3 replies to this topic

[IWantToFeelAgain]

Hi,

 

About a year and a half ago i weaned myself down from 90mg to 60mg using the bead counting method. I then stabilised at 60 for a year or so. I then went to the doctor (general doctor) last october to see about coming down further and he got me to quickly come down from 60 to 40 within about a month or so....i then became extremely depressed and suicidal.

 

At that time i took some time off work and stayed at 40mg, my mood improved slightly and i started to wean myself down via the bead counting method again. I was actually feeling fine but when i got down to 30mg i started to feel low again so have stabilised on 30g while i adjust. I have been having quite a lot of suicidal thoughts, although they are just thoughts and not serious plans to kill myself.

 

In some ways i feel like i need to stay on 30mg for a while and then slowly wean myself further down using the bead method. I would then keep slowly bringing myself down until i am off it altogether. Today i went to see a mental health doctor (after waiting for 3 months). This doctor initially told me that as 30mg is not a therapeutic dose that i should come down to 20mg for two weeks and then take 20mg every other day of two weeks, and then stop completely. I was a little dubious about this, however was planning to give it a go. About two hours later the doctor rang me back as she has spoken to the main consultant in her department and this consultant (who hasn't seen me and based his opinion on the relaying of information given to him by the doctor i had seen) says it sounds like i have relapsed into depression and should go back up to the dose that was originally working for me (which was 90mg). They think it is definitely a relapse into depression rather than the impact of cymbalta withdrawal. I now really don't know what to do as if i go back up to 90mg then i will be back to square one, and i will then start the process of wanting to come off again. I have been on cymbalta for about 4.5 years now and prior to that had been on seroxat (peroxetine) for about 7 or 8 years.

 

They also suggested maybe trying some other medication instead (one of them being agomelatine). Apparently this can lead to issues with your liver which id rather avoid if i can. I really don't know what to do...a big part of me wants to stick to my guns and continue to come off the cymbalta and see how i adjust to life medication free. If anyone has experience or advice that would be much appreciated.

 

Thanks,

[thismoment]

IWantToFeelAgain

 

Hi again.

 

If you take a snapshot of your position now, it would impossible to tell if the depression is from withdrawal or relapse. Relapse seems to be the default diagnosis perhaps because you can throw more drugs at it; doctors treat symptoms, and there's not much to treat in withdrawal.

 

You have doubtlessly developed some tolerance to duloxetine over the 4.5 years you have been exposed to it, and this is to be expected with all drugs. When you combine tolerance and reduced dosage, symptoms will emerge-- and depression is one of them.

 

I don't think it's a crazy idea to go back up some in the dosage and see if the depression is affected. But you should wean back up-- not just jump to 60 or 90-- otherwise you'll never know the true level of efficacy. You might be good at 45 mg.

 

To give yourself every advantage, when you do start to wean off from a position of strength (reduced depression), set a very long timeline to begin with, and that way you're not always playing catch-up. If your timeline is short-- like 3 months-- you will always be living with symptoms and it's impossible to tell how to fix it. Therefore, start with a long timeline that will NOT give you symptoms-- like 14-16 months. After some months (if you're feeling brave and symptom-free) you might shorten the timeline and see if symptoms emerge.

 

As you know, the every-other-day program the doc recommended is silly. 

[fishinghat]

Like TM said, your dr is silly. The everyother day routine jacks up your cymbalta one day just to crash the next. Repeating the withdrawal over and over. I would go back up from the 30 mg to 40. You were dealing with things fairly well then, Once stabile again I would again go back to weaning BUT at a much slower rate to give your body more time to adjust to the change.

 

These drs of yours sound like they are not familiar with cymbalta withdrawal. It is common to have bouts of anxiety and/or depression when coming off of it too fast. The suicidal thoughts are most common in those that wean too fast. You really need to slow down.

 

Good luck and pplease keep us posted.

[IWantToFeelAgain]

Thanks both - it's so useful having somewhere to bounce thoughts around about this stuff. The doctors seem clueless!

 

I weaned from 40 to 30 by taking 3 extra beads out a day (i think there are about 360 beads in a 40 mg capsule. I think i shall see if things improve while at 30mg and then if they do i will wean far slower than i have done, perhaps just by increments of 1 bead per day. If i don't stabilise at 30 then i will look to increase as you have both suggested.

 

Been off work due now for 3 months, don't know when i'll feel able to go back in