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I'm A Mess...getting Off Cymbalta And Wellbutrin


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#1 SonSetFree

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Posted 10 November 2021 - 04:36 PM

Hi All,

 

(I am typing this for my wife who has trouble with screens and typing.  She has been in WD since July 17 after discontinuing Wellbutrin and Cymbalta.)

 

I have a long history of AD use, but for the last 10+ years I have been on Wellbutrin, Cymbalta and Trazadone.  I started tapering Cymbalta by removing beads 3 years ago, in April I jumped from about 6 to 4 Beads.  I started having muscle twitching and spasms and a couple of melt downs but I did not attribute it to the Cymbalta drop because I didn't have my usual brain zaps that tell me I tapered too fast.  At that time I was also taking 75mg Wellbutrin and started to think my Wellbutrin was the bad guy, so on July 5th I stopped taking the Wellbutrin 75mg cold turkey (after about a week of alternating days) AND at the same time stopped my last 4 beads of Cymbalta.  For almost 2 weeks it was bliss, muscle cramping went away, no issues.

 

Needless to say I got hit hard about 13 days later.  Since then I have had countless physical and mental symptoms that have been debilitating (you all know).  Stomach, Insomnia, Flu Like Symptoms, No Appetite (lost 20 lbs) Depression, Anxiety, Crying Spells, depersonalization and more.

 

My GP referred me to a Psych who initially dismissed withdrawal and put me on 15mg Remeron.  So I broke it in half and took it to see if it would help with my anxiety, sleep and appetite.  It worked on the sleep and appetite for about a week, and then it all came back. So then I tried reinstating WB at about 22 mg a day.  It didn't do much, so I gave it more time, about a month of playing with my dosing slightly and still no change. 

 

I finally decided it must be the Cymbalta, even though I was down to 4 beads when I jumped off.  So I reinstated 2 beads, and it immediately helped with sleep.  I slept 8 hrs the first night I reinstated which was the first full night of sleep at the time in many weeks.  My appetite and anxiety improved, then after 2 weeks, it all came back, but with a vengeance, full on panic attacks off and on for about a week and a half.  Then I updosed 1 Bead and again, sleep and anxiety improved for a little less than 2 weeks, then the panic attacks and no sleep came back.  And that catches you up to where I am today.  So in summary 2 months in to my Cymbalta reinstatement I am currently in total despair; Severe Anxiety, with Panic Attacks every other day, crippling depression in multiple crying spells a day and not leaving the bed/couch/house much;

 

My current daily regiment:

7.5 mg Remeron and 50mg Trazadone at Night

22 mg Wellbutrin broken into 3 doses a day (10mg, 6mg & 6mg)

3 beads Cymbalta, 1 in the morning and 2 early evening (Tiny Beads from Torrent Manufacturer - 210 beads per 20 mg Capsule)

 

Big Questions:  Do you think this is Cymbalta or Wellbutrin WD?  Any idea why it improved then everything came back?  

 

Given I improved on the reinstatement and updose of Cymbalta, do you think I should updose Cymbalta another bead to see if it knocks it out again, or would I possibly be making things worse?

 

Thanks so much you guys are amazing for what you do. 

 

-Son

 


#2 fishinghat

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Posted 10 November 2021 - 06:04 PM

We hear this type of story so often. When one begins having serious withdrawal symptoms we get desperate for some relief. That included me when I went through my withdrawal. We start to tweak other meds, updose, down dose and try other meds. This reaction almost never works but usually make things even worse. I can assure you that your experience is not uncommon. Remember that a change in meds (updose, downdose or additional meds) usually takes 4 to 8 weeks for the4 blood chemistry to stabilize. Of course the smaller a change the less effects (positive or negative). 

 

To answer your questions...

 

I would think this is both Cymbalta or Wellbutrin WD. Remember that Cymbalta helps regulate serotonin and norepinephrine and Wellbutrin effects dopamine. So now instead of 2 neurotransmitters out of balance you have 3. The reason this is particularly bad is is that our body converts Dopa to dopamine to norepinephrine and then epinephrine. So now your dopamine is unstable and your body is searching for stability, it overproduces and then under produces as it desperately tries to regain control. This instability causes an instability in norepinephrine and then epinephrine which are already unstable from the Cymbalta withdrawal. 

 

By adding Remeron, which blocks serotonin and adrenaline receptors, this should have helped some BUT is your adrenaline high (probably) and your serotonin high and thus needs blocking? Research into serotonin levels during use of an AD or withdrawal from an AD shows that levels vary widely from one patient to the next. Drs, like yours, just typically throw a med at these symptoms and hope it works. One of the negatives is that Remeron has its own withdrawal that you will have to deal with in time. 

 

Now you understand I am no dr but just my opinion based on my experience with many on this site I would just suggest hold steady at your current med schedule you posted. Give things a couple months for things to stabilize before you make any more changes. Neurotransmitter stability can take up to 2 years for your body to regain control. That is why withdrawal is done so slowly. 

 

By the way that was an excellent post with the details that we need to see in order to understand the situation. Well done.


#3 invalidusername

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Posted 13 November 2021 - 07:32 PM

Welcome to the forum, and my apologies in the delay responding to you...

 

..however, Hat has got you offer to a fantastic start here. I agree that one of the problems is that another med has been thrown at the problem prior to letting the neurochemistry balancing itself out. Doctors feel obliged to offer an immediate solution which may turn out to be more harmful in the long run.

 

Very strange to be taking the Wellbutrin at different levels as with a very lengthy half life, it should make no difference. If it is not showing improvement, then I would suggest taking this out of the equation. The less we have to deal with, the easier the problem is to pinpoint. 

 

We have had a number of members who have had issues with the last few beads and I wouldn't be at all surprised if the issue is the Cymbalta. It concerns me that you say "about" 6 beads to 4. At this stage, 1 bead here or there can make a huge difference. When you dropped a bead from 20 to 19, we are talking 5% reduction. Your body can cope with that, but 6 down to 4 is a reduction of 33%. Nearly 7 times worse!! 

 

When it gets to this point, the drops need to be changed in order to get around these final drops, thusly;

 

6 beads

6 beads one day, 5 beads the next

5 beads

5 beads one day, 4 beads the next

...continue

 

Remain at each of these dosage patterns for as long as needed by simply listening to your body.

 

I would also suggest levelling our the dose to eliminate the issues of the short half life, so 6 beads are taken 3 + 3 beads (12 hours apart), 5 beads are taken 3 + 2 beads 12 hours apart etc.

 

Hope this make sense. This is my opinion, but I feel it is the way forward.

 

IUN


#4 SonSetFree

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Posted 14 November 2021 - 09:31 PM

Thanks FH & IUN!

 

"Very strange to be taking the Wellbutrin at different levels as with a very lengthy half life, it should make no difference. If it is not showing improvement, then I would suggest taking this out of the equation. The less we have to deal with, the easier the problem is to pinpoint."

 

IUN, are you saying I should just condense my Wellbutrin dose into 1 or 2 doses per day, or are you saying I should get Wellbutrin out of the picture all together?

 

FH, you think I should hold longer?  It has been two months since reinstatement of 2 Cymbalta beads a day and 2.5 weeks since I updosed to 3 beads.  That is the only med change I have made.  

 

BTW, i came down with a cold...and thinking of taking something like Mucinex to help loosen stuff up.  Are you guys generally seeing people able to tolerate these?

 

-Son


#5 fishinghat

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Posted 15 November 2021 - 07:48 AM

Well SSF, you did the change in Wellbutrin in July as well. I know that seems like a long time ago but nerves take a long time to heal and the body to adapt. I have seen members often take 6 to 8 months to stabilize after just one change let alone two. 

 

 

Have you felt any better in the last 2 or 3 weeks, basically the same or worse?

 

The manufacturer makes several varieties, each with different ingredients. Those containing Guaifenesin are fine but the varieties containing  Pseudoephedrine  or Dextromethorphan  can cause problems. The Pseudoephedrine  causes a raise in blood pressure and high heart rates in about 10% of the people who take it. The flip side of the coin is that in a similar % of members it greatly helped their withdrawal symptoms. If you decide to try a product with Pseudoephedrine  in it start at a very low dose and gradually work up. That way you can see what effects it has on you. If the heart/blood pressure issues develop stop taking the meds and the symptoms usually clear in 12 hours or so.

 

The Dextromethorphan  is a more dangerous situation. Taking both Dextromethorphan  with an antidepressant can cause serotonin syndrome which can be very serious and even deadly. They should never be taken together.


#6 SonSetFree

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Posted 15 November 2021 - 04:47 PM

Thanks for the info!

 

"Have you felt any better in the last 2 or 3 weeks, basically the same or worse?"

 

It's hard to say with the recent cold or whatever it is.  I feel like I have the flu...my body is extra weak and lethargic.  But also have congestion, dry cough, but no fever.  Hopefully it is the cold that has knocked me down.  Before that, I was doing better.  Immediately after updose, my sleep got better and the panic attacks stopped for about a week and a half.  Then anxiety started back up again, just not quite as bad as before.  It is hard to say if I'm doing better without waiting to see when this cold lifts.


#7 fishinghat

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Posted 16 November 2021 - 10:00 AM

I think you are right. Just get and get a lot of rest nd see what happens after you get over the cold.


#8 SonSetFree

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Posted 17 November 2021 - 01:08 PM

Hey Hat, thanks I will stay put for a while.

 

I wonder, hypothetically, if I maintained my current med regiment indefinitely, would I in theory not only stabilize, but eventually in time get back to normal?  Or would staying on a microdose of Cymb prolong the healing?  

 

SSF


#9 fishinghat

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Posted 17 November 2021 - 03:14 PM

it has been my experience with members on this site that most stabilize in 6 to 9 months and then when they make the final mini drop they take another 4 to 8 months to stabilize. This is compared to those who go all the way through bead counting nd take 8 to 16 months to stabilize. 


#10 invalidusername

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Posted 17 November 2021 - 07:17 PM

Hey SSF

 

To answer the question regarding the Welbutrin, yes - there will be no difference in reducing the level of dosing even if you are one of those who (due to fast metabolism, low bmi or similar) have the shorter half life. 

 

As Hat said, with the extra addition of the drug, it makes things more complex when trying to pinpoint specific issues. Yet, even after what seems like sufficient time for the symptoms to pass, they may still be having adverse effects. We have seen a number of people on the forum, particularly those as yourself, of whom have had to take these things slowly - and then reduce things almost to a standstill to get a bearable withdrawal plan.

 

Either way - we are here to help you. 

 

Hat has got a far better grasp than I on the OTC stuff than myself, so can't add anything more to that. You can certainly trust his well-founded knowledge.


#11 SonSetFree

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Posted Today, 01:15 PM

Hey Hat and IUN,

 

Been holding steady since our last conversation as Hat recommended.  So it will be over two months since reinstatement of Cymb and over one month since updosing 1 bead.  So you don't have to scroll up;

 

My current daily regiment:

7.5 mg Remeron and 50mg Trazadone at Night

22 mg Wellbutrin broken into 3 doses a day (10mg, 6mg & 6mg)

3 beads Cymbalta, 1 in the morning and 2 early evening (Tiny Beads from Torrent Manufacturer - 210 beads per 20 mg Capsule)

 

In these past two weeks,

 

The Good: 

I am seeing improvement in sleep.  I hit record for consecutive days of decent sleep (over 5 hrs).   I have seen some minor improvement in mood and anxiety...had a couple of days going without crying spells.  I also spent most of a 2 day period with Family during Thanksgiving and I don't think I could have a month ago. So I'm thankful.

 

The Bad:

Overall depression and anxiety and that underwater alternate universe feeling that i'm stuck in is still a major issue.  

Still have neurological things, dizziness and feeling car sick after doing certain activities like watching TV. 

Have muscle burning pain on the left side. 

Fatigue is big, although I had chronic fatigue before withdrawal (not saying my chronic fatigue isn't related to antidepressants and antidepressant changes...cold switching over the years as I believe it's related).   

I have had a couple of anger/rage flare ups...just said mean things that's out of character and overreacted to minor annoyances.

 

What do ya'll think?

Is this all to be expected this far out...almost 5 months?  Or since I'm not on therapeutic doses of an AD, could this be my normal unmedicated state?   Or, if you look at my symptom list, does anything jump out at you as being medication interaction related?  

 

At what point in your withdrawal did the crippling anxiety and depression lift?

 

I just want to feel well enough so that I can start a more active daily routine that I can stick to.  Maybe get a part time job or volunteer.  Something that will help with the depression and take my mind off my illness.

 

-Son

 

 

 

My current daily regiment:

7.5 mg Remeron and 50mg Trazadone at Night

22 mg Wellbutrin broken into 3 doses a day (10mg, 6mg & 6mg)

3 beads Cymbalta, 1 in the morning and 2 early evening (Tiny Beads from Torrent Manufacturer - 210 beads per 20 mg Capsule)





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