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Weening Off By Opening The Capsule Splitting up the beads
#1
ke7kin 
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Posted 10 December 2011 - 12:30 AM
#2
ALittleBird
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Posted 12 December 2011 - 01:15 AM
Hi ke7kin,
I'm sorry to hear that you and your husband have been having such a hard time with coming off cymbalta. I am on 60mg for ~6 yrs for pain from nerve injury and have found side effects worse than any perceived benefit. I have been reducing my medication by 1mg per day and have not had any significant side effects yet, so I do believe this process can be managed, but everyone needs a different amount of time to come off completely, so I would prepare yourselves for at least a month or two to complete this process.
I do not recommend that your husband stop cold turkey (depending on why he takes the med it can be very dangerous) or skip days in between doses; both of these methods will increase the odds of adverse withdrawal symptoms. Obviously, if he is having any physical or mental symptoms that are seriously concerning make sure to discuss this with his prescribing physician. Also, from what I have read on this site regarding physician 'monitored' reduction ofcymbalta is generally too fast for many people and they also end up having horrible withdrawal symptoms ( dr. will generall cut the dose by half for a couple of weeks, half again if necessary for a couple of wks, then discontinue completely).
I personally would have the predictable confusion and "brain zap" symptoms within a couple of hours if for whatever reason I forgot to take cymbalta. Therefore I was not going to take any chances during withdrawal; i live with pain constantly and I don't need any added with WD (withdrawal) from meds. Here is my method (just fyi, i have a degree in science, did biomed research for several years, and then managed drug trials for pharma for a really long time):
Since I am on 60mg and your husband is on 30mg you may need to verify the math that I will work out for you below. Also, this does take time, good eyesight, and dexterity, so you or someone you trust may need to help with counting the grains. As grams and therefore mgs are a measure of weight and not volume each capsule has a different number of grains inside. For a 60mg capsule I have determined there are approximately 450-465 grains; since Frank is taking 30mg this would be half the number of grains - approximately 225-233 - make sure to verify this by opening up a capsule and counting the number of grains inside (I have a quicky method to do this too, just keep reading). Therefore if you divide this by the number of mg (30) you find that 1mg is eqivalent to approximately 7.5 grains.
When I was doing my initial count of grains on a piece of folded College Ruled notebook paper/ thin ruled notebook paper, I noticed that each line when folded perpendicular to the lines was equivalent to 7-8 grains; perfect! Now you don't have to count every little bead. Make sure you verify this too on your piece of paper otherwise this won't work.
So each line on the folded paper=7.5 grains (2 lines =15 grains, etc.)=1mg; simple enough. Now you remove 1mg (7-8 grains) per day from the capsule and then close the capsule back up. I keep the removed grains in a used prescription bottle (those little things are expensive), which can be placed in a gel capsule you buy at a health food store or online for later use. Obviously, the benefit of using the folded piece of paper becomes apparent as the number of grains/mg/days increases. Some tips when using the paper to count; keep the piece of paper in a small V configuration so that the grains will easily line up in the valley; fold the two ends on the sides of the V so that the grains don't spill out unexpectedly; use a tooth pick to help line up the grains in the valley; number the lines to coincide with the number of mgs/days of the grains, and use a check box on each as you go in order not to loose your place; do this on a very steady table/area where pets, children, and others will not disturb the paper. Each capsule should be counted one at a time, but at least you don't have to worry about loosing your count of the grains since the paper is a standard guage, and then just unfold one side flap and gently pour the grains into an old pill bottle.
Good luck to you both and I hope this works as well for your husband as it has for me. If at anytime he finds that he is getting withdrawal symptoms, stop at that dose until the symptoms resolve before continuing the reduction of 1mg/day or whatever you work out between the two of you. Atleast this should give you a guidline to help him feel better during the process - give it as much time as is needed.
I'm sorry to hear that you and your husband have been having such a hard time with coming off cymbalta. I am on 60mg for ~6 yrs for pain from nerve injury and have found side effects worse than any perceived benefit. I have been reducing my medication by 1mg per day and have not had any significant side effects yet, so I do believe this process can be managed, but everyone needs a different amount of time to come off completely, so I would prepare yourselves for at least a month or two to complete this process.
I do not recommend that your husband stop cold turkey (depending on why he takes the med it can be very dangerous) or skip days in between doses; both of these methods will increase the odds of adverse withdrawal symptoms. Obviously, if he is having any physical or mental symptoms that are seriously concerning make sure to discuss this with his prescribing physician. Also, from what I have read on this site regarding physician 'monitored' reduction ofcymbalta is generally too fast for many people and they also end up having horrible withdrawal symptoms ( dr. will generall cut the dose by half for a couple of weeks, half again if necessary for a couple of wks, then discontinue completely).
I personally would have the predictable confusion and "brain zap" symptoms within a couple of hours if for whatever reason I forgot to take cymbalta. Therefore I was not going to take any chances during withdrawal; i live with pain constantly and I don't need any added with WD (withdrawal) from meds. Here is my method (just fyi, i have a degree in science, did biomed research for several years, and then managed drug trials for pharma for a really long time):
Since I am on 60mg and your husband is on 30mg you may need to verify the math that I will work out for you below. Also, this does take time, good eyesight, and dexterity, so you or someone you trust may need to help with counting the grains. As grams and therefore mgs are a measure of weight and not volume each capsule has a different number of grains inside. For a 60mg capsule I have determined there are approximately 450-465 grains; since Frank is taking 30mg this would be half the number of grains - approximately 225-233 - make sure to verify this by opening up a capsule and counting the number of grains inside (I have a quicky method to do this too, just keep reading). Therefore if you divide this by the number of mg (30) you find that 1mg is eqivalent to approximately 7.5 grains.
When I was doing my initial count of grains on a piece of folded College Ruled notebook paper/ thin ruled notebook paper, I noticed that each line when folded perpendicular to the lines was equivalent to 7-8 grains; perfect! Now you don't have to count every little bead. Make sure you verify this too on your piece of paper otherwise this won't work.
So each line on the folded paper=7.5 grains (2 lines =15 grains, etc.)=1mg; simple enough. Now you remove 1mg (7-8 grains) per day from the capsule and then close the capsule back up. I keep the removed grains in a used prescription bottle (those little things are expensive), which can be placed in a gel capsule you buy at a health food store or online for later use. Obviously, the benefit of using the folded piece of paper becomes apparent as the number of grains/mg/days increases. Some tips when using the paper to count; keep the piece of paper in a small V configuration so that the grains will easily line up in the valley; fold the two ends on the sides of the V so that the grains don't spill out unexpectedly; use a tooth pick to help line up the grains in the valley; number the lines to coincide with the number of mgs/days of the grains, and use a check box on each as you go in order not to loose your place; do this on a very steady table/area where pets, children, and others will not disturb the paper. Each capsule should be counted one at a time, but at least you don't have to worry about loosing your count of the grains since the paper is a standard guage, and then just unfold one side flap and gently pour the grains into an old pill bottle.
Good luck to you both and I hope this works as well for your husband as it has for me. If at anytime he finds that he is getting withdrawal symptoms, stop at that dose until the symptoms resolve before continuing the reduction of 1mg/day or whatever you work out between the two of you. Atleast this should give you a guidline to help him feel better during the process - give it as much time as is needed.
#3
ALittleBird
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Posted 13 December 2011 - 11:10 PM
Ke7kin,
As stated in another post, i made a small error in the above calc; instead of each line on a sheet of paper being equivalent to 1 day it is actually equivalent to 2 days, and therefore 1 line is the same as 2 mg not 1 mg. Sorry for that error, but everything else should still work out for you. Hope all is going better for "Frank".
As stated in another post, i made a small error in the above calc; instead of each line on a sheet of paper being equivalent to 1 day it is actually equivalent to 2 days, and therefore 1 line is the same as 2 mg not 1 mg. Sorry for that error, but everything else should still work out for you. Hope all is going better for "Frank".
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