plantsrule: Cymbalta / duloxetine taper help

[plantsrule]

 

Hi,

 

On 8/24/2020,  I dropped from 60mg to 30mg of duloxetine.  I've been on the drug since 7/2016.    The side-effects are sometimes difficult, but mostly mild or moderate.    I'm contemplating going back up to 50mg to minimize symptoms, but I'd like to give a few more days before making this decision.   It will be two weeks on 9/7/20. 

 

My Dr. recommended I go on a low dose of Lexapro to help wean off duloxetine, but my goal is to be medication free.       

 

In 2015, I did get off this drug by using a compounding pharmacy, but got back on six months later due to uncontrollable anxiety.   I was prescribed many medications, but nothing worked so I went back to Duloxetine.   At the time,  I attributed the symptoms to losing my father a few months before.   

 

Once or twice a quarter,  I take a .25 mg of Ativan for breakthrough anxiety.   

 

I'm considering the counting beads approach, but I'm overwhelmed by the process.   

 

I'm not on any other medications.  Healthy, with a non-processed whole foods plants only diet and run 5x a week, and try to walk the other two.   I have a great CBT therapist that I've seen on and off for years and presently check in every two weeks.  

 

5 feet 3 inches, 101 pounds, mid-40s, and  in a stable relationship for the last 2.5 years.      

 

Simple tracker app is used to keep track of symptoms and other factors  to get a better insight into the weaning process. 

 

Your wisdom is appreciated.

 

  

 

 

 

    

[Gridley]

Welcome to SA, plantsrule.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Please include any activity with the duoxetine and also the Ativan.  Use this link and press "save" after you're finished.

 

Account Settings – Create or Edit a signature.

 

The 50% drop you made from 60 to 30 is much more than we recommend, which is no more that 10% of your current dose every four weeks. Why taper by 10% of my dosage?  However, if your withdrawal symptoms remain mild, you might want to remain where you are at 30 and stabilize there for several months (6 or more) before tapering further at a !0%.taper rate.

 

The counting bead process is very do-able.

 

Tips for tapering off duloxetine (Cymbalta)

 

What has been your reaction since this cut?  What are your symptoms? The term "side effects" means the negative effects of the drug while you're taking it.  The term "withdrawal" means the effects of reducing/stopping the drug.  What have been your symptoms since your dropped from 60 to 30?

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

We do not recommend adding or substituting new drugs to deal with withdrawal symptoms. 

 

We don't recommend a lot of 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 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) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

[plantsrule]

Gridley,  thanks so much for the recommendations.  

 

The withdrawal symptoms intensified this morning, so I went back to my original dosage at 60mg today.   I thought I could pull through with a healthy diet and exercise, but it's just too difficult. 

 

I've experienced the following withdrawal symptoms: agitation, anger, brain fog, difficulty staying asleep, dizziness, headache, nausea, irritability, neck stiffness, jitters, stress, and sore eyes. 

 

Once I stabilize on the original dose, I will try a 10% per month taper without adding another medication. 

 

I'm grateful to know that counting beads is very doable, as it seems so overwhelming. 

 

 

 

 

 

[Gridley]

5 minutes ago, plantsrule said:

 

I've experienced the following withdrawal symptoms: agitation, anger, brain fog, difficulty staying asleep, dizziness, headache, nausea, irritability, neck stiffness, jitters, stress, and sore eyes. 

 

I'm sorry you're feeling bad.

 

The symptoms you describe are typical of withdrawal..

 

Regarding your reinstatement, it takes about 4 days for a dose change to get to full state in the blood and at bit longer for it to register in the brain.  

 

If the running is working for you, that's fine.  Many people in withdrawal find strenuous exercise too stimulating and do better with a milder form, like a walk in nature.

 

Please keep us updated on how you're feeling.

 

 

[plantsrule]

It’s great to know how long it takes to get into the blood and register in the brain.    Thanks for this.

 

That’s interesting about the exercise.  I like the way running makes me feel afterwards. 

Coffee was really overstimulating during this withdrawal period, and I abruptly reduced the amount I typically drink to 1tsp. of Organic Instant from 2 tsp. since I’ve been extra jittery. 

 

The doctor recommended Escitalopram 5 Mg to deal with withdrawal symptoms.   She mentioned that this is the dosage for kids.   After reviewing this site, I will NOT be adding another drug to the mix. 

 

Ugh, I am so overwhelmed with counting pellets.  I tried to empty a 30mg capsule and just count that but gave up.    Is there a video on this?

 

I plan on exploring compounding costs this week as the doctor said that Kaiser won’t pay for this.  I’ll send her Dr. Glenmullen’s testimony and my own litigation complaint about this drug.   I think I paid about $40 per month with another insurance company.   

 

The 10% approach seems to be the gentlest approach.  I’m grateful for this site and the thoughtful responses.  

 

 

 

 

       

 

 

 

 

 

 

[plantsrule]

 

I decided to do a 10% per month taper from 60mg of Duloxetine. 

Reverse Psychiatry – Careful, Slow Tapering.pdf

 

I found a compounding pharmacy that will do this affordably without insurance, but I don't know if I can get Kaiser to write the compounding prescription.  I provided Kaiser with my own litigation complaint from 2015 due to  difficulty getting off this drug and Dr. Glenmullen's testimony.    Does anyone have any experience getting Kaiser to write compounding prescriptions?   

 

If Kaiser won't write the prescription, I'll start weighing.    Should I ask for 20mg capsules to save time? 

 

[ChessieCat]

I'm assuming that the document attached to your previous post is your 10% taper plan.

 

Because we end up with some numbers with multiple numerals after the decimal point it can sometimes be easier to round the number to make measuring easier and more precise.  When rounding always ensure you round up so as not to reduce by more than 10%.  Also, if you round up, the next reduction will be based on the actual dose you took (ie the rounded up amount), not the "before rounding" amount.

[ChessieCat]

getting-custom-dosages-at-compounding-pharmacies-us-uk-canada-and-elsewhere

 

I suggest you also post your question is the above topic.

 

You also ask your compounding pharmacist for assistance.

 

Edited September 10, 2020 by ChessieCat

[plantsrule]

20 minutes ago, ChessieCat said:

I'm assuming that the document attached to your previous post is your 10% taper plan.

 

Because we end up with some numbers with multiple numerals after the decimal point it can sometimes be easier to round the number to make measuring easier and more precise.  When rounding always ensure you round up so as not to reduce by more than 10%.  Also, if you round up, the next reduction will be based on the actual dose you took (ie the rounded up amount), not the "before rounding" amount.

 

Yes, that's my taper plan.    Got it, will round up.    Thank you