Dman,
the advice here is for - real. i understand how you want to follow your doctor's advice - as he/she is the prescribing physician and you would think anyone prescribing a drug would know about what happens when that drug is discontinued - whether it be an anti-biotic, a blood pressure med - or an anti-depressant. unfortunately, doctors aren't up to date in the latest changes/recommendations by the manufacturer. that's why this web site and others like it exist. check out http://www.surviving...depressants.com
as for what eli lily recommends, here is the link to the actual information they supply:
http://pi.lilly.com/us/cymbalta-pi.pdf
you will find the following on page 4:
"2.7 Discontinuing CYMBALTA Adverse reactions after discontinuation of CYMBALTA, after abrupt or tapered discontinuation, include: dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue. A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible [see Warnings and Precautions (5.7)]."
and page 7:
5.7 Discontinuation of Treatment with CYMBALTA Discontinuation symptoms have been systematically evaluated in patients taking CYMBALTA. Following abrupt or tapered discontinuation in adult placebo-controlled clinical trials, the following symptoms occurred at 1% or greater and at a significantly higher rate in CYMBALTA-treated patients compared to those discontinuing from placebo: dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue. During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have been reported to be severe. Patients should be monitored for these symptoms when discontinuing treatment with CYMBALTA. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.7)].
please share this with your doctor. unfortunately, eli lily doesn't offer any advice once you've stepped down to the lowest dose they manufacture, which is 20 mg. they leave it up to the doctor, which is why they do the every other thing. they have no further direction. the survivors of withdrawal on this page offer sage advice. while eli lily advises not to break open the caps, their suggestion is relative to the impact the individual pills can have on your gastro-intestinal tract. that is why we recommend opening it up, taking out beads at a gradual rate, and the remaining beads you take be placed back into the cap and closed before taking it. compounding pharmacies will do this for you - at a price, which is why there are a lot of do-it-yourselfers here. however, the pharmacist typically won't do it without direction from your doctor