laurel53: Introduction to the group. Please help me with my withdrawal

[Littlegrandma]

Hi Laurel 

i cant answer your question, but congratulations on a GOOD day. We’ll take em when we can get em!

lg

 

[Altostrata]

Hi, Laurel.

 

It's looking to me like your "morning meds" are causing a lot of problems. I suspect the Cymbalta, because it is so very excessive. (Gabapentin is right up there, too.)

 

How are you taking the Cymbalta, 2 60mg capsules at a time? How do you feel about taking 3 beads out of one capsule for 4 days, then 6 beads for 4 days, then 9 beads for 4 days, etc.? Until one of the capsules is emptied?

 

You'd have to keep good notes every day, tracking your dosages and your symptoms.

[ChessieCat]

1 hour ago, Altostrata said:

You'd have to keep good notes every day, tracking your dosages and your symptoms.

 

This is the preferred format:  Keep Notes on Paper

[laurel53]

Forgot to mention that I have been taking Cal/mag/zinc and vitamin D3 for years, plus a particular multi my Lyme provider recommended for 8 months. Also use magnesium oil on tops of feet and backs of legs at bedtime.

 

[laurel53]

Altostrata, yes, I take two 60s of duloxetine in the morning. 

[laurel53]

Wow, bead counting! I know that my psychiatrist would laugh at that. Is that safe to make cuts so quickly? 

[Altostrata]

I am concerned that 120mg Cymbalta is way too much for you. Taking out a few beads every 4 days or so would be a gradual, but fast, reduction.

 

Bead-counting is the only way to gradually go off Cymbalta.

 

Meanwhile, you might invest in a scale so you can taper more systematically, see Using a digital scale to measure doses

 

If you get any strange symptoms, you would stop reducing and let your system settle down.

[ChessieCat]

Here is SA's topic:  Tips for tapering off Cymbalta (duloxetine)

[laurel53]

Thank you, ChessieCat. Altostrata, let me make sure my mind is working. If I did the bead taper, it would take a  minimum of 6 months to get down to 90mg. If I used a compounding pharmacy, reducing 10% per month, I could be at 60 mg at the end of a minimum of 6 months. Is that about right? First method more gradual?

[ChessieCat]

3 hours ago, Altostrata said:

Bead-counting is the only way to gradually go off Cymbalta.

 

See Post #1 in the tips for tapering cymbalta topic

[Altostrata]

What a compounding pharmacy can do for you is pre-package beads into capsules of measured dosages. You will need a prescription for each batch. (It can be more cost-effective to get a big batch of low-dose capsules.) If you want to pay them for that, fine.

 

The reason I am suggesting removing beads right now is because my intuition is you should reduce the Cymbalta dosage ASAP.  Taking out 4 beads is a way to get started on that.  Bead-counting for now would give you time to either 1) order a scale, or 2) do your calculations and get your prescription for compounded Cymbalta.

[laurel53]

So, here is what is happening in restatement of 1 mg citalopram on 2/29 from signature reinstatement made on 1/29 (CC). Not feeling great, but some days are good, or part of most days is good. Today not so good. I am able to sleep with white noise, I am staying the course of eating clean (already my habit), but I am not liking the weird anxiety I experience. With Alto's thoughts about my high dose of duloxetine,  I am  trying to think my next steps carefully. It bugs me that I don't have a physician supporting me in this mess. I am considering meeting with a different psych provider that my Lyme provider recommended. Will he be any smarter/supportive/helpful/sensitive? If he thought my dose was whacky high, would he just tell me to cut out some crazy amount, no discussion allowed.? I know all this ruminating is not helping me feel comfortable in my skin right now. Are we all renegades here? I know I need the support of friends. I don't know what to ask of them.

 

Thanks for listening.

 

Edited February 19, 2018 by ChessieCat
made correction to date of reinstatement

[ChessieCat]

You might find these discussions helpful:

 

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

What should I expect from my doctor about withdrawal symptoms?

[laurel53]

Read all the stuff in the above post about talking to doctors. 

 

I am also wondering about Buspar as a problem. Two years ago anxiety really ramped up for me. I was just starting with a new doctor, and he prescribed 10 mg Buspar twice daily. Eventually, things calmed down and got back to "normal" anxiety levels. 

 

This past summer, moods started to go wonky. I was dealing with a shoulder/neck injury that just seemed unwilling to resolve. I was working with a PT. I was  beginning Lyme treatment. I felt scared and low, worried I would not heal. By early fall I was having increased anxiety again, panic attacks, suicidal thoughts, was isolating,  etc, etc. Finally, in early October, I went to the hospital for 4 days, and was discharged to an outpatient program. The panic attacks seemed to be coming mid-morning. The hospital doc increased my Buspar to 20 mg twice daily, and told me to stop the 5 mg of citalopram. I did not do the latter action. 

 

I started to feel hope. My PT exercises were paying off, and my mood was lifting. November and December were  mostly good months. However, after I transitioned into another program, I was back with my regular psychiatrist. He was perturbed that I had not gone off the citalopram, and said he would not continue to prescribe it. I stepped down to 2.5 mg. Not very accurately, as I have mentioned. Things still seemed okay, and I had a lovely holiday season. 

 

On Jan 1, I stopped the citalopram. By a week later I was feeling angry and on edge. I tried telling my doctor what was happening and got the it's not withdrawal speech and a suggestion to take more Buspar, which I have not done. By now I was not sleeping, was having loud head noise, and basically feeling sick. I found this website. At my Lyme appointment  the docs recognized withdrawal, and I got a reinstatement Rx from them. I now was in the land of lying to my psychiatrist. I was feeling so hyped up much of the day, planning tortuous ways to kill myself, and hurting in my chest. After a week of thinking it was flu/cold, I started the reinstatement on 2/29.

 

In keeping notes every day I have noticed some things. I take my Cymbalta, a dose of gabapentin, and 20 mg Buspar in the morning. I tend to spread it out over an hour or more. Around noon most days  I start feeling panicky, hot and sweating, tight chested and heart palps, and restless.  Sometimes it resolves quickly, other times not until later in the PM. Around 1:30 I take the citalopram. At night I take another 20 mg of Buspar, the other dose of gabapentin, and 10 mg of amitriptyline. I usually have an abbreviated episode of sweating, restlessness, heart palps, increased anxiety, and discomfort as I move into sleep.

 

I know my Cymbalta dose is excessive. I am not sure how well the reinstatement is going. Would more citalopram help?  I wonder what the Buspar is doing. I believe this meds mess is making things worse. I don't think my current doctor can help me, and I have no way to know if another psych provider will either. There is a shortage of psychiatric providers in my state. I certainly do not want to CT anything else. See, my  mind is on overload! Need to find a new, supportive therapist, too. And be kinder to myself...

 

I am grateful for careful and considered responses from you good people here.

 

 

 

 

 

 

 

[laurel53]

Read all the stuff in the above post about talking to doctors. 

 

I am also wondering about Buspar as a problem. Two years ago anxiety really ramped up for me. I was just starting with a new doctor, and he prescribed 10 mg Buspar twice daily. Eventually, things calmed down and got back to "normal" anxiety levels. 

 

This past summer, moods started to go wonky. I was dealing with a shoulder/neck injury that just seemed unwilling to resolve. I was working with a PT. I was  beginning Lyme treatment. I felt scared and low, worried I would not heal. By early fall I was having increased anxiety again, panic attacks, suicidal thoughts, was isolating,  etc, etc. Finally, in early October, I went to the hospital for 4 days, and was discharged to an outpatient program. The panic attacks seemed to be coming mid-morning. The hospital doc increased my Buspar to 20 mg twice daily, and told me to stop the 5 mg of citalopram. I did not do the latter action. 

 

I started to feel hope. My PT exercises were paying off, and my mood was lifting. November and December were  mostly good months. However, after I transitioned into another program, I was back with my regular psychiatrist. He was perturbed that I had not gone off the citalopram, and said he would not continue to prescribe it. I stepped down to 2.5 mg. Not very accurately, as I have mentioned. Things still seemed okay, and I had a lovely holiday season. 

 

On Jan 1, I stopped the citalopram. By a week later I was feeling angry and on edge. I tried telling my doctor what was happening and got the it's not withdrawal speech and a suggestion to take more Buspar, which I have not done. By now I was not sleeping, was having loud head noise, and basically feeling sick. I found this website. At my Lyme appointment  the docs recognized withdrawal, and I got a reinstatement Rx from them. I now was in the land of lying to my psychiatrist. I was feeling so hyped up much of the day, planning tortuous ways to kill myself, and hurting in my chest. After a week of thinking it was flu/cold, I started the reinstatement on 2/29.

 

In keeping notes every day I have noticed some things. I take my Cymbalta, a dose of gabapentin, and 20 mg Buspar in the morning. I tend to spread it out over an hour or more. Around noon most days  I start feeling panicky, hot and sweating, tight chested and heart palps, and restless.  Sometimes it resolves quickly, other times not until later in the PM. Around 1:30 I take the citalopram. At night I take another 20 mg of Buspar, the other dose of gabapentin, and 10 mg of amitriptyline. I usually have an abbreviated episode of sweating, restlessness, heart palps, increased anxiety, and discomfort as I move into sleep.

 

I know my Cymbalta dose is excessive. I am not sure how well the reinstatement is going. Would more citalopram help?  I wonder what the Buspar is doing. I believe this meds mess is making things worse. I don't think my current doctor can help me, and I have no way to know if another psych provider will either. There is a shortage of psychiatric providers in my state. I certainly do not want to CT anything else. See, my  mind is on overload! Need to find a new, supportive therapist, too. And be kinder to myself...

 

I am grateful for careful and considered responses from you good people here.

 

 

 

 

 

 

 

[laurel53]

Just moments ago (11 AM here) :Took the Cymbalta, one pill, then second 15 minutes after, and before taking anything else, noticed I was having a ramping up in feelings. Shaky, intense pain in chest area, etc. Very intense fear and a sense that I needed to move around. Took  the gabapentin but no Buspar yet. Can't say if G helped or hindered things. Can't say if meds are the problem, or if this is my morning THANG. It was or felt like the worst panic attack ever. 

 

Body calmed down some, bit I truly thought I was going mad for a little bit. Or was going to seize (never have so no experience to go on there) or was going to have a heart attack. Was trying to talk on the phone with office where I want to have consultation. Actually have not slept well for 2 nights so tired.and stressed out.  While in that intense place,  I  had thoughts of having to go to the hospital. I know the outcome of that could be worse for me.  How do I plan my days now? I am getting afraid to leave the house. My brain says I need to tell someone about all of this, like a doctor. Ha, ha.

[Rosetta]

On February 19, 2018 at 11:18 AM, laurel53 said:

Just moments ago (11 AM here) :Took the Cymbalta, one pill, then second 15 minutes after, and before taking anything else, noticed I was having a ramping up in feelings. Shaky, intense pain in chest area, etc. Very intense fear and a sense that I needed to move around. Took  the gabapentin but no Buspar yet. Can't say if G helped or hindered things. Can't say if meds are the problem, or if this is my morning THANG. It was or felt like the worst panic attack ever. 

 

Body calmed down some, bit I truly thought I was going mad for a little bit. Or was going to seize (never have so no experience to go on there) or was going to have a heart attack. Was trying to talk on the phone with office where I want to have consultation. Actually have not slept well for 2 nights so tired.and stressed out.  While in that intense place,  I  had thoughts of having to go to the hospital. I know the outcome of that could be worse for me.  How do I plan my days now? I am getting afraid to leave the house. My brain says I need to tell someone about all of this, like a doctor. Ha, ha.

 

How are you today, Laurel? The "Shaky, intense pain in chest area, etc. Very intense fear and a sense that I needed to move around" is a normal part of being new to having a destabilized CNS, unfortunately.  You are not going mad, but I agree that it feels that way when in a panic like that. 

 

You are perfectly sane.  Your brain is sending out a signal for your body to produce adrenaline.  The brain is making a mistake, but the result is that your body responds without consulting your higher brain function.  You are being prepared to run or fight.  Your subconscious brain thinks that there is no time for consideration.  This is life or death to the subconscious, but you know there is nothing life or death going on.  So, you are confused in your consciousness.  If everyone around you were on high alert and getting ready to fight, you would feel normal.  But you know this is not warranted.  It's scary, I have experienced it many times.

 

Your higher brain function can be accessed with some difficulty to override the process.  It takes a lot of practice, but it is the most important skill you will learn while in WD.  The ramping up to panic can be short circuited.  That is the good news.  The ramping up feeling is something we have to learn to recognize and quickly begin calming techniques to avoid full blown panic.  I am not always able to think quickly enough or clearly enough to stop these spirals.  When I can I am able to avoid the worst.  

 

Can you stay home when you need to?  I hope so.  Yes, going to the hospital is often the wrong thing to do.  We should be able to get help from a doctor, but it's unlikely to happen.  Only a doctor you can trust with your brain can help you more than you can help yourself.  

 

Have you read this topic: 

I hope you can use the non-drug coping techniques, too.  They are in the Symptoms and self care section also.

 

Peace,

Rosetta

[Rosetta]

On February 14, 2018 at 3:57 PM, Altostrata said:

What a compounding pharmacy can do for you is pre-package beads into capsules of measured dosages. You will need a prescription for each batch. (It can be more cost-effective to get a big batch of low-dose capsules.) If you want to pay them for that, fine.

 

The reason I am suggesting removing beads right now is because my intuition is you should reduce the Cymbalta dosage ASAP.  Taking out 4 beads is a way to get started on that.  Bead-counting for now would give you time to either 1) order a scale, or 2) do your calculations and get your prescription for compounded Cymbalta.

 

Oh, also, did you start removing beads from Cymbalta or not yet?  Either way, that info might help when anyone checks your thread.  I hope today is much better for you!

Rosetta

[laurel53]

Rosetta, thank you for your kindness, in posting so much helpful info, and in asking how I am doing. Today is a better day so far. I have read the threads you posted and will go over it again and again. I am going to look at the posts on journaling, too. It seems many people  benefit from it. In and out of withdrawal. There is so much here on SA! 

 

I have not started removing Cymbalta beads. Is it "safe" while I am trying to stabilize in reinstatement? When I do, I will add to signature.

 

I so want this to be over... That may be my acceptance challenge. 

[laurel53]

Clarification request. I should be staying the course with the 1 mg citalopram, right? 

[Rosetta]

You reinstated 1 mg citalopram on Jan 29, correct?  Im sorry, I'm not a Mod.  It seems to me that it's ok to reduce the beads of Cymbalta based on the sequence of posts here, but that's not because I know anything about the drugs myself.  --Rosetta

[Rabe]

Could someone please help me....

I am switching from Clonazepam tablets to capsules compounded with rice flour.....  .2mg in day and .7mg at night as I have yellow dye allergy and the 

1mg pills are so hard to cut evenly etc. and the Dr wanted me on a steady dose. Started just the noon ones (2 of the .1mg capsules) for about a week and things seemed ok.  Started the evening ones(7of the .1mg capsules) about 3 days ago and my eyes and lower lip were getting puffy and my eyes irritated and I have been so anxious.  Thought it was food I was eating and stress of a move.  But tonight it feels like withdrawal...loud ringing and music in my ears, that inner anxiety, headache, some brain zaps, crying and such awful anxiety all through these days.  

Can the compounded capsules be less of a dose and/or absorbed less efficiently?  I am not feeling well at all and am not sure whether to go back to 1/2 a 1mg tablet and 2 capsules at night which seemed to be ok or what to do???  Any thoughts please? Probably ought to have waited until less stress but thought it would be a pretty even exchange.  I don't think so...unless it is something else?  Thank you!!!!

[laurel53]

Hello, all. After reinstatement and some time passing, I felt things shift some and the amount of time I had weird symptoms each day lessen. I was getting out some and going to appointments. Actually went shopping for fun a couple times!

 

Then I developed new stuff about three weeks ago  and an increase/return of some symptoms. Now I am having internal and external tremors, big muscle jerks, twitching, so much involuntary movement. Anxiety, of course, and pangs of depression. Not getting regular sleep, so often fatigued and headache-y. Some nausea and loss of appetite.Want to rest, but sometimes the vibrations in my chest, abdomen, and arms are so intense that they consume all my attention.

 

I have been treating Lyme (after clinical diagnosis) for a year, which had seemed good. The symptoms of WD are so similar to Lyme and co-infections. It could be a flare. It could be continuing WD. It could be both. I despair often and think of suicide. Of course, everyone tells me to go to the hospital, where I am sure the docs would mess with my meds. I have very small faith in most psychiatrists these days.

 

Forgot to mention the huge meltdowns and crying spells. Who stole my personality? I certainly cannot claim to be stable at the moment. I have started seeing a pain psychologist and hope she can be helpful.

 

What to do when reinstatement may have failed?  Thanks for reading.

 

 

 

 

 

 

 

 

 

[laurel53]

Hello, all. After reinstatement and some time passing, I felt things shift some and the amount of time I had weird symptoms each day lessen. I was getting out some and going to appointments. Actually went shopping for fun a couple times!

 

Then I developed new stuff about three weeks ago  and an increase/return of some symptoms. Now I am having internal and external tremors, big muscle jerks, twitching, so much involuntary movement. Anxiety, of course, and pangs of depression. Not getting regular sleep, so often fatigued and headache-y. Some nausea and loss of appetite.Want to rest, but sometimes the vibrations in my chest, abdomen, and arms are so intense that they throttle all my attention.

 

I have been treating Lyme (after clinical diagnosis) for a year, which had seemed good. The symptoms of WD are so similar to Lyme and co-infections. It could be a flare. It could be continuing WD. It could be both. I despair often and think of suicide. Of course, everyone tells me to go to the hospital, where I am sure the docs would mess with my meds. I have very small faith in most psychiatrists these days.

 

Forgot to mention the huge meltdowns and crying spells. Who stole my personality?

I certainly cannot claim to be stable at the moment. I have started seeing a pain psychologist and hope she can be helpful.

 

What to do when reinstatement may have failed?  Thanks for reading.

 

 

 

 

 

 

 

 

 

[Rosetta]

HI Laurel,

 

A mod might have a different view, but it sounds to me like reinstatement was successful.  I would guess that there is some other reason for your symptoms.  Has it been over 4 months since you reinstated?  Are you still taking 120 mg of Cymbalta?  Are you still taking amitryptiline?  Gabapentin? Buspirone?

 

Do you think you might have missed a dose sometime prior to 3 weeks ago?  Did you get a new prescription?  Did the manufacturer of one of your drugs change?  Did you switch to generic? Did one of your drugs have an expiration date that you didn't notice? Did something about your Lyme treatment change?  Did you have a cold or flu?  Did you start eating or drinking something new?

 

Maybe the citalopram expired?

 

I hope you feel better soon.

 

Peace,

Rosetta

[LadyBartonella]

How is going your Lyme treatment? Maybe this mess up with you.

I have this illness too.