. I have suffered for so long and now it seems like I am losing.

[Skyler]

I'm sorry I don't know what The Metro Area is, I live in the UK.

It's short for metropolitan..as in do you live in or have access to an urban environment. Sorry, I am often stymied by abbreviations myself.

 

My problems stem from ON the drug, so I suppose all this tolerance talk does not apply strictly to me, but that is how I feel I deal with this medicine as I couldn't tolerate it in the first place.

The tol withdrawal we talked about related to benzos, and though you do not appear to have said (we here tend to think virtually no one does), your situation is serious and needs informed attention.

 

I need to ask a question about diazapam.

 

I have only taken 2mg here and 2mg there maybe three times a month or so. Then six weeks ago I hit severe breathing problems and I took a range of 8mg dropping down to 1mg over the course of 2 weeks. CITA made sure I did not go past two weeks and enter the addiction phase. But now when I took 2mg last week it had zero effect. Can I not break that down either? I don't think it hurt any, I just didnt feel anything.

Bad stuff, and you will just need to keep increasing the dose for temporary help until you get too high. It has it's own baggage and given the serious issues you have had coming off the AD, I'd keep clear if at all possible. Note.. my quibbles about withdrawal are in part due to my benzo taper.

 

What is CITA?

 

Sorry to go on. I have suffered for so long and now it seems like I am losing.

 

Not to worry about going on.. you are sooo entitled. What I'm wondering.. are you well enough to contact sources other than those you mentioned. Maybe BAT (the tranquilizer and recovery place) which has a phone service that could give you leads, problem being they take forever to ans. the phone.. hold, hold, leave a message routine. Also, Alto has a Facebook page linked to this site.. check thru to see if she has liked any resources that could help you in the UK? Maybe an organization like MIND which is based in the UK would have someone who could do outreach. My suggestion would be to take the post in which you described what was happening above, and send it to people who express an interest so they will be apprised of your situation.

 

And then there are the resources Barb is going to email you. Hope this all is giving you some substantive help.~S

[Barbarannamated]

InNeed,

I received your pm and will get back asap.

 

I'm very concerned about you going to another psychiatrist. I believe it is extremely detrimental to anyone's state of mind to be told that their VERY PHYSICAL SYMPTOMS are "in their head". Is it possible to postpone your next appointment?

 

As Alto strongly suggested, please request a different doctor and NOT a psychiatrist. I'm gathering info from your posts - drugs, dosages, dates, effects. You mentioned that a family member had a similar reaction to Cymbalta. That is suggestive of a possible genetic enzyme/metabolism involvement.

 

I'm concerned also that the docs are hearing "withdrawal" and dismissing the bigger picture.

 

Most importantly, trust yourself. You did GREAT talking to that Neurologist in the ER ... intelligently convincing him to reconsider his knowledge and belief and tell you that he may have been wrong in his initial assessment. You know more about your history, condition and how these drugs have effected you than any physician.

 

I will be in contact.

B

[Skyler]

InNeed,

I received your pm and will get back asap.

 

I'm very concerned about you going to another psychiatrist. I believe it is extremely detrimental to anyone's state of mind to be told that their VERY PHYSICAL SYMPTOMS are "in their head". Is it possible to postpone your next appointment?

 

I'm concerned also that the docs are hearing "withdrawal" and dismissing the bigger picture.

 

Most importantly, trust yourself. You did GREAT talking to that Neurologist in the ER ... intelligently convincing him to reconsider his knowledge and belief and tell you that he may have been wrong in his initial assessment. You know more about your history, condition and how these drugs have effected you than any physician.

 

InNeed.. hold fast. Barb has taken a real interest, is good people. You have someone in your corner.

[Nikki]

InNeed I am so sorry for your troubles. I wish I could help. From what I gathered,

you had trouble while on Cymbalta, had a fast taper and then one one occasion you took two tablets.

 

I have done that with AD's. I forgot if I took one, so I took another and I had very bad side effects. I felt as if I had been poisoned. You said when you taper, things get bad.

 

Yes, find another doctor.

 

Cipro: Cipro levels me. I get horrific anxiety from it. When I have tapered and had to take it it was even worse. Diarrhea, my head is a mess. Can't think straight.

Vivid, crazy nightmares. Cipro can cause hallucinations in people with kidney failure.

 

I am not a doctor, don't know the contraindications for this, but I am wondering if a tricyclic may help you to settle down. They work for anxiety. Are binding, and will induce sleep.

 

I will look at it for you. I am sorry, I can't imagine the pain you are in.

 

Sending some healing prayers your way...

 

I wish I could hug you:)

[Nikki]

epocrates.com

 

 

I found this site. I typed in Contraindictions for Cymbalta

 

Please check this out and print it and give it to a doctor.

 

Your symptoms for paralysis and the sores on your feet are on this.

 

Ciproflaxin is not supposed to be used with Cymbalta as you said.

 

Read it again....I did not see Tricyclics as a drug to be avoided.

 

I hope this helps the doctors and you too.....

 

The site stated that for the muscle paralysis, get off of the Cymbalta and things should return to normal. However you will still have WD.

 

Hang in there....

[Nikki]

Cymbalta Drug Interactions: An Introduction

 

Cymbalta® (duloxetine hydrochloride) can potentially interact with a number of medicines. Some of the medicines that can lead to Cymbalta interactions include:

 

•Alcohol

•Certain arrhythmia medications, including propafenone (Rythmol®) and flecainide (Tambocor®)

•Certain fluoroquinolone antibiotics, including ciprofloxacin (Cipro®), norfloxacin (Noroxin®), and ofloxacin (Floxin®)

•Delavirdine (Rescriptor®)

•Linezolid (Zyvox®)

•Lithium (Eskalith®, Lithobid®)

•Medications that "thin" the blood (such as anticoagulant and antiplatelet drugs) or otherwise increase bleeding risk, such as:

 

◦Antithrombin (ATryn®, Thrombate III®)

◦Argatroban

◦Aspirin (Bayer® and others)

◦Bivalirudin (Angiomax®)

◦Cilostazol (Pletal®)

◦Clopidogrel (Plavix®)

◦Dabigatran (Pradaxa®)

◦Dipyridamole (Persantine®)

◦Drotrecogin alfa (Xigris®)

◦Eptifibatide (Integrilin®)

◦Fondaparinux (Arixtra®)

◦Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)

◦Lepirudin (Refludan®)

◦Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:

 

 

 

■Celecoxib (Celebrex®)

■Diclofenac (Cambia™, Cataflam®, Flector®, Pennsaid®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)

■Etodolac (Lodine®, Lodine® XL)

■Ibuprofen (Motrin®, Advil®, Nuprin®)

■Indomethacin (Indocin®, Indocin SR®)

■Ketoprofen (Orudis®, Actron®, Oruvail®)

■Ketorolac (Sprix™, Toradol®)

■Meloxicam (Mobic®)

■Nabumetone (Relafen®)

■Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)

■Oxaprozin (Daypro®)

■Piroxicam (Feldene®)

■Others (see List of NSAIDs for a more complete list of these medications)

 

 

◦Pentoxifylline (Trental®)

◦Prasugrel (Effient®)

◦Thrombolytics, such as:

 

 

■Alteplase (Activase®)

■Reteplase (Retavase®)

■Streptokinase (Streptase®)

■Tenecteplase (TNKase®)

 

 

◦Ticlopidine (Ticlid®)

◦Tirofiban (Aggrastat®)

◦Warfarin (Coumadin®, Jantoven®)

 

 

•Miscellaneous antidepressants, such as:

 

 

◦Bupropion (Aplenzin™, Budeprion XL®, Budeprion™ SR, Buproban®, Forfivo™ XL, Wellbutrin SR®, Wellbutrin XL®, Wellbutrin®, Zyban®)

◦Mirtazapine (Remeron®)

◦Nefazodone (Serzone®)

◦Trazodone (Desyrel®) or trazodone ER (Oleptro™)

◦Vilazodone (Viibryd™)

 

 

•Monoamine oxidase inhibitors (MAOIs), including:

 

 

◦Isocarboxazid (Marplan®)

◦Phenelzine (Nardil®)

◦Rasagiline (Azilect®)

◦Selegiline (Eldepryl®, Emsam®, Zelapar®)

◦Tranylcypromine (Parnate®)

 

 

•Pergolide (Permax®)

•Phenothiazine medications, including:

 

 

◦Chlorpromazine

◦Fluphenazine (Prolixin®)

◦Perphenazine

◦Promethazine (Phenergan®)

◦Thioridazine (Mellaril®)

◦Trifluoperazine

 

 

•Quinidine

•Quinine

•Ritonavir (Norvir®)

•Ropinirole (Requip®)

•Other SSRI or SNRI antidepressants, such as:

 

 

◦Citalopram (Celexa®)

◦Desvenlafaxine (Pristiq™)

◦Escitalopram (Lexapro®)

◦Fluoxetine (Prozac®, Sarafem®, Selfemra™)

◦Fluvoxamine (Luvox®, Luvox CR)

◦Milnacipran (Savella™)

◦Paroxetine (Paxil®, Paxil CR®, Pexeva®)

◦Sertraline (Zoloft®)

◦Venlafaxine (Effexor®, Effexor XR®)

 

 

•St. John's wort

•Terbinafine (Lamisil®)

•Tramadol (Rybix™ ODT, Ryzolt®, Ultram®, Ultram® ER) or tramadol/acetaminophen (Ultracet®)

•Tricyclic antidepressants, including:

 

 

◦Amitriptyline (Elavil®)

◦Amoxapine (Asendin®)

◦Clomipramine (Anafranil®)

◦Desipramine (Norpramin®)

◦Doxepin (Sinequan®, Silenor®)

◦Imipramine (Tofranil®)

◦Maprotiline (Ludiomil®)

◦Nortriptyline (Pamelor®)

◦Protriptyline (Vivactil®)

◦Trimipramine (Surmontil®)

 

 

•Triptans, including:

 

 

◦Almotriptan (Axert®)

◦Eletriptan (Relpax®)

◦Frovatriptan (Frova®)

◦Naratriptan (Amerge®)

◦Rizatriptan (Maxalt®)

◦Sumatriptan (Alsuma™, Imitrex®, Sumavel®) or sumatriptan/naproxen sodium (Treximet®)

◦Zolmitriptan (Zomig®)

 

 

•Tryptophan.

[xDebbiejo]

Hi in need

I'm so sorry to hear of the hell you are experiencing, I really wish I could help.

 

I am also from the UK and I suggest you call "Mind" too, they seem to know a lot about withdrawal symptoms and the dangers they can cause.

 

Please call them to see if they can help you!

Hoping you find relief soon

 

Lots of hugs for you x

 

Debbie

[Altostrata]

....My GP referred me to the psych dept hoping for an onward referral to a more specialist hospital. There is one called The Maudsley in London, but they refused to forward anything. I got the same psych who does not believe in wd and said my problems 'must be down to something else' to remove the med and seek a pain clinic....

 

InNeed, you must make a huge fuss and refuse this doctor's advice. He is just plain wrong. His attitude is insulting.

 

You must get a second opinion and a referral to the specialist hospital.

 

PRINT THE INFORMATION BELOW AND TAKE IT TO YOUR DOCTOR

 

Here is the page of Contraindications for Cymbalta Nikki referred to: https://online.epocrates.com/u/1033747/Cymbalta/Contraindications+Cautions

 

Contraindications/Cautions

• hypersens. to drug/class/compon.
• hepatic impairment
• hepatic dz, chronic
• alcohol abuse
• glaucoma, uncontrolled angle-closure
• avoid abrupt withdrawal
• caution if CrCl <30
• caution if seizure hx
• caution if hypomania or mania hx
• caution if suicidal
• caution if HTN [hypertension]
• caution if GI motility disorder
• caution if hypovolemia
• caution if hyponatremia
• caution if dehydration
• caution if glaucoma, controlled angle-closure
• caution if obstructive uropathy
• caution if smoking habit changes
• caution if bleeding risk
• caution if pregnancy 3rd trimester
• caution in pts <25 yo
• caution in elderly pts

See also http://www.drugs.com/ppa/duloxetine-hydrochloride.html for more information on adverse reactions and precautions.

 

http://www.drugs.com/drug-interactions/ciprofloxacin-with-cymbalta-672-0-949-2273.html

MAJOR INTERACTION ciprofloxacin ↔ duloxetine

 

Applies to:ciprofloxacin and Cymbalta (duloxetine)

 

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of duloxetine, which is a substrate of the isoenzyme. In 14 male study subjects, coadministration with 100 mg fluvoxamine, a potent CYP450 1A2 inhibitor, resulted in a 2.5-fold increase in duloxetine peak plasma concentration (Cmax), a nearly 6-fold increase in duloxetine systemic exposure (AUC), and an approximately 3-fold increase in duloxetine half-life. High plasma levels of duloxetine may increase the risk of serious adverse effects such as hypertension, hypertensive crisis, increased heart rate, orthostatic hypotension, syncope, and serotonin syndrome. Serotonin syndrome is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

 

MANAGEMENT: Concomitant use of duloxetine with potent CYP450 1A2 inhibitors such as fluvoxamine, ciprofloxacin, or enoxacin should be avoided.

[InNeedOfHope]

Thank you for this information. My computer won't let me open the source Nikki put up. Is there any way you could e mail or message the page so I can print it off.

 

I have fought this doctor since the beginning. I don't think he will budge. My GP was supportive (after initial disbelief) but now wants rid I think and to hand over to hospital because she is sick of seeing me.

 

She said referrals to the Maudsley can take months and I don't have months.

 

I spent an hour on the phone last night arguing with my brother who wants me to bin the tablets. I tried to explain why I can't do this and he says this is in my head that something bad will happen to me, says it will be like heroin wd and says it will be over in 3 weeks. Can't make him understand, says he won't read up about it because he doesn't care what others say, if something does not agree with you, you stop taking it.

 

I got stressed and was shouting by the end.

 

I don't feel I can fight this much longer, even if I can stand the pain. My body is giving up.

 

This is a pattern of what happens, I reduce and then I think I go too fast. So I use Valium to slow it down. (because staying on one dose for any length of time cripples me and the pain gets worse and worse)some of the worst akathesia and jerking settles down. Then as it slows down the pain gets sharper more intense. As I move on I get some relief as if I ave gone too slow. Then the feeling of going fast comes back. Each subsequent drop is getting sharper and more intense.

[drb]

Dear InNeedOfHope

 

On David Healy's site davidhealy.org he has a few documents found on the page http://davidhealy.org/call-for-papers/

The one called Antidepressants for Takers condenses much of what you will find on SurvivingAntidepressants.org

and thus much of what you have already heard or shared with us that you know.

 

In reviewing these documents I noticed one point which may feel obvious for some

and which seems to me to be more important than any of the others

and in the Antidepressants for Takers doc it's put this way:

"...the best safeguard you can have is a doctor who is on your side."

 

How "on your side" is to be understood and why that might help could be put in many ways.

An MD who is knowledgeable regarding WD from AD's and who is sympathetic to your needs

for instance your need of hope but also your need of access to someone

who can personally and professionally fathom the breadth of real difficulties that can occur in WD

will above all else be available to you, and prepared, with you, to expect virtually anything.

He or she will be prepared to deal with each difficult and scary and even boring event or change

with a positive and helpful readiness to help you solve the puzzle you are now dealing with.

 

He or she will be making some of the suggestions you will find in David's document

and among them are literal changes in your everyday routines

changes in routine that you will have read about on Surviving AD's.

They are things that appear to be very simple but really are not.

They usually require consideration and documentation.

 

An important example is sleep: a systematic approach to the question of how you sleep

might result in a sleep diary that attends almost only to sleep itself

but ends up looking pretty complex if you use it for say 2 weeks:

when did you go to bed, when did you turn out the light, when did you actually fall asleep,

did you wake up in the middle of the night, how many times, for how long,

when did you wake up for the last time that night, when did you actually get out of bed,

how would you describe the sleep (very good, very bad, pretty good, and so on)

were you using a drug or natural remedy? Perhaps it will include questions

regarding what you last ate the evening before going to bed, how much coffee or tea (or Coke etc),

and what you spent the evening doing (surfing? TV? reading? board games, lying down and feeling bad? and so on),

 

Your MD will look through that diary with you and try to tease out important information

patterns, habits, things you might not have noticed but that your MD should.

 

Each of the areas David writes about (sleep, physical exercise, nutrition, alcohol and other drugs)

and that are mentioned in many many posts on Surviving AD's

may appear pretty straightforward, but they really are not.

And attention to them is not instead-of-treatment.

To complicate matters further each runs into the others.

Details in each of these areas will of course impact on your emotional state.

What you ate will obviously also affect your body, thus your sleep, your ability to exercise,

and the actual physical exercise you get (or not) will affect your sleep, your sense of hunger,

your need for calories and so on.

 

So each of these areas literally deserves its own diary.

Seems pretty straightforward (not to speak of sometimes or often boring) but it is literally meant,

in other words keeping a record of these matters may be a discipline in itself

but the result is the point, the literal record will teach you and your MD a lot about

how you are reacting to and how you are dealing with the effect this WD is having.

 

The specific advice you need for each of the myriad problems simply cannot be given here.

It requires your watchful eye and heart

but also the watchful and sympathetic eye and heart of that MD you have not yet found.

He or she will ask you to keep that diary, so that when you meet

he or she knows together with you:

how much alcohol did you drink each of the past 14 days

did you do any drugs

what did you eat for breakfast on Monday, and Tuesday, and Wednesday, and so on,

what for lunch, dinner, snacks

what physical exercise did you get Monday, Tuesday, Wednesday, etc

(together with "do you have a gym card, do you like swimming, do you have a dog, and so on").

 

Once you have the “status” readings in all these areas

that your physician and you need in order to correctly understand your present situation,

then you may decide it is necessary to devise specific remedies for specific problems,

which may entail detailed changes in your diet, your physical exercise, your sleep routines, your intake of alcohol and so on.

And even that needs monitoring, so the diaries will likely be needed for that as well.

So that you are not pretty sure you know what you are doing,

but rather can be definitely sure that you know what you are doing,

and how each change is helping, or not.

Reeks of micromanagement, I know.

But it may be necessary.

Remember: this is not your ordinary state.

 

Another important thing your new MD will be able to offer you may sound corny (probably is):

he or she is part of your cheering squad, not just a sympathetic ear and a watchful eye,

he or she will be rooting for you, urging you to take the steps you can handle

because he or she will know that you will ultimately be successful.

 

That sympathetic and knowledgeable MD has an overview afforded by his or her situation:

partly because he or she does not have your present problems, though witnesses them with you,

he or she can shift when needed from being inside the reality that is your inner world

to the outer reality that is another's realistic view of you in your process of change.

 

He or she is like a talisman or an amulet in the state in which you find yourself these days.

This is not looking for magic, though it will be a lucky break when you find that MD,

but it is about initiation into the mystery of yourself, and protection from trouble in the maze.

When you are through with the project of safely arriving in the unmedicated state

you will be able to do without that MD, and the talisman or amulet can be discarded.

 

There is another matter to attend to in understanding how to understand

for each of us who has wandered into this maze of psychopharmacological [many deleted expletives].

It is in some respect for many people the elephant in the room in all this.

First: some that get hooked in this way had almost literally nothing "wrong with them" –

in other words the treatment was wrong from the start, they needed no AD,

they had no condition for which an AD would have made any sense

and their "only" real problem now is getting out of the trap.

 

For the rest – possibly (but only possibly) – including you, there was a real problem

that it might have made some sense to try to treat with among other things an AD.

That real problem does not usually evaporate in the process of being prescribed an AD

which may or may not have an effect on the discomfort or misery of "whatever it was" (or is),

but which for those who have these AD-related problems

– and it is important to recognize that not all people have these problems on AD's –

end up causing all sorts of hell, both before what turns into WD and during WD and sometimes after.

The real problem may be trauma (you called it that in your intro) or it may be not-yet-identified

but it is not unlikely that the problem will in some form remain and require your careful attention

after you have successfully withdrawn.

 

After having read your longest post (the intro) and a few others of your more recent ones,

I have the distinct impression that Altostrata's suggestion is the most important one to attend to now

and it is to get yourself that sympathetic knowledgeable MD who will be on your side.

I would like to say that I think everything else is secondary – but it isn't.

You still have to keep on keeping on, until you make that contact, and get into gear

with your new doctor. I hope you are able to find him or her as soon as possible.

 

Till then you have the best possible advice from Altostrata and others here,

but none of us can replace another human being that you will meet in the flesh regularly,

who will see you and hear you and apply a life of technical professional experience

and genuine and helpful sympathy.

 

drb

[Nikki]

Thanks Alto for re-editing so InNeed can print...

 

InNeed can you print the second sheet I posted about Drug Interaction with Cymbalta?

 

If you can't get an appointment at that facility for months, can you find a psychiatrist in your area? Maybe someone you know can recommend one. Take both sheets with you.

 

There has to be something you can take to help relieve your symptoms so you can get off Cymbalta....

 

What about searching this site to see if anyone here was able to do a crossover from cymbalta which aided them.

 

Keep in touch and please try and let what your brother said roll off your back.

 

Celeste

[Altostrata]

InNeed, I've sent you e-mail. Please let me know if you didn't get it.

 

I agree with drb, you need a doctor to champion you.

 

The page Nikki was referring to is posted in http://survivingantidepressants.org/index.php?/topic/1420-inneedofhope-cymbalta-hell-is-it-impossible-for-some-people/page__view__findpost__p__24331

[drb]

in a google search field i just wrote

site:survivingantidepressants.org cymbalta change

just got 55 hits this way

got 31 hits using the more relaible switch instead of change

many of the switch ones describe switches

virtually the whole site can be searched this way

not sure if it is as effective for a non-member

 

drb

[InNeedOfHope]

I just want to say thank you for your replies,I sincerely appreciate this. I need to go through each one and think about them carefully. I am hopefully seeing the GP in the morning.

 

The back of my head is rigid and I am struggling to hold it up. The use of my arm has come back a bit today but it is weak.

 

I am going to put up a few more patterns I see to see if this sheds any light as to whether my body just wants rid of this drug and I am making things worse going slow.

 

I am getting phobic about each drop now. Tomorrow will be the next one.

 

The one about finding a sympathetic doctor is spot on, but I have spent 18 months searching and trying to get understanding.

 

I do keep a diary (though this week have stopped too bound up in pain) but not in the depth outlined though I have made many connections. It is ironic the counsellor I see for CBT said I was obsessive about the diary and should no longer keep it as I had not found any patterns really. Patterns are what give us hope, but they can also give us dread as we see deterioration and not know how to control or stop it. If I ever get off this medicine in one piece I think maybe I can heal but until then it is a day to day pain management battle and a fight to stay alive as I believe there is a limit to what the body will put up with.

 

Had bad anxiety today but it was short lived.I sent a text to my friend saying my brother had upset me. It turns out I sent it to my brother! Not clever. Now I feel I have lost another ally. My sister-in-law is going to try to sort it out for me.

[InNeedOfHope]

Will check email too thanks Alto

[strawberry17]

Thinking of you InNeed

[Nikki]

Sounds like your sister-in-law is in your corner....

 

Think about you every day

[Altostrata]

InNeed, quite remarkably I have found an expert on psychiatric drug withdrawal syndromes in Manchester.

 

It is Dr Peter Haddad, Consultant Psychiatrist, Greater Manchester West Mental Health NHS Foundation Trust peter.haddad@GMW.nhs.uk.

 

http://www.psychiatrynorthwest.co.uk/general_adult_psychiatry/spr_posts/salford-haddad/index.html

 

Greater Manchester West Mental Health NHS Foundation Trust.

Trust Headquarters

Bury New Road

Prestwich

Manchester

M25 3BL

 

Tel: 0161 773 9121

Fax: 0161 772 3639

Email: communications@gmw.nhs.uk

 

Dr. Haddad has written extensively about antidepressant withdrawal syndrome, for example:

 

Adverse Syndromes and Psychiatric Drugs

A Clinical Guide

Edited by Peter Haddad, Serdar Dursun and Bill Deakin

http://www.oup.com/us/catalog/general/subject/Medicine/PsychiatryPsychology/?view=usa&ci=9780198527480

 

He may know a doctor to treat you.

 

His co-author Dr. Bill Deakin is at University of Manchester http://www.medicine.manchester.ac.uk/staff/BillDeakin

 

Serdar Dursun is at the University of Alberta in Canada.

[InNeedOfHope]

Thank you for that information and all your kind thoughts.

 

My GP is off sick. Been to see stand in because I don't know how long she will be off and handed the details of this consultant over. Tried to stress to the stand in doctor how desperate I am.

 

She says I have exzema now in ears. My neck on the right, the hard lump is because it is in spasm.This is the first time in 20 months I have had symptoms on the right in my head.

 

She prescribed Buscopan (which I haven't taken) because these days I would rather suffer than have another allergic reaction.Has anyone taken this? I was given this when I was in hospital and had the e coli infection was in so much pain not sure if this added to wd or not. Now I am lower I am more cautious about upsetting things.

 

I also have diarrohea every day, any ideas of how people have tackled this?

 

My head is the biggest issue at the moment, it is hot to the touch and tight and feels like it is being crushed. I feel I want to rip my hair out. Still getting stabbing in my right ribs front and back.

 

I really hope this doctor can help.

Sorry to go on.

[Barbarannamated]

InNeed,

 

You have a complex case and appear to metabolise drugs differently which makes you prone to drug interactions and increased effects. Alto can better comment on that, but your choice to not take Buscopan is wise, IMO. It works with acetylcholine and muscarinic receptors, similar to many psychotropics.

 

Try to stay hydrated. Have they checked electrolytes?

 

B

[InNeedOfHope]

I was given Buscopan at the same time as Cipro for a few days, but will not take this will use ice and heat.

 

I haven't had them checked, not sure how they do that, is that a blood test? I have been drinking, eating some banana and using a little salt on food.

[Altostrata]

I have no idea what Buscopan is, how it works, or if you should take it.

 

Can you not contact Dr. Chan, Dr. Haddad, or Dr. Deakin directly?

[Nikki]

The first thing that came to my mind when discussing your current symptoms was "shingles" not eczema.

 

Is it possible that you have shingles? Sorry don't mean to add confusion. Doctors do misdiagnose things. Sometimes we have to be our won best advocates.

 

Will send healing prayers your way.

 

If you take dry oatmeal, put it in a blender and pulverize it into a powder and add it to bath water. (add alot) and soak in it....you will help heal your skin problems.

It is like a miracle cure. I swear.

 

Give it a try:)

[InNeedOfHope]

Nikki, I don't think it is shingles it is much like other withdrawal symtoms, but then again, I saw my mother-in-law last week. She has shingles she is 73 and when she asked the doctor how long it would take to get better, they said it would likely take a year!! I have never heard of that before, but anyway, I can't not see her for a year, so she came to see me.

 

I did have shingles in my twenties (but not severely) and I can't remember much about it really, but I will try that oatmeal remedy.

 

Alto - In the UK, I have found that when we ring other hospitals to speak to doctors eg The Maudsley, they would not speak to us without going through the GP. It was ridiculous we were only ringing to find out what their specialty is to see if they could help us and they said to go through GP. We didn't understand how we could do that if we didn't know if they could help me in the first place. Spoke to a pharmacology person at The Maudsley who said they had never heard of what I was going through, but it sounded terrible and I should stop taking it right away!!! I spent half an hour on that phone call, the pharmacist kept saying, "and what is your original complaint, do you have anxiety?" I felt like screaming! Yes, I do, but I have also bled from my ear and had paralysis confirmed by a GP! I suppose my anxious feelings caused those symptoms! This wound me up (as it always does having to explain and justify, anxious somatising symptoms versus pure bad side effects and wd).

 

We ended up finishing the conversation as soon as they said to go CT, thinking this is an expert hospital and that is the best they can come up with.

 

We will try again on Monday to see if Dr Haddad is still there etc, because my GP is notoriously slow and now she has been given a get out of me being admitted to hospital to go CT, she is likely to be even more resistant to acting on my behalf. It seems she will not argue or even put forward my concerns as to why I think CT is dangerous, she said how bad can it be??? She said you can't go on like this, so go in hospital and they will hook you up to machines to monitor your oxygen levels etc. No one seems to get what 2 beads does to me, so what will 124 do?????

 

By the way I notice Dr Haddad referred to in the guidelines you published from NICE, which is encouraging as far as his standing goes.

[Altostrata]

Can you get a new GP? Perhaps one with more interest and energy?

 

Suggest in further conversations with medical personnel, you emphasize you are having a serious adverse reaction, the original diagnosis is not relevant.

 

Dr. Haddad is one of the world's experts on antidepressant withdrawal syndrome.

[strawberry17]

I was thinking change GP as well, your current one is a waste of time.

[Barbarannamated]

SAFER PILLS - QUINOLONE TOXICITY - RECOMMENDED DOCTORS

Names of a few quinolone-aware doctors/pharmacologists in UK on Page 16 of PDF link within:

 

http://www.saferpills.org/?page_id=334

[Barbarannamated]

InNeed,

Please let us know how things went with GP and/or if able to get in touch with Dr. Haddad.

 

I've had a rough several days. Doing a bit better and will post any info or thoughts here in your thread.

 

B