MissGussie: Trying to cope with withdrawing too quickly from Cymbalta

[MissGussie]

I’m 65 years old and have been on antidepressants since 1992.  I don’t have a record of the dates of my medication history.

 

  I took Prozac for many years, but after it seemed to become ineffective, I was prescribed Cymbalta, which increased in dosage over the years.  At some point, when it appeared that the Cymbalta was not as effective, I was prescribed Lamictal. Up until I began withdrawing from Cymbalta I was taking 120mg of Cymbalta and 200mg of Lamictal.  I am still taking the 200 mg of Lamictal.

I’ve joined this forum in search of help and support in withdrawing from Cymbalta and perhaps eventually, the Lamictal as well.
 

Beginning at the end of January, I started withdrawing and under the guidance of a psychiatrist, dropped from 120mg to 0mg  by about the 1st of March.  After feeling very sick, I started doing research on the web and found a lot of resources regarding antidepressant discontinuation syndrome and am now seeking help and resources to help me cope. 

 

in February, my psychiatrist prescribed 150mg of Wellbutrin at the point when I was taking 30mg of Cymbalta.  I was also prescribed Seroquel and Olanzapine during this time,  each of which I only took a few times because I was feeling so sick. With the Wellbutrin, I had a short period of being very hyper. Then I lost my appetite and couldn’t eat, had extreme fatigue, insomnia and nausea.  I thought it was a reaction to the Wellbutrin.  The dr then prescribed a lower dose of Wellbutrin and I was still experiencing the same symptoms. After stopping taking the Wellbutrin for a week, I started taking 10mg of Prozac for a week, and then 20mg for about 5 days, and continued having the same symptoms.  I stopped taking the Prozac about 2 weeks ago. I thought that the new antidepressants were what was making me sick....until I started doing research on the internet and learned about antidepressant discontinuation syndrome. 
 

Now it’s obvious to me that my dr knew nothing about the discontinuation issues either. He kept insisting my symptoms were a result of the new medications.
 

I am trying to cope the best I can by walking 45 minutes a day, eating as well as I can, even though I have no appetite and am nauseous, and doing guided medications to sleep at night. 
 

Even with the meditation, I don’t sleep very many hours and I’ve lost 20+ pounds. 
 

This process is very hard on my husband. He is as understanding as he can be without experiencing it but I know he feels like he has lost his wife.  I feel like I’ve lost me too and that maybe I’ll never recover. 
 

I have questions about taking magnesium and about working with a functional medicine dr during this time. I feel like I need to work with a dr during my recovery, but I’m not sure where to turn. I will not be using the previous psychiatrist.  

 

I am willing to learn all I can to help in my recovery. I have joined the Cymbalta Hurts Worse Facebook group and am joining the Withdrawal Project Support group as well.  I would like to have as many resources as possible.  

 

I understand that this post will be reviewed before it is posted.  I’m not certain about what should be written in the Introduction post. Will you be able to make suggestions on making any changes that could be made. 
 

 

 

 

 

[ChessieCat]

Hi and welcome,

 

To get you started, please create your drug signature.  This explains what is needed:  please-summarize-your-withdrawal-history-in-your-signature

 

Click on this link to go straight to your signature:  Account Settings – Create or Edit a signature

 

Remember to click Save when you have finished.

 

One of the other mods will respond as soon as they are able to.

[Gridley]

Welcome to SA.  If that is your real name, please suggest another screen name and I will substitute it.

Your Introduction post is fine.  You will recover.  It will take some time but it will happen.

 

Is the 200mg Lamictal the only psychiatric drug you're taking?

 

As you know, your doctor's taper of Cymbalta was extremely fast.  I'm sorry the doctor has put you through this drug merry-go-round.  You have figured out the resulting problem: antidepressant discontinuation or, as we call it, withdrawal.  All these drugs are different and one doesn't cover for another, leading to withdrawal.  The symptoms you describe, including nausea and lack of appetite, are common withdrawal symptoms.  The vast majority of doctors know nothing of this.  I'm going to give you some links about withdrawal and healing so that you have a better understanding of what you're experiencing.

 

What is withdrawal syndrome

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

When we take psychiatric 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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

Regarding a functional medicine doctor, that's up to you.  We have found that alternative doctors know as little as allopathic mainstream doctors (that is to say, nothing) about withdrawal.  They will tend to order a lot of tests that have no bearing on withdrawal and put you on a bunch of supplements which don't help and in some cases worsen the situation.  We do not recommend detox during withdrawal, which puts more stress on your system.  Gentle exercise like a walk in nature is better than strenuous exercise, which can be overstimulating.  Eat a healthy diet, and avoid caffeine, alcohol and sugar.

 

We don't recommend many supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

I would make no changes to the Lamictal until you've stabilized from all the drug changes you've been put through.

When the time comes to taper, we recommend tapering by no more than 10% of current dose every four weeks.  But, if you choose to go off it, that is some ways into the future.

 

Why taper by 10% of my dosage?

 

You mentioned meditation, which we definitely recommend.  I don't know if anxiety is one of your symptoms.  If so, I've found this restorative yoga pose very helpful with anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

Regarding resources to cope with withdrawal, take a look at the links in the following link and see what you think might be helpful to you.

 

Non-drug techniques to cope

 

Withdrawal can be very hard on the family.  

Helping family understand 1 2

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

[MissGussie]

I would like to change my screen name to MissGussie. 
 

I entered all my medication information but now I’m not seeing it. Did I do it incorrectly?

 

My dr suggested I take calm, and then I read that magnesium glycinate was preferred. I am confused as to the dose, there have been a lot of different amounts. I accidentally purchased 500 mg tablets. Can I cut them into smaller amounts like 75 mg and will that be accepted by my body? I am really anxious, almost obsessed about everything.

 

I was prescribed phenergan for nausea at the ER where I went when I became dehydrated. Do members take these types of medications during withdrawal? 

 

I am really feeling scared and panicky like I can’t do this. I don’t know where to turn. 
 

 

[Shep]

10 hours ago, MissGussie said:

I would like to change my screen name to MissGussie. 

 

Hi, MissGussie. Your name change is complete. 

[Gridley]

16 hours ago, MissGussie said:

I entered all my medication information but now I’m not seeing it. Did I do it incorrectly?

 

Here is the link that will allow you to enter your drug information.

 

Account Settings – Create or Edit a signature.

 

16 hours ago, MissGussie said:

I accidentally purchased 500 mg tablets. Can I cut them into smaller amounts like 75 mg and will that be accepted by my body?

 

500 would be too much to start.  Yes, you can cut them into smaller amounts like 75mg and see how that agrees with you.

 

16 hours ago, MissGussie said:

phenergan

 

Withdrawal can make you sensitive to all sorts of drugs as wells foods and supplements.  If you're not having a problem with the phenergan, it should be fine.  

 

[MissGussie]

Once I listed all my medications on my signature, I can't believe how many medications my psychiatrist prescribed over the past 4 months.  I am new to this forum but I imagine all of these medications like this have really combined to make me sick.  I can't believe I trusted my psychiatrist whom I have never worked with before.  I have an appointment with an integrated/functional doctor whose practice has a psychiatrist, therapist and nutritionist on Monday. I hope that is a good decision for me?  

[Gridley]

@MissGussie

 

Only one Introduction post per member.  Please post only there.  Here's the link:

MissGussie: Trying to cope with withdrawing too quickly from Cymbalta

 

45 minutes ago, MissGussie said:

I have an appointment with an integrated/functional doctor whose practice has a psychiatrist, therapist and nutritionist on Monday. I

 

It's up to you.  Alternative doctors know no more about withdrawal than mainstream allopathic doctors.  They tend to recommend a lot of supplements that generally don't help and sometimes make things worse.  

 

Your signature didn't show up.  Here's the link again.  Don't forget to click on the black rectangle "Save" at lower left.

 

Account Settings – Create or Edit a signature.

 

[MissGussie]

I had a 6 week tapering off cymbalta ending in February.  I was not aware of the repercussions. Is there anyway to reverse this?  I’m not sure I can manage. 

[MissGussie]

Also, my signature has been in my profile, but I’m not seeing it and it is not showing up when I post. Any suggestions?

[Altostrata]

Hello, MissGussie. In the Introductions forum, don't start new topics, post your questions here in your own Intro topic.

 

Your signature didn't take. Here are the instructions Account Settings – Create or Edit a signature.  Be sure to click the Save button after entering your information.

 

On 5/28/2020 at 1:03 AM, MissGussie said:

I started taking 10mg of Prozac for a week, and then 20mg for about 5 days, and continued having the same symptoms.  I stopped taking the Prozac about 2 weeks ago.

 

When you were taking 10mg Prozac, what effect did it have on you?

 

What is your current daily symptom pattern?
 

[MissGussie]

Can you see my medication list? I felt ok on 10mg of Prozac for a week. When I upped it to 20 mg I became very nauseous. I’ve tried everything. I just took 250mg magnesium, an hour walk, I haven’t meditated yet. I know people on here have little faith in the drs, but is there anything for some relief immediately?  The dr prescribed gabbepentin, but I haven’t taken it. Thank you for your help. I feel very desperate.  

[MissGussie]

My symptoms are terrible aches everywhere, obsessively thinking about how bad I feel. Feeling like I have to have a bowel movement. No appetite.

[MissGussie]

I have had some issues getting my signature to post.  I have just reentered and saved as suggested.  I hope it shows this time.

[Gridley]

17 minutes ago, MissGussie said:

I hope it shows this time.

Yes, it shows now.

[Gridley]

1 hour ago, MissGussie said:

Can you see my medication list?

Yes, it is here now.

[Altostrata]

Do you have any Prozac left? What I might do is reinstate 1mg Prozac (ONE MILLIGRAM). A liquid is the easiest way to to do this. You can get a liquid by prescription or make your own with water; this topic tells you how to do this Tips for tapering off Prozac (fluoxetine)

 

Please let us know how you're doing by adding posts to this topic. Please do not start any more topics in the Introductions forum.

[MissGussie]

Trying to cope with withdrawing too quickly from Cymbalta

 

I haven't been here in a while. I am sure I'm like other people who are in this forum.   I am having extreme antidepressant withdrawal symptoms. I have staggered from one attempt to another to cope, all the while hoping against hope that I can find some relief. 

 

Do people on this forum opt for continued interventional treatment for depression? My psychiatrist suggested that I try TMS.  I have read a lot of posts on here but have not seen very much about TMS.  I've read very many positive study results in scientific publications about TMS. (not from providers)

 

I would be very grateful for further input on some of the questions I have. 

 

Earlier, one of the moderators suggested 10mg of prozac to help.  Is it too late to try that since I have been off medication since March 5?  Should I ask my psychiatrist?  If I continue with the TMS, can I take Prozac in conjunction with it? If I do try to take the 10mg of Prozac and it continues to make me nauseous, should I continue to take it and use Phenirgan to cope with the nausea until I am stable?

 

I did see where it was posted that TMS would not help with withdrawal symptoms.  If I continue TMS, (I've had 9 sessions), will this exacerbate my symptoms?  If it doesn't help my symptoms, could it offer me some alternative form of treatment for depression ultimately?

 

I have insomnia.  My FP doctor suggested using CALM, a type of supplement for sleep.  Is this one of the things I can use in addition to other approaches? 

 

I am walking every day, using the apps called CALM and Insight timer to do guided meditations and working with a therapist. I still don't have an appetite and try to eat a healthy diet when I can eat.  

 

I have fallen over the edge in researching this, which I know is not healthy.

 

I really don't know where to turn.  Should I seek a 2nd opinion from another doctor?  

 

Edited June 20, 2020 by ChessieCat
added topic title

[ChessieCat]

I've merged the new topic you made with your original Introduction topic.  Only 1 Introduction topic per member.

[ChessieCat]

13 minutes ago, MissGussie said:

Earlier, one of the moderators suggested 10mg of prozac to help.

 

Alto suggest 1mg of Prozac:

 

On 6/1/2020 at 6:38 AM, Altostrata said:

What I might do is reinstate 1mg Prozac (ONE MILLIGRAM)

[ChessieCat]

 

SA's topic:  tms-transcranial-magnetic-stimulation

 

  

On 10/9/2012 at 10:17 AM, Altostrata said:

 

What is reinstatement?

Reinstatement means resuming the drug or its equivalent when withdrawal symptoms appear.

 

According to what medicine knows about psychiatric drug withdrawal syndrome, reinstatement is the only way to alleviate withdrawal symptoms.

 

 

 

Please read Post #1 of this topic:  about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

[ChessieCat]

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

More about how light stimulation affects our body clocks

[DataGuy]

Hi MissGussie,

 

If I understand correctly, your symptoms are insomnia, obsessive thinking, aches everywhere, nausea, lack of appetite and gastro problems which sound like IBS-type symptoms (common in withdrawal). Is that right? Can you give an update on the weight loss? Are you still down 20lbs?

 

As Altostrata suggested and Chessie pointed out, you may want to try reinstating 1mg of Prozac. This may provide a bit of relief or it may not, it is hard to say with any one individual. Do you feel the TMS is working? 

 

Can you also do a daily symptom journal? You record symptoms throughout the day, writing down what time they occur at, when they intensify, and when you feel some relief. 

 

As far as I can tell, the CALM supplement simply contains magnesium carbonate. This is fine, but I think you said you had already tried magnesium glycinate? Did this help at all? Do you find you feel better after the walks? Please continue to walk if you can. 

Edited June 20, 2020 by DataGuy

[DataGuy]

 

 

As for treatments for depression, I think you may want to opt for non-pharmacological approaches, like Cognitive Behavioral Therapy (CBT), mindfulness, meditation or other types of behavioral therapy. Here are some provided in the non-drug coping techniques link below. You may find these are more effective than medications. For most people, medications are not terribly effective, and tend to lose their benefit over time. For the average person, they merely improve depression symptoms a bit less than 2 points on a 54 point scale https://bmjopen.bmj.com/content/9/6/e024886. I would avoid more dangerous treatments like antipsychotics (like seroquel), ketamine or electroconvulsive therapy. Ketamine is only marginally effective and ECT generally has transient benefits and I'm not aware that it has been shown to help withdrawal. There is also some indication that medications like these increase mortality risk in older individuals. 

 

Unfortunately, unless reinstatement provides some relief, you are likely stuck with the withdrawal symptoms for awhile. These should gradually improve and become more tolerable. Your nervous system has been through a shock and now needs to heal itself and return to its natural state pre-medication. If you provide a symptom pattern and activity journal, we can try to help you navigate the withdrawal as best as is possible. 

 

[DataGuy]

And just to clarify about the medications: you are taking Lamictal? Do you still take the Pantaprozale 40mg Promethazine 12.5mg as needed? Any other meds or supplements?

[MissGussie]

Yes. I take 200mg of lamictal. I take the pantaprozole morning and evening. That was prescribed by a GI dr because I had an endoscopy and have an inflamed stomach.  I only take the promethezine if I am really nauseous and that had settled down the last couple of weeks. I don’t like it, it gives me dry mouth. The psychiatrist prescribed Gabapentin which I have taken a few times, at 600 mg.  I do have trouble sleeping so I’ve tried to sleep naturally using sleep stories on the Calm app. I never knew it, but I guess I have anxiety as well. I’ve been to the ER twice on a Sunday because I felt so sick. They just took my blood and had the social worker talk to me.  I am not suicidal but I don’t know how I can go forward with feeling this sick for such a long period of time. 
 

With the TMS, can I ask the dr about a tiny dose of Prozac?  When I was taking 10 mg earlier, I felt okay .  But after a week, it was raised to 20mg and I was really nauseous.  As I said, we have only 2 or 3 psychiatrists in my town. Are there any psychiatrists who treat withdrawal?  
 

After 4 1/2 months, I am feeling like I will do anything to not be so sick. 

 

 

[MissGussie]

I didn’t answer all,of your questions. Yes, I’m still down 20 pounds. I walk almost every day. I push myself to do household chores, personal grooming and to get out of the chair. I feel like this is the only lifeline I have. I have shared with many friends but It is difficult when the haven’t been there. Thank you for being there. 

[DataGuy]

15 hours ago, MissGussie said:

I didn’t answer all,of your questions. Yes, I’m still down 20 pounds. I walk almost every day. I push myself to do household chores, personal grooming and to get out of the chair. I feel like this is the only lifeline I have. I have shared with many friends but It is difficult when the haven’t been there. Thank you for being there. 

 

Ok, @MissGussie you are down 20lbs but you have not lost any more than that? That is good. 

 

I would say given the dose you were on of Cymbalta, the length of time you were on it and the rapidity of withdrawal, you are doing pretty well. The withdrawal associated with Cymbalta can be pretty severe. There are no real easy solutions to what you are going through. Many others have gone through the same thing and if there were an easy answer to get better then it would be well known to the withdrawal community and doctors. I know the feeling of being willing to try anything to make the symptoms vanish, but that is also a dangerous place to be in. Despite the fact you are feeling so awful, you need to take responsibility for your recovery and be very skeptical of claims that this treatment or that will speed up your recovery or get rid of your symptoms. You need to do an honest risk assessment of any drug or treatment you try. As far as I am aware, there is no drug that has been approved to treat withdrawal symptoms and in many countries they have not even recognized the severity of withdrawal, let alone tested any treatments for it. Without adequate testing of treatments for a particular condition, we should just assume the drug will not work. Most drugs fail to improve any condition and the number of drugs that are tested which end up being approved is something like 1 in 1000. 

 

It's encouraging that you have been able to tolerate many of the drugs you've tried. Many people in withdrawal suffer from nervous system hypersensitivity and cannot tolerate much of anything. I don't think you have reported that you are experiencing increased sensitivity to sound, light, medications etc? That is good. But I'd advise you to be very cautious in trying new medications or treatments. The proton-pump inhibitor pantaprazole is likely fine for now, but this medication can create dependency and can result in increased gastrointestinal problems upon withdrawal. First generation anti-histamines like promethezine are rarely used anymore and can have some pretty nasty side effects. This drug antagonizes the dopamine (D2) receptor and so can have side effects similar to antipsychotics, like movement disorders that can persist long after drug cessation (tardive dyskinesia or dystonia). If you do continue to use this I would do so very sparingly and at as low a dose as possible. Most drugs taken regularly (especially psychotropics like Gabapentin, Lamictal, Cymbalta, Promethezine etc) are associated with withdrawal symptoms or syndromes, so keep this in mind before accepting any new prescriptions.

 

The fact that you are exercising regularly and seeing a therapist are great first steps. I think the best thing you can do now is educate yourself as best you can by reading the links provided by other moderators, as well as other material on the site. This way you can give accurate information to friends and family to explain what has happened to you and the expected time it may last. This article by Chouinard and Cosci suggests AD withdrawal can last quite a long time: months or years. https://www.karger.com/Article/Abstract/506868. As far as I know there aren't any doctors who specifically treat withdrawal and most know very little about it, which is why they tend to discontinue the drugs far too rapidly in people like yourself. Someone like David Healy or Chouinard, whose article I just linked, would probably give the best advice.

 

Please keep up the good work and continue to educate yourself. At this point you are a fair distance from your jumping off point, so reinstating prozac or cymbalta is not terribly likely to work and could cause harm via an adverse event or negatively affecting your recovery. That the nausea has begun to abate is a great sign, you are well on your way to recovery. The best thing you can do is educate yourself and your family so that you can avoid making the situation worse or getting stuck on another drug like Cymbalta. This way you can stick to things that promote long term recovery like exercise, meditation, therapy, learning coping skills, relationship building, mindfulness and being a well-informed advocate for yourself in your medical treatment. If you have any specific questions, myself or the other moderators will do our best to answer them (eventually). But we encourage you to search the website first. If it is a problem specific to withdrawal, someone has likely experienced it before and so has asked the same question here earlier.