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I am looking for help to get past the withdrawal symptoms I am having after stopping Duloxetine 60mg 2x/day for 15 years.  Due to having to change doctors, I was unable to get it refilled.  I did taper the 2 weeks I had left and then it was cold turkey for 3 weeks before I saw a new primary care doctor.  During that time, I decided I wanted to stop taking this med after researching it.  I did get the prescription renewed, but I haven't taken it.  I was prescribed this med by my neurosurgeon for peripheral neuropathy after surgery for a spinal injury.  My current withdrawal symptoms are GI upset, wild mood swings, depression, inability to focus on anything, struggling to find my words when speaking, lethargy, lack of energy and of course the nerve pain has returned.  The first couple of weeks I had a lot of light headedness and dizziness, but that has improved this past week.  

When I saw my new doctor and told her I wanted help to get off this drug she said I need to stay on it.  So I am searching for a doctor to consult with and I'm not finding anyone in the Orlando area that specializes in this.  I have found protocols for doing this on this site which are very helpful.  But since I have been completely off the drug now for 3+ weeks after very little tapering, is it best to go back on the drug and start over with proper tapering or just try to tough it out?  If I went back on this drug is there a protocol to follow? Go back on at what dose?  Stay at that dose for how long before starting the taper?  I would love to hear from anyone who has messed this up and was able to correct their action and taper successfully as well as any recommendation for a doctor or practitioner then can help.  I am very open to working with someone via telemedicine.  I'd rather work with someone who is experienced via zoom than in person with someone who isn't just because they are near me.

Thanks you so much for any help!

SearchingForAnswers

Duloxetine 60mg 2/day starting March 2007 for peripheral nerve pain from spinal injury

had to change doctor due to moving to new city and couldn't get appointment before meds ran out.

I tapered what I had left over 2 weeks March 2022. Went 3 weeks without and decided to stay off.

Withdrawal symptoms have been bad.

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  • Moderator

Welcome, SearchingForAnswers

 

We are volunteers and all have different backgrounds and experience. We do not offer any recommendations or advice. My experience is with duloxetine, but never at such a high dose. I will do my best to give you a helpful perspective. 

 

I am so sorry you had to go cold turkey. The initial 2 weeks taper are far too rapid to have made any difference to the massive onslaught which you experienced when stopping completely. This is normal. 

 

I understand your strong desire to stay off the drug, but I can also see that there are arguments for going back on it. My own experience was cold turkey from 30 mg and I believed I could just push through the withdrawals. It is good that you have noticed some improvements in recent days, but there is no guarantee that will continue. I fell into that awful trap of thinking I just had to get the drug out of my system. It is not like that. The way the brain adapts to the drug makes this almost impossible. Bridging to another drug does not help and leaves you with another dangerous drug which will later need tapering. 

 

Reinstatement can succeed; do nothing; make things worse. The usual time limit is 2 weeks after stopping. Some support groups are very strict about that, others more flexible. I reinstated after about 6 months, at a lower dose. I would say my reinstatement has been successful. You can see from my own introduction what I went through before I decided I had to reinstate. 

 

It seems to me there is still that option for you: you may stabilize fairly quickly; you may stay as you are; you may get worse. This has to be your decision, as it was mine. In your situation now, knowing the appalling physical and especially mental states I went through after CT, I would take that risk again. But I am single and have no responsibility for others' care or welfare. Any steps you decide to take must be taken in the light of your own family circumstances and responsibilities.

 

Whatever you decide to do, it is essential to mitigate withdrawals from duloxetine with a healthy lifestyle, as far as this is possible; what many would call 'clean living'. Keep fully hydrated; have your blood tested and when you have the results, make sure you are taking sufficient vitamins etc. Cut out processed food, eat as little sugar as you possibly can; stop alcohol and coffee ... 

 

As far as finding a specialist to work with, that will not be easy. Even after the comparative increase in knowledge about the dangers of rapid or no tapering off duloxetine, this has not filtered through to most of the medical profession. You may be safer in the hands of a reasonably compliant doctor than one who thinks s/he is an expert and then insists on a dangerous taper.  Except in extreme circumstances, I would never suggest anyone should try to drop by more than 5% of each previous dose. You need to hold for at least 2 weeks (often more) between drops, in order to stabilize. 

 

If you decide to reinstate, I think I would go for half your original dose - 60 mg a day, taken once. Splitting the dose offers no benefits that I can see and makes it more complicated to taper. 

 

I recently took over the website Healing America Now and am busy editing it entirely, ready for a re-launch as an independent support for people taking or coming off duloxetine / Cymbalta. Even in its present form, you will find much support there.

 

I hope this will help you to see your way forward.

June 1998 20 mg Prozac

April 2001 Citalopram

Dates unavailable (illegible); Effexor, Venlafaxine, Amitryptiline, Fluoxetine

Duloxetine 30mg 2016

Cold turkey June 2018; massive withdrawal

Briefly, Mirtazipine

Reinstatement on 20 mg Duloxetine

Started tapering December 2018, currently at 1.6mg, 9 beads

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Hi @SearchingForAnswers

 

More experienced mods are better place than me to advise on possible re-instatement and the best dosages to do that with, but just wanted to say Hi.  You're not alone and this site is filled with people in the same position as you.

 

I do want to say however, that by reading a lot of threads on here it's pretty common for Drs not to be supportive of tapering at the slow speed necessary. After advice here I decided to not tell my doctors as I needed for them to prescribe the meds for the full length of my (very slow!) taper and couldn't guarantee that would happen if I told them.  So I've gone rogue and am doing it my way, as i figured nobody is going to care about MY health as much as me.

Sertraline:  2014. Sept 50mg. Oct 100mg. Dec 150mg. 2015-2019. 150mg. 2019  Apr-May 0mg. Beg May 150mg. End May 100mg. Late June 125mg. Late Aug 100mg. 2020 Jan 75mg. April 50mg.

2022  50mg. 1Jan 45mg. 1Feb 40.5mg. Water T24Feb 39.5mg. 3Mar 38.5mg. 18Mar 38mg. 25Mar 37.5mg. 22Apr 37mg. 5May 36.5mg. 18May 36mg. 1Jun 35.3mg. 15Jun 34.5mg.

Omeprazole.:  2016 20mg. 2022  20mg.  15Jan 15mg. 9Feb 10mg. 25Feb 6.5mg. 15Mar 3mg. 3Apr 1.5mg.  15Apr 0mg 🎉

Promethazine:  2016 25mg. 2022  25mg. 26Jan 22.5mg. 3Apr 20mg.  17Jun 18mg. 20Jun 16.5mg

Desogestrel:  2014 -  present:  75mcg

Supplements: Introduced gradually between April and June 2022.  Magnesium. 400mcg  Folic acid.  400mcg. Vitamin D. 10mcg.  Multivit/min. 1 tab

 

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Thanks to both of you for your insights!  The good news I'm hearing is that a healthy lifestyle will go a long way to help with this process.  I am onboard with that!  I am a 66 yr old retired registered nurse and have plenty of free time to put toward this effort.  Other than the last few weeks, I am very active and workout everyday.  I am a pescatarian and avoid sugar and oils.  So I think I need to force myself to get back to some physical activity today, even if I just start with walking?  

 

From what I have read in this forum, I should at least consider resuming this drug at a lower dose, stabilize and then start a very slow taper. It also sounds like if I decide to reinstate the med, I should do it very soon.  Why is that?  Is there a chance it won't be as effective the longer I wait?

 

Thanks again.  I have some decisions to make. I will also check out "Heal America Now" site.

Duloxetine 60mg 2/day starting March 2007 for peripheral nerve pain from spinal injury

had to change doctor due to moving to new city and couldn't get appointment before meds ran out.

I tapered what I had left over 2 weeks March 2022. Went 3 weeks without and decided to stay off.

Withdrawal symptoms have been bad.

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  • Moderator

Healthy eating is always important. Lots of hydration, a clean, balanced diet. I wonder whether I get enough protein, as I am a full vegetarian. But do the best you can. There are lots of suggestions on the website. But they are only suggestions; we all have to find our own way through this.

 

Yes. You should consider reinstating. There is nothing to say you won't be hit with life-changing withdrawals in the next days/weeks/months. It is a gamble, either way. The longer you leave reinstatement, the less likely your brain will adjust to it. It craves stability; suddenly going down and up is not stability! Only you can judge from your circumstances and how you feel now. It might help; might do nothing; might make things worse. If you are going to reinstate, do it soon. Your brain is trying to adjust to not having a high dose for a long time. 

 

Please bear in mind what Blossom71 said about doing any tapering 'off the record'. Truly understanding doctors are few and far between. A slow taper of duloxetine / Cymbalta is 5% or less than the previous dose, with holds of at least 2 weeks or more. Anything faster is highly risky. 

June 1998 20 mg Prozac

April 2001 Citalopram

Dates unavailable (illegible); Effexor, Venlafaxine, Amitryptiline, Fluoxetine

Duloxetine 30mg 2016

Cold turkey June 2018; massive withdrawal

Briefly, Mirtazipine

Reinstatement on 20 mg Duloxetine

Started tapering December 2018, currently at 1.6mg, 9 beads

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  • Moderator

I'm sorry, I never mentioned exercise. Yes, walking is good exercise. The usual advice is not to overdo things generally, but some duloxetine patients manage quite heavy workouts. The drug can cause tiny tears in the muscles which will cause you pain and difficulty in using them. But, like everything else with this drug, it varies according to the individual. I managed quite heavy workouts and have only recently had problems with my muscles. I surmise there is another reason for that.

June 1998 20 mg Prozac

April 2001 Citalopram

Dates unavailable (illegible); Effexor, Venlafaxine, Amitryptiline, Fluoxetine

Duloxetine 30mg 2016

Cold turkey June 2018; massive withdrawal

Briefly, Mirtazipine

Reinstatement on 20 mg Duloxetine

Started tapering December 2018, currently at 1.6mg, 9 beads

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  • Administrator

Welcome, @SearchingForAnswers What are your current symptoms? Are they better or worse at particular times of day? How's your sleep?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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My most bothersome symptom is the mood swings. Yesterday I had a pretty functional day. no emotional extremes and I managed to get a fair amount of non-thinking chores done.  Today was the opposite. If I wasn't crying or lashing out, I was totally apathetic and numb.  How can one day be so different than the next?  The GI distress is definitely worse in the mornings.  The only thing I can tolerate in the mornings is fruit.  I normally drink a fresh green smoothie - lots of green veggies and a little fruit.  Now I am having a fruit smoothie with a few greens and not until lunch.  By late afternoon I start to feel hungry and the GI upset is better.  My sleep is poor, which is something I have never struggled with in my life.  I am taking CBD before bed and just added GABA and they do help me fall asleep, but I'm usually up by 4am and can't fall back asleep.  My nerve pain has returned which is also disrupting my sleep.  I just started using compression socks and a neuropathy cream 2 nights ago.  I'm not sure it's working but I will give it more time.  

 

Thinking hurts.  I'm a stock trader and I literally can't seem to do a simple trade that I've probably done 1,000s of times, because my brain just locks down. The frustration sends me to tears or throwing things.  I am behaving like a child and can't seem to stop it.  So I do know that mental tasks certainly make me worse.  Meditation does help me calm down but it is short lived.  I am so grateful that I had this practice in place because it does help.

Duloxetine 60mg 2/day starting March 2007 for peripheral nerve pain from spinal injury

had to change doctor due to moving to new city and couldn't get appointment before meds ran out.

I tapered what I had left over 2 weeks March 2022. Went 3 weeks without and decided to stay off.

Withdrawal symptoms have been bad.

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  • Administrator

It seems your withdrawal syndrome isn't too bad. Typically, symptoms will fluctuate and very gradually fade. Be patient, hang in there. 

 

I'm sorry this is interfering with your work. Are you getting at least a half-hour of gentle exercise every day? This will help you feel better.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus
On 4/4/2022 at 12:49 PM, SearchingForAnswers said:

Meditation does help me calm down but it is short lived. 

 

Q:  How often throughout the day are you meditating.

 

You might find it helpful to do many short breaks for calming down throughout the day, rather than letting the stress build up; perhaps setting a timer to remind you, ie check in with yourself.  This can became a natural thing to incorporate in your day, a good habit.  I find now that I now pick up faster when I am getting stressed which means that it takes less time and effect to bring me back down to a calmer level.  Sometimes all I have to do is say a key word, like "chill", and it reminds me to take a few deeper breaths, which is a distraction, and then I can go back to what I was doing feeling calmer.

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

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I am at least walking a couple of miles most days which helps in the moment.  The GI upset keeps me from doing anything more than that. I am taking magnesium and have been for a few years.  I have not tried fish oil.  I will check out your link.  Thanks.

 

I am meditating in the morning and before bed.  I'll try to add another one during the day.

 

Do most people get back to normal at some point?  Or has this drug turned me into someone who is clinically depressed?

 

Duloxetine 60mg 2/day starting March 2007 for peripheral nerve pain from spinal injury

had to change doctor due to moving to new city and couldn't get appointment before meds ran out.

I tapered what I had left over 2 weeks March 2022. Went 3 weeks without and decided to stay off.

Withdrawal symptoms have been bad.

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  • Administrator

If you have GI upset, you may wish to suspend magnesium for a while.

 

2 hours ago, SearchingForAnswers said:

Do most people get back to normal at some point?

 

There would be no point to running this site if people did not recover.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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