9 replies to this topic

[feelingawful]

I was on Cymbalta (30 mg/day) for 3 1/2 years. Due to some medical issues, I had to stop taking it immediately - weaning off wasn't a possibility. That was two weeks ago, and I've been having some dizziness and headaches, but up until this morning it wasn't too bad. Then, starting today, it just got much worse: severe dizziness, headache, nausea, muscle cramps, and trembling (sort of like a bad case of the flu). I showed up at work and they took one look at me and sent me home. Don't know what I'm supposed to do about tomorrow, though.

Does anyone have any idea how long these severe symptoms usually last? Any ideas on how to control them (other than the weaning, which I medically can't do)? My doctor is starting me on Wellbutrin SR tonight (150 mg). Will that help, or is it only going to make things worse?

A few of my co-workers know what's been going on, but not my boss (didn't think Mr. "Depression Isn't a Real Illness" would be sympathetic). On the other hand, showing up for work looking like I'm going through the DTs probably isn't great for my career either. Anyone dealt with this before and have some advice on whether I should talk to him? Or maybe the Medical Dept. at work instead?

[feelingawful]

Well, wanted to add an update, for anyone else who might be in the same situation as me. I finally started feeling like a human being again on Wednesday of this week (June 30th). The time in between was absolutely miserable, and I ended up missing 2 1/2 days of work. Today, though, I feel completely fine again - no symptoms at all. Since that is much, much quicker than I was expecting based on what other people have gone through, I'm guessing that the Wellbutrin helped tremendously.

[cookie]

Dear Feelingawful:
It is difficult to know how long this symptoms will last. It varies from person to person. And stopping cymbalta abruptly makes the symptoms heavier.
I do not know about Wellbutrin, please tell us if it helped you.
Handling this at work, is something really difficult. One usually want to give our bosses and image of perfection, control, and strength (which I suppose you are not feeling at this moment). When my severe Depression struck, I talked to my boss which I had known for 7 years. My work in those 7 years was impecable, and above average. My boss was very supportive at the beginning. But this support lasted a month. At the end I had to quit my job. So please be careful on your decision on how are you going to handle this at work. I would suggest you talk to the Medical Department instead of your boss. And try not to mention the word "antidepressant" please. Maybe it is better is you just tell them you are quitting a med and are suffering withdrawal symptoms. It is just my opinion.
Keep us updated
Hugs
Cookie

[Inertia]

Yes, sadly there is too much stigma and misunderstanding/misinformation attached to mental illness for us to be able to just explain what's going on at work and expect an appropriate reaction. In my humble and less experienced opinion, I wouldn't recommend going further than a non-specific reference to medical issues or the least amount you are able to disclose in the vaguest terms. That ought to be enough. Technically you should be protected, as depression or other mental illness is considered a disability you can receive reasonable accommodations for and the medicine was a part of your treatment plan.

Edit: P.S. Great to hear you're doing better now and hope everything is going well at work.

[cookie]

Hello Inertia:
Yes there is so much stigma/misunderstanding attached to depression and mental illness. Bosses think it shows weakness of personality or people not being able to handle stress. They have no idea that it could be a chemical illness/neurotrasmitters not working.

Like any other organ in the body (liver, pancreas, etc) the brain can also get sick. When serotonin and norephinephrine do not work properly they can cause depression or fibromyalgia.

At the end, my opinion is that ALL illnesses are psychosomatic. So "if" depression shows weakness of personality, then cancer also. At the end is people not being able to manage their emotions.

After reading this site, I actually think that people that suffer from major depression are SO strong!!!! I´ve read many stories of people first bearing the symptoms of depresssion itself and then this symptoms of withdrawal while they go to work, take care of their children, etc.

I had two bouts of depression in my life. The first I didn´t mention anything to my boss, I even got promoted at that time. The second bout of depression I made the mistake of telling my boss, and I lost my job.

I am down to 20mg from 60mg. I am so excited!!!

Hope you get better
Hugs
Cookie

[MaureenV]

Hello Inertia:
Yes there is so much stigma/misunderstanding attached to depression and mental illness. Bosses think it shows weakness of personality or people not being able to handle stress. They have no idea that it could be a chemical illness/neurotrasmitters not working.

Like any other organ in the body (liver, pancreas, etc) the brain can also get sick. When serotonin and norephinephrine do not work properly they can cause depression or fibromyalgia.

At the end, my opinion is that ALL illnesses are psychosomatic. So "if" depression shows weakness of personality, then cancer also. At the end is people not being able to manage their emotions.

After reading this site, I actually think that people that suffer from major depression are SO strong!!!! I´ve read many stories of people first bearing the symptoms of depresssion itself and then this symptoms of withdrawal while they go to work, take care of their children, etc.

I had two bouts of depression in my life. The first I didn´t mention anything to my boss, I even got promoted at that time. The second bout of depression I made the mistake of telling my boss, and I lost my job.

I am down to 20mg from 60mg. I am so excited!!!

Hope you get better
Hugs
Cookie

20mg Cookie!! Congratulations! What are your weaning plans from hereon?


cheers, Maureen.

[cookie]

Dear Maureen:
My initial plan is to go from 20mg to zero in 9 weeks. So far I´ve been doing 2,5mg drops weekly, and want to keep on doing this until I am down to zero. Depending on how I feel I will have to adjust drops.

Concerning my weaning I have a few comments:
1. I am starting to ask myself, why did my doctor keep me on 60mg for such a long time (5 years) if now that I am on 20mg I feel well emotionally (in spite of some withdrawal symptoms).
I did my math, if these 57 days that passed since I started weaning I had taken 60mg as doctor adviced I would have put in my system a total of 3420mg, with weaning I actually just took a total of 1869mg these 57 days. That means that there are 1551mg that would have gotten into my system this period, but didn´t. Detox!
2. Is it true that even with weaning slowly, withdrawals strike after when one gets to zero????
3. I took cymbalta for Major Depression, I have to start thinking what alternative therapy/medicine I will use once I am cymbalta free. Any suggestions???

Hugs
Cookie

[MaureenV]

Dear Maureen:
My initial plan is to go from 20mg to zero in 9 weeks. So far I´ve been doing 2,5mg drops weekly, and want to keep on doing this until I am down to zero. Depending on how I feel I will have to adjust drops.

Concerning my weaning I have a few comments:
1. I am starting to ask myself, why did my doctor keep me on 60mg for such a long time (5 years) if now that I am on 20mg I feel well emotionally (in spite of some withdrawal symptoms).
I did my math, if these 57 days that passed since I started weaning I had taken 60mg as doctor adviced I would have put in my system a total of 3420mg, with weaning I actually just took a total of 1869mg these 57 days. That means that there are 1551mg that would have gotten into my system this period, but didn´t. Detox!
2. Is it true that even with weaning slowly, withdrawals strike after when one gets to zero????
3. I took cymbalta for Major Depression, I have to start thinking what alternative therapy/medicine I will use once I am cymbalta free. Any suggestions???

Hugs
Cookie

Hi cookie,


Unfortunately doctors can only go by the prescribing advice from the pharmas. There are zillions of drugs out there for any doctor to keep up with, although if it was a psych doctor I would have thought they'd be more familiar with each drug.

To bore you with my story again: my GP started me on 30mg of Cymbalta after six months of Lexapro (which otherwise worked really well for me) caused huge weight gain (from eating - I would constantly feel like I hadn't eaten all day) and horrible nighmares. One night it took my husband several minutes to wake me from a horrible one which I was 'acting out' and have never done that before in my life (it was at the time of the serious bushfires around Melbourne 18 months ago and I was trapped).

As per usual, I only got one month's supply and had to go back for a follow up before getting the six month's supply, and as luck would have it my GP was off sick for several weeks with swine flu and I saw another doctor, who, it turns out, is a bit drug happy.

When I asked for the 30mg again (as, apart from a few annoying side effects, I was happy with it - I'd already lost 3kg) only for him to insist that the standard therapeutic dose was 60mg, and not only that, he couldn't even give me 'repeats' for 30mg (as 30mg is considered the step up and step down dose), so I would have to have got a script for 30mg every single month from the GP. My own GP would have gone with this, as she believes in the minimum dose which works.

60mg made some of the side effects intolerable, and I figured if I'd been doing so well on 30mg, which wasn't a 'therapeutic dose' then hey, maybe I didn't need to be on Cymbalta at all. (The issues which had been around when starting Lexapro were mostly gone.)

Dropping back down to 30mg wasn't a problem (I'd been taking 60mg for only three weeks though) but then trying to take 30mg every second day was when the fun started.

Once I found this site I changed to 20mg every day which brought everything back to normal, then spent 10 weeks to zero - a bit like your plan.

After a few months I realized I needed 'something' - that if I didn't I was going to affect those around me too much, and started on Prozac. Didn't want anything further to do with the modern ones. As you probably know, the minimum therapeutic dose of that is 20mg.

My dose though varies between 5mg and 10mg. I did some research, and discovered that the way they work out the minimum 'usual' dose is by establishing the dose at which 'most' people find benefit. so with Prozac (i can't remember the actual figures) say 30% were helped with 5mg, 55% with 10mg, 71% with 20mg. So 20mg becomes the standard dose, despite the fact that MANY people need only 5mg. Either their depression isn't that bad, or they're particularly sensitive to the ingredients - who knows?

So there you go, after all that spiel. You may be one for whom 20mg of Cymbalta (which we can't even GET in Australia) may be the correct dose. I often wonder if that's why some people have so much difficulty with the lower doses - perhaps they DO need that lower dose. Unfortunately the withdrawal symptoms are so similar to someone needing help in the first place it's impossible to know.


2. (still reading?? )

The main difference between those who wean slowly and those who go cold turkey seems to be that cold turkey folk seem to have greater fluctuation. They can be feeling fine for a week or even a month or two then have recurring symptoms.

After unsuccessfully trying to drop at 10mg (due to brain fog) I then went down 1mg at a time, getting withdrawal symptoms sure, but they were very, very mild compared with earlier. I'm one for whom symptoms hit immediately, and due to the small drop, were gone after four days, then I'd do the next drop. I stopped completely at 1mg, and the symptoms (extremely mild) lasted nearly three weeks. By the third week it was only a matter of a few brain zaps a day, but interesting that my brain was still noticing the difference. If I had my time over again, I'd have dropped one bead at a time at that stage. What's the rush? (Except we all, almost without exception, just want to be RID of it).

3). Although my GP wasn't keen, I wanted a drug which had little reputation for withdrawal problems, and went for Prozac, but I'm only on 5mg. My GP says that many people have to try virtually all the different anti-depressants before finding one which is a good 'fit' for them. So in that regard I'm not much help. I had also started taking HRT at the same time as Lexapro, so that probably helped a bit, too.

regards, Maureen.

[cookie]

Hello Maureen:
Thank you for taking the time of giving me such a detailed answer to my question. Of course I read everything , your words of wisdom are always welcomed.
Thank you also for telling me your story of weaning, (which I didn´t know). I read that one of the side effects that bothered you the most were the horrible nightmares.

The research you did is very interesting, in which the -therapeutic dose- is established based on the dose at which most people find benefit. I wished doctors took into account that there are people who need less than that certain dose. I see that you were doing well on 30mg and then the other doctor gave you the “standard therapeutic dose” 60mg making your side effects unbearable.

A similar situation happened to me, when my psychiatrist went on vacation for a month and I went to another doctor who increased my dose from 60mg to 90mg cymbalta. That dose didn´t give me any additional benefits on my depression and gave me additional side efffects (made me manic and had severe itchiness). Imagine, when I started 90mg I woke up at 3:00 a.m. wanting to drive at night to buy a pack of cigarrettes. (I inmediately realized I was manic. I suffer from UNIPOLAR depression not bipolar).

I think this thought of yours is so interesting: “I often wonder if that's why some people have so much difficulty with the lower doses - perhaps they DO need that lower dose”.
I will look closely how I feel during weaning. My dream is to get down to zero or stay at a very low dose of cymbalta (the lowest dose my body can bear). But after reading this site, I was definitely not staying at 60mg!!!!!!!.

I´ll try the 1 bead drop at the end.

I am so glad that Prozac is working for you. That means that maybe your problem was only serotonin??? The effects of cymbalta on norephinephrine were not needed by your brain?.
I wish I could be medicine free. Due to my Major Depression I need “something” to help. I would like a natural therapy/medicine. I´ve got to have an alternative, once I am down to zero.

Thank you again
Hugs
Cookie

[Ms_M]

Maureen - Glad to hear Prozac works for you. I may ask for that when I go back later this month. It's ironic to me that even though Prozac has had its bad press, it is the one that is so helpful.