4 replies to this topic

[marylynn]

I need advice. I started cymbalta 3 months ago. I started at 20mg and felt good.
I increased to 40 mg 3 weeks and my trigeminal neuralgia has gotten worse. My dry eye has gotten worse. I gained 6 lbs and also can't sleep well. I feel so tired. So, I am going off. I am on a FB group which recommends going down 10% of dosage over a period of time. I was only on for 3 months and according to their formula I will be off it entirely NEXT March. I can't fathom doing this. Almost went crazy (Not really) bead counting yesterday. I took 12 beads out of my capsule and was instructed to stay at that for 7 days and then remove 10% after that.  I believe we are all so different and that the chemistry is so varied of our brains that it is not a good idea for me to stay on this for almost 8 more months.
The other things is I take imitrex as needed for face pain. I am stopping taking this b/c I was told I should not take this while on Cymbalta. I have been on it as needed for 7 years. (Imitrex)
Thoughts?
Marylynn

[brzghoff]

You weren't on Cymbalta/duloxetine for very long, however the recommended reduction is 5% to 10% every week or two. there are some who've had little problem, but others have suffered greatly when trying to accelerate the process. the idea is to minimize suffering - and in the case of those who were on it longer - minimize long term consequences. i know of a member on this board who took the C for back pain - i don't believe she was on it for even a year, but had to reduce by one bead per day off the brand name cymbalta. some of the generics only have about a dozen pellets making a slow taper more difficult.

 

the best approach is to start with the 10% reduction every 7 days and see how that feels. if you have minimal side effects, then stick with that or bump it to a more aggressive taper - your choice. you can always go back to the slower taper based on your own experience. when you get down to 20 mg or less, you may have to slow it down even more for the last few beads are the hardest for many - and the temptation to just "jump off" from what seems to be a ridiculously low dose is great. try to avoid it.

 

a too rapid taper can have a serious impact on brain chemistry as well. that's why you have to allow your body, and your mental health, to be your guide.

 

hope this helps and all the best to you!

 

with care,

 

brz...

[marylynn]

Thank you so much for taking time to respond. I am so pissed at this med and the sooner I have to stop swallowing it the better.

Yes I am on generic. So on average, there are 108 pellets per capsule. I pour the entire capsule into a large empty capsule and then dumped out 10 pellets  Repeat on second capsule.

The other thing is that I have been so inconsistent with the time I take it. I haven't missed a day but I was taking them at night around 6 and have been backing it off earlier and earlier. I know take BOTH caps in the am. Doc prescribed twice per day (Extended release) so I decided to honor that suggestion with the taper. Pill 1 at 8am and pill 2 at 2pm.

 

I do have a call into doc. I want to hear his taper recommendation just for my curiousity. I also need to be careful that he doesn't pull the script completely so that I can't taper "my way". I said to his nurse tat I want off it but I think I am going to tell him I changed my mind and want to just go down to 20 mg next go around.

 

If I only knew then what I know now!!
​Live and learn.

Mary

[brzghoff]

sometimes we have to take control and "manage" the situation. the strategy to tell the doc you want to stay on after all - and then bead count down on your own is not uncommon. its always best to get their blessing - and if they object consider their point of view - they may have a legit reason to not want you to bead count - i'd sure like to know what it is. sometimes the concern is that they think you need a "net" since there was a need to be on anti-d's in the first place. if that is the case there are cross taper strategies as well if the point is to go on another drug. others cross taper to a drug that isn't as tough to get off of - like prozac or zoloft, and then wean off the 2nd drug. it all depends on your goals.

 

the idea of bead counting is a slow controlled taper. what the heck is wrong with going slow? i never understood why a doc thinks its okay to pump a person up with 60 mg a day and then drop with a fast taper every other day effectively sending their patient off a cliff - but somehow its not okay to gradually reduce over a longer period of time. its okay to take it for the rest of your life but its not okay to spend 4-5 months slowly tapering? i would love to hear the logic of that.

[marylynn]

Here is my philosophy.