Cassie: mother switched to Cymbalta from Effexor

[Cassie]

My name is Cassie and I have some experience withdrawing from cymbalta I think two years ago. I used the bead method and it was very difficult.  I’ve got a MS in psychology so I can follow symptoms pretty well. The current situation has to do with my 73 yo mother who has had depression her whole life And has been on some type of anti depressant for between 35 and 40 years. She is getting older and has familial tremor and chronic pain.  Some digestive problems.... She's aging. Most recently she was on effexor to treat her depression. Her tremors had reduced to almost none but still had bouts of depression. Her beloved dog passed away and she was grieving.  She decided to ask the doctor for an increase in her effexor. He offered a switch to cymbalta instead. They did this.  They tapered from effexor and gradually increased Cymbalta. I don't have the exact time line but I will get that info.  I believe it has been a month since effexor was stopped. 
 

     Her depression has been worsening with no improvement.  Suicidal thoughts, confusion, crying jags, irritability and paranoia are some of her emotional symptoms. Her diagnosis is Major Depression.  Her tremor has returned,  but I'm not sure what other physical symptoms- it's hard to do in her current state. 
 

     It's really hard to determine what is happening. We took her to the er and after A very uneducated discussion (doc has no understanding of psych meds), we finally asked the er doc for Ativan. Which he did.  It has been a week since that.  The Ativan isn't really helping.  Psychiatrist appt on Wednesday and I'm afraid they aren't going to listen.  My mom can pull herself together long enough to present to the doctor and for him to tell her to stick it out.  
 

      I suspect there is some combination of withdrawal, or side effects from the new prescription. Heck, could it even be serotonin syndrome?  Also, mom is older- could something else be wrong with her?  Seems suspicious that the worsening condition follows the med change, though.  
 

     My dad is her primary care taker. He is very smart and pretty much had been taking this on himself. Really outstanding guy, but he and I together can't figure this out.  I don't trust that the psychiatrist will follow through in any real way.  
 

      I would really appreciate any insight that can be offered.  
 

-Cassie

[Altostrata]

Welcome, Cassie.

 

It is possible for a person to have withdrawal symptoms from one antidepressant even though she's taking another. Withdrawal might also aggravate pre-existing tremors.

 

How has your mother been sleeping? How has her symptom pattern changed since she's been off Effexor?

 

What dosages of Effexor and Cymbalta has your mother been taking? What dosage Ativan, how often does she take it?

 

Very few doctors, even psychiatrists, understand anything about psychiatric drug withdrawal or what to do about it.

 

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