ESRoar: don’t know what to do

[ESRoar]

Don’t know what to do.

 

I’ve been slow tapering off of cymbalta 90mg since July 2018. I had my baby in Sept 2019 and I’ve been struggling since 2 months postpartum with depression, anxiety, nausea, and diarrhea. I was at 39mg of cymbalta and tired of feeling awful all the time, so I went to a psychiatrist in the beginning of November. I was prescribed Zoloft 50mg, buspar 10mg tid, and Zofran 4mg. Dr felt cymbalta wasn’t agreeing with me and that this cocktail would make me feel better and possibly able to taper off cymbalta a little faster. I started feeling worse and was having heart racing, arm tingling, nausea, diarrhea, and the awful feeling of wanting to jump out of my skin. I called the dr and was told to go to the ER because of the cardiac symptoms. All of my tests were normal and I was given some IV Ativan, which made me feel better. For a few hours, I felt normal. 

I was told to stop the buspar, so I continued on with the Zoloft 50mg, cymbalta 39mg, and Zofran 4mg. I started with a new psychiatrist because the other one couldn’t see me for a month. She wanted me to drop the cymbalta to 37mg. On the 2nd day, I was so sick from that I was bedridden. I added the missing 2mg back in, in desperation. I kept getting sicker. Extreme nausea, dry heaving, could barely eat or drink, shaky/jittery internal feeling. I went to the ER because I wanted to die. They had me meet with an angry, young psychiatrist who thought I had serotonin toxicity and told me to stop all meds for a few days. I told him I couldn’t do that because of withdrawals, and he said “then I don’t know how to help you”. ER dr told me to reduce to 25mg of Zoloft. 
 

the next day, which was the day before thanksgiving, I was so sick with the nausea, shaky/jittery feeling and wanting to jump out of my skin. My psychiatrist met with me and agreed that I had symptoms of too much serotonin. She told me to stop the Zoloft and Zofran and take 20mg of cymbalta twice per day. I felt well enough to function and get out of bed on thanksgiving and Friday. 
 

Saturday and today- I’m on the 20mg cymbalta twice per day. To further mess me up, the brand of cymbalta changed on my prescription and the old brand is no longer manufactured. I’m extremely nauseous, diarrhea, shaky/jittery, want to jump out of my skin, every sound is irritating to me. I don’t know if I’m going through Zoloft withdrawal, or cymbalta brand name change issues. I was only on Zoloft for 2.5 weeks. Does anyone have any suggestions for what I can do?  I can’t function. I have to work tomorrow, and I don’t know how I will. 

 

Edited November 29, 2020 by ChessieCat
added topic title

[ESRoar]

MOD NOTE:  Duplicate of Post #1 - member created 2 Introduction topics and they have been merged.

 

I’ve been slow tapering off of cymbalta 90mg since July 2018. I had my baby in Sept 2019 and I’ve been struggling since 2 months postpartum with depression, anxiety, nausea, and diarrhea. I was at 39mg of cymbalta and tired of feeling awful all the time, so I went to a psychiatrist in the beginning of November. I was prescribed Zoloft 50mg, buspar 10mg tid, and Zofran 4mg. Dr felt cymbalta wasn’t agreeing with me and that this cocktail would make me feel better and possibly able to taper off cymbalta a little faster. I started feeling worse and was having heart racing, arm tingling, nausea, diarrhea, and the awful feeling of wanting to jump out of my skin. I called the dr and was told to go to the ER because of the cardiac symptoms. All of my tests were normal and I was given some IV Ativan, which made me feel better. For a few hours, I felt normal. 
 

I was told to stop the buspar, so I continued on with the Zoloft 50mg, cymbalta 39mg, and Zofran 4mg. I started with a new psychiatrist because the other one couldn’t see me for a month. She wanted me to drop the cymbalta to 37mg. On the 2nd day, I was so sick from that I was bedridden. I added the missing 2mg back in, in desperation. I kept getting sicker. Extreme nausea, dry heaving, could barely eat or drink, shaky/jittery internal feeling. I went to the ER because I wanted to die. They had me meet with an angry, young psychiatrist who thought I had serotonin toxicity and told me to stop all meds for a few days. I told him I couldn’t do that because of withdrawals, and he said “then I don’t know how to help you”. ER dr told me to reduce to 25mg of Zoloft. 
 

the next day, which was the day before thanksgiving, I was so sick with the nausea, shaky/jittery feeling and wanting to jump out of my skin. My psychiatrist met with me and agreed that I had symptoms of too much serotonin. She told me to stop the Zoloft and Zofran and take 20mg of cymbalta twice per day. I felt well enough to function and get out of bed on thanksgiving and Friday. 
 

Saturday and today- I’m on the 20mg cymbalta twice per day. To further mess me up, the brand of cymbalta changed on my prescription and the old brand is no longer manufactured. I’m extremely nauseous, diarrhea, shaky/jittery, want to jump out of my skin, every sound is irritating to me. I don’t know if I’m going through Zoloft withdrawal, or cymbalta brand name change issues. I was only on Zoloft for 2.5 weeks. Does anyone have any suggestions for what I can do?  I can’t function. I have to work tomorrow, and I don’t know how I will. 

 

Edited November 29, 2020 by ChessieCat
added mod note

[Gridley]

Welcome to SA.  I'm sorry you're feeling so bad and sorry for your experience in the hospital with the angry psychiatrist.  You were wise to ignore his advice.  Thank you for completing your drug signature.

 

Now that you're off the Zoloft, the serotonin toxicity symptoms should resolve soon and may have already resolved.

 

6 hours ago, ESRoar said:

To further mess me up, the brand of cymbalta changed on my prescription and the old brand is no longer manufactured.

It is common for symptoms to ramp up with a brand change.  These will resolve.  I wish I could give you specific timeline when this will happen but the damage is not permanent.

 

6 hours ago, ESRoar said:

I don’t know if I’m going through Zoloft withdrawal, or cymbalta brand name change issues. I was only on Zoloft for 2.5 weeks.

It's unlikely you're having Zoloft withdrawal, since you were on the drug for only 2.5 weeks  A person is at risk of withdrawal symptoms from over a month on a psychiatric drug.

 

6 hours ago, ESRoar said:

I’m on the 20mg cymbalta twice per day

 

Did you symptoms change (improve or worsen) when you went from once a day to twice a day?

 

6 hours ago, ESRoar said:

Does anyone have any suggestions for what I can do?  

 

There is no magic bullet to make you feel better.  Time is the great cure.  Make no further changes and would add no further drugs.  I would hold where you are with the Cymbalta for a few months to let your system stabilize.  Your system has been through a lot with the (likely) serotonin syndrome and  the brand change.  

 

Your Cymbalta taper has been slow and after you've stabilized you could resume it.  We recommend tapering by no more than 10% of your current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

As best I can can calculate, you've been tapering a good bit more slowly than 10% and that's to your advantage.  

 

This link is specifically about tapering Cymbalta.

 

Tips for tapering off duloxetine (Cymbalta)

 

 

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. Get supplements that are single ingredient (not mixed with other types of supplements).

 

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

 

 

Edited November 29, 2020 by ChessieCat
removed name

[ESRoar]

I started the 20mg twice per day on Friday morning. Previous to that, I was taking cymbalta in the am and Zoloft in the pm. When I was on just cymbalta before, I took it all in the pm.

 

ive felt absolutely terrible yesterday and today. I can’t function at all. So maybe the split dose isn’t working for me. 
 

im taking epa/dha fish oil at night and magnesium l-threonate. 
 

im wondering if I should try taking the full dose of cymbalta tonight?  That’s what my body was used to for years. 

[Gridley]

2 hours ago, ESRoar said:

im wondering if I should try taking the full dose of cymbalta tonight?  That’s what my body was used to for years. 

If you've already taken your morning 20mg dose today, I wouldn't take a full dose tonight, just the 20mg.  An extra 20mg in a day could be destabilizing.  

 

 Tomorrow you could try taking the full dose in the morning to see if that works better for you.  I know you used to take it in the evening but I don't want you to go into withdrawal.  If taking the full dose works better for you, you can get back to taking it in the evening by moving forward the time you take it by one hour every day until you get back to your previous evening time.

Edited November 29, 2020 by Gridley