fearbegone: support needed tapering for 19 months

[fearbegone]

hey, my new heroes...

I am feeling afraid and lost. This started for me in February 2018 when my retired psychiatrist's replacement said that I had to come off the klonopin or I would end up with dementia like my mom. (I will be 60 in August). With no suggestions as to how to taper, I found myself on Dr. Goggle and cut 1/4. Horrible withdrawals while maintaining a stressful position at work. Adding to my stress was a new partner who had moved from another state to move in with me. We never had time to stabilize our situation before my taper began and mom was diagnosed with advanced dementia.

 

I had a maddening search for a doctor to help me through this process and found an internist who upped the cymbalta to 90 mg and then later to 120 mg late summer after I tapered the klonopin to .25 mg  and back down to 90 mg in the fall. (I had been on cymbalta 60 mg and .5 klonopin since 2006. I started out with 75mg effexor and the .5 mg klonopin but I had withdrawals from the effoxor after missing 4 days of meds when out of town. Psychiatrist started me on the 60 mg Cymbalta. I remember the transition being a smooth one). 

 

In an attempt to continue with my Klonopin taper and to deal with the debilitating withdrawlas from what I now were Cymbalta-related, a different psychiatrist (still searching for competency at this point) was trying to cross me over back to the effexor and off of cymbalta. BIG issues with this process.

 

In February she dropped me to 60 Cymbalta and added 37.5 Effoxor. I did this for 2 weeks then dropped the Cymbalta to 40 mg and continued with the 37.5 mg effexor. I did this for 2 weeks but ended up in the ER with what I think was akastaisis. Was discharged with both a script for a beta blocker and an antihistamine. I finally was able, in my fear-induced panic, to take the antihistimine and sleep in the ER.  To date, I have used neither. I've white-knuckled and CBTed my way through the last couple of months.

 

I saw the psychiatrist in a few days after my ER visit and she dropped the cymbalta to 20 mg and stopped the effexor. I opted at this point to take my Family Medical Leave option and entered a 2-month long out patient CBT program which started on March 18th. During this time I was working with a psychiatrist for meds.

 

The psychiatrist affiliated with the outpatient program was a young man whose name I recognized and it turned out that he had developed a name for himself as a benzo withdrawal expert (Mad In America continues to ask him to blog). The entire two months in the program I did nothing but cry and I had my first full blown panic attack in 20 years. Meds at this point were 20 mg Cymbalta and .25 mg klonopin. I was being told that I needed to make another klonopin cut so I chose the date of April 19th, Good Friday, as I thought that fitting for my need for symbolism and to make a spiritual connection. I started by cutting that little pill into pieces but have ended up using a compounding pharmacy and have been taking 7.5 ml (.1875 mg) daily. He kept telling me that I was on such a low dose of the klonopin that I could jump if I wished. We never discussed the issues related to what I think are cymbalta withdrawal symptoms. I told me that I could be med free soon and regaining my new life.

 

The program ended on May 18th and I left with no med changes. Life got worse. I've had some good days but mostly they have been filled with crying and dread; a lack of meaning and a huge sense of loss. (I was having to make decisions about the future of my professional career which ends on July 24th. I've had no income now for 2 months and became eligible to apply for our agency's Disability plan on June 19th. I have applied and am waiting, hopeful, but waiting. My new relationship is suffering and I feel very misunderstood.)

 

Within the past 2 weeks I finally found doctors in town that have successfully tapered others off of benzos and Antidepressants. Three different opinions on med changes but they all share the thought that I need to stabilize before finishing the benzo WD. Yet, I question the plan. I need your wisdom.

 

SOOOOOOO, they all wanted to try new meds while finishing the cymbalta taper which wasn't even registering in my mind as a cause perhaps for my current state of being.

One wanted Lamictal, one suggested Lexapro and another zoloft because I have family members living mostly stable lives on this drug. (multiple SSRIs from 1986 - 1998 were tried, nothing worked for me until we found the cocktail with klonopin). Diagnosed as GAD.

 

The plan that was written up is this:

• Start .25 zoloft on 6/24/19 and take this for a week with the 7.5 ml klonopin and 20 mg Cymbalta.

So far, I have been less anxious but the foggy head and fear are still fairly high. I hate this spacey feeling. I've spent a lot of time alone in my room, afraid and tired but not able to sleep. My night time sleep has been affected a bit since starting the zoloft. I have trouble getting to sleep.)

• tomorrow she wants me to start 50 mg zoloft and drop the cymbalta while maintaining the klonopin.
• OR, take the cymbalta every other day.
• She wants me to stay  at 50 mg to see how I am doing. We will up it if needed. (I felt an almost immediate shift in attitude the first two days on the .25 Zoloft but this has since gone downhill. I am triggered by the thought of putting new meds into my body.)

 

How long will it take me to get off of the cymbalta and is switching over to zoloft a good idea?

 

I AM SO FREAKING AFRAID!!!!!!

 

Please share your support and wisdom. HOPE, is there hope for me. 

 

The compounding pharmacy will fill cymbalta capsales but I need  a plan as I fear that dropping another 20 mg is too much, too soon.

 

How long can I take the cymbalta and zoloft together without SS?

 

Looking forward to hearing back soon. Trying to make today a good day but I am feeling victimized and adrift.

 

With much appreciation.

fearbegone

 

 

 

[fearbegone]

did you get my intro?

 

good morning,

do you have any ideas for me? anxiously waiting to hear back.

thank you,

fearbegone

 

Edited July 1, 2019 by ChessieCat
added topic title

[manymoretodays]

Oh my fearbegone.  And welcome aboard.

 

Just reading the potential drug switches and then all the recent changes in medications/drugs is making me  feel a bit unsettled.

What are you taking right now?

Please put your withdrawal history in your drug signature

this is the portion that can be seen below others posts, unless you are using a phone device.  And this is very helpful to us.

 

Here at Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.   This would apply to frequent shifts in dosages of medications/drugs and or switches between different drugs as well.

 

You've had a lot of changes to medications it sounds like in the past several months.  No doubt you are experiencing a lot of withdrawal(WD) symptoms.

Dr.Glenmullen’s withdrawal symptom list.

Brain Remodelling

What is withdrawal syndrome.

 

I think it's possible, that you may have encountered some adverse reactions to your medication(s) at present along withdrawal(WD) symptoms and syndrome.  If I were you, I would certainly proceed with caution from here on out and so hoping that your prescribers will pay heed as well.

Serotonin Syndrome or Serotonin Toxicity

This ^ is a possibility, that perhaps some of this occurred when you and your doctors were trying to get you switched from Cymbalta to Effexor. 

Tips for tapering off Cymbalta(duloxetine)

 

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

and by stable, it often become a whole new realm of WD stability

 

There's definitely hope for you, fearbegone.  If you would, for now, just get to work on the signature portion for us and hold steady with your current doses of medication.  That will really help us to sort things out and offer further advice.

 

Meantime, or while you are working on that.  I'll just give you the general link to our Symptoms and Self Care forum  Go ahead and skip on down to the pinned topic on non-drug coping for emotional symptoms.  In the first post there you'll find several indexed coping tools that might help now.  Perhaps some of the videos may be easiest to try right now.

 

And hugs.

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

Welcome, welcome!

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

 

 

 

 

Edited July 2, 2019 by manymoretodays