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#1 confused2021

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Posted 27 January 2021 - 11:34 PM

Hi,

 

I came on here to get some advice please as this looks like a good support forum.

 

I've been on Cymbalta for 12 years -60mg and never had any issues, my mood was stable and I was going well.  In August last year I decided to come off slowly and I did over 4 months resulting in dizziness, mood swings, irritability and increased anxiety, suicidal ideation.

 

I was suffering so much I went back on 30mg approximately two months ago, still not right and back to 60mg one week ago.

 

I'm feeling spacey, anxious throughout my body and my vision is off. I feel like I'm not here.

 

Does anyone know please if this is normal and if it will pass?  The doctor seems to think it may take a few weeks.

 

My goal is to get stable and then come off properly using the techniques described here.

 

Any support or clarification would be great.

 

Thank you so much,

 

Confused.....

 

 


#2 fishinghat

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Posted 28 January 2021 - 08:21 AM

Welcome confused

 

I have seen many members go through this situation. It seems like that if a person goes back up on dose soon after dropping in dose it is OK in just a few days BUT if the person tries to go back up in dose several weeks after a drop things just don't go smoothly. Even with all my experience on this site and with this subject I have no idea why. It may take you several months to actually stabilize again. 

 

One thing that you might consider is to review our ebook. It has information on what things members have tried and their outcomes as well as a lot of medical research information.

 

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


#3 invalidusername

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Posted 28 January 2021 - 08:29 AM

Hi confused and welcome,

 

As Hat said, these meds can be quite an enigma, but often is the case that we see people up their dose a bit too readily resulting in the same thing they were suffering from as a result of dropping too fast. Rest assure that a 4 month withdrawal for the time you were on them will be the cause of the symptoms initially - there is nothing wrong and no permanent damage per se. But ideally you would have eased back up the dose rather than a big jump back to the original dose. 

 

True to say, your neurochemical situation will be all over the place at the moment which will be the reason behind the symptoms. Hopefully they should level out.

 

Best thing you can do now is just stay put on the present dose until you stabalise. If you were to move back down to 30mg, it will only confuse the system further. I would recommend some supplements to aid the process of stabilization of which we are here to help with should you need us.

 

IUN


#4 confused2021

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Posted 29 January 2021 - 01:23 AM

Dear Fishing Hat and IVN

 

Thank you so much for your reply, to say this drug is a nightmare is an underestimate, I literally felt like I was going mad last night! Intrusive thoughts, anxiety and insomnia!  I will persevere. 

 

Thank you for the e-book and your replies once again, its really kind of you.

 

Confused :-) 


#5 confused2021

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Posted 29 January 2021 - 01:29 AM

Dear Fishing Hat and IVN

 

The e-book is great but HUGE!

 

Could you please recommend which supplements that may benefit me?  There are so many in the e-book, I'm not sure which one to choose? 

 

Thanks

Jacqui


#6 fishinghat

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Posted 29 January 2021 - 08:46 AM

It really depends on which symptoms you are having but here is a starting point. If you are interested in a particular one I would suggest you then go to the ebook to read details about it.

 

Items Proven to Help Many with Cymbalta Withdrawal.
 
Diphenhydramine, (over the counter) also known as Benadryl, is an antihistamine and as such is not only used for allergies/colds but also as a sleep aide. It does have a mild anxiolytic effect. May lower blood pressure and cause irregular heartbeats. Your body does build up tolerance to it after a few weeks so use it off and on. This medicine has many drug interactions.
Begins working in 15 to 30 minutes
Peak levels - 2 to 2.5 hrs
Half Life – 4 to 6 hrs
Use by members for anxiety relief and to help sleep is too numerous to mention. 
Diphenhydramine should NOT be taken with hydroxyzine. Drugs.com
 
serendipity - I found Benadryl to produce hangover effects, and cause palpitations when taken long term. Even if you wake up in the middle of the night, and can't get back to sleep, even a teeny amount (say, 15mg) can induce sleep again. 
Schmb - Benadryl worked on a limited basis for me, because sometimes it makes me jittery, and that only made the zaps much worse, so just use some caution in case you are sensitive to it.
FH - One caution on benadryl. It is famous for bad reactions with other medicine so check your compatability closely. The maximum dosage of benadryl is 25 to 50 mg every 4 to 6 hours and do not surpass 300 mg in a day.
 
Benadryl Total
Medicinal ingredients:
•Acetaminophen, 500 mg
•Diphenhydramine Hydrochloride, 25 mg
•Pseudoephedrine Hydrochloride, 30 mg
 
It contains diphenhydramine which is the active ingredient in regular Benadryl and also pseudoephedrine which is common in most cold medicines. The Diphenhydramine helps with sleep and anxiety and the pseudoephedrine helps block the action of adrenaline which produces a calming effect. 
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#7 fishinghat

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Posted 29 January 2021 - 10:47 AM

Well sorry about that confused/ I went to post a whole document but only the first part posted and then the site crashed so I am going to try and post the rest.

 

Melatonin
FH - a research article where it was shown that taking no more than 0.7 mg of liquid melatonin under the tongue (sublingual) helps with anxiety. Place it under the tongue until dissolved and gone. In case you are not familiar with melatonin it is the chemical your body produces in the evening to make you sleepy and ready for bed. I suggest you start with around 0.1 mg and work up from there. Too much will relax you but it might also make you sleepy.
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L-theanine 
L-theanine is an amino acid precursor to glutamate (involved in the synthesis of GABA) and glutamine. It can cross the blood brain barrier. It is only produced by plants and fungi and a component in some teas. It inhibits glutamine transporters and glutamate transporters, and thus blocks the reuptake of glutamine and glutamate. Theanine increases serotonin, dopamine, GABA, and glycine levels in various areas of the brain. Caution – Most plants that contain L-theanine also contain caffeine and it can be a significant contaminant in L-theanine supplements. It is synthesized from glutamate using the enzyme glutamate decarboxylase and pyridoxal phosphate (which is the active form of vitamin B6) as a cofactor. This process converts glutamate, the principal excitatory neurotransmitter, into the principal inhibitory neurotransmitter (GABA).
 
Member's comments
(puritan's pride) 200 mg capsules 2- 3/ day. I have been taking this prior to cymbalta detox. It helped me reduce my dosage of clonazepam. Within 20-30 mins I feel more calm. I do believe it is helping keep the anxiety in check.
Tinabee - For now I have started taking fish oil and a supplement called Theanine Serene that is supposed to help with anxiety. I know it sounds silly since I've only taken the anxiety supplement for a couple days but I really feel like it has helped.
200mg L-Theanine in the morning with a full glass of water on an empty stomach, you can take again in late afternoon 100 to 200 mg if needed (make sure it is suntheanine - it helps with headaches and pain as any painkiller I had just did not cut it)
Member's comments were generally favorable.
 
Page 1 and 2, detailed information on L theanine and its usage.
Research
The research shows that all green tea leaves contain both L-theanine and D- theanine BUT only the special processing used by the manufacturer produces pure L-Theanine and is the choice of many of the research biologists.
 
 
Five of the six products contained significant amounts of D-theanine. Only one product, SunTheanine, appeared to contain only the L-theanine enantiomer. D-theanine is not used by the human body.  Suntheanine is the pure ingredient and that is what you want. 
 
Key Points
Theanine increases serotonin, dopamine, GABA, and glycine levels in various areas of the brain. 
Scientific Information
A National Standard monograph that reviews current research on theanine reports that it is likely safe in doses of 200–250 mg up to a maximum daily dose of 1,200 mg. Theanine is used to help with anxiety, blood pressure control, mood, and cognition. 
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#8 fishinghat

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Posted 29 January 2021 - 10:50 AM

Ashwagandha
(Withania somnifera )
All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales.
 
Our results provide evidence indicating that key constituents in WS may have an important role in the development of pharmacological treatments for neurological disorders associated with GABAergic signaling dysfunction such as general anxiety disorders, sleep disturbances, muscle spasms, and seizures.
 
300 mg twice a day.
Final BAI scores (anxiety test) decreased by 56.5% in the Ashwagandha group. Significant differences between groups were also observed in mental health, concentration, fatigue, social functioning, vitality, and overall quality of life with the Ashwagandha group exhibiting greater clinical benefit. No serious adverse reactions were observed in either group.
 
250 mg 2x/day
 
500 mg/day for bipolar, effective.
 
Each capsule contained 300 mg of high-concentration full-spectrum extract from the root of the Ashwagandha plant. Each person took 2 capsules a day. The treatment group that was given the high-concentration full-spectrum Ashwagandha root extract exhibited a significant reduction in scores on all the stress-assessment scales on Day 60, relative to the placebo group. The serum cortisol levels were substantially reduced in the Ashwagandha group, relative to the placebo group. No serious adverse events were reported.
 
W. somnifera extract is effective in treating obsessive compulsive disorder
The results suggest the protective effect of WS in the management of ethanol (alcohol)withdrawal reactions.
 
Preliminary results suggest that Withania root extract can be used in the management sleep loss and associated oxidative stress.
 
Effective for anxiety
 
WSG also exhibited an antidepressant effect, comparable with that induced by imipramine in the 'behavioural despair' and 'learned helplessness' tests. The investigations support the use of WS as a mood stabilizer in clinical conditions of anxiety and depression
 
It has a Cognition Promoting Effect and was useful in children with memory deficit and in old age people loss of memory. It was also found useful in neurodegenerative diseases such as Parkinson's, Huntington's and Alzeimer's diseases. It has GABA mimetic effect and was shown to promote formation of dendrites. It has anxiolytic effect and improves energy levels and mitochondrial health. It is an anti-inflammatory and anti-arthritic agent and was found useful in clinical cases of Rheumatoid and Osteoarthritis.
 
1,250 mg/day × 10 days
All volunteers tolerated WS without any adverse event.
Safety and side effects
 
This product is comparative to lorazepam in its ability to control anxiety. That is impressive.
 
250 mg twice a day.
At 6 weeks, significantly more patients met a priori response criteria in the drug group (88.2%) as compared with the placebo group (50%). The drug was well-tolerated and did not occasion more adverse effects than did placebo. It is concluded that this ethanolic extract of Withania somnifera has useful anxiolytic potential and merits further investigation.
 
This study provides scientific validation to the anxiolytic, anti-inflammatory and anti-apoptotic properties of ASH-WEX, which may serve as an effective dietary supplement for management of SD induced stress and associated functional impairments.
 
Members Comments
One member reported taking it during withdrawal and said it was very beneficial.
Brz - ashwagandha update:
had to stop - bummer.
definitely allergic. just like sk8ermama. i couldn't figure out why my allergies hadn't gone away even after the pollen count dropped way down. stopped the ashwagandha and my congestion and headaches subsided. not to mention i had a very tight chest feeling. very uncomfortable. my side effects are not uncommon from what i've learned. i may try again way down the road but now that i'm battling reflux, i don't want to complicate things. i've heard rhodiola is a similar adaptogen, but don't want to introduce anything new into my system right now.
 
Many other members have had good success with it but your body does build up tolerance to it so it must be used for short periods of time. 
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Deep breathing, sighs, yawns....
These activities cause an increase in the release of dopamine, endorphins and serotonin. This fact has been used by psychologists for decades to help control anxiety, depression and sleep. By causing yourself to yawn several time over a 10 or 15 minute period it will release enough of these neurotransmitters to help relax and induce sleep. Sighs work much in the same fashion but to a lesser degree, Breathing exercises are the most effective. A good psychologist should be used to teach the most effective techniques.
 
Member comments and tips -
deep breathes, breath(ing) - 22 comments all positive
Raven - Breathe it deep calming breaths and hold them for about 5 seconds before slowly letting them out.
Gail - you need to breathe, yes breathe in and out slowly.
FH - Deep breathing. Close your eyes—and try taking deep, slow breaths— making each breath even deeper than the last. If you have a psychologist who could teach you relaxation techniques, controlled breathing and heart rate, etc. These techniques really do work.
Raven - Just do you best to stay calm and use breathing techniques. My husband and FH have given me great tips on breathing when anxiety strikes. FH because he is a veteran and my husband because he has asthma.
Keys to breathing:
** Take slow deep breaths (breath in deeply and slowly)
** Hold for at least 15 secs if you can
** Exhale slowly
***repeat as needed*
 
FN - What helped me the most with this was yoga ...the breathing exercises ... once learned, they can be done anywhere, anytime .... the release of the built up anxiety in my body was tremendous ...
Janson - . i've learned a few breathing exercises via yoga and that helps immensely to calm down those nerves that are about to snap. even without knowledge of specific breathing exercises, just take deep full breaths with hands on your stomach and see your tummy rise on the breath in and then fully breath out. so simple, so effective.
Note - There must have been well over 100 members that had posts similar to the one below. Shortness of breath, heart pounding, skip beats, tightness in the chest or chest pain. these are classic anxiety symptoms and are the result of elevated adrenalin e levels. Adrenaline is a vasoconstrictor and bronchiole constrictor. These shallow rapid breaths allow CO2 to build in the lungs and worsens the symptoms. Alpha-agonists (eg. clonidine) and beta blockers (atenolol) work well t o block the effects of this excess adrenaline. Breathing exercises also help considerably in breaking this Cycle. As you can see below ZA got it really right.
Snap87 - Just scared with the shortness of breath and heart palpitations more than anything.
ZA - the 'out of breath' symptom is actually shallow breathing and I had that for about 2days it is very exhausting as it causes your oxygen saturation to drop. what worked for me 'was awareness -slow deep breathing -then a little aerobics. it helped to up my b/p and neutralize by blood gases.
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#9 fishinghat

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Posted 29 January 2021 - 10:53 AM

Conditioned Response -
One of the methods that can have a dramatic effect on anxiety is the development of a phrase in association with breathing exercises and relaxation techniques. This usually takes time to develop but is very effective. The process is begun by selecting a phrase...say the word "easy" for example. When you notice that you begin to get too anxious then lay down, close your eyes and begin your deep breathing exercises while also doing relaxation like 'progressive relaxation' all the time repeating the word 'easy' in your mind. With practice this becomes very effective and the need to lay down to achieve success is not necessary. You simply stop in place, close your eyes and say the word 'easy" to yourself while relaxing and breathing deeply. You then proceed on with your activities. This can be further used by your spouse to help you control your anxiety. If your spouse notices you becoming anxious they can simply develop a certain place she/he touches you gently as a signal that you need to stop, breath and relax. With practice this becomes automatic and can easily be done in public without drawing attention to your state of mind. The is a conditioned response so it MUST be practiced until it is a reflex action to be most helpful.
 
Three members report using this technique with excellent results.
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#10 fishinghat

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Posted 29 January 2021 - 10:56 AM

Prescription Meds
 
Clonidine
Clonidine  (Catapres, Kapvay, Nexiclon, Clophelin) is a classic blood pressure medicine BUT it is very effective on anxiety. It is an alpha adrenergic antagonist which means it stimulates the alpha adrenaline synapses located in the frontal lobes of the brain. When these synapses are stimulated by the clonidine the brain thinks that it is due to adrenaline and it tells the adrenal gland to produce less adrenaline. It is a little slow to kick in, about an hour and a half. It has a 12 hour half life. Most drs prescribe 0.1 mg twice a day. One to be taken about an hour before bedtime and the other in the morning. Because it decreases adrenaline it has a strong calming effect which helps a person get to sleep and stay a sleep. It is not unusual for people to have a little drowsiness from clonidine until they get use to it (1 or 2 weeks). It does NOT work faster sublingual (under the tongue) like benzos.  These have no withdrawal but your blood pressure may spike for a couple weeks if you cold turkey. Due to the lowering of blood pressure and sleepiness it is common for the patient to start with ½ tablet at bedtime. Once the patient adjusts to the medicine they begin a ½ tablet in the morning. As sleepiness and blood pressure stabilize they are slowly worked up to the 2 tablets (0.1 mg each) a day. 
Begins working 60 to 90 minutes
Peak levels – 3 to 5  hrs
Half Life – 12 - 16 hrs
There are too many research articles on clonidine's anxiolytic properties to list here.
FH - I started clonidine but it was a relief to me NOT to be able to feel my heart pound through my chest. As long as your bp is OK you shouldn't have a problem. 
That is why the slow start up. This gives your heart a chance to adapt to the new med. I did the same slow start up and my bp stayed within normal range. Just keep monitoring your bp and you should be OK.
FN - clonidine worked wonders for me 

#11 fishinghat

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Posted 29 January 2021 - 11:03 AM

Hydroxyzine, (Vistaril, Atarax) - is an H(1)R antagonist, is very effective against anxiety in most people but some get no help from it at all. It is not addictive nor does it have withdrawal but it also can lower blood pressure some but that usually goes away with time. This medicine should be started slowly to give your body a chance to adjust to the blood pressure effect. Normal dose is 25 mg four times a day but can go as high as 400mg/day.
Begins working in 30 minutes or less
Peak levels - 2  hrs
Half Life – 15 to 20 hrs
Do not take with cimetidine as it increases hydroxyzine levels in the blood.
 
(Mayo Clinic)
For oral dosage forms (capsules or suspension): 
⦁ To help control anxiety and tension: 
⦁ Adults—50 to 100 milligrams (mg) 4 times a day. 
 
Atenolol is a beta 1 adrenergic receptor antagonist, also known as a beta blocker. It does not pass  through the blood brain barrier which limits its side effects compared to other beta blockers. It has been linked to a higher risk of type 2 diabetes. It may cause drowsiness and lower blood pressure. Typical dosage around 25 mg four times/day. Dosage should be slowly increased.
Begins working in 30 minutes to an hour
Peak levels – 2 – 4 hrs
Half Life – 6 - 8 hrs
SF - So now I am on one. It is called Atilonol (Atenolol?) and calms down your heart rate too.

#12 fishinghat

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Posted 29 January 2021 - 11:05 AM

Buspirone (Buspar) is a seratonin 5-HT1A  receptor partial agonist and a dopamine antagonist at the receptors. It functions as a weak anti-anxiety medication similar to diazepam in strength (a weak benzo). No withdrawal or tolerance issues. Dosage should be kept low if taking a ssri and/or snri or St. John's Wort as it may cause seratonin syndrome. DO NOT take with grapefruit or grapefruit juice. May lower blood pressure. Typical dosage is 10 to 20 mg three times per day.
Begins working 3 to 7 days after begin dosing
Peak levels - 1  hrs
Half Life – 2 - 4 hrs
Buspar (15mg) and Melatonin (3 mg) yielded the best anti-depressant effect of any combination concentration tested. (See Melatonin below)
Buspar and melatonin in combination is anxiolytic.
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Dos and Don'ts
 
DON'T ...
take PPIs, acid reducers or antacids with an antidepressant as it will effect absorption of the antidepressant.
 
take St. John's Wort, 5HTP, tryptophan, SAMe, Dextromethorphan (a cough syrup/cold medicine) with an antidepressant - Serotonin Syndrome.
 
Don't take Stimulants (Make anxiety worse)
Caffeine 
Over-the-counter cold preparations contain phenylpropylamine and pseudoephedrine*
Sleep deprivation
Marijuana*
Magnesium*
MSG
Alcohol
Stress
amphetamines
ecstasy
nicotine
Ginseng
L-Tyrosine 
B Vitamins*
aspartame
Coconut Oil 
Taurine 
DHEA 
Ginkgo 
Iodine 
Arginine
Sugar
Kava
* - Only some people have this reaction.
 
Things containing caffeine..
List of energy drinks with caffiene. (over 100)
 
take Depressants (Make depression worse)
Oxalic acid is a depressant found in members of the spinach family and cabbage, broccoli, brussels sprouts, chives and lamb's quarters are high in oxalates, as are sorrel and parsley. Rhubarb leaves contain about 0.5% oxalic acid. Oxalic acid can cause depression, lack of minerals, kidney stones, and more. Cooking does not affect oxalic acid. People with kidney disease, a history of kidney stones or suffer from depression should avoid these foods. 
 
other depressants:
Aspartame
Gluten
High Fat Dairy
Sugar 
alcohol
Trans fats
Sodium 
Caffeine
Pesticide residue on foods
GHB
exposure to organic solvents (paint, varnish, stains, cleaning solvents, paint thinner, etc).
 
Do mot take any calcium or magnesium products within 2 hours of a medication as it can effect absorption of the medication. 
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Do
take 500 mg of vitamin C per day or 300 mg of NAC - (N-acetyl cysteine) an antioxidant
learn Cognitive Behavioral Therapy or Mindfulness
sleep as much as possible
Keeping a Journal  - Don't trust your memory during withdrawal.
Stay hydrated

#13 fishinghat

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Posted 29 January 2021 - 11:12 AM

Last section....

 

Omega 3
Dose - Omega 3 is recommended at 2000 mg/day EPA and DHA for anxiety, give or take a couple hundred depending on what research you read. It has been shown that only the EPA and DHA components effect anxiety. Any other omega 3 fatty acids don't do anything for anxiety. Life Extensions, Mega EPA/DHA, is distilled (molecularly purified) so you don't get any impurities with your product plus it contains no mercury. Some even provide a certificate of analysis if requested. They also have ones that are enteric coated now that will not irritate the digestive track and has no fish burbs to them. 
 
This thread contains a detailed discussion on use of Omega 3.
 
Also this thread....

#14 invalidusername

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Posted 29 January 2021 - 08:24 PM

Well Hat has covered it all and all of the info has been tried and tested by hundreds, if not thousands, of members. Best amount of research data available! 

 

You will probably find that symptoms wax and wane, or change as you go through the withdrawal, so it might be a situation of keeping abreast of the options should you need them. 

 

We are more than happy to help you out with this if you find it a bit daunting - which is common given that you are in the midst of a withdrawal. So please just shout if you need anything. Whether you are anxious, depressed, have itching, stuff growing on your face! We can point you in the right direction :)

 

IUN


#15 confused2021

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Posted 12 February 2021 - 07:00 PM

Thank you.

 

I regret coming off the 60mg, I felt much better when I was on it. 

 

Is it actually worth coming off this drug?  I don't see any positive posts from people? 

 

I feel like crap but not as numb. 

 

Please give me hope that this won't last forever and I will return to normal? 

 

Thank you

Confused


#16 fishinghat

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Posted 13 February 2021 - 09:17 AM

Well confused, that is a deep question. I can say it doesn't last forever but 8 months to 16 months after your last dose would be normal. That is a long time to feel real bad. There are a lot of success stories on this site. The advantages are that you feel more 'normal', less brain fog and the risk of the severe long term effects of Cymbalta are minimized, especially if pregnant.

 

There has been a fair amount of research on why some people come off antidepressants and proceed normally with life and others simply have to go back on them almost right away. A significant number of people have certain gene mutations that cause them to be more likely to be depressed or anxious and when they come off the AD they immediately relapse and others simply have a continuously severe stress situation in life and some after coming off an AD they relapse. Most psychiatric organizations recommend that their psychiatrists try to wean someone off an AD after 6 months of use if the psychiatrist thinks their life condition has improved enough to warrant the effort. This decision is an educated guess depending on the drs experience. Several commercial organizations offer genetic testing to see if individuals have any of the common gene mutations associated with depression and/or anxiety. There is still a lot of debate as to the accuracy of this testing.

 

As for our members it has been my observation that the major reasons for coming off an antidepressant are ...

 

Wanting to have feelings again and less 'numbness' 

Dealing with fairly serious side effects of long term use

and pregnancy.

 

I wish I could give you a more rosy picture but I can't. The decision on to continue using an antidepressant is one that only the patient can make and requires a variety of things be considered.

 

Do remember that we are here to help and if you decide to go back on an antidepressant no one here will judge or criticize you. We are here to support you no matter what you decide.


#17 invalidusername

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Posted 13 February 2021 - 10:22 AM

Again Hat a handle on this one and agree with him 100%.
 
It can be a long time to feel bad and the problem being the one doing the weaning is that you see such little steps, the weekly improvements can be so small that you don't notice them and it can keep you in a state of upset, whereas others can see it improving in you. The strength of the withdrawal has to remain. 
 
Most people think that a withdrawal stops when the drugs stop, but unfortunately, that is not the case. 
 
"The decision on to continue using an antidepressant is one that only the patient can make and requires a variety of things be considered."
 
A very concise answer. You know yourself better than anyone else, so this is a road that you must navigate yourself, but you need not do this alone.
 
If there is further information that you would like to share with regards to the decision making process, we are more than happy to give advice and options, and again as Hat sai, we will support you whichever route you decide. Never any judgement from our part - just love and support.
 
IUN




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