Montebella: Withdrawal from Cymbalta

[Montebella]

My introduction:  Dealing with withdrawal from Cymbalta and not enjoying it one bit!  

 

Previous brief history with Celexa (2003-was going through a rough time) Looking back I believe the Celexa caused me to be a bit manic, probably because I was not depressed in the first place?  Took that for about a year. 

 

Also took Wellbutrin (2007? for smoking cessation) did not help with the smoking and caused me to be very irritable and easily enraged over the smallest things.  Took that for about two months. 

 

2009 (I believe spring or summer of): Went to Psychiatrist after my doctor decided he could no longer help me since I did not seem to tolerate any of my previous psych meds well.  At the time my husband was working out of town and I had an extremely stressful and dysfunctional job of my own.  Was also found to be severely anemic around this time.  Thought I was depressed because I was so tired and so overwhelmed.  But I was still taking care of things at home and going to work.  It hadn't really impacted my life other than I was a little more irritable with my kids and craved more alone time. 

So, I found a psychiatrist and made my appointment.  He spoke to me for about 20 minutes and gave me some worksheets to fill out.  Went on to diagnose me with cyclothymic disorder.  I had never heard of it but trusted him and actually was really happy that now I was going to get fixed!  He first prescribed me Remeron and Lamictal, I can't recall which on I had first.  But I stopped taking one because it didn't do anything and the other one made me eat enormous amounts of food at night- usually consisting of carbs and lots of butter.  When I stopped taking it I had no more night cravings.  I wish I could remember which one caused that!  I did not take either one for more than a month.  He then prescribed me Cymbalta.  I was initially at 60 mg then 30 mg and finally 20 mg.  At this point I was convinced that I needed a medication and that we just needed to find the correct one. 

 

Side effects of Cymbalta: extreme fatigue, night sweats, memory issues.  Did not have any positive effects that I can now distinguish, although when I first started taking it I think I convinced myself that it was helping, about a year in I think I knew it had not "fixed" me but taking it was routine.

 

In January of 2013 was changed to generic then in February of 2013 I missed two days doses.  Went through what I did not realize was severe withdrawal with horrible nightmares, insomnia, extreme mood swings, brain zaps (to me not so much a "zap" but rather a feeling like my brain and/or eyes are out of sync with my head- if that makes sense), thoughts of worthlessness and feeling like my family would be better off without me.  I isolated myself from everyone.  My husband was the one who connected it to missing my doses and went to get the medication for me.  Felt better within two hours of taking it again.  Spoke to the psychiatrist whose solution was to change me back to name brand and increase my dosage.  I accepted the name brand but not the increase.

 

 I started researching and tapering by bead counting in that same month because I realized that first- it wasn't really helping me and second- it was going to be difficult to stop taking it.  My tapering schedule was not consistent but on average I went down about 10 beads every week to two weeks.  Had to go back up a couple of times due to symptoms being unbearable.  Around July of 2014 I slowed down and took 3-5 beads out every 1-2 weeks.  I'm now taking out just one bead every 1-2 weeks and am down to 13 beads and have really hit a wall.  

 

I have had days here and there during tapering where I have been dizzy or felt no motivation and have had a few nightmares. It has been a struggle to maintain my home and keep up with my kids schedules, etc...Thankfully my husband has stepped up and pretty much taken over housekeeping.  I have also learned to accept my home in a much messier state than I would ever have tolerated before.  In July I had an episode of atrial fibrillation which was found to have no structural cause (EKG, echo cardiogram were all normal, blood pressure is and always has been normal).  I am 38 years old with no personal or family history of heart problems..... 

 

Now, as of the past month or so, I have been having severe anxiety (intense, unwarranted fear), heart palpitations, emotional instability (3 hour crying spells, no tolerance for any annoyance or stress, state of mind changes from hour to hour), insomnia, fatigue, loss of interest in everything, etc.  I have been missing work a lot because I just can't get there.  Taking  a shower or brushing my teeth takes serious effort and all I want to do is lie down.  I am exhausted and want to sleep but can't sleep.  I have trouble speaking- I get tongue tied a lot I can hardly type any more.  I make mistakes constantly and sometimes I type a completely different word than intended- it's very strange.  Anxiety comes on without warning and I feel sick with intense fear and heaviness in my chest.  I have to force myself to eat. I have to force myself to pretty much do anything. 

 

I have been trying to take care of myself.  Trying to walk when I can but that's easier said than done these days.  Trying breathing exercises and started taking supplements.  I also finally located a psychologist who has a holistic view and experience with helping people withdraw from psych meds.  I am hopeful that she can help me get through this.  I can't even count how many times I have thought about asking for xanax or something to help with the anxiety or even thought about just staying on the Cymbalta for the rest of my life.  But I know that on the Cymbalta I'm not myself and it's not better.  And I feel like relying on xanax is counter productive at this point, for me. 

 

And I used to think I was depressed.  I know now that I was not depressed and most likely there was nothing wrong with me at all!  I would take the way I was over the way I am in a heartbeat. 

 

Anyways, that's my story so far.  I have found this and other sites so helpful.  It is invaluable to be able to hear other's experiences and I so appreciate that this resource is here! 

 

Thanks for having me.  

[mammaP]

Hi Montebella, welcome to SA. I'm sorry that you are in this state but glad that you found us. Sadly you 

are experiencing withdrawal even though you were careful with your tapering and doing what you thought

was the best. The lower doses can be the hardest and long holds can be necessary. 

You might be best to stop tapering for a while, or even go up slightly and hold for a couple of months to allow

your nervous system to recover. When you have stabilised you can restart your taper and take it more slowly,

we recommend tapering not more than 10% of the current dose with at least 4 weeks between drops.

 

 Many people find that fish oil capsules and magnesium help with symptoms, but the best healer is time. Your 

brain and nervous system have  been altered by the drugs and need to regrow, tapering too fast means they

haven't had time to adjust between cuts. I know, I did it myself with effexor. Thought I was tapering very slowly

and took a year to taper 37.5 but it was not regular or precise enough and I ended up with withdrawal.

I have now been tapering from 5 beads for 18 months, holding for several months between cuts to allow recovery.

 

We use the 3 Ks to taper, Keep it stable, Keep it simple, Keep it slow.  http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

Hopefully you will feel better soon if you hold for a while before resuming the taper. I know you want to be off but 

time and patience are our life savers here! 

Edited October 24, 2014 by Altostrata
changed name for privacy

[Montebella]

Hi Mamma, Thank you for responding.  I think I am going to hold for a bit and see how it goes.  I may consider going up slightly if I am still experiencing the degree of symptoms I am.  How much would be recommended to increase if I do go that route?  

 

Also, I have a question about the 10% taper.  How does that work when you are down to such low doses?  Once I get to 9 beads than I have no option other than to taper more of a percentage.  Then each taper the percentage increases- am I correct?  Perhaps that is part of why it gets so hard when you are down to the lower doses?  

 

Lastly, supplements.  I realize now that I should have included these in my intro.  I am currently taking:  cod liver oil (225mg EPA, 315mg DHA, 900 IU vitamin A & 12 IU vitamin D), Vitamin E 400 mg (with 70 mcg selenium), d-ribose 9-13.5 grams, sunflower lecithin 3600 mg (phosphatidyl choline 630 mg), DMAE 500-750 mg, choline bitartrate 250 mg, inositol 250 mg, ubiquinol coQ10 100-200 mg and B complex (riboflavin 1.7 mg, niacinamide 20mg, B-6 2mg, B-12 1200 mcg & panothenic acid 30mg)  I also take fish oil at times but not consistently.....  

 

I began taking these when I had the a-fib episode, have been taking them for about 2 1/2 months. 

 

Thank you again

[Montebella]

I just realized I wrote the wrong year for this in my intro.  This was in January and February of 2014

 

In January of 2013 was changed to generic then in February of 2013 I missed two days doses.

[Altostrata]

Welcome, TS.

 

The drug that made you want to eat everything in sight was Remeron.

 

When you're tapering by removing beads, you have no choice but to reduce by one bead at a time at the end. You may need to do this very slowly, with frequent holds to allow your nervous system to recalibrate.

 

The a-fib might have been brought on by withdrawal. Taurine is good to stabilize heart rhythm -- see our topic on this in the Symptoms and Self-Care forum http://tinyurl.com/3hq949z
 

[Montebella]

Alto- thank you!  The food craving with that was just unreal!  I have suspected that the a-fib was part of the withdrawal and thankfully I haven't had another episode.  I will check out Taurine since I am still having palpitations at times.  Thanks again! 

[Montebella]

Update- I started taking magnesium about 5 days ago and also added vitamin D3 since I have a history of deficiency in that.  I stopped tapering and have now been at 13 beads Cymbalta for two weeks and I feel SO MUCH better.  I'm not sure if this is due to the magnesium or holding my taper or both but it's so nice.  

 

I haven't had anxiety or uncontrollable crying for at least 5 days.  I have been a bit irritable in the evenings and am still struggling with motivation but overall I am much improved.

 

 One thing I have noticed is for the past two days I have felt heavy behind the eyes.  Difficult to describe but I recognized the feeling immediately as being one I would get before I started to taper if I was late taking my Cymbalta.  Almost as if the back of my eyes are swollen in my head  .  It seems to have subsided and is very slight as of right now.  

[Rhiannon]

Hi--

 

A lot of us find that in withdrawal those B vitamins are just too stimulating. So that's something you can look at if you need to. Supplements can be pretty tricky in withdrawal.

 

I'm glad you're holding and feeling better. I would recommend continuing to hold, because more than likely you are going to have some more ups and downs before you stabilize fully. That's just how withdrawal and recovery go. The healing process is bumpy. Given how fast you've been going, I think your nervous system needs more time to stabilize and recover, just to give it time to catch up with what you've already done.

 

You're down to a nice low dose now, so take your time and let your brain recover from the mangling it's been through, so it will be strong and able to cope smoothly with the last part of the taper, and when you're done it will be able to balance out and you won't get that postacute withdrawal months down the road. That's my advice. 

[Montebella]

Appreciate the advice Rhi.  I have decided I'm going to hang out where I am for at least two months.  It's hard to go so slowly sometimes- I get impatient..but if I can avoid or reduce any part of the misery then it's well worth it.  Just knowing that it is possible to feel better is a real encouragement.  I know I have a bumpy road ahead and just have to hang in there and take it easy on myself.

 

 I did read about the B vitamins being stimulating for many and have actually reduced how often I take them.  I will probably hold off on them for now. Have a doctor appointment today where I will be asking him to provide medical support through my tapering.  I think I am going to ask him to check all of my vitamin levels as well.  

[Montebella]

Update:  Have been feeling much better physically but having lots of anger and irritability towards my family.  I can't stand being around people!  Last night my husband snapped at me, just barely and really no big deal- he's stressed- and I immediately went into a three hour crying spell.  I'm just exhausted and so tired of this.  I have a 14 year old son who is getting resentful and my husband is, too.  My daughter just goes right into caregiver mode and tries to make me feel better which just breaks my heart more.  At work today I completely blew a situation out of proportion (in my head , thank goodness- I didn't act) but my perception is just so skewed.   My sister is moving this week and I just don't want to help!  She needs my help and I can physically provide the help but that's not enough I guess.  So of course guilt over that.  She is always helping me and I just can't reciprocate....    I'm just not keeping up with the things I need to do or should be doing and it's really getting to me.  And here I am crying, AGAIN.  

 

Suffice to say these past few days have SUCKED.  

 

Good news is I spoke to my Dr. and he agreed to provide medical supervision for my tapering.  This is something my psychologist requires.  I do feel as though I found a good psychologist as she has a lot of experience with medication withdrawal and does not recommend psych meds for her patients.  My doctor just seems at a loss with me.  I can't tell if he thinks I am being dramatic, if he thinks my symptoms are psychosomatic or if he thinks I am just abnormally sensitive to these types of medications.  Regardless, I was clear in explaining that I have a plan for tapering and do not intend to go on any other medications, ever.  He's willing to speak with my psychologist as well so maybe that will help bring him around.  I know he is prescribing this stuff to others and I really hope he can acknowledge what it does to people at some point.  

[Montebella]

Still very irritable and reclusive.  Don't really want to be around anyone at all.  Just a couple of small episodes of anxiety since I last updated so at least that is good.  

 

Heart palpitations still at night before I fall asleep and in the morning.  I just ordered Taurine and will be trying that since they are distracting and often trigger anxiety.  

 

It's been hard for me to stay asleep and I've started taking benadryl again.  Was taking it before but stopped for a couple of months.  I seem to have no trouble falling asleep but if I am woken up at any time I am just immediately wide awake.  And the smallest thing wakes me up.  I am thinking of getting a sleep mask- I already wear earplugs due to husband snoring .  But even those don't keep me from waking when he does snore and they are the highest sound blocking I could find.  I'm sure the poor quality of sleep is contributing to my general irritability.  

 

The isolating is an issue though.  I just can't tolerate people, even those I love.  Just being civil is a chore.  If I could stay home in bed all day I would, gladly.  Unfortunately my back has been bothering me lately and lying in bed just makes it worse.  

 

I am seeing my psychologist every week and working on meditation and mindfulness with her.  

 

I'm concerned though because I can't really remember the last time I felt well.  The intense anxiety stopped mid-October.  While I was having that I do recall distinctly having a couple of really good days at least every few weeks.  The intensity of symptoms definitely decreased but I'm not getting those good days now.  Just steadily angry, apathetic, unmotivated, antisocial and just basically trying to get through each day.

 

 I am continuing to hold my taper but I am wondering if this could mean it is time to step down again?  Or do I wait until my symptoms are completely gone?   

[Rhiannon]

In general, given your history, I'd say it's best to hold and wait and see how these current symptoms play out. Everything you describe is pretty typical in withdrawal, and given the history you describe it sounds to me like you're still experiencing withdrawal symptoms, which do tend to morph and change over time.

 

You may see if you can add in a bit of exercise and maybe some light exposure, this being the dark time of year. If you find it too stimulating you can cut back. I know it's hard to push yourself to get out when you're feeling so agoraphobic and apathetic--I struggle with that all the time. I keep a stationary bike in my house so I can get some exercise when I can't manage to force myself to get out.

 

My personal approach would be to hold for a couple more months and keep that daily journal--it's more important than it sounds. Our brains don't do a good job of compiling and remembering data related to withdrawal and symptoms when we are in withdrawal. Your body is the expert on this stuff, but it takes time and experience to learn how to hear what it's saying.

[Altostrata]

Hello, Montebella. How much magnesium are you taking?

[Montebella]

In general, given your history, I'd say it's best to hold and wait and see how these current symptoms play out. Everything you describe is pretty typical in withdrawal, and given the history you describe it sounds to me like you're still experiencing withdrawal symptoms, which do tend to morph and change over time.

 

You may see if you can add in a bit of exercise and maybe some light exposure, this being the dark time of year. If you find it too stimulating you can cut back. I know it's hard to push yourself to get out when you're feeling so agoraphobic and apathetic--I struggle with that all the time. I keep a stationary bike in my house so I can get some exercise when I can't manage to force myself to get out.

 

My personal approach would be to hold for a couple more months and keep that daily journal--it's more important than it sounds. Our brains don't do a good job of compiling and remembering data related to withdrawal and symptoms when we are in withdrawal. Your body is the expert on this stuff, but it takes time and experience to learn how to hear what it's saying.

 

Thanks Rhi,  Yeah, I've fallen off on the writing in my journal and I need to do that.  I will continue to hold and try to get back on track on doing things that are actually good for me like taking a walk, etc...  Just the basic stuff that is so hard to put into action sometimes! I really needed to hear it, though, so thank you!    

 

Hello, Montebella. How much magnesium are you taking?

 

Hi Alto,  I am taking 400 mg of magnesium glycinate each evening.  

[Altostrata]

You may wish to take the magnesium glycinate in divided doses throughout the day. It is better absorbed that way.

[Montebella]

Will do- thanks!

[Montebella]

Well, it seems I am finally getting a window!  The fog just kind of lifted yesterday and I felt, dare I say, normal.  I was able to go home and cook dinner, help the kids with homework and even do some cleaning up around the house.  Today feeling pretty much the same.  I feel like....myself.  It's so nice to know I was still in here somewhere!  

 

I am still holding off on dropping down another bead until after Christmas.  I am hopeful that I will get to enjoy this "ok" feeling until then.  But I know that it may only be a few days so I'm just going to try to enjoy it while it lasts!  

[mammaP]

Glad to see you have a window Montbella, I hope it stays open for you, enjoy it! 

[Montebella]

Thanks mammaP 

[Montebella]

Checking in.  My window lasted a couple of weeks then slowly closed.  Symptoms were fairly steady (malaise, lack of interest, irritability) until I dropped another bead on January 1st.  Two days after the drop I was having crying spells and felt completely hopeless.  About a week after dropping I had three days of what I believe are brain zaps.  I had shooting pain zip through my from the top of my head to behind my ear a split second before being gone completely.  Not severe pain but enough to make me wince.  This would occur especially if I moved my head or eyes too quickly and was accompanied by a slight vertigo feeling.  Thankfully that seems to have passed as well.  

 

I have been meeting with a meditation group once a week and I am hopeful this will help.  I definitely feel great right after meditating.  Now just trying to get that feeling to last beyond the few hours after.  

 

If all remains fairly stable my plan is to continue with monthly drops of one bead for the next couple drops.  I will probably stretch it out a bit once I am down to about 5 beads.  

[Altostrata]

It often happens people will have a few days of withdrawal symptoms after a drop, then they go away.

 

Still, you're down to a very few beads, and each reduction of a bead represents a larger and larger percentage of the entire dose.

 

Since you started getting these symptoms when you reduce, you may wish to hold longer between each reduction and let your nervous system get used to the new baseline dosage before reducing again by a bead.

 

It's not unusual to go slower at the end.

[Montebella]

I am doing very well with the slow pace of my tapering.  Since I have slowed down considerably I have been feeling much, much better.  I plan on continuing with at least 3 months between drops.  

 

I was also able to quit smoking two weeks ago, which I was scared to attempt before when my symptoms were worse.  It did send me over towards the depressed side but it was manageable and I have come out of it.    

 

Overall, I find I have fewer episodes of depression and severe anxiety.  Still getting the windows and waves but they don't dip and spike as much as before.  I definitely attribute this to slowing things down and really listening to my body before making drops.  Impatience caused me a lot of misery that I don't wish to experience again.  

[Montebella]

Definitely feeling my last drop.  No motivation, tearful, hard to focus.  Hanging in there and just trying to get through it.

 

I got smacked down a bit, I think I was hoping that drops would be easier, though I know realistically they will probably be harder the lower I go.  It had been so long since the last and I was feeling well.  

 

I also am feeling very ambivalent towards others, including those I love- and am ambivalent about life in general.  I am just kind of shut down at the moment, while simultaneously having crying spells and rages- yay.  This is different and not very helpful.

 

My family is pretty much over me (or at least it feels that way).  I have a ten year old and a fifteen year old and it's hard to distinguish normal teen/preteen behavior from behavior that my issues have caused.  

 

Hoping it passes quickly.  

[Montebella]

I'm miserable.  

 

So tired of this.  I feel like I am changing as a person, and not for the better.  I am apathetic, irritable, emotional, mean and angry all at once.  The only emotions I seem to feel are the negative ones, and those are completely blown out of proportion.  I know this is messing with my kids and family, and my relationship is barely hanging on.  I don't talk to my friends really and basically avoid interaction unless I am at work where I have to fake it.  I don't have the motivation to do anything good for me.  I wish I could just go away and come back when this is all done.

 

I have come so far and that's great.  But it doesn't feel like much of an accomplishment when I feel worse than I ever did before taking these medications.  

[Altostrata]

Montebella, this might be a good time for a nice, long hold, maybe until after the holidays. Let your nervous system settle down, relax as much as you can.

[Montebella]

Doing much better now.  Holding for a very long time (months? years?) to minimize the negative effects on my family.  This last drop was very rough and took me a few months to get through.  I have since started to exercise almost daily and focusing on eating a healthier diet.  Having a bit of anxiety but not too much and usually manageable, so I feel pretty much normal for now!    

[Altostrata]

Very good to hear that! Are you still taking 7 beads?

[Montebella]

Thanks Alto!  Yes, still holding at 7.    

[Montebella]

Still feeling "normal" and have not dropped further (still at 7 beads).  Sadly, my relationship couldn't survive and I am now getting ready to continue this alone.  I feel like, in general, my family is just kind of over this and so am I!  But unfortunately it's with me for a while yet.  I have had some thoughts about doing a Prozac bridge just so I can get off the Cymbalta fully.  But I realize this is not a good time as everything else is completely up in the air.  Lots of anxiety and I'm heartbroken and in pain- but all of this is normal when a relationship ends so I have to remember that.  I am convinced that my withdrawal directly contributed to the loss of my relationship.  My last drop I lost the ability to feel connection/love for my husband and my children and though these feelings have returned (thank goodness), it seems the damage was irreparable.   Frankly, I'm terrified to drop further but once things settle down in my life I know I will have to get back on track with the tapering.  

[Petunia]

Hi Montebella,

I'm so sorry your relationship ended. Its sad how much damage these drugs do to peoples lives. My relationships have also been effected badly because of withdrawal.

 

I agree with you that its not a good time to be thinking about making any drug changes. The fact you are still feeling ok at 7 beads is good. If I were you I would hold there for a long time, its a low dose and so the side effects and damage its doing will be minimal. Give yourself enough time to adjust to the ending of your relationship.

 

We rarely recommend the Prozac bridge and only as a last resort when someone is finding it impossible to taper off their original drug. When switching to a new drug there is a high risk of it not working the same way, causing symptoms and side effects of its own and not covering the withdrawal symptoms from the previous drug.

 

Our moderator MammaP has experience of tapering down to zero using the bead counting method with effexor. She had to go extremely slowly when getting down to a few beads, with long holds in between, but she finally managed to taper down to zero. Here is a link to her journal thread if you are interested: ☼ Hello. mammaP checking in!

[Montebella]

Thank you Petunia for the kind words and the input.  I will read up on MammaP's experience and keep taking things very slowly =)