Trying To Take My 88Yr Old Mother Off Cymgen (Cymbalta)

Hi Fishinghat

 

Please may I check again.  

 

- So this week I took 1 (one) bead out of each capsule every day over a 7 day period.  A total of 7 (SEVEN)  BEADS LESS PER 7 DAY WEEK (1 bead p/day out of each capsule for 7 days.  Meaning the dosage is reduced by exactly the same amount (one bead) from each capsule).  Then I keep to that dosage for a two week period.

 

- Then I drop another 1 (one) bead out of each capsule every day over a 5 day period.  A total of 5 (FIVE) BEADS LESS PER 5 DAY WEEK.  Then I keep to that dosage for a two week period.

 

-  Then I drop another 1 (one) bead out of each capsule every day over a 4 day period.  A total of 4 (FOUR) BEADS LESS PER 4 DAY WEEK.  Then I keep to that dosage for a two week period.

 

- Then I drop another 1 (one) bead out of each capsule every day over a 3 day period.  A total of 3 (THREE) BEADS LESS PER 3 DAY WEEK.  Then I keep to this dosage ongoing all the way down till we reach 10mg per day - keeping an eye on side effects.

 

 

However although Mum had a UTI (urinary track infection) and was given URIZONE 3mg on Wednesday, she also had terrible side effects on the 7 bead drop (one bead per day).  This was on the Wednesday night which was only 3 days after the most recent drop.  So serious side effects after just 3 beads less.    

 

She felt like her blood or body inside was freezing cold (her temperature was normal).

She shook and shook.  Like her legs were kicking out (jerking violent movements) and she was having full body shudders.

She felt like she was dying. She also felt random pain in her head, her neck. 

This lasted for an intense hour and a half-ish which was really full on! then thrashing body movements throughout the rest of the night.  

 

Thursday (last night), she slept well despite another bead less.  Friday, (today) she seems to have regulated despite another bead less.  We still have one bead less to go Saturday and Sunday before I keep her at this dosage.  

 

Are these typical side effects for cymgen (cymbalta).  I have seen these side effects before but that was when I was dropping her 5mg every two weeks!  

 

If the side effects show 3 days after a drop then would she not be having side effects every 3 days after every bead less per capsule or does the system adapt after withdrawals on the forth day after a drop?

 

Do you think I should keep to 7 beads per every 2 weeks knowing she will have an awful one nighter every 2 weeks.  

It's not possible to go any slower because I can't take one bead out on one day and not the next as her dosage will go down and then up again?

 

 

Is there anything you can recommend that I could give her on day 3 of the week I do the drop that would help combat these side effects out of the ones you mentioned previously.  Something that could make her sleep for the night so that the side effects are not felt or is that impossible.  Or something that stops the body from jerking spasms or whatever is going on there.  It feels to the touch like her muscles are spasming as her legs jerk around.

 

p.s. when I say one bead less per day I don't mean that I reduce the overall dosage by an extra bead every day... not 1 bead less on monday then 2 beads less on tuesday etc.  I mean literally only one bead out/less of each capsule so that each capsule has exactly the same dosage for the week.  I worry that that is not clear.  (I do have dyslexia so worry that the wording may be misleading... and take a while to understand the guidelines).

 

Sorry to bother you again.  

Best wishes to you x

Ayla

"This week Mum had terrible side effects on the 7 bead drop (one bead per day). She also had a UTI (urinary track infection). However she felt:

Like her blood or body inside was freezing cold (her temperature was normal).

She shook and shook. Like her legs were kicking out and she was having full body shudders.

She felt like she was dying."

I want to be careful here and be sire I understand. a 7 bead drop is taking out one additional bead each day for a week. Right/

So, example, lets say 300 beads on Monday, 299 on Tuesday, 298 on Weds, 297 on Thurs, 296 on Friday, 295 on Saturday and 294 on Sunday. The symptoms you mention is very common and that is definitely too fast for her.

How many beads a day are you removing right now and are you still dropping or holding steady?

I want to be careful here and be sire I understand. a 7 bead drop is taking out one additional bead each day for a week. Right/

 

No not one additional bead each day for a week.

 

Only one bead from each capsule.  So...

 

Last 2 weeks each capsule had 323 beads (exactly the same amount of beads in each capsule). She takes one capsule a day.

 

This week each capsule has 322 beads (exactly the same amount of beads in each capsule).  So only one bead out of each capsule - not an additional one every day.

So this entire week all her capsules have 322 beads per capsule.  

That means in comparison to last week each day has one less bead in it than the previous week not than the previous day.

 This entire week will have exactly the same dosage day to day (which is one bead less per capsule than last week).  

 

That means that over a 7 day period overall she only has a reduction of 7 actual beads.  Then I hold her at that exact amount for the next week as well.  So over the first week a reduction of 7 beads only in total.  And the second week no further reduction at all.

Got it.

"That means in comparison to last week each day has one less bead in it than the previous week not than the previous day."

So what do you think. Do you think she can handle this Ok? I guess at this point I would stay with this rate for a few weeks and see how she does.

The third day is when the symptoms start to hit from a drop in the number of beads. That is normal. There are some things that can help. Some drs prescribe clonidine or hydroxyzine for the withdrawal symptoms. Some members have also had good ;luck with using Benadryl as well. Now the Benadryl (the one containing diphenhydramine) may cause some sleepiness if taken during the day. If you want to give it to her during the day I would recommend just 10 or 20 mg. Just enough to relax her some. Of course at night the full 50 mg would be fine. Benadryl is usually available at your local drug store.

Hi Fishinghat 

This has come up on my drug interaction checker:

 

Hat is there anyway to reduce the meds slower than I currently am?  

I can't see how to do that other than some days beads out and others no beads out but that would put her up and down in the dosage which everyone says not to do.  Reducing by one bead only is clearly the slowest way?  Is that right?

 

Ayla

Well, a tip of my hat to you Ayla. They are processed by the same cpy mechanism in the stomach and can effect how much Benadryl is absorbed by the body. I did not know that. Good catch. This reaction should not be a concern as long as you do not exceed the recommended dosage of Benadryl. If you experience excessive sleepiness than cut the dose of Benadryl back. From my drug interaction website.


Moderate
diphenhydrAMINE  DULoxetine

Applies to: diphenhydramine, Cymbalta (duloxetine)

DULoxetine may increase the blood levels and effects of diphenhydrAMINE. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects.

"Hat is there anyway to reduce the meds slower than I currently am? "

The only way I know is to weight your dose. Unluckily in order to weight down to the 0.01 mg level you would need a good analytical balance which could run you well over a $1000.

"I can't see how to do that other than some days beads out and others no beads out but that would put her up and down in the dosage which everyone says not to do. Reducing by one bead only is clearly the slowest way? Is that right?"

You are correct. I wish I could help more.

Interesting. I just did a search of the medical journals and did not find any research into this drug interaction. If there has been no research how do they know one effects the blood levels of the other? Curious.

I can't find anything either - but did find a paper which inferred a possible interaction;

 

https://search.proqu...holar&cbl=43703

 

"A 70-year-old woman developed tachycardia, dry mouth and cardio-pulmonary arrest, following a overdose with duloxetine [Cymbalta] and toxicity with cyclobenzaprine, duloxetine, diphenhydramine"

 

Whether there is more in the full article I do not know.

 

Edit - I should state this study has obviously involved doses far greater than being discussed here on the forum, and no immediate alarm should be concluded as a result of my post...

Thank you both x  

 

I gave Mum some Bach Rescue Night.  Bottle says 

'a unique combination of the flower essences of Rock Rose, Impatiens, Clematis, Star of Bethlehem, Cherry Plum (Rescue tm) with White Chestnut which combine to help you enjoy a natural nights sleep.  4 drops directly on the tongue.

 

She also drinks Rooibos Tea (Red Bush tea) and Buchu and Rooibos tea. 

 

Mum told the carer 'Goodbye I am going to heaven now'.  This was in the middle of the night.  My sister and I sat with her for the rest of the night.  She was very calm and convinced she was on her way.   When she came round she spoke of having beautiful dreams and being somewhere beautiful.  When we asked why she came back she said 'because of you'.  

 

I know my Mum is 89 but I can't help feeling that this drug is killing her literally.  Everything else is working perfectly, heart, brain, lungs, kidneys, spleen, gut... the whole lot have been x-ray'd and scanned etc.  All amazing for her age...  just the exhaustion and fear and confusion and fright when she has a reaction to Cymbalta.  These are the treasured moments, days, years of her life when she could have had peace of mind and joy and days to relax and spend quality time with those she loves and who love her.  I am so angry that she has to suffer this way.  

 

I feel there is no amount of money that a company could pay out to compensate for the theft of this woman's life!!!

I honestly believe that manufacturers of any drugs should be the actual people it is tested on.  If you are prepared to sell it you should be prepared to take it.  Don't sell sh...t you wouldn't take yourself.  Makes sense to me. 

 

Anyway.  Thanks for being witness to what we all go through I am sure.

 

Much love

Ayla

Your mother was granted a very special journey last night. She was given a moment in Heaven, but she clearly has reasons to still be here. I think she would have been given this choice last night - you are all blessed, and what a wonderful time to witness. I know there are meds at fault here, but just cast them aside for the moment and console yourselves with the wonderful experience that your mother had last night.

 

Thank you so much for sharing. 

 

God Bless you all.

Bach Rescue Night is a sleep aide manufactured by Gotas de Bach. If I interpreted correctly that is a Spanish product. As it is a supplement it is not regulated on the USA so not much I could find out. I looked at the ingredients and it seems Ok. Reviews I saw did not mention of any bad reactions just a 50% success rate in helping sleep. Without the doses I can't really say for sure that there are no concerns.

 

Rooibos Tea
Due to the harsh processing of this product most of the organic components are destroyed during preparation. Also many of these products are high in caffeine so be sure and get a caffeine free product and one with independent analysis. Unprocessed Rooibos Tea is famous for causing Salmonella poisoning.
https://www.ncbi.nlm...pubmed/24789759

Red Rooibos Tea Nutrition Facts
Rooibos tea is rich in many minerals such as iron, calcium, potassium, copper, manganese, zinc, magnesium, and alpha hydroxy acid. According to the USDA Human Nutrition Research Center on Aging at Tufts University in the United States, the tea contains antioxidants like aspalathin and nothofagin and extremely potent and versatile phenolic compounds. Red rooibos tea has no oxalic acid, and therefore, it can be consumed by people who have kidney stones.

 

https://www.organicf...ooibos-tea.html

 

The article above pretty much reflects what I found in the medical journals.

Buchu
Used to treat urinary infections and as a skin applied insect repellant.

Side Effects & Safety
Buchu is LIKELY SAFE in food amounts and POSSIBLY SAFE when used as a medicine. But it is POSSIBLY UNSAFE in larger amounts and when the oil is consumed. Buchu may irritate the stomach and kidneys and increase menstrual flow. It may also cause liver damage.

Special Precautions & Warnings:
Pregnancy and breast-feeding: Don’t use buchu in amounts that are larger than usual food amounts if you are pregnant. Buchu is LIKELY UNSAFE when taken during pregnancy. There have been reports linking buchu to miscarriages.

If you are breast-feeding, buchu is POSSIBLY SAFE in food amounts, but don’t take larger amounts. Not enough is known about the safety of buchu during breast-feeding.

Bleeding disorders: Buchu might slow blood clotting and increase bleeding. In theory, buchu might make bleeding disorders worse.

Kidney infections: Even though some people use buchu for kidney infections, health experts advise against this.

Liver problems: Large amounts of buchu may cause liver problems, even in healthy people. Therefore, people with a history of liver problems should avoid buchu. Taking a large amount of buchu might make liver disease worse.

Urinary tract inflammation: Don’t use buchu if you have pain and swelling in the urinary tract.

Surgery: Buchu might slow blood clotting. There is some concern that it might increase the risk of bleeding during and after surgery. Stop using buchu at least 2 weeks before a scheduled surgery.

 

Hi

 

Not sure if anyone is around.  Mum just bit into her cymbalta tablet and swallowed GD knows how many of those little balls before I got her to spit out what was mainly capsule left.  Anyone got any idea whats going to happen to her?

Hi Ayla....

 

If it was just the one she should be fine. The coating on the beads are not supposed to come into contact with the stomach, hence the capsule. However, as I said, if it is just the one, I doubt there is any cause for concern. 

 

Hat - what is your take on this considering the age of Ayla mother??

Hi God-like

 

Thank you.  She felt like she was going to vomit and then 15 minutes later is out cold.  And I mean out cold.  Sadly my mother has been diagnosed with presumed cancer of the liver which they think might be a metastasis from an unknown primary.  Odd thing is though as a result of so many side effects from this poison from hell she has had scans and ultrasounds and up until last march when they only notice a fatty liver (slightly) their was no cancer whatsoever.  They say a biopsy is the only way to tell but three different doctors feel that it looks 100% like a cancer.  We are bewildered and desperately sad.  She has lost weight, is in pain which we are handling with painkillers of various types and somehow I just wonder if this drug has caused this.  Apparently it does not present like a typical cancer in the liver but ... and a biopsy of the liver is just too dangerous.

 

So now they are pushing for us to drop cymbalta as quickly as possible before she cant swallow or ingest it anyway.  We are down to 26mg per day with dreadful full body jumping confusion and hallucinations as we go.  Tonight the tablet she chewed would have been another 2mg drop for the next 5 days.  

 

I feel ill

My goodness - I really feel for you. This is quite a situation. Cymbalta has been known to exacerbate pre-existing liver problems, and there is an FDA warning about this, but with regards to causing it, this cannot be said. If there were advanced stages expected, particularly with metastasis, there would be pain involved, and with the liver, jaundice and paling of skin etc can be expected.

 

I can see why they are pushing for it to be stopped.

 

I would really like to see what Hat has to say about this one. Whilst I am quite sure that the one-shot of beads from this dose should be OK, I'd like a second opinion. Been a crazy busy forum day... it amazing when they happen out of nowhere

 

Hang in there... Hat will be along later no doubt.

So sorry for your mom's situation Ayla. That is sad.

Yes, IUN is right on that there is an FDA warning about not taking Cymbalta if you have a preexisting liver condition. And yes it can cause liver damage. My drs (and I have had a few, lol) all recommend a liver function test every 6 months when taking antidepressants.

As far as the taking of an extra tablets worth of beads I would expect her to be sleepy, dizzy and a little confused but that should pass in 3 or 4 days.

I am very concerned about the "diagnosed with presumed cancer". Presumed? Did they not run a PET scan or do blood tests for cancer serum proteins? I do agree it would be best if she came off the Cymbalta as fast as possible but to wean to fast could be horrible given her age and so many of the supplements that might help her could also put a strain on her liver. Has she had an Ast and Alt done and if so do you know the results? (These are blood tests).

Hi there

 

Could I check with you both and thank you for your feed back...

 

- No pet scan or biopsies.  They feel the diagnosis from the colour contrast CT Scan is convincing enough not to do anything intrusive at this point.

 

Mum is not swallowing her cymbalta tablets and bit into another one last night.  

 

We have been told that it is SAFE to empty the balls into yogurt or put into syringe with juice or water or such and administer that way in order not to have her go cold turkey at this point.  

 

We will be giving, if successful this way, 23mg for 5 or 7 days then 20mg for 5 or 7 days and so on dropping 3mg at a time?

 

To be honest we are not sure at this time how much longer she will be with us for.  But she is strong and it may be longer than we think.

 

Thoughts on ingesting the balls without the capsule?

 

Ayla

So she did not take an extra tablet... she took her normal tablet but bit into the capsule and swallowed some of the beads without the capsule.  We have been told you can take cymbalta that way.  The beads themselves are coated with something that allows the content of each bead to dissolve apparently... 

Each bead is enteric coated and the manufacturer has said it can be taken with food as long as it is not chewed. Cymbalta is converted to naphthol in the stomach if it comes in contact with stomach acid. Normally we don't recommend that nut in your mon's case there may be little choice.

Thank you both.  x

The sauce is there to aid the swallow and passage through the stomach, and whilst ideal that beads should not be taken this way over a length of time, it is possible. And if this is going to be the way forward, then so be it. Better that than cold turkey for your mom at this stage.

 

We all have to pick our battles, and you are doing such a wonderful job for your Mom.

 

God Bless you...

Ayla....

 

Don't worry if you can't reply just yet, but thinking about you today and wondering how you are getting on. Last time we spoke there was a lot on your plate. Sincerely hope your Mum has been able to get some rest from all the previous issues.

 

IUN

Hi there

 

Mum passed on Saturday 21st of September.  We are still trying to recover from the shock.  It was traumatic watching my mother going so quickly.  She did not really have enough time to get to grips with what was happening and time to come to terms with it all before she became disorientated or uncommunicative because of morphine.  It is absolutely shocking how little we have to aid those who are dying.  I have no doubt if pharmaceutical companies thought there was any or more money to be had they would be able to come up with alternative 'drugs' that could allow people to die with more dignity whilst not being in pain.  

 

I know my mother was 89 but no one wants to die at any age.  I strongly suspect the 'cancer' if that's what it was in her liver, was caused by this medication.  We should have perhaps ordered a post mortem but it is a complicated procedure here and odd as it may sound I just wanted her body to be left alone at last after being subjected to so much whilst being on Cymbalta.

 

I will never forgive the manufacturers of this drug for creating this drug and further denying for so long the side effects thereof.  They should have to be on it personally before selling it is what I believe.

 

Thank you both for all your guidance and support throughout this nightmare.

 

I am so grateful for all your time and advice and care.

 

Please go well

 

x

 

Ayla 

Ayla,

 

Please first accept my condolences - I am sorry to hear of the passing of your dear mother. I can feel the ambivalence of emotion in your words from what you have written and you must do right by what your mother would have wanted. I agree that it is just wrong that her last moments on the earth were during some painful times, but the consolation is in the somewhat overused platitude that she is no longer in pain, but it is more fitting here than other such circumstances.

 

I am sure I speak for us all in saying that it is nothing short of a privilege to have aided you in any way we could. Your mum will be resting in the Summerland looking down on her amazing daughter for showing such love and affection.

 

God Bless,

 

IUN

My condolences on the loss of your mother as well. Take solace, she is at peace now. I wish we could have done more for her while she was with us.

Remember, God loves you.