3 replies to this topic

[Sfava987]

Hello everyone. I am a 47 year old woman who has been on SSIs/SSRIs for the better part of 16 years. I have been trying to wean off of generic Cymbalta for good, without switching to any other drug to replace it. After being on generic Cymbalta for about 6 months, at a max dose of 90mg, I gradually reduced to 20mg over four weeks and had no withdrawal symptoms. But after stopping the 20mg, I had the full blown discontinuation syndrome and could not drive or function. So, I went back on the 20mg and stayed there for a couple months, but the Tinnitus and some brain fog remained along with burning pain in my heels and the bottom of my feet. I also got a frozen shoulder. My question is, "Considering my age and long term use of SSIs/SSRIs, how many weeks or months should I take to wean from the last 20mg down to zero?" The capsules do not all weigh the same nor do they all contain the same number of beads, so how can I be as accurate as possible when graduating the doses downward in very small increments??? This is my dilemna. I do have a gram scale, but it rounds to the nearest gram, and so far, going down 1gram for two weeks has not been good for me. If I need to go down only half a gram, I would need another scale. And using bead counting can't be accurate when weaning slowly either. Any and all opinions and advice would be greatly appreciated. I haven't felt well for a while and don't know if I have a stomach virus or if it's due to the 1gram drop over the last two weeks.

[thismoment]

Sfava987

Going from 90 mg to 20 in 4 weeks then stopping altogether is a very short timeline considering your long-term exposure to these drugs. It's not uncommon for symptoms to be light until you start removing the last 25% or so.

Are you stable now at 20 mg?

Sorry to hear about those symptoms that are still hanging on; hopefully they will diminish soon.

I think going from 20 mg to 0 isn't significantly different than going from 90 to 0-- it's going to take some time, especially with your length of exposure. How long is unknown. Start with a long timeline (consider using about 8 months and reduce by perhaps 5% every 2 weeks) and see how it goes for a couple of months: if symptoms emerge, stop reducing until you stabilize, slow down the weaning and extend the timeline by going to say 5% every 3 weeks.

A weigh scale needs to accurately measure to .001 of a gram, and the reviews online are all over the map-- it'll cost about $100. with no real guarantees of accuracy. I've tried both weighing and bead-counting and prefer to count beads. I know the number of beads varies from capsule to capsule, but that doesn't matter-- count the beads in a few capsules and work out an average number and work with that.

Gastro-intestinal issues are very common with serotonin drugs, and the symptoms can hang on for some time. I had significant GI troubles in withdrawal and I had to modify my eating habits to feel comfortable. I ate small portions, and nothing 4 hours before retiring for bed. Laying down after eating causes nausea for me still, and I get that flu-like pain in the pit of my stomach, and nowadays I am in pain if I over-eat even a little.

As a general rule in weaning, if there are uncomfortable symptoms you are weaning too fast. You should know that ultra long-term weaning (a year or more) is anecdotally reported to be virtually symptom-free.

Take care.

[Oncebit47]

Hello!

I was taking 60mg for chronic pain for about a year and a half. Put on 30 lbs and craved sweets like crazy! Decided it wasn't helping like my pain med does and the additional weight is just aggravating my pain. So, I dropped myself to 30 mg once a day for about 10 months. Took 30 mg for so long because trying to taper more produced unpleasant side effects. I tried going every other day, but got brain zaps really bad. Because I am a teacher, I decided to wait until school let out to reduce my dosage more.

At the beginning of June I asked my doctor to lower my dose to 20 mg ( lowest available ). He did so without any argument. I started taking the 20 mg each day and only had real minor withdrawal symptoms. For the past 2 1/2 weeks I have been taking one every other day and am feeling it! I have to say the first week was worse than it is now, so I am going to continue the every other day for a while longer before I try to go to every two days. My goal is to be completely off before I go back to work middle of August. Other than being slightly agitated and hypersensitive to noises, the brain zaps are the absolute worst part.

I wish you luck, let me know how you do!

[thismoment]

Hi Oncebit47

 

Hi and welcome!

 

Don't skip days-- this puts you in-and-out of mini-withdrawal as the half-life of duloxetine is only 12 hours.

 

Here are two better ways to do it:

 

1. Taper off in a linear fashion (for example-- one bead out today; two beads out tomorrow; three beads out the next day and so on). 

 

or

 

2. Reduce the last 20 mg by 10% each week and be done in 10 weeks. That means, 2 mg removed today and stay at that reduced dosage for a week; then remove 4mg for a week; then remove 6 mg for a week and so on.

 

Enjoy the off-season!

 

Take care.