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SDOE: Cymbalta withdrawal causing chronic sleep maintenance insomnia


SDOE

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Would like advice/hear experience on sleep maintenance insomnia. I've been waking up consistently between 2AM to 4AM after I started an aggressive taper. Often I will be awake for 2-3 hours then fall back asleep but very frustrated with this sleeping pattern as I used to be a morning person. Was at 30mg Cymbalta (6/29/17) and currently at 6.25mg. Foolishly, I thought the main symptom I needed to watch was the brain zaps; however, I slowly realized the insomnia was not from peri-menopause but the Cymbalta withdrawals. 

Recently, researching sleeping aid options such as: Oleamide,Glycine, and Phosphorylated Serine.  I believe these would be safe options with Cymbalta from what I can tell. I'm not even sure how much 6.25 mg of Cymbalta has on me as I back in October 2016 I was on 60mg and dropped to 30mg.

I really would like to avoid re-upping my dosage to solve my insomnia. 

 

 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • ChessieCat changed the title to SDOE: Cymbalta withdrawal causing chronic sleep maintenance insomnia
  • Moderator Emeritus

Hi SDOE, welcome to SA.  As a fellow insomniac I strongly advise you  to updose, then wait until you are stabilsed before startiing a slow taper. This is the start of withdrawal and can get much worse before it gets better.So many people arrive here in withdrawal after tapering too fast and withdrawal insomnia is one of the most common symptoms. The only way to stop withdrawal is to reinstate the drug if already quit, or increase the dose. You have taken only 5 weeks to get from 30 to 6.5 which is extremely fast. Sadly this is what most doctors would advise, and when patients are sick they say the illness has returned when it is in fact withdrawal. No one EVER wants to go back, I certainly didn't  want to go back on after I tapered all the way off too fast but  couldn't function, as did many, many more of our members. Supplements rarely help in withdrawal and some make things even worse because we become sensitive and can't tolerate them.

 

 I am sorry I know this is not what you want to hear, I feel for you right now but there isn't any other advise we can give. I will get some links to topics that will explain things for you. We advise tapering 10% of the CURRENT dose with 4 weeks or more between drops. It is long and slow but people can function while tapering. The drug is sneaked away so that the brain can adjust to the lower doses.  When you started cymbalta it changed the way the brain functioned. For 13 years your brain has adapted and worked round the drug. Taking it away too fast is throwing it into chaos and it is trying to regain homeostasis.  It is a lot to think about. Here are the links. 

 

What is withdrawal syndrome

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Why taper 10%

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Tapering cymbalta

http://survivingantidepressants.org/index.php?/topic/283-tapering-off-cymbalta-duloxetine/

 

Withdrawal insomnia

http://survivingantidepressants.org/index.php?/topic/53-tips-to-help-sleep-so-many-of-us-have-that-awful-withdrawal-insomnia/

 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator Emeritus

Hi SDOE, and welcome to SA from me too.

 

I can understand your reluctance to updose.  I found SA after attempting to reduce my dose from 100mg to 50mg of Pristiq.  I suffered 3 weeks of very bad brain fog and at the end of the 3 weeks I was unable to type.  I am a professional typist so not being able to do something which I have been doing for the last 40+ years alerted me to the fact that something was not right.  I decided to updose and within about 4 hours my foggy head started clearing and I was able to type again.  I had a benchmark and knew that it wasn't placebo.

 

About reinstating and stabilizing to reduce withdrawal symptoms     (especially Post #1)

 

Since then I have done a lot of researching and reading of both this site, books and YouTube and understand that the drugs change our brain.  These helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

The good news is that since updosing I have done a taper of no more than 10% of the previous dose since then (November 2016) and am now down to 20mg.  I have experienced only minimal withdrawal symptoms and tapering has faded into the background of my life.  As my dose reduced I started feeling more like my old (or I should say younger) self.  This, after 25 years on ADs.

 

Please read the links both mammaP and I have provided so that you can make an informed decision.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thank you ChessieCat & mammaP for the information. I will look at it; you're right It isn't what I wanted to hear but at the same time the insomnia is getting so bad that I've thought about going back up on my dosage. So essentially, it is my plan B.

When I dropped from 60mg to 30mg, I had occasional insomnia and attributed it to peri-menopause but after this fast drop it's very clear it is Cymbalta withdrawals and it's not occasional...it's been my new normal.

It really is my main problem along with being angry/short tempered at times. I really hate the idea of increasing Cymbalta dosage as it makes me feel ADD, dull, like I can't think straight but I know if I can't solve this insomnia, it is my only option.

Already taking Magnesium supplements, Vitamin C, B Complex, Fish Oil, 3 mg melatonin, D3, 100mg Progesterone Caps.

Thanks!

 

 

 

Edited by mammaP
Added tags

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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Ok. I'm slowly taking more again. Back up to 10mg. My beloved cat that followed me around the house constantly died unexpectedly at 2.7 years old this past Friday. The insomnia has gotten way worse due to my grief.  

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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How quickly do I reinstate/updose Cymbalta because I saw the more time goes by the less chance there is that reinstatement will work to alleviate withdrawals? Do I only do 10% a week increase? I’m having chronic maintenance insomnia now. Only reason I decided to go back up. I can deal with 2 nights a week that began in November, from the 60mg to 30m decrease, but not 7 nights a week (now.)

The other withdrawal symptoms weren’t bad. Brain Zap/Dizziness would only last about every 4 days when I decreased. The anger a little bit longer but stabilized in a few weeks.

Back Story

11/2016- Jumped from 60mg to 30mg. I was recovering from surgery thought it was perfect time to go through dizzy spells/brain zaps. Insomnia began, it was about 2 days a week-did not attribute to withdrawals until the taper schedule below then I understood what was going on. Now it is every night waking up.

This was my taper schedule-my goal is to get back near the 30mg if needed.

6/29-25mg

7/7-20mg

7/10-15mg

7/17-about 13mg

7/18-10 mg

7/22-about 8mg

7/31-about 7.5mg

8/1-6.25mg

Increasing

8/9-7.5mg

8/16-10mg

 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • Administrator
On 8/8/2017 at 0:57 PM, SDOE said:

Would like advice/hear experience on sleep maintenance insomnia. I've been waking up consistently between 2AM to 4AM after I started an aggressive taper. Often I will be awake for 2-3 hours then fall back asleep but very frustrated with this sleeping pattern as I used to be a morning person. Was at 30mg Cymbalta (6/29/17) and currently at 6.25mg. Foolishly, I thought the main symptom I needed to watch was the brain zaps; however, I slowly realized the insomnia was not from peri-menopause but the Cymbalta withdrawals. 

Recently, researching sleeping aid options such as: Oleamide,Glycine, and Phosphorylated Serine.  I believe these would be safe options with Cymbalta from what I can tell. I'm not even sure how much 6.25 mg of Cymbalta has on me as I back in October 2016 I was on 60mg and dropped to 30mg.

I really would like to avoid re-upping my dosage to solve my insomnia. 

 

 

 

Hello, sdoe. This is classic withdrawal insomnia.

 

It will take at least 4 days for your system to fully register the increase in dosage to 10mg. You may not see a big improvement right off; even a little bit of improvement is a good sign. I would give it a chance before increasing the dosage.

 

In addition, there are things you can do to improve your sleep. See 

 

The waking between 2 a.m. and 4 a.m. is triggered by your natural circadian increase of cortisol, the stimulating daytime hormone. It is triggered by light. Wearing a sleep mask can help.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you for the information Altostrata. Yesterday was day number 4 and I think I could feel the poison (aka Cymbalta) change kicking in. Last couple of days I felt that anger (from within) at different parts of the day. Also, the last 2 nights I slept at least 5 hours straight through. We'll see if it continues. I'll wait at least a week before increasing a tiny amount again. I've ordered some magnesium citrate powder.

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • Moderator Emeritus

Hi SDOE, good to hear that your sleep is a little better.  I do remember when I ran into trouble, my sleep was disrupted and it took a while for it to get back to normal.  I would advise you to be very cautious about increasing your Cymbalta too quickly as you have already made two up-doses to your medication in a fairly short period of time.  In my experience, these drugs are very powerful even in small doses and it's best to make changes very very slowly.  

 

If you feel that you are improving even slightly at 10mg, I would hold there for at least another couple of weeks or longer and see where you are then.  The pattern I noticed when I make a decrease (in your case an up-dose) is that I won't feel anything for about a week to 10 days and then I'll have mild withdrawal symptoms for about a week and in the third week, things settle back down.  I would normally give it another good week just to ensure my CNS has settled.  If it were me, I would hold at your current dose of 10mg for at least another three weeks, if not longer and see if you are feeling any better and decide then whether or not you needed to increase further.

Edited by baroquep

Current Prescription Drugs for Hypothyroidism:  Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)

Tapering Schedule
September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR
December 9, 2016 - reduced 60.75
January 5, 2017 - reduced 54.67
January 30, 2017 - reduced to 49.0
February 20, 2017 - reduced to 44.0 
May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper)
July 17, 2017 - reduced to 38.24
August 15, 2017 - reduced to 37.5 (50% of my original dose)

October 15, 2017 - reduced to 35.6

November 12, 2017 - reduced to 33.8
December 15, 2017 - up-dose to 35.6
December 28, 2017 - up-dose to 37.5

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Thanks for the tip baroquep. I actually like the idea of not increasing the poison (Cymbalta); believe me I don't want to take any more of this stuff than I need. I know I definitely tried to taper of too soon, the insomnia withdrawal was unbearable. 

I just thought I risk the possibility of reinstatement not working if I updose too slow. I guess I'm just getting confused about what to do. Thanks

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • Moderator Emeritus

Hi SDOE, Understand, it can be very confusing.  So you know, as you already initiated the updose on August 9th, you are good.  

 

Have you been keep a log of your daily symptom pattern?  It's important for the moderators to be able to gauge your progress over the new couple of week.  I'm attaching a few links below that will help you organize this information.

 

Rate Symptoms Daily to Check Patterns and Progress

Dr Joseph Glenmullen's WD Symptoms Checklist

 

I'd also recommend taking Omega 3 Fish Oil and Magnesium as they tend to be calming to the central nervous system and the magnesium helps to relax you.  I have found that both of these supplements have been very beneficial for me.  You can read about how they help below:

 

Magnesium

Omega-3 Fish Oil

 

Hang in there, hope you are feeling better soon. Let us know how you get through the next couple of weeks.

Current Prescription Drugs for Hypothyroidism:  Synthroid 100mcg / Cytomel 5mcg (15 years Pristiq/Effexor)

Tapering Schedule
September 15, 2016 - switched from Pristiq 50mg to Effexor XR 75mg; November 10, 2016 - reduced to 67.5 Effexor XR
December 9, 2016 - reduced 60.75
January 5, 2017 - reduced 54.67
January 30, 2017 - reduced to 49.0
February 20, 2017 - reduced to 44.0 
May 20, 2017 - reduced to 40.25 (holding for additional month due to late onset of withdrawal symptoms after this taper)
July 17, 2017 - reduced to 38.24
August 15, 2017 - reduced to 37.5 (50% of my original dose)

October 15, 2017 - reduced to 35.6

November 12, 2017 - reduced to 33.8
December 15, 2017 - up-dose to 35.6
December 28, 2017 - up-dose to 37.5

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baroquep, thank you for the suggestion of keeping a daily symptom pattern as this is not something I thought of or have done at least as far as moods. My fitbit tracks my sleep. I keep a daily log of supplements and vitamins.

I will admit my mood patterns are a bit complicated. My mother died in early June as a result of a terminal illness, so I was somewhat mentally prepared. Then my cat, who I was extremely close with, unexpectedly died the other week. This I was not mentally prepared for at all. The grief has brought on a lot of mood changes-crying due to being sad from the losses and having guilt/regret of not doing enough.

It will be difficult for me to tell if the mood changes are brought on from grief or medication changes.

I could be wrong but it seems like the withdrawals only affect my sleep and anger/patience; I think the rest is all grief. The anger seems temporary as I adjust to either the increase or decrease of the med. The insomnia is what drives me crazy. I want to keep busy but lack of sleep prevents me from keep a routine.  Even though, I'm going through a lot if I sleep better, I feel better throughout the day. 

Last night I actually slept 7 hours. Whenever, I woke up I fell right back asleep. This used to be my norm but now it is a rarity. 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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One last thing, I have been taking the Fish Oil and Magnesium Oxide. I read it is better to take a Magnesium ending in "ate", so I actually ordered one with Magnesium Citrate the other day.

 

So looks like I need to increase the amount of fish oil according to the link. Thanks

 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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Hello,

I read this information on another site (someone's post) about the cause of withdrawals. It seems to make sense about withdrawals for SSRIs; I'm not sure if it would apply to SNRIs. Does any of this possibly ring true?

 

 

Cortisol is the main reason why SSRI withdrawal can be so bad. 

I wonder for a long time what was up with the cortisol issue in withdrawal. Some reported that they blood test showed elevated cortisol. Some claimed that they doctors told them that cortisol was causing of the horrendous insomnia they experienced. Some reported experiencing adrenalin exhaustion, which implies very low levels of cortisol. I myself noticed that many of the symptoms I experienced were either consistent with very high levels or with very low levels of cortisol. So which one was it? It is a long story how I came to believe what I believe but I am quite sure that I may be close to the truth. I would like to share it with you and I will make it short. 

(Everything below applies mostly to long term SSRI users.)

I put it in points:
1. SSRIs elevate cortisol levels. Elevated cortisol suppresses HPA axis and that has calming effect on a system. That is why SSRIs work on anxiety and panic attacks. Cortisol at first is elevated in the blood and with time it goes down after system adjusts. It is tissue were cortisol stays elevated during SSRI duration treatment. IT IS LIKE BEING ON STEROIDS!!!
2. The central nervous system (CNS) with time gets used to functioning on high levels of cortisol.
3. In withdrawal cortisol levels in tissue go to normal levels. HPA axis awakens and starts producing massive quantities of cortisol desperately trying to bring the tissue’s cortisol levels back up. It of course fails. That explains panic attacks, anxiety and insomnia during withdrawal. 
3. Especially at night when cortisols go down CNS goes crazy. It will produce cortisol in extreme amounts to get back to what it learned over years is “normal” levels of cortisol. That is why some find it easy to sleep during the day and cannot sleep at night.
4. Even though the cortisol levels are normal the system experiences symptomps of adrenalin exhaustion. It acts like it was running on too little cortisol. It is system’s subjective perception. It simply got used to high levels and now does not know how to function without them.
5. If one withdrawn to fast or quit SSRI abruptly it takes 6 to 9 months to make CNS start changing its mind about cortisol levels. The time should be counted form the offset of insomnia and not from the last dose of SSRI. After 6 to 9 months cortisol levels will very slowly start to go down. The longer the SSRI intake was the longer time is needed for recovery.
6. In slow taper, 2 weeks is when differences happen. HPA axis adjusts to small changes every 2 weeks so dose adjustment should be done in minimum 2 weeks intervals.
7. To get some relief in withdrawal one actually has to increase the cortisol levels. Theoretically even steroids would help. There are other drugs that would do it but I was not brave enough to test any. I went with SSRI.
8. Withdrawing too fast and staying in a limbo state of recovery for too long can actually exhaust adrenalin glands. They will burn themselves trying to produce high levels of cortisol.
9. Unless one experienced a negative reaction going back to SSRIs even after a year works. I also believe that switching between them works too but I see no benefits in doing so. Slow taper of whatever one is on is the best way to go.
10. Exercising helps lower the levels of cortisol in tissue.
11. In withdrawal one will experience chronic fatigue syndrome symptoms (cortisol connection).
12. Circadian rhythm is destroyed in withdrawal due to cortisol overproduction and only time will repair it. Sleeping schedule or melatonin will not make any difference. I believe in sleeping anytime possible and in taking melatonin if it helps.
13. One should stay in bed if one is comfortable even if one doesn’t sleep. In withdrawal sleep is very light and fragmented (again cortisol issue). It is possible to sleep and be fully aware of surroundings so one may sleep without knowing about. If somebody can lay with closed eyes for longer periods of time this person is probably sleeping some. I recommend evaluating sleep based on how tired one is the next day.

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • Moderator Emeritus

I moved your new topic to your Intro.  Each member only has 1 Intro topic.

 

To find existing topics on SA I used google and typed in survivingantidepressants.org cortisol:

 

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

 

high-cortisol-and-ssris

 

forest-bathing-reduces-cortisol-aids-mood-immune-system

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thanks for the info ChessieCat. Sorry about the posting confusion.

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • Moderator Emeritus

No problem SDOE :)

 

Did you get the chance to fill in the survey? Posting just in case :)

 

There is a very important survey on drug WD at the moment. We might finally get some acknowledgement for all the suffering these drugs caused us.

 

Adding your experience would be very valuable. It only takes a few minutes. They extended it because they got so many replies after Alto mobilised our members here but the more people join, the more powerful we are.

 

I even invited my friends who are not on the forum and some of them were not even aware that what was happening to them was a WD... Every vote counts.

 

https://roehamptonpsych.az1.qualtrics.com/jfe/form/SV_6gSHZN88sOmHDlr

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • 3 months later...

Update on my sleeping pattern.  It is going really well.  I realize what worked for me may not work for everyone. I increased my Cymbalta incrementally to 22.5mg by 9/19. Now I have decreased it slower to 17.5mg. I am decreasing in 2.5 mg increments every 4 weeks. The first few days I alternate with the previous dosage. For example when I started the 17.5mg, I’ll alternate by taking the old dosage of 20mg for about 4 days.

Around the week of 9/24, my sleep was stabilizing so I was sleeping through the night 5 out of 7 nights. Granted in early October, at times I slept only 5 hours straight but much better than waking up after only 2-4 hours of sleep.

Since around mid-October, I started sleeping an average of 7+ hours a night. If I wake up at night I normally fall back asleep.

This is what works for me and it took a lot of work to figure this out. Around 8:30pm, I use yellow orange glasses while watching TV and dimming or shutting off lights around the house. The glasses are supposed to help block blue rays emitted by electronics; who knows if they really work. I try to avoid my phone and computer around this time, but if I do I’m using the glasses and it’s generally before 9pm. Around 9:15-9:30pm, I take 3 mg of time released Melatonin and 3 mg of Melatonin. Between 9:30pm to 10pm, I lay in bed and watch TV and it is something slow moving. I record CSPAN2/3 shows on the weekend. These are great because there are no loud commercial interruptions. I take 1 Benadryl around 9:40pm. I set the TV timer; when I feel drowsy, I put on sleep mask. Usually, I’m asleep before 10:30pm.

I realize the Benadryl, is not for everyone, but I started it because I read the first generation anti-depressant were modeled off it. Last night I took 2/3-3/4 of a pill and I still slept great. I’m going to attempt to take this decreased amount of Benadryl as I prefer to take as little drugs as possible; also, in the morning I’m feeling a tiny bit groggy. My goal obviously, it to wean off the Cymbalta then wean off the Benadryl and decrease the melatonin. I’ve read melatonin can cause negative feedback. If your body sees you have enough melatonin it will decrease the amount of serotonin it creates and we all know how important serotonin is.

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • 1 year later...

I know my insomnia is a very small problem compared to what others are suffering but I would like to provide updated information to people that suffer primarily from insomnia.  Before all this insomnia tapering mess I was a deep sleeper that slept 7 to 8 hours straight without waking up at all. My sleep can now easily be destroyed by a stressful event.  This past week was not stressful and after analyzing my sleep log this is where I am at my insomnia started in 2016.  Overall, my sleep has been slowly improving but some weeks it feels like I'm moving backward.

 

2 times I slept either close to 7 hours or 7+ hours with briefly waking up but falling right back asleep without benadryl= 28.5% of the week 

3 times broken sleep (I was able to fall back asleep but was awake for hours)=43% of the week

2 times slept either close to 7 hours or 7+ hours with briefly waking up but falling right back asleep and took benadryl before bed =28.5% of the week

 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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  • 1 month later...

Shortly after I did my last update, my sleep came crashing down.  My periodic use of Benadryl may or may not work. Sometimes I only sleep 4 or 5 hours. Other times, I can fall back asleep after 1 to 3 hours. I sleep through the night approximately 1 night a week.  Even though I've I went through all these different difficult stages of withdrawal I am considering finding a doctor that might work with me on doing another taper.  It is so frustrating because I know I would be back to my old self if I could just sleep as I used to (7 to 8 hours deep sleep.)  Since quitting in January, over time I feel like my emotions have stabilized but my sleep pattern is getting worse...

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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Hi  I also suffer from insomnia, I feel the same as you if I could only sleep...I could handle  my daily life much better... How do you cope?

also take supplements, So you are not alone...

2007-2016 citalopram 20mg -40mg

tappered and discontinued all of oct 2016 6 month taper  (wd symptom  insomnia and some ocd anxiety)

Nov.2016 -May 2017 cipralex 20mg

June-Sept 2017  xanax 0.25- 0.50mg   3 times a week

June 2017- Sept. 25.2017  Paxil  20mg - last week was 30mg bc of drug feeling reaction

Sept 27 - Oct 12 2017 Fluxatine 20mg

discontinuation Oct 13-18th 2017 withdrawal  from paxil and fluxatine

Reinstated Oct 19- 23 Fluxtine 10mg, Oct 24- 2 2017 Fluxatine 5mg,  Nov 2-19 2017   Fluxatine 10mg Dec-Jan 4 2018 Fluxatine 20mg, Reinstated Feb 18 2018  fluxatine 1mg, didnt work  June 6  Celexa  5mg than 10mg, June 3 Klonopin  .5 - 1mg,    june 11 oxazepam 5-10mg,   zopiclone in june  7.5mg  on and off,    June 24 reduced  to  5mg Celexa 

Nov. 20 2018 titration k  0.02mg reduction from 0.5- 0.380mg,  Nov.  25 2018  mourol 1 dose for cystitis

March started Brassmonkey method   0.30 k   current 0.28 kcelexa 5mgNov.2021 0.08 updose  0.09 feb. 2022 0.085k  march. 0.08 april 0.075k may0.070k june 0.065 june23  0.060

NOTE: using liquid Rivotril - 2 drops of (2.5mg) rivotril  with 20ml water 

 

 

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On 8/26/2017 at 7:27 PM, SDOE said:

Hello,

I read this information on another site (someone's post) about the cause of withdrawals. It seems to make sense about withdrawals for SSRIs; I'm not sure if it would apply to SNRIs. Does any of this possibly ring true?

 

 

Cortisol is the main reason why SSRI withdrawal can be so bad. 

I wonder for a long time what was up with the cortisol issue in withdrawal. Some reported that they blood test showed elevated cortisol. Some claimed that they doctors told them that cortisol was causing of the horrendous insomnia they experienced. Some reported experiencing adrenalin exhaustion, which implies very low levels of cortisol. I myself noticed that many of the symptoms I experienced were either consistent with very high levels or with very low levels of cortisol. So which one was it? It is a long story how I came to believe what I believe but I am quite sure that I may be close to the truth. I would like to share it with you and I will make it short. 

(Everything below applies mostly to long term SSRI users.)

I put it in points:
1. SSRIs elevate cortisol levels. Elevated cortisol suppresses HPA axis and that has calming effect on a system. That is why SSRIs work on anxiety and panic attacks. Cortisol at first is elevated in the blood and with time it goes down after system adjusts. It is tissue were cortisol stays elevated during SSRI duration treatment. IT IS LIKE BEING ON STEROIDS!!!
2. The central nervous system (CNS) with time gets used to functioning on high levels of cortisol.
3. In withdrawal cortisol levels in tissue go to normal levels. HPA axis awakens and starts producing massive quantities of cortisol desperately trying to bring the tissue’s cortisol levels back up. It of course fails. That explains panic attacks, anxiety and insomnia during withdrawal. 
3. Especially at night when cortisols go down CNS goes crazy. It will produce cortisol in extreme amounts to get back to what it learned over years is “normal” levels of cortisol. That is why some find it easy to sleep during the day and cannot sleep at night.
4. Even though the cortisol levels are normal the system experiences symptomps of adrenalin exhaustion. It acts like it was running on too little cortisol. It is system’s subjective perception. It simply got used to high levels and now does not know how to function without them.
5. If one withdrawn to fast or quit SSRI abruptly it takes 6 to 9 months to make CNS start changing its mind about cortisol levels. The time should be counted form the offset of insomnia and not from the last dose of SSRI. After 6 to 9 months cortisol levels will very slowly start to go down. The longer the SSRI intake was the longer time is needed for recovery.
6. In slow taper, 2 weeks is when differences happen. HPA axis adjusts to small changes every 2 weeks so dose adjustment should be done in minimum 2 weeks intervals.
7. To get some relief in withdrawal one actually has to increase the cortisol levels. Theoretically even steroids would help. There are other drugs that would do it but I was not brave enough to test any. I went with SSRI.
8. Withdrawing too fast and staying in a limbo state of recovery for too long can actually exhaust adrenalin glands. They will burn themselves trying to produce high levels of cortisol.
9. Unless one experienced a negative reaction going back to SSRIs even after a year works. I also believe that switching between them works too but I see no benefits in doing so. Slow taper of whatever one is on is the best way to go.
10. Exercising helps lower the levels of cortisol in tissue.
11. In withdrawal one will experience chronic fatigue syndrome symptoms (cortisol connection).
12. Circadian rhythm is destroyed in withdrawal due to cortisol overproduction and only time will repair it. Sleeping schedule or melatonin will not make any difference. I believe in sleeping anytime possible and in taking melatonin if it helps.
13. One should stay in bed if one is comfortable even if one doesn’t sleep. In withdrawal sleep is very light and fragmented (again cortisol issue). It is possible to sleep and be fully aware of surroundings so one may sleep without knowing about. If somebody can lay with closed eyes for longer periods of time this person is probably sleeping some. I recommend evaluating sleep based on how tired one is the next day.

Hi

 

On 8/26/2017 at 7:27 PM, SDOE said:

Hello,

I read this information on another site (someone's post) about the cause of withdrawals. It seems to make sense about withdrawals for SSRIs; I'm not sure if it would apply to SNRIs. Does any of this possibly ring true?

 

 

Cortisol is the main reason why SSRI withdrawal can be so bad. 

I wonder for a long time what was up with the cortisol issue in withdrawal. Some reported that they blood test showed elevated cortisol. Some claimed that they doctors told them that cortisol was causing of the horrendous insomnia they experienced. Some reported experiencing adrenalin exhaustion, which implies very low levels of cortisol. I myself noticed that many of the symptoms I experienced were either consistent with very high levels or with very low levels of cortisol. So which one was it? It is a long story how I came to believe what I believe but I am quite sure that I may be close to the truth. I would like to share it with you and I will make it short. 

(Everything below applies mostly to long term SSRI users.)

I put it in points:
1. SSRIs elevate cortisol levels. Elevated cortisol suppresses HPA axis and that has calming effect on a system. That is why SSRIs work on anxiety and panic attacks. Cortisol at first is elevated in the blood and with time it goes down after system adjusts. It is tissue were cortisol stays elevated during SSRI duration treatment. IT IS LIKE BEING ON STEROIDS!!!
2. The central nervous system (CNS) with time gets used to functioning on high levels of cortisol.
3. In withdrawal cortisol levels in tissue go to normal levels. HPA axis awakens and starts producing massive quantities of cortisol desperately trying to bring the tissue’s cortisol levels back up. It of course fails. That explains panic attacks, anxiety and insomnia during withdrawal. 
3. Especially at night when cortisols go down CNS goes crazy. It will produce cortisol in extreme amounts to get back to what it learned over years is “normal” levels of cortisol. That is why some find it easy to sleep during the day and cannot sleep at night.
4. Even though the cortisol levels are normal the system experiences symptomps of adrenalin exhaustion. It acts like it was running on too little cortisol. It is system’s subjective perception. It simply got used to high levels and now does not know how to function without them.
5. If one withdrawn to fast or quit SSRI abruptly it takes 6 to 9 months to make CNS start changing its mind about cortisol levels. The time should be counted form the offset of insomnia and not from the last dose of SSRI. After 6 to 9 months cortisol levels will very slowly start to go down. The longer the SSRI intake was the longer time is needed for recovery.
6. In slow taper, 2 weeks is when differences happen. HPA axis adjusts to small changes every 2 weeks so dose adjustment should be done in minimum 2 weeks intervals.
7. To get some relief in withdrawal one actually has to increase the cortisol levels. Theoretically even steroids would help. There are other drugs that would do it but I was not brave enough to test any. I went with SSRI.
8. Withdrawing too fast and staying in a limbo state of recovery for too long can actually exhaust adrenalin glands. They will burn themselves trying to produce high levels of cortisol.
9. Unless one experienced a negative reaction going back to SSRIs even after a year works. I also believe that switching between them works too but I see no benefits in doing so. Slow taper of whatever one is on is the best way to go.
10. Exercising helps lower the levels of cortisol in tissue.
11. In withdrawal one will experience chronic fatigue syndrome symptoms (cortisol connection).
12. Circadian rhythm is destroyed in withdrawal due to cortisol overproduction and only time will repair it. Sleeping schedule or melatonin will not make any difference. I believe in sleeping anytime possible and in taking melatonin if it helps.
13. One should stay in bed if one is comfortable even if one doesn’t sleep. In withdrawal sleep is very light and fragmented (again cortisol issue). It is possible to sleep and be fully aware of surroundings so one may sleep without knowing about. If somebody can lay with closed eyes for longer periods of time this person is probably sleeping some. I recommend evaluating sleep based on how tired one is the next day.

Hi where did you get this info., very interesting...

2007-2016 citalopram 20mg -40mg

tappered and discontinued all of oct 2016 6 month taper  (wd symptom  insomnia and some ocd anxiety)

Nov.2016 -May 2017 cipralex 20mg

June-Sept 2017  xanax 0.25- 0.50mg   3 times a week

June 2017- Sept. 25.2017  Paxil  20mg - last week was 30mg bc of drug feeling reaction

Sept 27 - Oct 12 2017 Fluxatine 20mg

discontinuation Oct 13-18th 2017 withdrawal  from paxil and fluxatine

Reinstated Oct 19- 23 Fluxtine 10mg, Oct 24- 2 2017 Fluxatine 5mg,  Nov 2-19 2017   Fluxatine 10mg Dec-Jan 4 2018 Fluxatine 20mg, Reinstated Feb 18 2018  fluxatine 1mg, didnt work  June 6  Celexa  5mg than 10mg, June 3 Klonopin  .5 - 1mg,    june 11 oxazepam 5-10mg,   zopiclone in june  7.5mg  on and off,    June 24 reduced  to  5mg Celexa 

Nov. 20 2018 titration k  0.02mg reduction from 0.5- 0.380mg,  Nov.  25 2018  mourol 1 dose for cystitis

March started Brassmonkey method   0.30 k   current 0.28 kcelexa 5mgNov.2021 0.08 updose  0.09 feb. 2022 0.085k  march. 0.08 april 0.075k may0.070k june 0.065 june23  0.060

NOTE: using liquid Rivotril - 2 drops of (2.5mg) rivotril  with 20ml water 

 

 

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lalala,

Thanks for your response. 

 I’m really in no position to dole out coping advice as my insomnia is so bad I cannot live a normal life.

The information I posted about cortisol was a long time ago.  I googled and think this is the forum where I found it. Really there isn’t much more on it than what I posted.

http://antidepressantwithdrawal.info/forum/archive/index.php/t-794.html?s=b2465e65aa03649c2fe8b03e8ef54d07

 

-2005 -2016 60mg Cymbalta

11/2016 abrupt drop to 30mg. Insomnia started (about 2x a week.)

6/29/2017 started aggressive taper. Dosage:6/29 25mg,7/7 20mg,7/10 15mg,7/1713mg,7/18 10 mg,7/22 8mg,7/31 7.5mg,8/1 6.25mg. At 6.25mg insomnia every night (waking 2-4am.) 

8/2017 began up dosing 8/9 7.5mg,8/16 10mg.

Late 2017 new taper from 25mg. Approx 10% reduction per mos (mini-tablets.) 10mg sleep would not stabilize. Cont'd taper meds running out.

Jan 2019 stopped taper at 2.5mg. Using only supplements. Morning 500mg tyrosine, 100mg L-theanine, 600mg NAC. After breakfast 1000mg fish oil, 5mg iron, 2000IU D3, B complex, 500mg ginseng, 50mg ginkgo, probiotics & 50mg zinc. Bedtime 1000mg tryptophan, 500mg gaba, 3mg time released melatonin, 325mg magnesium powder, & 100mg progesterone.

Feb 2019 brain zaps gone. Still have chronic insomnia & anxiety at times.

March 2019-Purchased Alpha Stim

May 2019-sleep still inconsistent.

 October 2019- (Morning) L-Tyrosine, Super B complex, 5mg ferritin,fish oil, vit c, (Evening)200mg progesterone, 1mg Natrol Time Release Melatonin, 325mg Calm magnesium, glycine powder. Alpha Stim only seems to help with anxiety not insomnia. Usually wake up nightly average of 2 hours. *Using 25mg Benadryl or 12.5mg Doxylamine Succinate occasionally

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