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DavidfromTexas

Hi, everybody. My name is David.

 

I just discovered these forums a couple days ago as I was searching the internet for answers and hope. I'm in pretty bad shape right now, even as I am typing these first lines I am starting to cry. I feel better about asking other people who have been through the same issues as me, as opposed to a psychiatrist that just wants to put me on medication. Warning: this is going to be a long post, I apologize and thank you in advance for reading.

 

LONG-TERM MEDS HISTORY: I am now 30 years old, and have been on Anti-Depressant medication for 20 years. I was diagnosed with pretty severe OCD/Anxiety around age 10 or 11, and immediately started on Anti-Depressant medication. (It was warranted, I was in such despair and largely unable to function even in everyday activities like school and doing normal kid things, and was never going to be able to get through any kind of Behavioral Therapy at that point in my life). SO we started with Zoloft (Sertraline), and it made a HUGE difference pretty immediately. I was able to be much more of a "normal" kid, though I did have setbacks here and there. After the better part of a decade, when the Zoloft seemed to not be working as well anymore, we switched to Cymbalta (Duloxetine), which I have been on for approximately the last decade. Which brings me to...

 

SHORT-TERM MEDS HISTORY:  Sometime in 2017 (I think), I decided I finally wanted to try going without my medication. I began a tapering with my prescribing psychiatrist that lasted 6+ months UNTIL the beginning of 2018 when I dropped COMPLETELY off of the medication. The tapering process was 90mg down to 60mg, then down to 30mg, then eventually down to nothing. I had NO physical withdrawal symptoms when I did this, and I remained off of the Medication for maybe around 3 months. The only REAL reason I decided to go back on the medication after those 3 months was because I had been feeling much more down/sad since being off of them, BUT I was unsure how much of that was normal (my 4-year first-love relationship finally died at the end of 2017) and how much of that was possibly a side-effect of being without the medication.

 

SO, by April of 2018 I had decided to go back on Cymbalta, and I pretty quickly went all the way back up to 90mg. The plan was to be on it for a little while longer to give myself time to heal from the loss of this relationship. By the end of Oct. 2018 I had made it back down to 30mg, where I would stay for the next 5-6 months. (I think I tried dropping off the medication once during this period but went back on pretty quickly because I started feeling some physical withdrawal symptoms that I hadn't before. At this point, my memory is kinda blending it all together.) I tried dropping off again this April and felt the withdrawal effects worse than I did the previous time. So once again, I went right back on it. THEN I started seeing a different Dr (a nurse practitioner) who has experience helping people wean off of meds. Following her suggestions, THIS TIME I weaned from 30mg down to 20mg daily for 2 weeks, then started taking the 20mg ever other day for 2 weeks, then down to half of the 20mg pill every other day for 2 weeks (opening capsule and pouring out approximately half of the beads), and then finally taking half a 20mg pill every 4 days for a couple weeks. Doing it THIS way prevented the physical withdrawal symptoms I had experienced the couple times before. BUT now it's the emotional despair that I am worried about... 

 

WHERE I AM NOW:

I have now been completely off of the medication since July 2nd.

If I can just get through this depression and sadness, I just KNOW that I will be able to handle the issues that originally plagued me 20 years ago. I have lived through it all, and with the experience and memories and knowledge that I have now, I should be able to cope with it much better.

 

I am just worried that it's the worst timing ever. Here we are, over a year and a half since my relationship was fully dead, and I am struggling with it worse than I have at any point since its death. I have only recently decided I need to do whatever I can to get past it because it is CERTAINLY not coming back (talked with her a few days ago). BUT what is now troubling me, is that I'm not sure if my current depression is due to the loss of the relationship OR if it's due to me being completely off of medication now and my brain having to re-wire itself and recover. OR if it's a really bad combination of both. I've never been through heartbreak like this before, but it seems to be getting progressively worse, where in normal circumstances it should be getting progressively better as time wears on.

 

How can I tell the difference between true, natural depression and depression that's an effect of withdrawal?

I assumed (maybe naively) that if I didn't have any physical withdrawal symptoms then I probably wouldn't have any emotional symptoms either.

 

Just looking for some thoughts/insight from people with similar experiences. I am scared that I will have to remain on Anti-Depressants for the rest of my life, and who knows how THAT might even damage my health. I have been researching alternate, more natural forms of therapy for someone like me with Serotonin issues, the use of things like magnesium supplementation and whatnot. MY MAIN CONCERN IS BEING ABLE TO BE HAPPIER AGAIN, and I'm just hoping I can do that without Anti-Depressants. 

 

(I'm also dealing with other smaller physical issues like PE, which began as soon as I started weaning and gradually got worse the less amount of meds I took. But again, at this point, the more important thing to me is my mental health and mood. I don't want to feel heartbroken and hurt anymore.)

 

Thanks for reading. I appreciate your time.

 

David

 

 

 

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Dejavu

Hello David, and welcome to SA from a fellow Texan! You will find a great deal of information and support here. This is your personal intro topic where you will post all questions and updates.

 

The first thing we would like you to do is create your signature. The link is below. This is where you will list all of your medications, dates you used them, and dosages. I know you have already put that in your first post, but your signature will appear at the bottom of every post you make so that the mentors and mods can see your history without having to go back through your thread each time.

 

http://survivingantidepressants.org/index.php?/settings/signature/

 

It seems you have gone off and on psych meds very quickly. Doctors know very little about withdrawal from psychiatric medications and withdrawal syndrome, which is why this site exists. You have been tapered from both zoloft and cymbalta too quickly, which has now caused nervous system destabilization. Many doctors recommend skipping doses as a tapering method, but it is not a good idea. The brain craves stability, and by skipping doses, you are basically putting yourself into withdrawal every other day. All these things tend to have a cumulative effect, and make it harder and harder to withdraw each time. You have basically done cold turkey withdrawals from both zoloft and cymbalta, and your system is now in flux. Here at SA, we recommend tapering mo more than 10% of your current dose every 4-6 weeks. There is a good reason for this. Please read the link below.

 

Be aware also, that withdrawal symptoms are can be delayed, not showing up sometimes for several months. This usually leads doctors to decide that your symptoms are a relapse of your condition rather than withdrawal, which leads to more drugs, more destabilization and more severe withdrawal. It becomes a vicious cycle.

 

I think it's very possible, if not probable, that your present depression is a symptom of withdrawal. The link below lists some of the many known withdrawal symptoms.

 

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

How long has it been since you took Cymbalta? Do you have any left? It's possible that a tiny reinstatement - 1 or 2 mgs - may alleviate your symptoms. You would then hold that dose until you stabilize and then taper by 10% later. 

https://www.survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

The last thing I will suggest is that you get yourself into some therapy, pronto. It is possible to live drug free, but having been medicated for so many years and from such a young age, you will need to build a skill set for dealing with anxiety. I would recommend a therapist who specializes in CBT or DBT. 

 

I know I've thrown a lot at you. Please complete your signature and answer my questions and we will be able to suggest a way forward for you. 

 

Again, welcome to the forum. We are happy to have you here.

 

 

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DavidfromTexas

Hi, Dejavu. Thanks for your prompt reply. (Also, I know Dallas. I went to SMU)

 

-I haven't been on Zoloft since around 2009/10. If I remember correctly, at the point of switching from Zoloft to Cymbalta, we did just a straight switch, no slow tapering off of the Zoloft first. Are you saying this event from 10 years ago could STILL be affecting my nervous system??

Also-- there were some times, mainly when I was still an adolescent, that I went a couple days without taking my medication, usually because I was busy doing something/had a late night/etc and just forgot. Could that have done any lasting damage?

 

-Can repeated tapering, or off & back on, of anti-depressants do lasting damage to the brain? If so, I am nervous to go back on my meds now that I am completely off again, knowing that the goal in the future is to be medication-free again.

 

-To answer your question about Cymbalta, I took my last minuscule dose of Cymbalta on July 2nd. But I still have several bottles of Cymbalta in different dosages lying around. I never threw them out as I was weaning, just incase I needed them in the future. I believe I have mainly 60mg bottles left. Maybe 1 or 2 30mg bottles. And just a few remaining pills of 20mg. I am able to go back to the Dr for more prescriptions if I need to.

How would I get 1 or 2 mg doses? The smallest capsules they make are 20mg, which is why I was opening and dumping out some of the beads when I was tapering down from 20mg.

 

-The emotional pain I am feeling at the moment seems to come from an inability to let go of the recent past, which could very well have something to do with my obsessive tendencies (OCD). BUT... 1) I do not believe I am not incessantly obsessing about it...I am still able to eventually let it go when I get to work and have to focus on getting things done. It only gets bad when certain things trigger memories, certain memories trigger sadness, and it just keeps going down. That's why I say I'm not entirely sure that the sadness is NOT normal to a certain degree.

I actually AM seeing a counselor once a week. Just had my first 2 sessions. Never had any kind of therapy before, for now it's just talking and listening, and she will come up with some suggestions. No CBT. But talking and listening is better than nothing, since until now I have really had nobody I could talk to about anything I've been feeling.

 

-Does the fact that I have been on Anti-Depressants for 20 years make it harder for my brain and nervous system to adjust after having tapered off? Is there less hope for someone like me to me meds-free than somebody who was on them for a much shorter period?

 

In the end, if I absolutely need anti-depressants to be a normal person, I will take them. The main reasons I've wanted to try to be free of them is:

1. I am concerned about damage to my health from decades-long use, since so little is still known about these drugs

2. I do not want to have lived my entire life having never truly experienced it, the world, people, myself, everything. Knowing what it felt like to be "normal" like people who don't need meds.

3. I have been sleeping WAY too much for several years now, and when I think about it, even when I was in high school. I have also been "dozy" throughout the day for the same amount of time. There are periods where I can sleep up to 13 or 14 hours. Granted, the most recent times where that has been the case, I have also been sad to some degree. BUT I always felt that the extra sleeping and doziness throughout the day could be due in part to the Anti-Depressants. (The first time I dropped off of Cymbalta in 2018 with no physical w/d symptoms, my body started pretty immediately waking me up after 8 hours of sleep. That part was refreshing.)

 

I apologize for my long-winded-ness (bloviating?).

 

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DavidfromTexas

Do you think It's too soon to try reinstating? Should I give my mind more time to adjust? It's only been 21 days.

 

Also worth noting, I was definitely still experiencing sadness even when I was on 30 mg, MAYBE even 60 mg dosage (though less so). I think it HAS gotten worse at lower doses, but that being said, it doesn't seem to me that going back on to an even lower dose than before would have any effect on what I'm feeling. What do you think?

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Dejavu

David, all good questions. I will attempt to answer them in order:

1 hour ago, DavidfromTexas said:

Are you saying this event from 10 years ago could STILL be affecting my nervous system??

No, I misread your post, sorry. I didn't realize your withdrawal from zoloft was that long ago. However you were directly switched over to cymbalta, because zoloft was no longer working, which means you had developed a tolerance to it. Repeatedly changing, altering doses, or going on and off tends to have a cumulative effect in the sense that your system becomes more sensitized to these drugs over time. This means that it may become harder and harder to withdraw, or it may be that the drug(s) are no longer effective or cause adverse reactions. Given these possibilities, I think your plan to get off is probably a good one.

 

1 hour ago, DavidfromTexas said:

that I went a couple days without taking my medication, usually because I was busy doing something/had a late night/etc and just forgot. Could that have done any lasting damage?

No.

 

1 hour ago, DavidfromTexas said:

Can repeated tapering, or off & back on, of anti-depressants do lasting damage to the brain?

Permanent damage? No. You will heal, but it might take some time. Cold turkey and/or fast taper (which you have unwittingly done), tends to result in longer-lasting and more severe withdrawal symptoms than does a slow taper, which is why I've asked you to consider reinstatement. 

 

1 hour ago, DavidfromTexas said:

That's why I say I'm not entirely sure that the sadness is NOT normal to a certain degree.

Yes, what you describe is a well-known withdrawal symptom. In my own journey, at some of my lowest points, I have caught myself "relitigating" painful life events from decades ago. And it feels fresh; like it just happened yesterday. Many members describe this symptom.

 

1 hour ago, DavidfromTexas said:

actually AM seeing a counselor once a week. Just had my first 2 sessions. Never had any kind of therapy before, for now it's just talking and listening, and she will come up with some suggestions. No CBT. But talking and listening is better than nothing, since until now I have really had nobody I could talk to about anything I've been feeling.

This is great. You are setting yourself up for success already.

 

1 hour ago, DavidfromTexas said:

-Does the fact that I have been on Anti-Depressants for 20 years make it harder for my brain and nervous system to adjust after having tapered off?

It is a component, as are age, type of drug, dosage amount and length/pace of taper. You may have a bigger challenge than someone who has been taking ADs for only a year or two. But let me be clear: everyone is different. And very little research has been done on "discontinuation syndrome." Drug companies have successfully lulled the medical community into the false assumption that withdrawal past a few weeks does not exist.  So we are all feeling our way through the dark here, but certain patterns do emerge. What you have going for you is that you are young, and younger brains are much more neuroplastic than older ones. So let's focus on the positive here.

 

1 hour ago, DavidfromTexas said:

Is there less hope for someone like me to me meds-free than somebody who was on them for a much shorter period?

We have many members who were on these drugs for a longer time than you, and they are currently tapering successfully, or have completed their tapers and come out the other side. I urge you to read some of our success stories. These folks are truly inspiring!

 

56 minutes ago, DavidfromTexas said:

Do you think It's too soon to try reinstating? Should I give my mind more time to adjust? It's only been 21 days.

Reinstatement most reliably works within a month after stopping. You would reinstate only a tiny amount, perhaps even just a couple of beads to start. I know that sounds nuts, but sometimes that's all it takes, and taking too much can make things much worse, because your CNS is already sensitized. Please read the link I sent you about reinstating. I understand your hesitation about reinstating. The decision is yours, but you need to be aware that your symptoms could get much worse, and you will have to ride them out, which may take months or even a couple of years. The other remaining option is to reinstate, stabilize, and start a slow, gentle taper. 

 

There is a link called Tips for Tapering Cymbalta here on this site. I cannot find it right now, but I will do so tomorrow and send it to you.

 

Let us know what you decide to do. We will be here to advise and support either way.

 

 

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DavidfromTexas

Ok, thank you for all the answers! I am willing to do the reinstatement if it's best. I appreciate your willingness to help me through this so much!
 

I have read through the reinstatement pages, and I am curious about a couple things. I'm not sure in my particular case how much of a dosage for initial reinstatement would be advised. Also, if I do not feel improvement soon after, I'm wondering how long I should give the reinstatement at the same dosage before possibly increasing it more?

 

This last tapering I did consisted of opening the 20mg capsules and just pouring out what I thought to be "about half" of the beads. After reading the tapering sections, I see now that this may have been severely flawed.

 

You said that repeated tapering and coming off and on the medication might make it harder for withdrawal in the future or possibly make me more sensitive to drugs (adverse reactions). That makes A LOT of sense, because the 2nd time I dropped from 30mg to nothing was so much different than the first time. First time no physical symptoms at all. 2nd time there were definitely physical symptoms. Now I'm imagining what might happen if I did it a 3rd time.

Does this mean I could have possibly effed this up to the point where even if I decided I DO need Anti-Depressants in the future, that it would be hell for me to go on them or perhaps they wouldn't even work for me? If so, this is getting scary. (A little of this is probably my OCD/Anxiety kicking in lol, but still a little nerve-wracking.)

I wish I had known about this site before starting my taperings.

 

At this point, I am just hoping that any damage I may have done to my brain can be corrected or healed.

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DavidfromTexas
Posted (edited)

If reinstating will be better for my brain at this point than just simply trying to ride out everything I’m experiencing (leaving the brain alone), I’ll be glad to reinstate. Wondering if I should try going back on a full 20mg dose and then start the long process of tapering correctly, OR if I should even just leave the med alone for a while once I’m back on it, and see if I notice a change in my relationship-related sadness/depression, and THEN proceed after that point. Because I’m not sure how keen I am on the possibility of just ending up right back where I am if I’m not ready. Let me know what you think, and I will start as soon as possible. 

I guess the most important thing for me right now is to be completely functional, as I have a lot of things to take care of in the near future. I was simply too eager to be off the medication, and careless. 

 

One more question: If reinstating does not provide relief from the withdrawal symptoms Im facing, should I still continue to take the medication and do the long slow tapering as if it WERE having an effect on my symptoms? Is it possible that even though I wouldn’t be feeling relief of the symptoms that it actually WOULD be making a physical difference with the receptors in my brain and therefor helping it transition? Not sure if that made sense or not

Edited by DavidfromTexas

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ChessieCat
13 minutes ago, DavidfromTexas said:

Wondering if I should try going back on a full 20mg dose

 

Hi David,

 

Please read Post #1 of About reinstating and stabilizing to reduce withdrawal symptoms

 

It is better to reinstate a lower dose and increase if needed than to risk taking too high a dose.  Once we experience withdrawal symptoms our nervous system can become sensitised and taking too much can cause issues.

 

The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

I'm not able to read through your posts tonight as I am very tired.  I'll ask the other mods what their thoughts are on a dose you could try.  The dose we suggest might be 1mg or 2mg.  Definitely not more than 5mg.

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manymoretodays
Posted (edited)

Hi David and welcome aboard,

Here you go:

Tips for tapering off Cymbalta(duloxetine)

^ this should help

 

And do look through the reinstatement and stabilizing link as well(in the above post).

 

22 days off now, correct?  And you have 60 mg capsules and 20 mg capsules to work with?

What was the final dose of Cymbalta that you jumped off of?  Or if you can give a close approximation of that, that might help.

 

If you still have some of the 20 mg Cymbalta/duloxetine:

You might count the beads in the 20 mg capsules to get an average.

 

I agree it might be best to start low, lower in dosage than doing a full 20 mg dose.

Also keep notes please:  Keeping daily notes

Use this simple format:

Sample notes:

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

I think if I were you, and had decided to reinstate,  I would go with the 2 mg dose, or as close as you can approximate to that with the beads.  Do try to stay with your initial reinstatement for 4-7 days, keeping the notes.  Post them here, in the above format.  

This might not relieve you of all of your current withdrawal symptoms, yet may offer some improvement.  It may take up to a week, however, to see this.  From there, you could potentially go up a bit in dose, or just hold at the 2 mg dose,  and then later slowly taper off of that.

 

I'm not sure I can answer all of your most recent questions, at present.  But I think that the reinstatement might help, with WD symptoms, and probably won't, in any case, make you worse, or harm you in any way.   If, after reinstatement, significant new symptoms occur, that we can differentiate from your ongoing WD symptoms........at that point you could stop the reinstatement.  That's some of the reasoning behind starting low, real low, with dosages in reinstatement. 

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

Edited by manymoretodays
additional comment at end

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DavidfromTexas

Thank you guys for your replies. 

 

I must admit that I am still hesitant about going back on the meds in fear that it could be doing more damage than had already been done. I’ve also got some okay days too, they’re not ALL terrible. I have not really had ANY physical withdrawal symptoms, but my emotions do seem to be more on the surface, like if somebody were to come up to me and ask me what’s wrong, I would probably start crying if I had already been thinking about it a little. My “bad” days recently have consisted of more crying. BUT to be fair I was more emotional too when I was taking 20mg/day, I think it’s gotten worse since then, but only a bit, and I figured it was just because I was trying to face the fact that I had to let her go. The sadness seems like it is coming from the loss of the relationship, but I guess like it says elsewhere on here, neuroemotions seem completely justified when you feel them. So I just don’t know anymore. 

But reinstatement seems to be the general suggestion here, and yall do know more than me about this stuff. 

 

To answer your question, I’m not exactly sure what approximate dose I had been taking after dropping down from 20mg. I was opening up the capsules and just dumping out “about half” of the beads. And then after THAT I tried to halve it again for the last dosage level. So it’s hard to say about how many that would have been. Maybe around 5? But I’m sure that I didn’t get it exactly the same each time by just eyeballing it either. 

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DavidfromTexas

Is starting to supplement with things like magnesium a good alternative to reinstatement? Or does it not work that way?

 

I’m worried about this being the 3rd or 4th time I’ve tried tapering and subsequently reinstating. 

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DavidfromTexas

Until my scale comes in, should I just count out the beads and do the math to get to 1mg??

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Dejavu

Dave, I am a total mathematical zero with no experience with cymbalta, so I will leave the calculations to the "sharper knives" among the staff to advise you on those questions. @brassmonkey and @manymoretodays are both pretty good at that. With regard to the remainder of your concerns:

 

The only two supplements SA recommends are magnesium and fish oil. Neither will be sufficient to act as a substitute for reinstatement, but I find 400mg daily magnesium very calming to my system. I use mag glycinate, which is less likely to cause stomach issues than the other types. Magnesium is better absorbed by taking it periodically throughout the day rather than in one big dose, so I do 100mg tablets 4× a day. You should start with a small dose and gradually work your way up, to see how you react, since your system is sensitized right now.

 

Reinstatement is a personal decision. And it is a difficult one in your circumstances. If you were being slammed by symptoms ar the moment, reinstatement would be a no-brainer. But the problem is this: if you choose not to reinstate, it is possible you will become more symptomatic down the road a few weeks or months, after it's too late for reinstatement. You are then stuck with waiting out your withdrawal symptoms, which can take a very long time. No hard and fast rules (remember, no R&D has been done on this syndrome because according to conventional medical opinion, it does not exist), but folks who CT or fast taper tend to have more severe and/or prolonged withdrawals.

 

Some people even become non-functional for a while after a CT or too-fast taper. I was one of those people. One month after my fast taper from zoloft, I was hit hard with debilitating symptoms which rendered me essentially bedbound wirh a plethora of both physical and mental symptoms for the better part of 4 months. Fortunately, I was able to reinstate. I am now going through windows and waves while I stabilize and get ready to begin my taper. Had my withdrawal waited longer than 30 days to rear its ugly head, I shudder to think how I might be suffering now and for some time to come.

 

We have a very beloved and courageous member here named Rosetta. She has battled cold turkey withdrawal for 2.5 years now. Below is a quote from her intro thread:

 

 However, I would like to add my voice here and say two things that I feel are important:

1. You will in all likelihood get better - much better, and

2. If a moderator suggests that you reinstate, please read the horror stories of those of us who did not have that chancebefore you decide that you "do not want to go "backwards."

 

I'm not trying to frighten you. And of course, it is not a certainty that you will crash if you do not reinstate. But it is a VERY distinct possibility, and once the process of CNS destabilization has begun, turning it all around is a challenge of patience and personal fortitude the likes of which I've never before experienced.

 

Bottom line: Everyone is different. None of us are either doctors or fortune tellers, and we cannot give medical advice or predict the future. That's what makes the decision whether or not to reinstate so difficult. But here at SA, we take a harm reduction approach to coming off these dangerous meds, which is why we are inclined to advocate reinstatement in cases that meet the criteria for doing so. For me, it was absolutely, positively, unequivocally the right decision. 

 

Whatever you decide, know that we will stand with and support you. We want to see you suceed, and we want to see you heal. And you can.

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DavidfromTexas

Ok, I am taking my first dose tonight. I don’t want to wait another day since I’m already a week away from the month mark since my last pill was taken. 

 

I do not have a scale yet, so I am counting and doing math. I have taken the average of the beads from five 20mg capsules. They each had a different number from 112-117, averaging out at about 115 beads. I am dividing 115 by 20 which equals 5.75 beads for 1mg. If I’m going for a 2mg dose as suggested, I am doubling 5.75 which equals 11.5 beads for 2mg. Rounding up to 12. 

 

I’m not sure how microscopically accurate these calculations have to be, since the beads do vary in size by the TINIEST amount. Plus, some break apart, etc. SO, @manymoretodays and @brassmonkey, if you would please let me know if these calculations are sound I would appreciate it. Until I hear back, I’m just going to go ahead and take the dose tonight just to get started. 

 

ALSO. I’m just using the clear giant gelatin capsules I bought from the Vitamin store. Is that sufficient? They’re much bigger than the 20mg capsules lol. 

 

Thank you all. 

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DavidfromTexas

I FORGOT TO MENTION. For an unrelated problem, my ENT currently has me on:

 

2 Cefdinir (antibiotic)/ day

1 Claritin/day

1 probiotic/ day (for any stomach upset due to the antibiotic)

1 Pepcid AC/ day

 

Ive only been on these meds since Friday, as I am having a quick little procedure tomorrow to fix a nasal cyst. 

I checked the drug interactions on the Drugs.com website and I don’t think I found any of these reacting with Cymbalta. Should these all be okay together with the Cymbalta?

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DavidfromTexas

Wednesday, July 24th

 

9:30am—Took my daily Vitamin D and temporary Claritin dose

10:00am—Got up, felt fine

11:30am—Took my temporary anti-biotic

12:30pm—Felt worried/scared after reading more on the forum, shed a couple tears very quickly on my way to a class

3:00pm—Took my temporary (hopefully) Pepcid AC and ate a late lunch

4:30pm—Began to notice the TINIEST background headache (possibly tension), it does not really bother me. (I get these sometimes when I haven’t eaten enough or something. They are VERY RARELY actually painful.) 

8:30pm—FINALLY got to take my first reinstating dose of 2mg after dividing and calculating them out. 

10:00pm—Going to have slight snack, tiny headache is still in background. 

 

 

Wanted to tag on a question to this post: 

 

Do y’all think that I may have been suffering from some degree of emotional withdrawal for the entire year and half since I FIRST dropped down to 0 from 30 mg at the beginning of 2018?

And if so, does that year and a half of constant slight withdrawal make the outlook for my recovery look significantly longer?

 

I guess it’s being unable to have definitive answers to these things that troubles me the most. 

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DavidfromTexas
Posted (edited)

 

If somebody already took a single dose of 2mg as their first reinstatement dose, but decided they wanted to try reinstating with 1mg INSTEAD, is it acceptable to switch the VERY NEXT DOSE (only the 2nd dose of reinstatement) to 1mg??

Edited by DavidfromTexas

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DavidfromTexas
15 hours ago, manymoretodays said:

...From there, you could potentially go up a bit in dose, or just hold at the 2 mg dose,  and then later slowly taper off of that.

 

 

You think this could work??

 

Because after reading a lot of the information in these forums, I’m REALLY starting to worry that the couple unwitting mistakes I made in this last year and a half has screwed up my life for the next 5 years!

 

If I WERE able to start tapering from the 2mg after a few months of being on it steadily, then maybe my correctly-timed tapering would only last 2 years or so?

 

Would it be wise (even though I have taken one dose of 2mg already) to try taking just 1mg as my reinstatement??

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ChessieCat

If you want to reduce to 1mg it would be best to do this straight away.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the blood.

 

It is difficult from the information you have provided in your drug signature to work out what doses you were taking when since April 2019.   To help us out please add dates and doses.  Please make sure include the last date you took your drug as well as state that you were taking x mg alternate days.

 

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DavidfromTexas
2 hours ago, ChessieCat said:

If you want to reduce to 1mg it would be best to do this straight away.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the blood.

 

 

Okay cool, do you think having taken it for only one dose and then dropping down the next day will have any adverse effects?

 

2 hours ago, ChessieCat said:

It is difficult from the information you have provided in your drug signature to work out what doses you were taking when since April 2019.   To help us out please add dates and doses.  Please make sure include the last date you took your drug as well as state that you were taking x mg alternate days.

 

 

I will try my best, I didn’t originally put specific dosages in that period because there were not EXACT dosages, I was pretty much eyeballing my reductions when I poured out beads. 

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ChessieCat
5 minutes ago, DavidfromTexas said:

Okay cool, do you think having taken it for only one dose and then dropping down the next day will have any adverse effects?

 

Yes it should be okay.  Please keep daily symptoms notes on paper of what improves/worsens so that if your symptoms stay unbearable we can assess to see if you need to updose.

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DavidfromTexas

Gotchu. Thank you so much!

 

Actually as I am writing this I have just woken in the middle of the night with a little bit of nervousness (excitability?) where I couldn’t go back to sleep and started to briefly, but ultimately controllably, have the shakes. Which is something I used to wake up in the middle of the night with as a kid when I was having issues. I have experienced it only once or twice within the last couple months, which makes me think it is still mainly a part of withdrawal. But coincidently I took my first reinstatement dose about 7 hours ago, so...

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DavidfromTexas
Posted (edited)

Yeah, I actually just read that post, but what I experienced was nothing super alarming, no panic. It was actually a pretty calm intermittent shake that I was able to make go away within a couple minutes. Actually nothing in comparison to the ones I had as a kid. But still, maybe it means something. And definitely no sunlight yet here in California. 

Edited by DavidfromTexas

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DavidfromTexas

Is there a specific time I should be taking the dose of Cymbalta? 

 

In all my years I have always taken it immediately before bed at night. And my bedtime has always varied because I’ve never really been on a 9-5 schedule, and I have pretty much always been a night owl. 

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manymoretodays
Posted (edited)

Good morning LA DavidfromTexas,

If you took the Cymbalta at night before, I think that sticking with a night time dose will be fine.  Did you have any sleep problems before when taking it at night?  Take it at the same time, each night.  Consistency pays off and is important.

 

I come up with the same that you do on the math.

10 hours ago, DavidfromTexas said:

I do not have a scale yet, so I am counting and doing math. I have taken the average of the beads from five 20mg capsules. They each had a different number from 112-117, averaging out at about 115 beads. I am dividing 115 by 20 which equals 5.75 beads for 1mg. If I’m going for a 2mg dose as suggested, I am doubling 5.75 which equals 11.5 beads for 2mg. Rounding up to 12. 

 

So, 6 beads(rounding up) is equal (approximating) to 1 mg.

12 beads is equal to 2 mg.

 

Yes, as Ccat said, if you do decide to go on down to 1 mg, you can go ahead and just take 6 beads tonight.

 

Yes, the capsules are large.

And welcome to the "weeping widows" club of sorts.  It can definitely affect males, as well as females.  Thankfully now, most of my tears are gratitude tears.  Note the shakiness in your notes please.  Is this something that comes on for you with nervousness, or is it brand new?

 

Good job, on checking meds, in general and for your upcoming procedure at Drugs.com.

I think that these temporary meds will be okay.  Do let your ENT know that you are back on a small dose of Cymbalta.

 

8 hours ago, DavidfromTexas said:

Do y’all think that I may have been suffering from some degree of emotional withdrawal for the entire year and half since I FIRST dropped down to 0 from 30 mg at the beginning of 2018?

And if so, does that year and a half of constant slight withdrawal make the outlook for my recovery look significantly longer?

 

I think your outlook for recovery is looking great DfromT!  Lot's of patience required.  Do some discernment with your reading, on site, and off site.  Sometimes, members get quite overwhelmed after they first arrive here.

You may want to begin to get into some non-drug coping, as soon as possible.  What have you got going now, or what do you do?  For example:  Do you meditate, exercise, do journaling, explore your spirituality,  or do therapy with a trusted therapist?  

Look at this all, as a wonderful new journey into finding yourself and make it an adventure.

 

Non-drug techniques to cope with emotional symptoms

tons of stuff indexed at the bottom of the first post ^

 

You might also like the "Finding Meaning" Forum.  Just go to the home page and you'll see it.

 

Best for your procedure today,

L, P, H, and G,

mmt

 

Oh, and good job with preliminary notes.  Keep those on paper, and then post here.  3 days worth, all in one post will be great and make it easier for us, too.

Don't forget to add in your sleep.  If you want, you can just do a rating scale for symptoms too, over on the right hand side.  Like from 1-10.  For worried/scared.  Or tears.  And then if you want to put more in narratives, in another post, as you have done, that's great!  Keep the notes simple and direct.

 

Edited by manymoretodays
notes comments, med check

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Altostrata
12 hours ago, DavidfromTexas said:

I FORGOT TO MENTION. For an unrelated problem, my ENT currently has me on:

 

2 Cefdinir (antibiotic)/ day

1 Claritin/day

1 probiotic/ day (for any stomach upset due to the antibiotic)

1 Pepcid AC/ day

 

Ive only been on these meds since Friday, as I am having a quick little procedure tomorrow to fix a nasal cyst. 

I checked the drug interactions on the Drugs.com website and I don’t think I found any of these reacting with Cymbalta. Should these all be okay together with the Cymbalta?

 

The antibiotic may be causing your headache or other symptoms.

 

Be sure to take your Cymbalta at the same time each evening. Please be sure to keep daily notes of when you take your drugs, their dosages, and any symptoms throughout the day. Post a full 24 hours of notes in this topic so we can see what's going on.

 

You also seem to have some true emotional turmoil going on, which may not be drug-induced. You might want to see a counselor about your regrets and grief regarding your relationship. You will also need skills to manage the way you think about yourself and your emotions if you do run into drug withdrawal symptoms.

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DavidfromTexas

Even if reinstating doesn’t alleviate some of the withdrawal symptoms, is It possible that the meds are still working to relieve the troubled centers in your brain? Making it worthwhile to continue taking it?

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DavidfromTexas

@Altostrata Im thinking maybe I’ll try taking the dose I’m supposed to take tonight TOMORROW MORNING. That might help me get to where I’m taking the pill at the same-ish time every day. What do you think?

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DavidfromTexas
7 hours ago, manymoretodays said:

Good morning LA DavidfromTexas,

If you took the Cymbalta at night before, I think that sticking with a night time dose will be fine.  Did you have any sleep problems before when taking it at night?  Take it at the same time, each night.  Consistency pays off and is important.

 

 

I used to always take my dose right before bed every night. But my bedtime always fluctuated, and still does, because 1) I work dinners in a restaurant, and 2) I am a night owl so am up late a lot (due in part also to working in a restaurant). I have always felt that the Cymbalta made me sleep much longer, because when I came off of it the first time in 2018 I was waking up naturally after 8 or 9 hours of sleep. Most of the time I’ve been on Cymbalta I have been able to sleep 11 hours. Sometimes if it’s REALLY bad I can sleep for 12-13. But that may be when I’m extra depressed or something. 

 

Either way, I can either take this next dose TOMORROW MORNING instead of tonight, OR just take it late enough at night to where it can be consistent every day. Like 1am. That way I can try to get it to where I’m taking my medicine at approximately the same time every day. The only thing about taking it at night is that it may make me sleep longer. But I guess I’ll just have to try harder to force myself out of bed. 

 

Whats the process if you are already steadily taking meds and want to switch your meds time from night to morning? Because I have tried that a couple times in the past too. Any special way you have to do it?

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ChessieCat
27 minutes ago, DavidfromTexas said:

Whats the process if you are already steadily taking meds and want to switch your meds time from night to morning? Because I have tried that a couple times in the past too. Any special way you have to do it?

 

Generally we suggest moving by 1 hour each day.  

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ChessieCat
4 hours ago, DavidfromTexas said:

Even if reinstating doesn’t alleviate some of the withdrawal symptoms, is It possible that the meds are still working to relieve the troubled centers in your brain? Making it worthwhile to continue taking it?

 

Reinstatement

 

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description


When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

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DavidfromTexas

Through this discovery process, I guess I never really asked something I’m interested in knowing about:

 

Is there any evidence (besides making the brain rely on the chemicals from the anti-depressants) that the long term use of anti-depressants can cause any really serious health issues? Cancer, further brain diseases, etc?

 

One of the main reasons I have wanted to get off the meds is because I have no idea how it could be damaging my health down the line, especially when I’m older. I’d hate for a serious health issue to pop up later in my life and find it was something that could’ve been prevented by not taking anti depressants for decades. 

 

Otherwise, if I found I REALLY DO need the meds, I would stay on them indefinitely just to have as normal of a life as possible. 

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DavidfromTexas
Posted (edited)
38 minutes ago, ChessieCat said:

 

Reinstatement

 

Here's some additional information which might help you to understand what is happening

 

 

I guess what I was really asking is if I don’t ever feel any relief from withdrawal symptoms, should I just stop taking the medication again, or should I keep taking it for at least several months in the hope that it’s helping my brain stabilize even if I’m not feeling it? Like how would we know it’s working on something if we never feel any results?

Edited by DavidfromTexas

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ChessieCat

If after 1 week of being on 1mg (or 2mg if you decide to stay with that dose) your symptoms are still unbearable, please provide symptoms improvement/worsen notes (from the beginning of reinstatement) and we can assess them to try and work out if you need to increase your dose by a small amount.

 

Unless you get an immediate bad worsening of symptoms, it is generally better to stay on the drug.  The brain likes consistency and it is may take a couple of weeks to work out whether reinstatement is working and how much improvement you are feeling with your symptoms.  Improvement may be very subtle, but in a week or two you might realise that you are feeling better than you currently are.  And remember that stabilisation can have a windows/waves pattern.  It isn't a case that you start to feel good and it keeps improving.  You might feel a bit better for a short time and then get hit with a worsening and then an improvement, which might be related to the same thing, or it could be a different thing that improves.  That doesn't mean that reinstatement isn't working, it's just your brain trying to adapt to the drug changes.

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ChessieCat

It is well worth learning about psychiatric drugs and the pharmaceutical/medical side of things so that you can make informed decisions.  I found these very helpful:

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)
 
Website:  The Council for Evidence-Based Psychiatry

                 Videos:  Where did the chemical imbalance theory come from? (1 minute)

                                How are psychiatric diagnoses made?  (1 minute 30 seconds)

                                Why do psychiatric drugs have withdrawal syndromes? (2 minutes)


                                Can psychiatric drugs cause long-lasting negative effects? (1 minute)


                         Do antidepressants work? (2 minutes)      
 
Video:  Simple Truths About Psychiatry - Series of 10 by Dr Peter Breggin
 
 
And this one is interesting but a bit more taxing on the brain.  The researchers got clinical trials through Freedom of Information.  Don't let the title mislead you.  I've included some information below the video link about how many clinical trials they can do but only need to provide two.
 
 
 
Approval Criteria Used by the FDA

Antidepressants and the Placebo Effect by Irving Kirsch (link to full article)

Abstract:

Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain.  Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory.  But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect.  Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin.  Nevertheless, they all show the same therapeutic benefit.  Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind.  The serotonin theory is as close as any theory in the history of science to having been proved wrong.  Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

Excerpt:

How Did These Drugs Get Approved?
....
The FDA requires two adequately conducted clinical trials showing a significant difference between drug and placebo.  But there is a loophole:  there is no limit to the number of trials that can be conducted in search of these two significant trials.  Trials showing negative results simply do not count.  Furthermore, the clinical significance of the findings is not considered.  All that matters is that the results are statistically significant.
....
(NB:  emphasis in abstract and excerpt are mine)
 
 
 

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