32 replies to this topic

[thismoment]

When I was withdrawing from Cymbalta I would often find myself depressed and impatiently waiting for my mood to lift.  The hardest thing for me was to get moving and direct my gaze outward. And you know, I could drive my blues to a deeper hue by perpetuating this cycle of inertia: I can't get going because I'm depressed and I'm depressed because I can't get going.

 

Surely there are many paths to that intensely personal elevation of spirit we call joy. I found it helped me to assign some meaning to even the most mundane chore: Do it right, and do it to a standard that honours the effort. 

 

There is an undeniable link between dignity and joy, and depression erodes dignity. But if you do even the simplest task the way you know it should be done, and do it to the standard that is worthy of your effort, I think the spark of dignity that results will lead you to uncommonly brighter places.

 

If this sounds like New Age woo-woo, I apologize. And I'm not talking about an expensive trip to Nepal- I'm talking about cleaning off the kitchen counters and folding the laundry.

[fishinghat]

As usual, well said thismoment. It is interesting to note the comparative opposite with anxiety. It is almost impossible to set down and relax. Constant motion is the problem. Not being able to set back and relax causes me to be irritated at myself which causes more anxiety.

[equuswoman]

Indeed, yes♥

[gail]

Thismoment, I just love reading you, brings insight!

 

Joy, this has been eluding me for quite a while, on cymbalta and off cymbalta.

 

And I hope to God that this simple word JOY, will be back in my vocabulary one day for more than a few minutes.

 

I miss myself so much, I miss that person that would be in awe just seeing a frog, a flower, a cow, whatever, those things used to bring me joy and smiles. The simplest things. Where is that person? Yup. I miss her.

[fishinghat]

Embrace who you are and optimize what you have. I will never be the person I once was but will always be the best person I can. The Lord will give me the strength.

[gail]

I believe that this is a intresic (dont know how to spell the word) part of who I am at the deepest level, the child quality, and since this is God's gift to me, it will resurge when the timing is right.

 

I feel like Job, when everything was taken away from him for a while, at the end , he got it all back. Patience.

 

I dont want to be like I was, low self esteem, bad choices, but I want to be who I AM  at the deepest level.

 

As you say, Fh, the lord will give me strenght to be patient.

[Wagtail]

Thismoment , how right you are .. One of the things that make me feel worse while I am sitting on the couch watching anything on tv that will keep my mind from over thinking things, is seeing jobs that need to be done , but I can't do because I haven't got the motivation or energy.
Well yesterday I felt a little better so I took down just one curtain from the lounge room & washed it . I thought that I would baby step the chore by doing one curtain every day until I completed the task .
Well guess what !, I managed to wash & re-hang three curtains .. I felt so good that I did a little dance , ha ha .
A positive day . :-)

[gail]

Good for you Wagtail, baby steps goes a long way, glad you had a better day.

[thismoment]

Hi Gail

You said some important things by expressing a profound desire for a different reality. I understand the longing to re-connect with that part that was lost or altered during the Cymbalta experience; I spent time in that space too.

"I miss myself so much, I miss that person that would be in awe just seeing a . . . flower . . . The simplest things."
"I want to be who I am at the deepest level."

You know that old adage regarding the wisdom in knowing the difference between what you can and can't change? Well I think these two items you so eloquently expressed can be changed-- you can alter them in your favour. In the past we've talked about neuroplasticity, and the fact that all experience changes the brain, and that change is physical. People call it 're-wiring', and while that's a coarse metaphor for activity at the cellular level, it's pretty good: experience re-wires the brain to alter the default behaviour. It's re-training. We can do that!

You spoke of flowers. Visit a botanical garden or conservatory where you can feel that growth in perfect conditions. The garden is a powerful image and metaphor in our culture. Immerse yourself in this environment and it will stimulate memory and invigorate your brain with a tactile, organic, and primal experience. It's the sensuous, luscious garden that fostered our evolution over millennia. I find this green space to be enveloping and profoundly connecting, a fundamental feeling of home.

You can bring that aspect of who you are at the deepest level to the surface, and you can BE that person. The process is the same- you have to pull it out, dust it off, and try it on. Walk around in that part of you that you want to become, that part you want to imprint upon your entire being. Treat someone as you know that part of you would treat them- this will change your brain.

There's a small caveat I need to mention. Much of how we view ourselves comes from how we allow other people to treat us. So put this in place first: we need to train others how we want to be treated. That's the cornerstone for creating a home for the person you will become. When you coax this gentle and noble part of you to take centre stage, she will be fragile at first and will need to have support already in place.

I wish this for you, with all my heart.

[freddiekatt]

Hi,

I'm trying to taper off of cymbalta....been doing it now for about 3 weeks... but it's nighmarishly scary to what happened with effexor...which took me 6 months to get off...and a brutal 6 months that was!

 

These are both SNRI's.  So for ME....can't be on this drug.  I've been on ciprolex for a year before they changed me to cymbalta for fibromyalgia.  On ciprolex...I could miss a dose no prob.  It's an SSRI.  Anywho, here is my question....

 

I am tapering....on my own...cause doctors (in canada) don't know or care.  So I tried going down to about half a dose (in beads) every other day.  SOOOOO much withdrawal...brain zaps, dizzy, confused, headaches, lethargic.  Much more.  Then I started doing every 36 hours.  Still lots of withdrawal.  Now I'm doing every 24 hours but keep decreasing the amount....and I'm still sick with withdrawal.  This has been 3 weeks of this and I think I'm at the point that I have to just go cold turkey if you will..  enough is enough!  I've tapered.  I'm at a very low dose...a quarter of the 30 mg....so whats that....like 8 mg a day?  I've given my poor brain time to get off...3 weeks.  So can I just stop at this point?  What's the benefit of going every other day?  I mean I just withdrawal.  And I'm tired of it.  Yes, I know I have perhaps months of this in store....but I just feel like....why do I keep putting this poison into my body?  

 

I'm sure it's a fine antidepressant and perhaps helps other fibro sufferers.  I know for me that I will never take an SNRI again.  I promised I wouldn't after effexor.  Then they put me on cymbalta and I didn't know it was the same drug class.  

 

I mean I'm not going cold turkey at this point.  I have a small amount in my system...less than 10 mg.  So can't I just stop at this point and deal?  I mean I did this with effexor and was like a heroin addict....opening pills at work for just a few beads to make me feel normal.  

Peter mary and joseph!  I want off this crazy ass drug now.  How long will it take?

[fishinghat]

Be aware that for most the last few beads give the worse withdrawal. Be prepared to slow down when you get to the very end. Now this is just an example. Some can only remove 1 bead a day and others 7 or 8 beads a day. You will have to play with it a little bit to find what works for you.

 

The first 3 or 4 weeks of withdrawal after finishing your cymbalta are the worse with some slow, and I mean slow improvements. By the 8th to 12th week usually see signs of good days followed by bad days but at least there is light at the end of the tunnel. Now that is the average.  Some have withdrawal that lasts last 6 months to over a year but these are rare. Research says between 30 to 80% of people do not experience withdrawal while other research shows that around 7% experience withdrawal of 6 months or more.

[thismoment]

Hi Freddiekatt

 

I cut and pasted these three items from your post.

 

1. "This has been 3 weeks of this and I think I'm at the point that I have to just go cold turkey if you will..  enough is enough!  I've tapered.  I'm at a very low dose...a quarter of the 30 mg....so whats that....like 8 mg a day?  I've given my poor brain time to get off...3 weeks.  So can I just stop at this point?"

 

 2. "I have a small amount in my system...less than 10 mg"

 

 3. "So can't I just stop at this point and heal?"

 

1. You have been pretty much cold turkey up to this point because of the erratic nature of your tapering. Cutting the dosage in half or putting in steps is cool turkey. Maybe not cold turkey, but close enough to bring on the symptoms of withdrawal. The most effective tapering I know of is a slow taper on a constant slope (example: day one take out 2 beads; day two take out 4; day three take out 6, and so on).  Even so, you will still have withdrawal symptoms, but milder.

 

2. Even if you had the full 30 mg in your system and you quit today, it would be 99.9% out of your system in 5 days. But you would be in full-blown cold-turkey withdrawal for a number of weeks. (What's up- the drug is gone?) The drug changes your brain, and how it functions. The drug maintains the altered condition (it slows the re-absorption of the neurotransmitters serotonin and norepinephrine back into the brain), so when the drug is gone,  your brain has to scramble to physically alter itself and re-learn how to do this work again on its own. It's scrambling to stabilize itself and simultaneously it screams out to you, "A little help here! For God's sake pop a capsule. . . I don't know if I can re-set!!"  

 

And the equilibrium it arrives at cannot possibly be exactly as it was before you started the drug, but it will close enough- after all, it's an emergency repair.

 

3. Yes, you can stop at any point and heal. The question is how can you tolerate the discontinuation symptoms? The symptoms are easier to bear when you taper off slowly. Is there any difference to how your brain ends up- cold turkey or tapering? I don't think so, but fishinghat would know the answer to that.

 

You can do this! Stay strong and make a plan and do it. It helps you- and all of us here- if you continue to post your progress.

 

Best wishes.

[gail]

Thismoment, so well said, so well explained about the brain. Really appreciated reading this, simple but to the point!

 

Thank you, stay with us, you are an angel.

[fishinghat]

Thismoment. I have to agree with you. I don't think there is any difference in the net outcome whether you cold turkey or wean. Having said that I would say that the worse your withdrawal the more you maybe conditioned to fear further withdrawals or even going on a new med.

[BelaLugosisDad]

Freddicat. For god's sake don't do this. 

 

http://www.ncbi.nlm....pubmed/15121647

 

"When you open the document go to page 4 and look at the charts. You will see that at lower doses you must taper EXTRA slow, not faster. At higher doses, when you cut 1 mg, it only reduces your receptor occupancy by a small amount; but from 1 mg down to 0 you drop from 20% occupancy straight down to zero!

That's why we say calculate your cuts based on 10% of your CURRENT dose."

 

​-RHI of surviving antidepressants.

[Wagtail]

This moment , very well explained ... Should be copied & pasted on every new members wall ... Short but sweet & understandable .:-)

[thismoment]

Thismoment. I have to agree with you. I don't think there is any difference in the net outcome whether you cold turkey or wean. Having said that I would say that the worse your withdrawal the more you maybe conditioned to fear further withdrawals or even going on a new med.

 

Hi fishinghat

 

I was wondering if you'd comment on this- I'm wondering if the 'quality' of repair the brain achieves is affected by the level of stress throughout the discontinuation. In other words, could a higher stress discontinuation produce a more hastened repair that could lead to (for example) residual artifacts as in chronic antidepressant syndrome, where the symptom is there for life?

 

I wonder if there's a correlation between stress and quality of brain self-repair.

 

Thank you.

[fishinghat]

Hey, Thismoment, I hope you are doing well.

 

I don't think the quality of repair would be affected during stressful discontinuation but I am sure the speed of repair and side effects would be. Stress (whether in discontinuation or note) causes the blood brain barrier to become more permeable and I am sure that would cause some increase in symptoms during withdrawal. With regards to developing artifacts....well to be absolutely honest I am not sure. My common sense tells me that residual artifacts, all other things being the same, would be probable in most people with this type of damage. .Research indicates complicated structural changes. Ssris affect at least 5 neural circuits in at least 2 different areas. On top of that they produce at least two types of alteration to each nerve cell in those circuits. Given that these areas are known to have nearly no healing ability after trauma it is unlikely to completely heal after a chemical induced damage, such as from Cymbalta, thereby probably leaving artifacts.

 

Know I don't want anyone to freak. That doesn't mean you won't have some significant healing. With ssri there is structural changes in the nerve cells. With say a motorcycle accident there are actual destroyed nerve cells. But I think it would be naïve to think complete repair would occur.

[fishinghat]

Oh yea, in regard to "I wonder if there's a correlation between stress and quality of brain self-repair". With the increase in permeability in the blood brain barrier with stress I would expect it to negatively affect brain repair in both quality and quantity but I have to admit I am only guessing.

[fishinghat]

For those who may not be aware the brain basically does NOT repair itself in cases of nerve cell death. A dead cell literally dissolves away. The brain DOES have a remarkable way of rewiring itself when a certain part of the brain is damaged. This is called neuroplasticity. Neuroplasticity does require good cells to be close to each other in order to rewire that brain circuit. It is also a long process. A wound to the skin may heal in a couple weeks. A wound to a nerve circuit may take years to rewire IF rewiring is even possible.

 

Thismoment, here are a couple articles that may shed a light on stress during neuroplasticity.

 

http://www.nature.co...l/1301574a.html

 

http://neuro.psychia...ticleid=1213973

[fishinghat]

Wow, the first article has an amazing section that reviews the effect of stress on neuroplasticity. One thing to point out is that many of the anti-depressants cause neurogenesis, which is the transformation of stem cells to new nerve cells. It has been shown that these new nerve cells typically do not mature or function in the carrying of signals.

[thismoment]

Fishinghat

 

I just read that article- thank you for finding it- who knew? 

 

One of the things that I was thinking about that led me to wonder about this was Cymbalta and pregnancy. The 3 or 4 months or more of withdrawal stress could be worse for the baby than staying on the Cymbalta throughout the pregnancy. It will be interesting to see where the science on this goes. It breaks my heart to imagine the kind of distress pregnant women on Cymbalta are facing. 

[fishinghat]

Oh that would have to be horrible. Combining withdrawal with morning sickness, etc.  One good thing though, I think women are stronger than men.

[FiveNotions]

If a woman stayed on cymbalta throughout pregnancy, wouldn't her baby be born with a physical dependence on the poison...and then, out of the womb it wld immediately stop getting the drug and go into immediate withdrawal?

Who would want to risk putting an innocent soul through the same hell we have been going through?

Same for animals/pets that are put on Prozac....as soon as the owner stops giving the poison to them they go into withdrawal....and suffer....

[fishinghat]

You are exactly right FN. There are even a couple case studies on newborn withdrawal. What a way to start life.

[thismoment]

'What's best' is a convoluted issue of science and ethics. It's obvious that it would be best not to start a pregnancy while taking this kind of drug. But when a woman finds herself pregnant while on the drug, all routes of withdrawal will impact the baby. However, the science to tell us which route will have the LEAST impact on the baby doesn't appear to be there yet. If it is, I can't find it.

[Carleeta]

Thismoment. .I agree with you...

[fishinghat]

Definitely right.

[FiveNotions]

BelaLugosisDad, you're back! I was worried about you! How are you feeling, did a bit of time in hospital help?

[Wagtail]

Hey, Thismoment, I hope you are doing well.
 
I don't think the quality of repair would be affected during stressful discontinuation but I am sure the speed of repair and side effects would be. Stress (whether in discontinuation or note) causes the blood brain barrier to become more permeable and I am sure that would cause some increase in symptoms during withdrawal. With regards to developing artifacts....well to be absolutely honest I am not sure. My common sense tells me that residual artifacts, all other things being the same, would be probable in most people with this type of damage. .Research indicates complicated structural changes. Ssris affect at least 5 neural circuits in at least 2 different areas. On top of that they produce at least two types of alteration to each nerve cell in those circuits. Given that these areas are known to have nearly no healing ability after trauma it is unlikely to completely heal after a chemical induced damage, such as from Cymbalta, thereby probably leaving artifacts.
 
Know I don't want anyone to freak. That doesn't mean you won't have some significant healing. With ssri there is structural changes in the nerve cells. With say a motorcycle accident there are actual destroyed nerve cells. But I think it would be naïve to think complete repair would occur.

I've reached my LIKE quota for the day ...I LIKE THIS POST
As usual fishinghat you make complete sense to me. :-)