aplywi: tapering and in pain

[aplywi]

Hi everyone.  I'm in the process of tapering from 30mg of Cymbalta and it's not going so well.  Part of issue is that I had to switch pharmacies and they changed the generic.  I recalculated but I think that might have messed things up for me.  I am currently at 166 beads down from 185  average.  My muscles and joints hurt like crazy. Even little joints like my finger joints hurt like crazy. It all feels inflamed.  My shoulder legs back, you name it, it hurts. And the headaches, the reason I am tapering are back full force.  

 

I am now on Cpap too, which started in the past month since they found i have sleep apnea.  I don't know if that affects things or not.  I am sleeping better than I was at first, but I still wake up in pain.

 

I have been reading about supplements and I am so confused. Everything is conflicting. I don't know what I need to take , how much, when, which is best company.  I am going to try Omegas since that seems to be the one most recommend but will that help with the body pain?  I'm seriously at the point where I want to go to my doctor and get a steroid because I can't take this anymore.

 

Can anyone help me???

 

Thanks,

April

 

[ChessieCat]

Hi aplywi and welcome to SA

 

The first thing we need to know is how quickly you have been tapering.  If you have been tapering too quickly the pain may be from tapering too quickly and are possibly a withdrawal symptom.  Please don't start taking anything new until we have assessed your tapering history.

 

Are you taking any other drugs - if yes, please include them in your signature (instructions below).

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

I'm going to give you lots of links to check out.  Just work your way through them one at a time as you feel able.

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold at that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because psychiatric drugs create a physiological dependence, not physical like caffeine or nicotine.

 

Patience is needed to get off these drugs.  We suggest throwing out the calendar and listening to your body and your symptoms.  If after 4 weeks you don't feel stable or life circumstances are a bit more stressful than usual (for example the Christmas period, winter time, or job change) it is generally better to stay at that dose for a bit longer until things settle down.

 

Please read the topics about talking to doctors before you see your own doctor (in green below)

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Tips for tapering off Cymbalta (duloxetine) 

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

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

What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

Tapering Calculator - Online

 

It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

Please also be aware that many members find that the lower their dose gets the slower they need to go, either reducing by <10% of the previous dose and/or holding for longer.

 

There are many existing topics and discussions on this site.  You can use the site search function at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need.

 

This is your own Intro topic where you can ask questions and journal your progress.  We suggest that members visit each others Intro topics so that can support and encourage each other.

[aplywi]

Thank you so much for your response and all this information!. I have attempted to create a signature. I hope I did it correctly!  I just read the part about not using a multivitamin and I did start one based on information I read elsewhere.  I don't really take a lot of meds.  And I'm confused most days about this tapering business. I understand the basics, although various places recommend different things.  I am just in so much pain. Even typing right now is hurting so much because my fingers are so tender.  I type for a living so that's going to make work tough for me.

 

Anyway, I am going to try and read the links you provided. And read around on the site. I really need more support than I was getting elsewhere. Thanks again for your response and all the nifo!

[ChessieCat]

You are welcome.  Thank you for completing your signature.  I realise I haven't responded to your question.  My post was to get you started and get the information from you.

 

Please answer these questions in a post

 

Q1:  Would you mind telling us how old you are please?

 

Q2:  Can you remember when  the aches and pains started?

 

Q3:  What was the reason you changed from Paxil to Cymbalta?

 

Q4:  What symptoms / start up effects did you get during and after the change over?

[aplywi]

Q1:  Would you mind telling us how old you are please?  I will be 51 in April

 

Q2:  Can you remember when  the aches and pains started? I have Fibromyalgia, so aches and pains are normal for me, however, I was doing fairly well back in December , but since then I think within the past month I have started with the several joint pains and muscle pains.  I had high BP and headaches with Cymbalta which is why I am trying to taper off.  

 

Q3:  What was the reason you changed from Paxil to Cymbalta?   The reason I was switched was because Paxil was managing my Panic Disorder, but not my Fibro pain. I was getting discouraged and depressed so the doctor had me switch over to Cymbalta with the promise that I would feel better.  

 

Q4:  What symptoms / start up effects did you get during and after the change over? I'm not sure if you mean the change over from one generic to another or the change over from Paxil to Cymbalta. So I will address both

 

When I went from Paxil to Cymbalta the biggest issue I had was insomnia and digestive issues such as stomach pain and diarrhea. Not long after starting Cymbalta I had an obstructing kidney stone. (never had a kidney stone before in my whole life) .   I had constant nausea and headaches.  I noticed my bp was elevated at each doctor visit.  They apparently switched me a few time on generics. I did not realize this until I started reading.  I had a stomach endoscopy and I have erosive gastritis.  I have taken rantinidine for it, but not consistently and not recently. 

 

I was on Camber brand initially, and they switched me to lupon. Lupon is the large beads so I couldn't taper. So I got switched back to Camber.  Unfortunaely, they couldn't fill the script right away and I ended up on Sulco for a week. That was just  recently. When I got the camber I counted out the beads and have stuck at 166 for a week.  I also started CPAP during this time so I wasn't sure if I was having trouble sleeping because of the cpap or because of the change in generics.

 

Currently, I am having severely dry eyes, pains in joints, fingers and knees especially, muscle aches and these blasted headaches. I also think my TMJ is flared. I have been seeing a chiropractor for a month, with little pain relief.

 

I hope that's enough info. Sorry if too much! I appreciate your help!

 

 

 

 

 

 

 

 

[ChessieCat]

Thank you for responding to my questions.  And a couple more:

 

Q1:  Why were you originally prescribed Paxil?

 

Q2:  When were you diagnosed with fibromyalgia?  Prior to ever starting a psychiatric drug or after?

 

On 26/02/2018 at 4:09 PM, aplywi said:

I type for a living so that's going to make work tough for me.

 

Several of our moderators use voice software.  That is something you could look into.

[aplywi]

Thank you for responding to my questions.  And a couple more:

 

Q1:  Why were you originally prescribed Paxil?  I was prescribed Paxil for Panic Disorder.  I was agoraphobic and it was the only thing that helped me . It was very effective for my PD symptoms.   

 

Q2:  When were you diagnosed with fibromyalgia?  Prior to ever starting a psychiatric drug or after? I did not have Fibromyalgia until well after I started Paxil. I had had back issues from childbirth, but I was thinner and I did not have the deep muscle pain at that time. The most I had was the PD and IBS. 

 

 

As for the typing issue, I don't think thing voice software would help as I work in INsurance and enter claims so a lot of money values in multiple systems.  I do use a mouse as much as I can though. 

 

 

I hope this gives you more info.  The headaches have been daunting . I can't seem to shake them although I get them more at work than at home.   I am still holding on my taper because I am experiencing pain, headaches and palpitations a lot.  Today my cheeks were flushing a lot. Not sure what that was. I tried taking Omegas last night for the first time. Not sure it did anything. I had palps after, but not sure if it was related or not.  I haven't had any palps  all day today, so I will see if it happens again after I take them tonight. I do have magnesium but didn't want to add that yet.

 

Thanks!!

[ChessieCat]

Did you check out this list of AD withdrawal symptoms?  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Some of the symptoms you are describing can be withdrawal symptoms.  Eg TMJ face-jaw-tongue-muscle-tension-and-pain

 

To find this topic I used google and typed in survivingantidepressants.org TMJ

 

[ChessieCat]

29 minutes ago, aplywi said:

As for the typing issue, I don't think thing voice software would help as I work in INsurance and enter claims so a lot of money values in multiple systems. 

 

Of course, voice software wouldn't be much help with that.

[aplywi]

3 hours ago, ChessieCat said:

Did you check out this list of AD withdrawal symptoms?  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Some of the symptoms you are describing can be withdrawal symptoms.  Eg TMJ face-jaw-tongue-muscle-tension-and-pain

 

To find this topic I used google and typed in survivingantidepressants.org TMJ

 

3 hours ago, ChessieCat said:

 

 

 

Supposing these are withdrawal symptoms do I just push through? I want to get off this stuff, but I'm afraid it will get worse and worse and I won't be able to function.  I wish there was a quick way off.  

[ChessieCat]

10 minutes ago, aplywi said:

I wish there was a quick way off.  

 

We all do.  Acceptance

 

Cymbalta 30mg May 2017-December 20 2017 (taper began)

 

Taper-  December 20, 2017 using weighing method.  First drop to 27.5mg  (ok) 2nd drop 25mg  January 15, 2018

Pharmacy switched me to different generic. Switched to bead counting. 185 avg so 166 beads. February 19th, 2018

 

 

Are you able to provide information about your reductions so the dosages can be compared?  When you say 185 avg is that how many beads in a 30mg capsule?  Are you able to give a mg estimate of 166 beads?

 

It could be that you are still experiencing difficulties because of the change/s to/in generic drug/s. generic-vs-brand-versions-of-antidepressants

 

[aplywi]

The 185 is the average number of beads across 3 caps. They all had varying amounts.  Based on that the 10 percent taper was 166 beads or minus 19 (18.5 rounded up).  When I first started I had gone down to 27.5mgs based on the weighted measure. I don't have that data now as I gave that up because I didn't trust the scale.  I'm not sure what the amounts in mg would be for 166 beads. I can try to figure it out I guess.   My next 10 percent drop would be to 149 beads. I haven't done it yet.

 

I did take magnesium last night and I do think it helped some, although I think it is bothering my digestive tract. But I think my other symptoms felt a little better.  I didn't have a headache today which is the very first day in a while I didn't have a headache!

 

I think I saw somewhere on here you don't recommend taking a lot of supplements only Omegas and Magnesium? I have both of those now. I'm still holding the taper until I feel good.   I also switched to putting the beads back into the original capsule. For some reason I think that makes a difference. I had been putting them in new gelatin caps.

[ChessieCat]

All approximate amounts:

 

185 beads = 30mg

 

30mg / 185 = 0.162mg dose per bead

 

166 beads x 0.162mg = 26.9mg

 

149 beads x 0.162mg = 24mg

 

Looks like you are doing okay with your calculations for dosing and reductions.

 

 

It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.