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Altostrata

Tips for tapering off Cymbalta (duloxetine)

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ChessieCat

Is the compounder going to use Cymbalta powder (raw or "bulk") or are they going to use the already made version of the drug?

 

There are several different things which can be used/done:  enteric, sustained-release and slow release additive. 

 

I suggest that you ask specific questions so that you know exactly what you will be getting.  It's also a good idea if you reword back to them what you think they have told you so that you make sure that you are talking about the same thing.  They will probably use "trade terms" which you may think means something different.

 

You will need to keep notes and be aware of interdose withdrawal.  I was only taking my Pristiq capsules once a day >10mg and that was okay for me.  However once I got to 10mg I started taking it twice daily.

 

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DavidfromTexas
Posted (edited)
1 hour ago, ChessieCat said:

Is the compounder going to use Cymbalta powder (raw or "bulk") or are they going to use the already made version of the drug?

 

What is the difference between Cymbalta powder and the”already made version of the drug”?

 

Im going to go ahead and get my prescription for 1mg from my psychiatrist, and then when I go to drop it off I will double check all these answers. 

 

I was asking for details when I spoke to this particular pharmacist and she was very helpful. She was reading directly from the PCCA formula they are required to follow.

She told me: 

1) the capsule used in the formula is designed to survive stomach acid to dissolve in the intestines

2) there is actually a filler they use whose purpose is a slower release. 

So she said it should have the same action as the Delayed Release capsules

 

Edited by DavidfromTexas

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ChessieCat

I'm really please to see that you ask the right questions and got the answers from them.

 

44 minutes ago, DavidfromTexas said:

What is the difference between Cymbalta powder and the”already made version of the drug”?

 

Some drugs are available to the compounders as the raw material (pre tablet /pre capsule manufacturing), not the pharmaceutical tablets or capsules.

 

44 minutes ago, DavidfromTexas said:

2) there is actually a filler they use whose purpose is a slower release. 

 

I thought that they would probably add this as well as use enteric capsules.  My compounded Pristiq has the slow release added and it extends it by about 6 hours.

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DavidfromTexas
Posted (edited)

So do you think those 2 factors considered, that the encapsulated powder is a good option for people on minimal doses and tapering?

Edited by DavidfromTexas

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ChessieCat

Unfortunately I have no idea, and I doubt anyone else does either, unless they have tried it that way themselves.  You will have to try it and see if it works for you.  That's what another member, Fresh, had to do with breaking up and weighing and then compounding Pristiq (which is only available in 50mg and 100mg in Australia, other countries can get 25mg, and isn't supposed to be broken up or powdered) and it was only because of her experimentation that I've managed to do what I am doing.

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DavidfromTexas
Posted (edited)

Just thought about this...do the clear gelatin capsules you get from the vitamin store even have the ability to make it past your stomach??

I know the capsules from the manufacturer have a special coating to get them through the stomach without dissolving...

Edited by DavidfromTexas

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DavidfromTexas
6 minutes ago, ChessieCat said:

 

Yaaaa I didn’t order mine, I just bought them for the neighborhood vitamin store... 

Rookie move. I’m sure they’ve just been dissolving in my stomach. 

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ChessieCat

If you have been putting the whole beads into a gelatin capsules it's not a problem:

 

On 5/7/2011 at 5:26 AM, Altostrata said:

 

each bead inside the gelatin capsule has an enteric coating to protect the drug from stomach acid

 

 

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DavidfromTexas
7 hours ago, ChessieCat said:

If you have been putting the whole beads into a gelatin capsules it's not a problem:

 

 

Ahh yes. I just thought since the original capsules are coated as well that that would be a necessary component to help the meds pass unharmed. 

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DavidfromTexas

Is putting the divided beads back into their original capsule fine? Just to be sure it gets past the stomach. Is this all good?

 

The only advantage of the gelatin capsules that I personally bought was that they’re clear so you can see the insides. But just to be sure its making it to its intended point of dissolution I feel like you should be able to use the original capsules. 

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Guilietta

A compounding pharmacy located in Worcester, MA (and ships to many US states) compounds duloxetine into an oil based suspension, which I take with an oral syringe. My insurance does not cover compounded prescriptions so I pay out of pocket. The approximate cost for 12 oz of duloxetine prescription written as 15 ml/5 mg (I was starting from 20 mg), is about $135 (I think).  Since duloxetine liquid must be kept at room temperature - consider that if you have this shipped.  Their website: https://boulevardcompounding.com/.

 

I am so grateful to have found these folks. I've had a lot of bumps with my taper along the way and they've been patient with my questions about dosage calculations, etc.

 

Currently on 9.75 mg as of this morning. Duloxetine journey - been on this toxin for about 5 years - was up to 60 mg and then down to 20 mg. Started tapering in December 2018 from 20 mg.

 

 

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Altostrata
On 7/26/2019 at 2:53 PM, DavidfromTexas said:

I asked the pharmacist that I talked to already and she said they use a capsule that is designed to break down I the intestines. So the action of the timed release should be the same as the pellets, no? The capsule begins to dissolve in the intestines and the powder begins to leak through. Should that not have the same effect as the pellets?

 

Please get more detail from the pharmacist. As far as I know, those types of capsules have not been available to compounders, only to pharmaceutical companies.

 

However, compounders can weigh out the beads from existing duloxetine capsules and repackage them in custom dosage capsules. Those would be conventional extended-release duloxetine, as the coating on each bead delays release to the intestines.

 

Any duloxetine liquid would definitely be immediate-release.

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DavidfromTexas
Posted (edited)
47 minutes ago, Altostrata said:

 

Please get more detail from the pharmacist. As far as I know, those types of capsules have not been available to compounders, only to pharmaceutical companies.

 

However, compounders can weigh out the beads from existing duloxetine capsules and repackage them in custom dosage capsules. Those would be conventional extended-release duloxetine, as the coating on each bead delays release to the intestines.

 

So you’re saying that a producer like PCCA who produces wholesale for compounding pharmacies across the country wouldn’t have the access to the original capsule design? Or design one that is equally good? 

 

My concern with having the compounding pharmacy simply divide the beads down to 1 mg arose when I read what a member said about being told the beads themselves suffered from each other in their designed release-times. Which means dividing them up would negate the efficacy of the delayed release design since they all LOOK the same but are apparently not. 

Edited by DavidfromTexas

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Guilietta

If the liquid duloxetine, which contains beads in an oil suspension, is no longer timed release - why is this the case?

 

My bottle appears to contain beads of different sizes.

 

 

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Altostrata

Any drug made from a liquid taken orally might be absorbed in the mouth, throat, and stomach as it goes down. It is impossible to make a liquid extended-release.

 

@DavidfromTexas if such a capsule is equivalent to the coating on Cymbalta beads, that would be a new development in compounding. Please double-check that to recommend it here. I wouldn't want someone to order such capsules and then find they don't work as expected.

 

1 hour ago, DavidfromTexas said:

what a member said about being told the beads themselves suffered from each other in their designed release-times.

 

Who said this?

 

As for weighing the beads and putting them into capsules, you may not be able to get an accurate weight when you're down to a few beads. At that point, you'd have to taper bead by bead. What people do is taper by the smallest beads in the capsule.

 

The weight of the varied beads in a larger batch averages out.

 

You'll have to allow for a little variation, insisting on perfection will keep you from tapering at all.

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DavidfromTexas
Posted (edited)
On 1/3/2017 at 3:19 PM, cymbaln00b said:

I'm new to this topic, so please forgive me if I'm overlooking something obvious...

 

There appears to be a logical problem underlying all of the tapering strategies in this thread.  I just had a lengthy discussion with my local pharmacist, and she claims that the "micro-beads" contained in Cymbalta are heterogeneous wrt enteric coating.  In other words (to use a made-up example): 25% of the beads might be coated to time-release after 1 hour, 25% to release after 2 hours, 25% after 4 hours, and 25% after 8 hours.  The problem is that when you sub-divide your dosage, you have no way of knowing whether you're getting a balanced cross-section of these different enteric coatings.

 

The pharmacist wasn't sure, but it sounds like the same problem might also apply to the mini-tablets that are found in some generic forms of duloxetine.  See www.wjpps.com/download/article/1438355089.pdf

 

I'm not sure whether to believe the pharmacist, as she seemed to be motivated by a strong agenda of discouraging patients from doing ANY form of DIY dose adjustments, and she may have just been making up this issue of differential enteric coatings.  But if she is right, all of the methods in this thread would be unreliable, and potentially dangerous --  they could have the inadvertent effect of clustering the delivery of the drug into short, time-limited spikes, rather than smoothing out the delivery.

 

This stuff is a bit above my pay-grade.  Is there anybody out there with enough knowledge of pharmacology to confirm whether this is actually an issue?

 

 

 @Altostrata this was the introduction of the varying beads question. I also outlined my conversation with the pharmacist about the powder in the posts above, and I contacted PCCA by phone to confirm that they do in fact make Duloxetine powder for compounding, as well as liquid duloxetine

 

For the other parts of your question: What the pharmacist told me is that the PCCA formula for the powder/capsule version uses a coated capsule like the coated capsule that is normally used, and that there is also a filler they use to help facilitate slower release. I’m not sure exactly how that does that, but she was saying that because of these different components the action of the medicine should be the same: it passes through the stomach and the capsule begins to dissolve in the intestines. 

 

In the commercial capsules available 20mg and up, don’t they only start to dissolve in the intestines as well?

The info I have read on this site would seem to suggest that BOTH the capsule AND the beads have coating to withstand stomach acid...

 

 

I have emailed PCCA Attn: the Clinical Compounding Pharmacist with my question about the bead designs varying and if I get a response I will also ask about their capsule design. 

Edited by DavidfromTexas
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Altostrata

You have quoted cymbaln00b quoting a pharmacist that cymbaln00b says may not be communicating accurate information. This is advice at least twice removed from an unreliable source.

 

We have many people here successfully tapering duloxetine by counting beads or using the mini-tablets. Variation in the beads, if any, averages out in a dose.

 

1 hour ago, DavidfromTexas said:

Duloxetine powder for compounding, as well as liquid duloxetine

 

Yes, we know this is available. The powder has to be packaged in something to extend its release. Without protection, the chemical formula of duloxetine is destroyed by stomach acid.

 

1 hour ago, DavidfromTexas said:

the PCCA formula for the powder/capsule version uses a coated capsule like the coated capsule that is normally used, and that there is also a filler they use to help facilitate slower release. I’m not sure exactly how that does that, but she was saying that because of these different components the action of the medicine should be the same: it passes through the stomach and the capsule begins to dissolve in the intestines. 

 

This indicates the pharmacist is aware that the capsule alone doesn't do the job. I would want to know more about the timing equivalency.

 

1 hour ago, DavidfromTexas said:

In the commercial capsules available 20mg and up, don’t they only start to dissolve in the intestines as well?

 

The beads are coated so they can travel through the stomach and dissolve in the intestines.

 

The question you want to ask PCCA is if they have tested equivalence in release between prescription duloxetine beads and their formulation with delayed-release capsules (they are plastic) combined with the delayed-release filler. You want to find out to what extent the person is guessing.

 

PCCA probably won't know anything about the composition of duloxetine beads, you'd have to ask the manufacturer for that. Be aware that anyone you speak to on the phone might not know what they're talking about.

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Guilietta
Posted (edited)

I have been in touch with the PCCA since yesterday afternoon to learn about obtaining extended-release duloxetine and who in my area has compounded duloxetine. The PCCA Customer Service Representative told me the following, which may be helpful:

 

"Duloxetine can be made into an Acid Resistant capsule which delays the release until it reaches the intestinal area.  There may be something further they can do with the actual formulation regarding the gradual tapering of the dosage over time after that, but that would be something they would need to discuss with one of our clinical services consultants."

 

The PCCA also indicated the names of two pharmacies in my state who have ordered duloxetine powder in the last 4 months. I have left word with them to contact me for futher information - including whether they have tested equivalence in release between prescription duloxetine beads and their formulation with delayed-release capsules (they are plastic) combined with the delayed-release filler. The PCCA indicated that they do not have control over what the pharmacies actually do as they are independent. I was repeatedly told that the pharmacist should contact a PCCA clinical service consultant as that is 'what the pharmacies are paying for.'

 

I am currently using the duloxetine liquid - and today I am trying to split the dose  to see if it helps minimize the side effects (note by CC - possibly means withdrawal effects caused by interdose withdrawal) from mid-afternoon through the evening hours.

 

 

Edited by ChessieCat
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DavidfromTexas

Hi @Guilietta. Please update us when you find out anything! 

I have kinda let go of the idea of the powder since I first discovered the possibility, and have been leaning towards just reducing by counting beads and rounding to the nearest whole bead. Since people have said it has worked for them and is less involved and has less factors than having the prescription compounded. 

 

But I’d still love to know what you find out, maybe I’ll change my mind!

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Guilietta
Posted (edited)

Hi David.

 

I heard back from one of the compounding pharmacies, who told me:

 

Quote

 

"I can definitely compound duloxetine for you in specific doses not commercially available. However I am not able to compound the capsules as extended release. I can compound the duloxetine in a similar delayed release manner, however your dose may require minor dose adjustments with your doctor."

 

 

I don't know what 'similar delayed release manner' means. Do you know?

 

I will let you know what I learn from the 2nd pharmacy.

 

Congrats on getting down to 1 mg!!!

 

 

 

Edited by ChessieCat
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DavidfromTexas
Posted (edited)

Thank you! I actually didn't do my tapering correctly, I stopped pretty much cold turkey, so I just started my reinstatement doses a week ago, and we're going to see if I want to up-dose in a couple days or not.

 

When I spoke in detail to the pharmacist at one of the compounding pharmacies here in LA, she was telling me that the way they would compound the powder, adhering to PCCA's formula for doing so, is that the medicine would come in powder form, there would be an added "filler" that facilitates delayed release, and that the capsules themselves would ALSO be designed for delayed release (acid resistant in order to pass through stomach). The "similar delayed release manner" probably means that they can't guarantee it will be the EXACT same because they won' be using the same capsules, but they have designed capsules similar to the ones the meds normally come in.

She was reading this information directly from her portal on the PCCA website where they get all their specific formulas to follow.

 

So, if that is correct, the way I understood it is that the "filler" that goes inside the capsule with the powder would somehow help slow the release of the powder itself once the capsule begins to dissolve in the intestines.

 

I haven't spoken to her since, because everything about my own dosage is still up in the air, but I think I have decided to go the counting beads route. I am praying and hoping that I can stay on as low a dose as possible so that the counting beads method would probably not be so big of an issue. 

 

To the other point about the beads version. Since we know that the beads themselves cannot be crushed, the powder or liquid would be the only other versions to try.  I have read from other members here that compounding pharmacies would be able to simply divide the beads for you, essentially "compounding" them by counting them out and giving you the precise smaller dosage you would need, but I think at that point it's a question of you feeling it's worth it to pay for that when you could probably just do it yourself. It would take the effort out of it for you, but would cost more money.

 

Did this first pharmacy address the equivalence/potency question? That was one of the concerns I had as well when thinking about doing this. The pharmacist I spoke to said that they do NOT test the powder for equivalence of potency compared to the beads.

Edited by DavidfromTexas

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Guilietta
Posted (edited)

Hi David.

 

The pharmacy just responded to me on the equivalence/potency question. They do not test:

 

Quote

 

"We have not tested equivalence between prescription duloxetine beads and our formulations and do not have the means to do so unfortunately. The duloxetine capsules I compound do not use delayed-release capsules and contain the pure duloxetine drug powder (which is not delayed or extended release). My formulation does not include "delayed release filler" but contains a bicarbonate filler which may delay absorption of duloxetine."

 

 

So we get closer to the truth. The filler 'may delay' absorption of the duloxetine but for people on a lower (and low) dosage - I would think that the extended release is particularly important.

 

Beads seem like the way to go. How many beads are in your current 1 mg dose? My 20 mg duloxetine has about 100 beads - so then 1 mg would be about 5 beads.

 

 

Edited by ChessieCat
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DavidfromTexas

Hmmm. The equivalency/potency answer is what I would've suspected, as that is the same answer I got.

 

However, I guess not all PCCA Member pharmacies follow the formula PCCA provides, because the pharmacist I spoke with told me she would follow the the PCCA formula exactly, which calls for the delayed-release capsule and the filler.

 

Are you sure the pharmacies you contacted are PCCA Member pharmacies? You can search on the PCCA website to find Compounding Pharmacies that are PCCA members. 

 

When I opened my 20mg capsules, they all had varying number of beads, but I took the average of the number of beads from 5 capsules (112, 114, 115, 116, 117) which came out to about 115 beads per capsule. Thus, in my case 1mg comes out to about 6 beads. 2 mg is 12.

 

My only concern with the beads method has been what another poster mentioned a while back...that a pharmacist suggested to them once that the beads within each capsule vary from each other in their design for specific release times. I'm not exactly sure how that would work, and the poster actually said they weren't sure if they believed that pharmacist or not. Nobody else seems to know if that claim is true or not. 

But I have decided not to worry about that. As others have mentioned, there have been several people who tapered successfully by the counting beads method.

 

I am guessing the number of beads in each capsule will vary from manufacturer to manufacturer. The manufacturer that makes the prescriptions I've gotten lately from my pharmacy here is called Rising Pharma.

The prescription is generic duloxetine.

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Guilietta

Hi David.

 

PCCA told me that just because a pharmacy was a member of PCCA does not mean that PCCA knows how any pharmacy (or every one) would compound as they are independent. The pharmacy I contacted yesterday and the one I am working with for the liquid are both PCCA. They are listed on the PCCA website.

 

10 minutes ago, DavidfromTexas said:

However, I guess not all PCCA Member pharmacies follow the formula PCCA provides, because the pharmacist I spoke with told me she would follow the the PCCA formula exactly, which calls for the delayed-release capsule and the filler.

 

 

I read the same post about different beads in the same capsule - for specific release times - but I don't know who said this or how they know. This is a good point of comparison about counting beads vs a liquid. 

 

 

18 minutes ago, DavidfromTexas said:

I am guessing the number of beads in each capsule will vary from manufacturer to manufacturer.

 

You are correct.  I don't know the name of my generic manufacturer - but I can tell you that one capsule had 100 beads and I'm sure there is variation in exact numbers (so much for quality control!).

 

One thing I have read and been told - is the importance of doing a hold between cuts. At your 1 mg - maybe you might hold there for two weeks (maybe 3?) before making another change.

 

Even after you have stopped this poison altogether - it can/will take your system months to recalibrate itself. Even a neurologist came out and said this to me. There are a number of people on SA who make this same comment.

 

 

 

 

 

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DavidfromTexas

Oh, okay. Interesting. Well I guess the best bet then would be to keep contacting different pharmacies until you find one that will follow the PCCA formula like the pharmacist I spoke with. 

 

Yeah, about holding, I am going to hold for quite a while actually as soon as I can find the reinstatement dose that is working for me. I am thinking of taking that dose with no change for several months to allow for more healing before starting to reduce again.

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Guilietta
Posted (edited)

Hi David,

 

I hope you had a good night. The empty quote block above is there by accident, fyi.  Here are a few things I learned since my split taper:

 

1. On the split dose (60/40) yesterday - I felt much better in the afternoon and evening than on the single full dose in the morning. I am repeating this again today.

 

One caveat about this is that I had been holding at the same dose since 7/28 - so it is possible that the 5 days since the decrease of .25 mg helped wtih this. Tomorrow I am scheduled to decrease to 9.5 mg. We'll see how that goes.

 

2. This morning I examined the contents of the liquid more closely. While I had noticed that some of the granules (they dont' actually look like beads - they don't rol and I can crush them) stick to the inside of the bottle and there are also some on the top of the bottle (see image) - I hadn't thought much of it. This gets to our discussion that we don't know how much of the medicine that we are actually getting. This may apply to the bead counting as well.

 

G.

 

 

Edited by ChessieCat
removed blank quote

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DavidfromTexas

Hi @Guilietta. That’s good to hear!

 

About the beads...when we open up the capsules and look very closely we can usually see a tiny bit of powder dust on the walls of the capsule, I have assumed this is due to the natural moving around of the beads in transport since they were originally put in the capsule. They do seem to be more solid than not, and don’t seem like they would be completely broken just from transport.   They are also apparently coated so that probably makes them more solid.

Somebody correct me if I’m wrong, but I feel like a tiny amount of powder rubbing off of them inside the capsule would be normal. 

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Guilietta

Unless I ask my pharmacist (who already things I am a PITA) how she makes my duloxetine - I don't know for sure whether she is using bulk drug product or pellets. I know that they product the oil suspension first, shake/process that separately.  

 

How hard is it for you to 'squish' one of these pellets (maybe float a few in cooking oil for a couple of hours) - but I don't know if that would tell us anything concrete. I like an empirical approach to things even if I don't understand it.

 

G.

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Guilietta

Is anyone in the cymbalta/duloxetine taper group using liquid to taper (besides me)?

 

Thanks...

 

G.

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VincentV

The psychiatrist has prescribed Cymbalta (again) and i picked up the prescription today. I didn't take it last time, and though my depression spike is very bad, I probably won't take it this time. Desperate as i am to get ECT. 

 

I am curious though, my generic cymbalta says the capsules are 'gastro resistant'. I cant open them simply, I have to cut them open. Surely this means that when I wanted to taper I'd have to source special gastro resistant capsules to put the reduced amount in? Where would I reliably find those?

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SDOE
21 hours ago, VincentV said:

The psychiatrist has prescribed Cymbalta (again) and i picked up the prescription today. I didn't take it last time, and though my depression spike is very bad, I probably won't take it this time. Desperate as i am to get ECT. 

 

I am curious though, my generic cymbalta says the capsules are 'gastro resistant'. I cant open them simply, I have to cut them open. Surely this means that when I wanted to taper I'd have to source special gastro resistant capsules to put the reduced amount in? Where would I reliably find those?

VincentV when I took Cymbalta my capsules contained mini-tablets. When I tapered I bought NOW delayed release veg capsules for tapering.  It may not have been the best way but that is what I did.

I realize from your statement you are suffering from depression but I hope you have explored other options before taking Cymbalta.  I was a very long term user so perhaps short term may not do as much damage.  I'm still suffering from bad insomnia and at some point I may give up and reinstate as it just doesn't seem to be getting better for me.  I fear I have permanent damage. Right now I'm using tryptophan and in the past I have used tyrosine.  Also, I purchased AlphaStim but it hasn't helped with my insomnia but believe it has helped with my anxiety. I feel as though during my withdrawals I've suffered more from anxiety than depression but I have had both and I think Alpha helped with it.

 

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Guilietta
22 hours ago, VincentV said:

my generic cymbalta says the capsules are 'gastro resistant'. I cant open them simply, I have to cut them open. Surely this means that when I wanted to taper I'd have to source special gastro resistant capsules to put the reduced amount in? Where would I reliably find those?

 

The first place I would look at is Amazon. Otherwise - could you purchase from Boots? I am not terribly familiar with what you can purchase in the UK without a prescription. If you google 'gatro resistant capsules + surviving antidepresants' you will get some hits. There has been discussion about this on the site about this. I'm thinking tno try with one of my 'old' capsules if I can break, remove beads, and resuse the capsule.

 

 

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Guilietta
46 minutes ago, SDOE said:

I was a very long term user so perhaps short term may not do as much damage.  I'm still suffering from bad insomnia and at some point I may give up and reinstate as it just doesn't seem to be getting better for me.  I fear I have permanent damage.

 

The insomnia (and other WD effects) linger. I would NOT reinstate until you check with the mods.

 

Could you perhaps be more positive that you are recovering and will heal. This is along process. I was on duloxetine for 3 years and other ADs before then. I am so angry about this - but will be positive about moving fnorward.  :)

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SDOE
1 hour ago, Guilietta said:

 

The insomnia (and other WD effects) linger. I would NOT reinstate until you check with the mods.

 

Could you perhaps be more positive that you are recovering and will heal. This is along process. I was on duloxetine for 3 years and other ADs before then. I am so angry about this - but will be positive about moving fnorward.  :)

Guilietta, I don't mean to sound negative but the insomnia first started in 2016 and got progressively worse.  I've searched this website and I haven't found anyone that was a long term user of only Cymbalta (10+ years) that has healed. Maybe there are some but I haven't found any. I know I'm not where I once was in 2017, 2018, & there was some really bad times in 2019 but I just had no idea how tough this road was going to be.  I have healed in a lot of ways but the insomnia prevents me from living a life like I led before.  I've tried a lot of things to try to solve my insomnia and so far I cannot. At this point, I'm not reinstating but I don't want to live like this forever.  I just keep trying different things for now.

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CymbaltaDrone

Responding to the insomnia concern.

I didn’t realise or I’d forgotten until reading this that my insomnia was possibly a aide effect of having used cymbalta in the past. The start of it was after I stopped using cymbalta, so it’s possible. I suffered terribly from it until just recently, for more than a few years, and the fatigue from it caused other endocrine issues like low thyroid, burnout and food cravings leading to weight gain. What changed for me was the following, all starting in June this year:

1. I started taking He Shou Wu, on advice of a friend. I’ve since learned this is a very popular tonic for general fatigue. Within hours of first taking it I felt a level of rest and support deep inside that I hadn’t felt for probably two decades. 

2. I started taking sleep herbs after watching the online documentary series “Remedy - Ancient Medicine for Modern Illness”. It also supported the He Shou Wu I’d started a couple weeks before. The first couple weeks the herbs made me feel sleepy when I took them, and after that effect lessened I though maybe I’d built a resistance to them, but what I’ve found is that they help me stay asleep and fall back asleep if I wake up for some reason. I definitely notice a difference when I forget to take them. 

3. I started taking a daytime serenity herb mix. During the day I feel calmer, more mellow, less stressed. 

4. I got an Apple Watch and the pillow app and started tracking how much time I’m actually asleep versus just in bed. I’m working on getting my asleep average up to 7hrs/night. Right now it’s at 6hrs48mins. I feel freaking amazing - and weigh 15lbs less - compared to 4 months ago before I started all of this. It boggles my mind to think back to how little sleep I was getting before (<<5grs/night) and still somehow functioning feeling like I was perpetually being tortured. With a job and three kids under 10. 

 

I should add that I also take 5HTP (I know - generally not recommended by SAD) and GABA 2-3X/day (I always take morning and evening but sometimes forget in the middle of the day). They also helped my falling sleep improve when I started them about a year ago (which was years after I stopped ADs).

 

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