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gardenlady

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manymoretodays
Posted (edited)
On 3/31/2019 at 9:24 PM, gardenlady said:

I'm able now to get the Teva brand, at least until the next time they have inventory problems.  I guess I'll keep on with the Cymbalta taper vs trying to bridge to Prozac.  I'm already doing a micro taper and going very slowly.....even at this pace I still have 3 or more years of tapering to go, so don't see how slowing down even further is feasible.  

 

I'm in such a funk with no life....I need to be around people, but can't be as I can't relate to people anymore due to the personality disintegration, so voluteer work isn't an option.  I don't see how I can do this much longer.....all I do is eat, sleep and watch TV.   I have no purpose or meaning in life.  No family or friends and no one to connect with.   These drugs have gutted my soul and I can't do things normal people do anymore.  It's impossible to experience pleasure in anything....going outside depresses me as does everything else.  I can't connect with God and desperately need to.  I have no one to talk to and no encouragement or support outside of this group.  I'm so frightened and afraid I'll die and go to hell so I'm afraid to live and afraid to die.   The spiritual agony and alienation from God is the worst.  

 

(((((((gardenlady))))))))

I found that just exploring things spiritually really, really helped me.  And the God I believe in.......sure knows everything I've been through........and that I am doing my bestest, giving my "new life", so to speak........away to others.  I mean in those ways that I can and am capable of.  Praying even to help me stay uncrabby, and all negative, and stuck on my own pity pot of woes.  Which I could, I suppose, and do from time to time. 

 

Then I shift.  Practice giving thanks and meditating.  Try and just "be" with others.......listening.  My gosh......no one ever listens anymore out in the real world.  They are all so busy, busy.....getting ahead and on their devices and I don't know what.  Be the change you seek in others.

 

  That's where I find God.  I do an AA program and practice and meetings and sponsorship too.  That's helped.  It just happened that way for me.  And I'm not saying to go to AA, if you don't or never have had problems with alcohol or other non-prescribed substances.  I'm just saying explore your spirituality......whatever that might mean for you.  And try and do that with others a bit.  I love Church sometimes, coming from a Lutheran upbringing and background.  It's comforting.  The spirit is usually there.  I like a lot of different churches too.  Some just for the music.  Some just for the friendly people and community.  And some.......well, I guess maybe I'm a Universalist now.......lol........rather than just of one or another religious group.  Works for me.

 

This withdrawal you are going through.......well, this is work.  Work gives one worth.  And maybe you can surprise yourself too......and find yourself exceeding your present view of yourself and WILL find something on the ground where you can be helpful to others.  Or start the search for the "worlds greatest therapist", like mine.  It took me a lot of years to find one that worked well for me, and with me.  Without being too condescending and authoritative or clinical about it all.  I just go in bursts to see my therapist.  Then I don't go at all for awhile.  We can be our own therapists......yet, when it's real hard........best to talk to someone in person.

 

Yoga?  If you've got medicare......you can get a free membership to a gym.  Most have yoga and other classes or areas that you can utilize.  I like to swim, sauna, do Yoga, and might even do some strength training again one of these days.

 

Head on over to finding meaning too.  Get in "hopeful" discussions around how your faith is helping you now.  Not hindering.  Helping.

 

Alrighty.  Have a really good day today, okay?

Love, peace, healing, and growth,

mmt

 

Oh and look how far you HAVE come.  Off the benzos!!!  WOW.  HUGE.  HOLDING is work too.  So, do consider that, at least until your mood lifts a bit.  It will.  Change is the only constant that we have sometimes.  It'll change, it'll get better again for you.

Edited by manymoretodays

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Frogie
On 3/31/2019 at 9:24 PM, gardenlady said:

I'm able now to get the Teva brand, at least until the next time they have inventory problems.  I guess I'll keep on with the Cymbalta taper vs trying to bridge to Prozac.  I'm already doing a micro taper and going very slowly.....even at this pace I still have 3 or more years of tapering to go, so don't see how slowing down even further is feasible.  

 

I'm in such a funk with no life....I need to be around people, but can't be as I can't relate to people anymore due to the personality disintegration, so voluteer work isn't an option.  I don't see how I can do this much longer.....all I do is eat, sleep and watch TV.   I have no purpose or meaning in life.  No family or friends and no one to connect with.   These drugs have gutted my soul and I can't do things normal people do anymore.  It's impossible to experience pleasure in anything....going outside depresses me as does everything else.  I can't connect with God and desperately need to.  I have no one to talk to and no encouragement or support outside of this group.  I'm so frightened and afraid I'll die and go to hell so I'm afraid to live and afraid to die.   The spiritual agony and alienation from God is the worst.  

gardenlady:

 

I’m so sorry you are going through this. It’s really difficult for you right now. I can relate to your situation 100%.

 

Five years ago, my fiancé lost his job in the city I was born and raised in. The company went bankrupt and closed their doors.  I’ve never lived anywhere else. I am an only child, and my mom and dad have passed away. I packed up with him and moved 2 1/2 hours away from my son, daughter in law, my uncle, friends, but most importantly, I moved away from my granddaughter. I had her almost every weekend. I now have seen her actually for 1 Christmas since. I have to drive the 2 1/2 hours to take her Christmas presents to her, to go to her birthday parties, etc...  And I only see her for weekends here and there. I’ve lost 5 years of HER and MY life. And now I just can’t make the drive. So, when my son and daughter in law are in a good mood, they will meet us 1/2 way. I haven’t seen her since January.

 

We moved to a town of 600 very snobbish rude people. If you aren’t from this town, you can’t make a friend and they will tell you that to your face.  We have a very small overpriced grocery store, a hardware store, car part store and a gas station with a convenience store. I have to drive 16 miles one way to see a dr, go to a “decent” grocery store (no bakery or deli), 2 dollar stores and a pharmacy that is owner owned. If I want to go to Walmart it’s 50 miles one way. So we do all that type of shopping on line. I’m miserable too. I sit alone all day, eat and watch tv. I was doing ok until a year ago because I had my chihuahua. But she became very ill a year ago and I lost her after 16 years.  I was devastated. I really was all alone. When my fiancé comes home from a 10 hour day, he’s tired. I don’t blame him. But I want to talk. He wants to relax. So, I sit and watch more tv. I drive an hour one way to see my therapist. If I didn’t see her, I really would be crazy lol...

 

After living like this for 5 years, I “melted” and told my fiancé I couldn’t live like this anymore. It wasn’t fair to me to live like this. It wasn’t fair to us. I cried for days. But I felt something. I haven’t felt anything in so long. I think he took all of it to heart because he is fixing the place up and just has some outside work to do and we are putting the place up for sale May 15th. I never thought I would see the day. He is scared to look for a new job. I can’t blame him but he’s doing it for me. 

 

After all of this, I really think God was listening to me. And asked my fiancé to take me out of this situation. I now talk to Him everyday. I hope he hears me. 

 

I just took my last dose of Lexapro March 31st after a very long, rough taper. I still have Xanax to taper. But you know what? I’m going to make it. I have people on here that I support and support me back. We chat on here. I’ve made friends on here that are in the same situation as me with these evil drugs. They live overseas, and 1,000’s of miles away from me. But they are my connection to the world.

 

Just remember(I don’t know how religious you are), I don’t go to church, but I talk to God a lot. I hope he hears me. But it comforts me just knowing I talk to him. I believe He hears me.

 

Like mmt said, try going to a gym (I wish we had one). She said google therapists, that’s an awesome idea. She is really good at coming up with things to do. Very smart. I do word search puzzles, and I google places to live, now that I know we are moving.

 

Now that I’ve talked your ear off, I want you to know, like mmt said, you are not alone. You have everyone on here. I would love to have a new friend. I don’t know how religious you are, I don’t go to church, but maybe just talk to Him. You don’t have to pray, just talk. If you would like to talk to me you can PM me. I also have a thread called Frogie Off-Topic (I think it’s something like that) where we can chit chat. 

 

This is a wonderful site to meet “friends” that you have a lot in common with. And get the help you need to get off these meds. 

 

I hope we can be friends. You can never have enough. I hope I didn’t scare you off. I just wanted you to know, you’re not alone.

 

Take care,

 Frogie xx

 

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gardenlady

Frogie and mmtd, thank you for your kind, understanding responses.  I really do appreciate it.  Right now, I don't know what to write.... the words won't come and/or my thoughts too jumbled to express....it's like having a stroke.  I'm extremely negative, self-absorbed, fearful with anhedonia such that I'm not interested in anyone or anything and am unable to experience pleasure.  

 

As as far as God goes, it's the God of the Bible Whom I long to know intimately as He revealed Himself thru Jesus Christ.  I could care less about religion....it's intimacy and connection with God in Christ Whom I am seeking for relationship.  I've never been able to have that and now the AD withdrawal effects have obliterated any ability to relate to Him or anyone else.  I'm cut off from life and living in a terrifying darkness.

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gardenlady

Can someone please explain what this article means in layman's terms?  I don't understand the difference between the two graphs shown in the screenshot and what the take-away is.  

 

2016-July-01, Cymbalta (duloxetine) 

MMarie Found this paper on dose and 5HTT occupancy of duloxetine. Takano, 2005 A dose-finding study of duloxetine based on serotonin transporter occupancy The site,  academia.edu, requires login: 

 

Link to screen shot of dose-occupancy and dose-plasma concentration curves

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brassmonkey
Posted (edited)

Most psych drugs work by changing the levels of a specific neurotransmitter in the body. They usually increase the amount of the neurotransmitter by shutting down the receptor that absorbs it. This is called "down regulating" and a receptor that is down regulated is referred to as being "occupied".  These charts show the percentage of receptors in the body that are "occupied"  at a give dosage of the medication.  The percentage is on the left scale and the dose is across the bottom. Both charts are showing the same thing but the one on the left show the affects of the listed strength of the dose while the one on the right shows the affects of how much of the drug ends up in the blood from taking that dose.

 

If you trace a line up from the 10mg mark on the bottom of the left chart to where it hits the curve and then over to the left it shows that at a 10mg dose 55% of the receptors in the body have been down regulated (shut off).  Do this again for 20mg and you will see that 75% of the receptors have been shut off.  As you can see the higher the dose the more receptors are shut off, but because of the curve of the line the more you take the less affect it has.

 

The curve tells us several things.  For one thing it shows that the larger the dose the less cumulative affect it has, so in reality a very high dose is not much more effective than a lower one.  But more importantly it shows that at the lower doses (10mg and below) a very small change in dose will result in a very large change in occupancy. A large decrease in occupancy means that there is a lot of healing to be done and a large increase in symptoms is most likely.  The curve also shows why it is so important to go slowly at the lower doses as a very small change in dose causes a very large change in occupancy.

 

These charts are one of the bases from which we worked out the 10% taper rule.  The curve line for a 10% taper very closely matches the curve for occupancy.  By removing the occupancy in a controlled manner we can allow the body to heal itself while the drug is still having an affect and keeping WD symptoms at a minimum. It's like playing Jenga and only removing blocks from the top of the stack.

 

 

Edited by ChessieCat
corrected spelling

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gardenlady

Maryb, I completely understand what you are going through.  The benzo could be having a major, detrimental effect on you.  I tapered a benzo prior to my Cymbalta taper.  You would do well to taper off of the benzo and then the Cymbalta if you cannot handle tapering the Cymbalta, first.  All of these drugs cause brain impairment and your goal should be to get off all of them and not reinstate.  I am hopeful that most people do heal, although it can take many years even after completing the taper.  You are fortunate in being as young as you are.  Those of us who are older have a more complicated and difficult path as we may not have the luxury of healing time required.  There is hope for you as long as you will get off of the drugs and stay off.  

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ChessieCat
2 hours ago, gardenlady said:

Maryb, I completely understand what you are going through.  The benzo could be having a major, detrimental effect on you.  I tapered a benzo prior to my Cymbalta taper.  You would do well to taper off of the benzo and then the Cymbalta if you cannot handle tapering the Cymbalta, first.  

 

gardenlady Maryb's situation is currently being assessed.  She may be experiencing interdose withdrawal from her benzo.

 

Maryb:  Please note:  SA generally suggests going off the AD first, which is an accelerator.  Post #1 of this topic explains this:  taking-multiple-psych-drugs-which-drug-to-taper-first

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gardenlady

A nurse practitioner friend of mine is worried about my homebound, agitated and depressed state due to Cymbalta withdrawal and is urging me to bridge to Prozac 10 mg.  She said she's never seen anyone having to taper as slowly as I am and thinks I need to get off of the Cymbalta.  She's really concerned and trying to help me, but is treating me like her other patients who aren't as sensitive to small drops as I am as that's all she knows.  So, I'm afraid that I might end up even worse off than I already am, although now I'm virtually non-functional.  I don't know what to do.  I've yet to read about a successful bridge off of Cymbalta to another AD.  It seems like people who are extremely sensitive end up worse off when they try to bridge. 

 

The scary thing is that I have another 2 to 3 years of tapering Cymbalta ahead of me and I'm afraid I won't survive it as I get worse the lower in dose I get.  I'm currently at 66 beads/12.5 mg.  My sleep is messed up so that if and when I do sleep, it's in the daytime so I'm up all night with nothing to do but stare at the wall.  I have akathisia, internal and external, and horrifying doom, despair and terror 24/7.  I need to get my circadian rhythm back, but don't know how.  If I try to go for a walk or exercise, I get more depressed and cry the whole time.  I'm 66 years old and live alone with no support.

 

I've successfully cross-tapered from one AD to another many times in the past with no trouble.  However, I've never been as sick as I am now so am wondering if Cymbalta is in a completely different league from other ADs and that it's nearly impossible to bridge from it.  

 

Do any of the moderators have any suggestions on what I should do?

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Songbird
13 hours ago, gardenlady said:

I've yet to read about a successful bridge off of Cymbalta to another AD.

 

Baxter managed a successful bridge from Cymbalta to citalopram. 

 

13 hours ago, gardenlady said:

I've successfully cross-tapered from one AD to another many times in the past with no trouble.  However, I've never been as sick as I am now so am wondering if Cymbalta is in a completely different league from other ADs and that it's nearly impossible to bridge from it.  

 

Do any of the moderators have any suggestions on what I should do?

 

We can't tell you what you should do - switching is always a gamble - it's impossible to predict an outcome.  However, it is possible as it has been done.

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manymoretodays
Posted (edited)
18 hours ago, gardenlady said:

A nurse practitioner friend of mine is worried about my homebound, agitated and depressed state due to Cymbalta withdrawal and is urging me to bridge to Prozac 10 mg.  She said she's never seen anyone having to taper as slowly as I am and thinks I need to get off of the Cymbalta.  She's really concerned and trying to help me, but is treating me like her other patients who aren't as sensitive to small drops as I am as that's all she knows.  So, I'm afraid that I might end up even worse off than I already am, although now I'm virtually non-functional.  I don't know what to do.  I've yet to read about a successful bridge off of Cymbalta to another AD.  It seems like people who are extremely sensitive end up worse off when they try to bridge. 

 

Hi gardenlady!

And I am so sorry that you are still so debilitated from WD.

Is your NP willing to work with you on a possible cross over bridge?

And I'll enclose the link to bridging for you here, as it has been updated this month by Alto:
The Prozac switch or "bridging" with Prozac

extracted from the first post: 

Citalopram or Celexa and its sibling escilatopram or Lexapro have half-lives of about 35 hours, a relatively long half-life among SSRIs, and are other candidates for a bridging strategy. They also come in a liquid form.


You must find a knowledgeable doctor to help you to with a bridging strategy. You might wish to print this post out to discuss it with your doctor.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

 

 

Can you print off and share and/or send an e-mail copy of the first post to your NP, so that she might further guide and help you? 

It might be worth a try to cross over to either Prozac or citalopram.  No shame in trying something new.

It sounds like she might be willing to help. 

 

Try not to feel too, too discouraged, by it all right now.  This rather lengthy period that you have had of despair. 

I'm concerned about your isolation too, and lack of support.  No uptick in hope with the changing season and more light?  Are there any places that you can find to go in the daytime, with community of some kind?  Someone, anyone that you could engage for some companionship and friendship and possibly just help with daily living skills......until your spirits pick up a bit?

 

Love, peace, healing, and growth,

mmt

Edited by manymoretodays
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manymoretodays
18 hours ago, gardenlady said:

The scary thing is that I have another 2 to 3 years of tapering Cymbalta ahead of me and I'm afraid I won't survive it as I get worse the lower in dose I get.  I'm currently at 66 beads/12.5 mg.  My sleep is messed up so that if and when I do sleep, it's in the daytime so I'm up all night with nothing to do but stare at the wall.  I have akathisia, internal and external, and horrifying doom, despair and terror 24/7.  I need to get my circadian rhythm back, but don't know how.  If I try to go for a walk or exercise, I get more depressed and cry the whole time.  I'm 66 years old and live alone with no support.

 

Oh gardenlady,

I think it's really important too, that you attend to some of your insomnia now too.  Sleep is so very important for healing and repair.

Can you slowly, perhaps an hour at a time, push back your sleeping into the nighttime hours?

 

Some more tips and links that might help you slowly regain your circadian rhythm:

On 4/26/2016 at 9:01 PM, Altostrata said:

"Sleep hygiene": Get off computer, tablet, or smartphone in early evening, turn down lights, plan to settle down for some time before bed. Keep bedroom dark and cool, don't do anything else in bedroom but sleep (and sex). Keep regular waking and bedtime hours.
TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime
 
- For those with light sensitivity Light-sensitive? Try blocking out blue light: Your computer may be your problem
 
- Meditation and meditative breathing: Stops "busy brain" and allows the nervous system to settle down for sleep
Easing your way into meditation for a stressed-out nervous system
Non-drug techniques to cope with emotional symptoms
 
- Magnesium, low-dose melatonin, and possibly fish oil before bed
Magnesium, nature's calcium channel blocker
Melatonin for sleep: Many people find it helpful
King of supplements: Omega-3 fatty acids (fish oil)
 
- Blackout curtains and sleep mask to reduce light stimulation causing early-morning waking.
Waking with panic or anxiety -- managing cortisol spike
Sleep problems - that awful withdrawal insomnia
 
Other relevant topics: Tips to help sleep -- so many of us have withdrawal insomnia
 
White noise devices for sleep
 
Update on milk peptides for sleep: Our friend Lactium again   
 
Glycine for sleep? 
 
Taurine (L-taurine amino acid) for sleep  
 
L-Theanine for anxiety, insomnia

 

 Hoping you kind find something in ^ to try.

 

And best,

mmt

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gardenlady
11 hours ago, Songbird said:

 

Baxter managed a successful bridge from Cymbalta to citalopram. 

 

Thanks, Songbird.  Baxter's story is encouraging!  Is hers the only one to be successful in bridging off of Cymbalta to another AD?  If so, that's discouraging and makes me all the more fearful.  It's hard to imagine that on this site with the hundreds of stories there is only 1 of a successful bridge from Cymbalta.  I'm so terrified....I don't know what to do.  

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gardenlady
On 5/21/2019 at 4:09 PM, gardenlady said:

A nurse practitioner friend of mine....is urging me to bridge to Prozac 10 mg.  

MMT, Thanks for your response.  As my post specified, the nurse practitioner friend is urging me to try the Prozac bridge.  There is no doctor who is AD-wise and can help with this process, so hers is the only help I would have.  She is knowledgeable about the Prozac bridge as she has helped others with it, so she doesn't need education from me.  However, she has never seen anyone as sensitive to small drops of Cymbalta as I am, so she is treating me like her other patients who aren't as sensitive since that's all she knows.  I'm absolutely terrified to take her advice and try the Prozac bridge as I'm afraid I'll become psychotic and suicidal when cutting the Cymbalta as I live alone and have no support.  However, life on Cymbalta is nothing more than existing.  

 

The sleep hygiene stuff has no effect on my sleep and doesn't help at all as I have tried everything.   I've tried all the supplements available and none helps.  Nor does meditation, magnesium nor anything else you suggested.  My body simply will not sleep, no matter how tired, until daylight comes.  I've gained 14 pounds the last 3 months and can't fit into any of my clothes. 

 

I'm stuck and at my wits end....I have no idea what to do.  

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manymoretodays
5 hours ago, gardenlady said:

As my post specified, the nurse practitioner friend is urging me to try the Prozac bridge.

 

I don't know gardenlady.  As you are getting to the lower doses, where there are more significant changes in the plasma concentration and dose occupancy.

Or so it appears to me when I look at those curves.  Might explain why it's all gotten more difficult with the symptoms.  And why you are so very sensitive now to any changes.

You might benefit from going even slower, or doing even less of a percentage drop than you already are.  Or even just holding for longer and really work, work, working non-drug coping.  While finding that light again.....that great light that exists at the end of this WD thing.  It's there.  Or it can be there, if you keep looking and searching for it.

I know Cymbalta can be a tough one, an uber ugly bear of a drug to get off.  And you've come off some other bears already.

 

6 hours ago, gardenlady said:

 I'm absolutely terrified to take her advice and try the Prozac bridge as I'm afraid I'll become psychotic and suicidal when cutting the Cymbalta as I live alone and have no support.  However, life on Cymbalta is nothing more than existing.  

 

Yes, the known might be better than the unknown. 

 

All I can say.....is read through the link I gave you with an eye towards the possible benefits and risks of bridging(with either Prozac or citalopram).   Perhaps making a solid decision will help you somehow.  And if you are just not feeling that the NP will be there for you, don't do it.

 

Do you have options to see someone that might be helpful in teaching you coping skills to get through now?  Like a good therapist or even meditation teacher?  Or is this NP now your sole support for both therapy and medication?

 

For now, I'd say sleep on it.......or sleep on it in the daytime tomorrow, if you can.  Write on out the pros and cons.  Study the link and write on out the pros and cons again.  Then give it another day.  Perhaps then the decision will be easier to make.

 

We can't decide for you.

 

Best,

And Love, peace, healing, and growth(sincerely),

mmt

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ChessieCat

It might also be worthwhile reading back through all posts (both your own and responses) in your Intro.

 

It might also be helpful jotting down the timeline of drug changes etc and what your observations were at that time.

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gardenlady

Thanks, mmt, for your kind response.  Yes, the NP will be there for me as much as is possible, but she's not a family member living with me and there is no support that can take the place of that.  If I'm suicidal in the middle of the night, I'm on my own, so I'm very afraid.....I'm having SI now and fight it off the best I can.  I wish there were more Cymbalta bridge success stories out there.  Songbird shared Baxter's with me, but it's the only one and that in and of itself is scary.

 

When I got off of benzos, I bridged from Ativan to Valium and as depressed as the valium made me, at least I was able to taper which I couldn't do on the Ativan.  I wonder if I would have the same experience with a Cymbalta bridge...of course no one can tell me and Cymbalta seems to be more lethal, for me anyway, than any benzo was.  Cymbalta is like a demon from hell that invades the mind and makes one into a hellish, unrecognizable person.  That's what it's done to me.  As bad as benzos were, they never had that effect on me.   Cymbalta is in a demonic class all by itself. 

 

I know that you can't decide for me, but I wish I had someone who could help me think it through.  It's absolutely terrifying doing this alone with no in-person support.  Thanks again, though, for responding....that means a lot.    

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Shep
On 5/22/2019 at 6:27 PM, gardenlady said:

  I've tried all the supplements available and none helps.

 

Which supplements did you try? Please list them and the dates, to the best of your recollection. We don't want to make any recommendations if it's possible that some of your symptoms may be connected more to supplements than to the drugs. 

 

Also, you came off Valium on January 11, 2018, which is about 16.5 months ago. A lot of people on the benzo forums mention having waves in the 18 month range, which is very close to where you're at now. So this could be a benzo wave. You may want to hold a bit longer and see if this wave passes before doing a bridge. Just a thought, as a bridge for the AD taper is unlikely to help with a benzo wave and could lead to even more nervous system destabilization. 

 

 

On 5/23/2019 at 1:00 AM, ChessieCat said:

It might also be helpful jotting down the timeline of drug changes etc and what your observations were at that time.

 

This is a good idea from ChessieCat. 

 

Let's go over your supplements before you make a decision. And if you find anything else in your history that you think is worth exploring, please let us know. 

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gardenlady

Thank you, Shep.  I've tried these supplements off and on between 2017 and 2019.  I don't have dates.

Melatonin, 1 mg extended release, 3 mg 5 mg and 10 mg

Lavender 

CBD oil

L-theanine

Magnesium (I still take that)

Others that I can't remember

 

None of the supplements had any effect at all, good or bad.  

 

I've felt completely agitated since starting Cymbalta in Sept 2016.  The benzo withdrawal was bad, but the Cymbalta taper has done something to me that is indescribable....gutted my soul and changed me into an angry, bitter, raging, mean person so that I'm unrecognizable from the person I used to be.  I'm not in a wave now as I've never had waves and windows....just a constant state of agitation, fear and black chemical depression.  I've felt this way for the last three years and it gets worse the lower in dose that I get.  I've not had one minute of a window.   I constantly breathe loudly and audibly through my mouth...I think it's my body's way of trying to calm itself.  I also have akathisia and insomnia and any sleep I get is in the daytime and only in 1 to 2 hr intervals. I'm unable to socialize, relate to anyone, read, listen to music or distract other than tv in small amounts.  I'm incapable of experiencing any pleasure of any kind.  Being outside and hearing birds sing depresses me as does everything and everyone. 

 

All my drug changes are in my signature.  There has been no symptom change other than a continual, downward slide with constant fear and thoughts of death, doom, and eternal damnation.  I can't imagine living like this much longer.  All I can think about is getting off of this poison drug...I'm obsessed with it. 

 

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Shep

Are you currently taking any supplements?

 

I read over several pages of your thread and several things stood out.

 

Estradiol and progesterone for hormone replacement - have you had any hormone testing done lately to make sure you're taking the right dose of these hormones? 

 

Synthroid for thyroid - have you had your thyroid checked recently? 

 

How is your diet? If you're not a vegetarian, are you eating red meat? This is an article from Dr. Brogan's website about depression and diet, especially the importance of red meat. 

 

Red Meat for Your Depression

 

If you're not able to tolerate fish oil, eating fish several times a week can help - omega 3 is good for feelings of depression. 

 

The fact that your feelings of depression have been so constant may mean it's exasperated by withdrawal, but may have underlying hormonal, thyroid, and / or dietary issues involved, as well. 

 

I was a vegetarian for over 30 years before withdrawal, but because I could no longer tolerate supplements for iron, B12, etc., I switched to a paleo diet and started to feel better within a few weeks. I'm not advocating the paleo diet for anyone, please research what's right for you, but do make sure you're eating to stay strong. It's important. 

 

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gardenlady

Thank you, Shep.  I forgot to mention that I take fish oil/Omega 3.  My current supplements & prescription drugs are:

 

Synthroid - 88 mcg

Rosuvastatin - 5 mg

Estradiol - .5 mg

Medroxyprogestrone - 2.5 mg

Vitamin D - 5K units

Cymbalta - 12.3 mg, currently tapering

CalMagZinc -  1000/500/25 mg

Nordic Natural Omega 3 - 2840 mg

 

My blood tests are current and are all normal.  My thyroid level is tested every 3 months as I am post Graves disease since 1998.  I have osteopenia bordering on osteoporosis due to Graves Disease.  I am on the lowest dose of HRT possible as I need to discontinue it at age 70 (3.5 years fro now) due to increased risk of cancer.  My goal was to get through AD withdrawal before tapering off of the HRT.  Although I take magnesium and fish oil, I've not benefited from any noticeable improvement in my psych symptoms.   

 

My depression kicked in full-swing with the advent of psychotropic drugs.  Prior to that, I never had any dietary problems or adverse reaction to any food.  I have  high cholesterol (familial tendency) regardless of how healthily I eat...and I do eat very healthily...always have. 

 

It's fairly clear that my problems are due to psych drugs since I didn't have these extreme symptoms prior to taking them.  I started the benzo for insomnia and the AD for sadness due to being single.  Neither of those issues warranted psych drugs, but ignorant doctors prescribed them and I dutifully did what I was told.   I tolerated the AD (although it failed to help my sadness) until I was crossed to Cymbalta at which time I became agitated and began tapering.  The intense agitation, increased depression and personality change started when I began the taper of it.  I seem to have recovered from acute benzo withdrawal (which I tapered slowly and properly) but any progress is masked by the Cymbalta withdrawal.  

 

Cymbalta gives strong evidence of being the culprit here, not food or any other medication, as far as I or my endocrinologist can tell.  I'm concerned that I am permanently brain damaged from psych drugs.  

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gardenlady
On 5/23/2019 at 12:00 AM, ChessieCat said:

It might also be worthwhile reading back through all posts (both your own and responses) in your Intro.

 

It might also be helpful jotting down the timeline of drug changes etc and what your observations were at that time.

Thanks for your reply, CC.

 

I'm not clear on what you're getting at here.  My posts show only how consistently miserable and desperate I've been in tapering Cymbalta.

 

The timeline of drug changes is in my signature.  My only observation is being glad to be rid of each degree of poison with each drop in dose.  

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Shep
17 hours ago, gardenlady said:

My blood tests are current and are all normal.  My thyroid level is tested every 3 months as I am post Graves disease since 1998.  I have osteopenia bordering on osteoporosis due to Graves Disease.  I am on the lowest dose of HRT possible as I need to discontinue it at age 70 (3.5 years fro now) due to increased risk of cancer.  My goal was to get through AD withdrawal before tapering off of the HRT.  Although I take magnesium and fish oil, I've not benefited from any noticeable improvement in my psych symptoms.   

 

Thanks, GL. I'm glad you're able to keep current with blood tests and everything is checking out. 

 

17 hours ago, gardenlady said:

Vitamin D - 5K units

 

 

Do you feel any different after taking the vitamin D? A lot of members report it causes agitation, so I just wanted to touch base on this. 

 

That's all I can see, GL. I'll let the AD experts take over for your questions about a bridge. 

 

 

17 hours ago, gardenlady said:

I'm concerned that I am permanently brain damaged from psych drugs.  

 

I think you're getting too many side effects from the AD to go down this path, not to mention still recovering from benzo withdrawal, which can take several years to completely resolve. 

 

It's a long road, GL, but there's no reason to think you won't taper and feel a lot better once your nervous system is no longer being taxed by this drug. 

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gardenlady

Thank you for your kindness and help, Shep.  No, the vitamin D has no effect on me at all.  And, I have to take it, anyway, because of my osteopenia.

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manymoretodays
Posted (edited)
On 5/21/2019 at 3:09 PM, gardenlady said:

A nurse practitioner friend of mine is worried about my homebound, agitated and depressed state due to Cymbalta withdrawal and is urging me to bridge to Prozac 10 mg.

 

Hey gardenlady,

So one thing that I noticed, after studying the recently updated Prozac switch or bridging information(the critical stuff is all in that first post there) is this:

On 11/17/2011 at 12:23 PM, Altostrata said:

Note on above: If you have tapered to a lower dose of Seroxat/Paxil, Effexor, Cipramil/Celexa, Lustral/Zoloft, etc., an even lower dose of Prozac may be more tolerable. If you are about half-way down, you might want to try 10mg Prozac. If you have decreased further, you may wish to try 5mg Prozac. More is not better for nervous systems sensitized by withdrawal.

 

And keep in mind, I am only a lay person, peer who has experienced WD oneself, and have never personally guided anyone at all through a bridge. 

The drug equivalency chart for Prozac and other SSRI's and SNRI's doesn't list duloxetine/Cymbalta either.  So that makes it tough too.

 

And it would take a bit of cautious calculating as well for your NP to come up with a careful dose of citalopram too, which I think she could do using the equivalency chart in the first post.

 

So.....me thinks that......10 mg of Prozac might be a bit high to switch or bridge with.  Something you might discuss with your NP, if you are just not comfortable printing off or directing her to our topic here, on bridging to read herself.

 

My concern would be that you are already dealing with so much agitation, at times........or at least I'm picking that up from some of your symptom descriptions.  And then that you might be at risk for some serotonin syndrome type stuff if the switch is to too high a dose of Prozac.

Do you follow?

 

Potentially, you could hit a lot of bumps,  as you wait to get to full effect of the Prozac, while reducing your 12 mg dose of Cymbalta.  And of course you would need to get off the Cymbalta completely within two weeks of starting the Prozac, from my understanding.

On 11/17/2011 at 12:23 PM, Altostrata said:

Risks of bridging

A bridging strategy has the following drawbacks for a minority of those who try it:

 

  • Dropping the first antidepressant in the switch may cause withdrawal symptoms even though you're taking a bridge drug.
  • Adverse reaction to the bridge drug, such as Prozac.
  • Serotonin toxicity or adverse effects of a drug combination.

  • If withdrawal symptoms are already underway, switching to a bridge drug may not help.
  • Difficulty tapering off the bridge drug. All of the bridge drugs can be difficult to taper themselves. 

 

About serotonin toxicity: For antidepressants, you run the risk of serotonergic toxicity if you are taking an SNRI, particularly at a high dose, with an SSRI, or too much of one antidepressant. (Never take an MAOI in combination with another antidepressant!)

 

Serotonergic effects of an SSRI such as Prozac, Celexa, or Lexapro are ADDED when combined with an SNRI such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), venlafaxine (Effexor), venlafaxine XR (Effexor XR), milnacipran (Savella), and levomilnacipran (Fetzima). This is why doctors familiar with the Prozac switch will cross-taper by adding a LOW DOSE of Prozac to an SNRI.

 

So.....if you are still deciding and considering pros and cons of a switch or bridge to Prozac OR citalopram.  You might consider starting the switch with a lower dose than the 10 mg that the NP uses with "all her other patients".  

You ARE an individual case, not exactly like any of her others, and hopefully she is open to discussion and further study before making changes with you.  NP's as a whole, ARE or can be pretty great to work with, as they come from a professional Nursing background.  More whole person oriented in their training.  And then with the addition of medicine Nuts and Bolts thrown in.  As well as bits of pharmacology.  Just saying.......as I come from a Nursing background and advanced education in that area.........the majority of my work was in Pediatrics though.......babies, kids, and their families.  Fond memories though.  I tried some psych nursing(in lock down facilities) and woah, oh boy........not a good fit there, and I pretty much hated it.

 

And okay.  That's my further 2 cents for today.  How are you holding up?  And again.......a long HOLD might just be the ticket for awhile too.  How are you doing cognitively overall?  You sound pretty sharp.  You will get there.......that there that will be a better here than it all seems now.  I think too.....that if somehow you can get back with some, any kind of community, of people where you are comfortable........you might find your faith connection again too.  It's hard I know!

 

L, P, H, and G,

mmt

Edited by manymoretodays
further clarity

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manymoretodays

And heyo again.  You might enjoy The Work of Byron Katie.  You can just go on and find, or listen to one of her videos, without having to invest a lot of money........or you might decide it's worth it too.  I'm not promoting really.......It's just that her stuff, at one point, really helped me.  I found a lot of stuff along the way, as support and helping me to shift a bit, and be patient with this whole process.

 

(and weird too.....as I'm finishing up for a bit at my desktop......for some reason my bookmark on Byron Katie was selected.  B)  So I thought I'd share it with you.)

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ChessieCat
On 5/26/2019 at 3:47 AM, Shep said:

How is your diet?

 

You may have missed Shep's question.

 

Do you drink coffee, drinks containing caffeine, or alcohol?

 

Have you ever had you B12 levels checked?

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gardenlady

Thanks, mmt.  Yes, I've already spoken to my NP about taking 5 mg Prozac vs 10 mg.  She's very insistent that 10 mg is the way to go, but I'm sure if I pushed it, she'd agree to the 5 mg rather than my not doing it at all.  However, I'm still so spooked about bridging that I'm not sure I want to do it, although I'm having suicidal thoughts on Cymbalta along with all the other symptoms I mentioned.  It might be more risky for me to keep tapering the Cymbalta than attempt the Prozac bridge, however, I'm undecided and really don't know what to do.

 

Also, at the low doses I'm dealing with, serotonin syndrome would be unlikely if I did attempt the bridge.  And, I've taken Prozac before with no ill effects. 

 

I looked at Byron Katie's site and she seems to have a Buddhist leaning, which isn't for me.  But, correct me if I'm wrong.  

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manymoretodays

Hmmmmm.  Okay.  Well, maybe that you can't decide is your decision for now.

 

Maybe so, with Byron Katie.  I just found her to be very calming in her approach.  I watched some of the videos and felt better somehow.  That's okay, if it isn't appealing to you.

This quote came to mind, so I'll leave you with it.

 

“I sought my God and my God I couldn't find;
I sought my soul and my soul eluded me;
I sought to serve my brother in his need, and I found all three;
My God, my soul, and thee.”

 


William Blake
Hope it's a good one for you today, in general.
L, P, H, and G,
mmt

 

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gardenlady

I am still tapering Cymbalta and am at 50 beads/9.6 mg.  I started at 60 mg in May 2017 but had to hold for 11 months.  I resumed my taper in April 2018 which has been very brutal and slow.  I ditched the Prozac-switch idea as I was too scared to do it knowing how kindled I am.  

 

Each drop is nasty and at this rate (one bead at a time) I still have about 2 years to go.  Has anyone else gone this slowly?  What was it like when you finished.  Unfortunately, there are virtually no Cymbalta success stories on this site, or any other site that I can find.  Does anyone know of any?  It's odd that there are success stories for almost all other ADs except Cymbalta.  Wonder why?

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ChessieCat

It might be that Cymbalta / duloxetine isn't prescribed as much as other antidepressants.

 

It's also an SNRI (serotonin-norepinephrine reuptake inhibitor).  It could be that SSRIs are more commonly prescribed.

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gardenlady

I have developed circadian rhythm sleep disorder due to Cymbalta tapering and withdrawal and would appreciate advice on how to get back on a normal sleeping schedule.  Due to withdrawal symptoms, my insomnia caused me to stay awake all night and not fall asleep until after daybreak after which I would sleep in 1 to 2 hour increments until early to mid afternoon.  That pattern has now become entrenched and regardless of exercising and taking all sleep hygiene precautions, I am unable to fall asleep prior to dawn.  

 

Besides exercise and sleep hygiene, which I've already tried unsuccessfully, are there any other solutions to enable me to reset my circadian rhythm so that I can sleep at night rather than in the daytime?  I am assuming that shift workers are faced with this problem and are able to overcome it.  Surely there is something that can help re-regulate sleep.  

 

I am continuing to taper Cymbalta very slowly, one bead per week, and am currently at 49 beads/9.3 mg.  I have been tapering for 1 year and 5 months, starting at 60 mg.  It will likely be two or more years before I complete my taper as I will need to slow down the taper considerably as I get lower in dose.  Besides irregular sleep, I am having intermittent akathisia, involuntary loud, audible pursed-lip breathing and an inability to socialize or relate to people, normally.  I have a constant sense of dread, doom and fear which started when I began taking Cymbalta and worsened when beginning the taper.  

 

I would be grateful for any advice on correcting my circadian rhythm sleep disorder.  

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ChessieCat

One thing you could try is going to bed 1 hour earlier each night.

 

There is a lot of information on the internet.  I suggest you do a google search for "how to reset sleep pattern".

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gardenlady

Thanks, Chessie.  Regardless of what time I go to bed, I don’t drop off to sleep till after dawn.  I have googled the topic but don’t get anything other than sleep hygiene and exercise suggestions.

 

 I hoped that others going thru withdrawal might have ideas as insomnia is a common symptom.  It’s hard to imagine that I’m the only one with this problem.

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Shep

Gardenlady, I've known buddies over on Benzo Buddies who slept during the day and enjoyed their nights awake while the rest of the world slept. Many of them enjoy the lowered cortisol levels and are able to get a few things done around their homes. 

 

Unless you are having to work and / or take care of family during the day, you may not want to fight this. If your brain/body is wanting to sleep during the day, that may simply be how it's going to be for awhile. I wouldn't look at that as a "disorder". It may be a habit that you've acclimated to, or it may be what your brain/body is needing for now. 

 

Since you're active over on Benzo Buddies, you may want to look up Peruzer's blog in the Buddie Blogs section of the forum. I haven't been on that site for about 4 years, but I remember she was one of the night owls. She may not be active anymore (like I wrote, it's been a number of years), but at least you'll know you aren't alone with this pattern. And you'll likely find others. 

 

However, if you think you may benefit from changing this pattern, ChessieCat's idea of moving your bedtime by one hour a day sounds like a great idea to slowly ease you into it.

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gardenlady

Thanks, Shep.  Regardless of what time I go to bed, I don’t drop off to sleep till after dawn.  So, going to bed earlier doesn't do any good, unfortunately as my circadian rhythm is so messed up...I just lie there awake for hours and hours till after dawn.

 

As I've been off of the benzo for over 18 months, I'm no longer active on Benzo Buddies.   I have looked for sleep solutions there, but no one seems to be sleeping only in the day as I am.  However, I'll check out Peruzer.  Hard to believe I'm the only one on SA with this problem as sleep disturbances are nearly universal among people tapering. 

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ChessieCat

You might find it helpful to learn CBT techniques to help with your thought patterns.  When we don't think we can do something we can set ourselves up to fail, and when we do fail we say see I knew it wasn't going to work which then cements it even more into our thought pattern.  I've had to learn to just rest without actually sleeping.  For about the last year or maybe even longer, I've been listening to podcasts of people talking.  I choose things which are interesting enough to keep my mind on the topic but not so interesting that it keeps me awake and I need to make sure that there are no loud parts during the talk and I just leave it on all night.  I've found it very helpful to quiet my mind from any "monkey mind" chatter, particularly from thinking about negative things from my past, also worrying about what might happen in the future, and replaying conversations and interactions that I have had recently or in the past.

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