New Here. Need Advice How To Taper

Hi, I just found this site and thought it would be good to get some advice from others that have experience with tapering.

I started taking Cymbalta in 2009 for major depressive disorder and anxiety with 60mg. I was doing fine with that dose but in 2017 got fired from a job and had another major episode, so got bumped to 100mg. (60mg+2x20mg). I ended up retiring early from the working world but then dealt with depression (although much less severe) from losing my work identity. I'm coping much much better now, anxiety is rare (easier without job stress) and I seem to be handing life much better with my ongoing therapy and CBT. The high dose of Cymbalta killed my sex drive, and I want to see how I manage and experience life off this drug.

I started my taper 9 weeks ago. I dropped 20mg for 30 days from 100mg to 80mg and the next 30 days I took 60mg, with no noticeable side effects.

For the last 4 days, I have been taking 50mg (2x20mg+dumping out roughly 1/2 the pellets from a capsule, putting it back together).

So far so good, but I am wondering how long I should stay at 50mg, and how I should taper moving forward to minimize potential withdrawal symptoms.

Thank you,
Don

PS. Is bead counting necessary, or can I just get a scale and weigh pellets? Also, running out of 20mg and 60mg is not a concern as I have 90 days of each.

Hi Don - and welcome...

 

First up, grab yourself a copy of our eBook - it will help you a lot on the upcoming journey;

 

https://www.cymbalta...tion-the-ebook/

 

Overall, it sounds like you are doing really well, and the time taken is about right - might be a bit quick for some, but if it has worked for you, then that's great. Essentially, the rule is simply that the closer you get to 0, the slower you need to get. You have to think in logarithmic scales, so that 100 to 90mg is 90% and 10 beads reduction, but 10 beads from 20mg is 50%, so it needs adjusting accordingly when you get to a point which is usually around the last 20mg. 

 

So you can probably get away with 10mg drops until 20mg and then you need to put the brakes on dropping 10 beads for the first 25%, then 5 beads for the following 25%, then 2 or 3 beads for the 3rd quarter and then 1 or 2 beads for the last and final quarter (or 5mg). Hopefully that makes sense.

 

We can help you with a plan if needed, but at all times you need to listen to your body. There will be times that you need to stop and stabalise before moving on to the next drop. Time and patience is the key.

 

Scales work fine if you don't have patience to count - there are a number of links and reviews from members in the eBook.

 

Let me know if you need any help - other members will be along tomorrow no doubt...

 

IUN 

Welcome Cymbaltaweaner1

 

Well it sounds like IUN has got you off to a good start. I am sure you will have a lot of questions as you go along so don't be afraid to come back and we will help as much as possible.

Thank you for the quick reply will check out the ebook.


I was thinking of trying to move to a % based reduction, such as 10% every 2 weeks. So if at 50mg now, in 2 weeks I go to 45mg, then 40.5 mg, etc. So once at 20mg, I'd be dropping 2mg...once at 10mg dropping 1mg, etc.


Or, perhaps, dropping 5% per week instead of 10% every two weeks.




Thank you.

Don

Don,

 

That is exactly what we are talking about and looks like a sound plan. But be prepared to hold in places where necessary. The biggest part to remember is that if you feel bad, hold at the present level until you stabalise, don't see it as an invitation to get off even quicker; this is where a lot of people make the mistake and end up giving them a far worse taper than what could have been.

 

Keep in touch and let us know how you get on.

 

The eBook will answer a lot of questions, but we are here should you need us for anything - just ask.

 

IUN

Hi, I just got a new 90 day supply of 20mg Cymbalta from Kaiser. All the labeling is identical between the new and old, and pills are same size, color and have the same markings. But the new pills have 140 beads per capsule whereas the last batch had 114. To make 10 mg last time I used 57 beads. So this time I should use 70 beads correct? Or is it possible the new capsules were over-filled or perhaps each bead is slightly smaller? Very odd to me.

Thank you for any insight / advice.

This is not uncommon. It depends on which factory and which production line was used to make the beads. Just go with 70 beads and it should be OK.

Exactly as Hat said - we have a cataloging somewhere on the site of how many beads are in which brands. Rarely will you find that two brands have the same amount of beads, so don't worry...

Hi Invalidusername, I do not understand the point of your last comment. You mention a catalog of how many beads are in each brand, but this happens to be the same brand with different counts. Or perhaps you are implying the the catalog you have includes single brands, that sometimes have different counts? I'm concerned that perhaps the first batch I got is a "True" 20mg, and the 2nd batch is within manufacturing tolerance and is actually 24mg (The extra beads are about 20% more), which would throw off.my taper.

Now, if I had some of the old pills and a scale, I could weight a set of 10 old versus 10 new to compare weight.

Ah - my apologies. I read it wrong. I thought it was a different brand. 

 

But yes, this still happens. Essentially, the manufacturing process goes by weight rather than the amount of beads which explains why there can be difference, and pharma plants have a number of different machines which can be set up with different specs. The cymbalta is always a tricky one as the coating on the beads is weighed and factored into the overall weight, and there is of course no knowing how much coating there is.

 

In the UK we have this chocolate called Maltesers (might be the same in the US) which is honeycomb balls coated in chocolate. The honeycomb in this instance would be the actual drug and the coating is the chocolate. We have had debates so many times about this!! But the beads go through a sieve before being put into the capsules so there should be some uniformity, but again it isn't a case that the sieve process lets through x number of beads, it goes on weight, so if the sieve is different from one plant to another, then the amount of beads will vary, but the amount of med should be the same. 

 

The FDA allow a maximum of 10% tolerance so there is still a chance that you could have a batch that is out compared to the first. But more likely that the process is set up to factor in a greater amount of coating than the previous. 

 

Scales can be used, but fortunately most people aren't THAT sensitive....

Hi, so I spent 1 week at 50mg, then 1 week at 45mg, now 40mg the last 2 days. So far, still not aware of withdrawal symptoms.

I've read so many of the horror stories on this site, I'm wondering if it makes sense to slow down a little just to make sure I don't get a bad surprise (I started about 4 months ago at 120mg). So perhaps alternate drops of 10% for 1 week, then 2 weeks. For example, since I did 45mg for 1 week, stick with 40mg 2 weeks now, then do my 36mg 1 week followed by 32mg 2 weeks, 29 mg 1 week, 26mg 2 weeks, etc Yes, more cautious but perhaps more time for brain to acclimate to each dose?

Thank you for any insight!

I agree with that approach.

Hi,

Just wanted to wish you luck with your taper!

This might have been said already, but sometimes the withdrawal symptoms don't really kick in until you're under 30mg. I didn't notice much until I was around 20mg. 

I think many people don't have too much trouble getting off this stuff, so hopefully you're in that group! I know it's so tempting to go faster just to be completely done ASAP, but realistically there's no rush and it's definitely better to draw it out longer than to be sorry later.

 

You got this!

Sorry if this is a repeat. Not sure where my comment went from earlier. Someone had suggested just going to 10%/10 days and keep same pace.

At the reduction of 10% per 10 days, that leaves me at 1mg in 1 year. (Then down to 7 beads, so perhaps 1 per 10 days....worry about/deal with that later)

Over the last 11 years of being on it, I am not aware of negative effects, so there is no rush to be off Cymbalta. Considering that, is this tapering plan a good pace or would you suggest even going slower? For example, once down to 20mg, slown it even more.

I guess I'm thinking better go slower. That this is better than getting to withdrawal symptoms and having to back up. But of course, prefer not to go way too slow. Bead counting is a PITA.

Don't feel bad CW, I just lost all my posts for about an 18 hour period. Don't know what is happening to them.

Recovered messages from this afternoon;

 

CW

 

Thanks for the input. If I move to 10% reduction every 10 days, that's about 27%/month. So I estimate in 1 year, I will be down to 1 mg from 40mg now. Does that sound like a good pace? I've been on Cymbalta since 2009, and can't say for certain I've ever had negative effects being on it, just know it's not designed for that and my life/health should be better off of it. Given that, there's no particular urgency to be off it either. So, I could even go slower.Counting beads and make pills is a PITA though ha ha.

 

FH

 

That sounds like a good pace.