Jump to content



Photo

Very Slow Tapering


  • Please log in to reply
3 replies to this topic

#1 Lily

Lily

    Member

  • Members
  • PipPip
  • 10 posts
  • why_joining:
    I came down from 60mg to 30mg last year over a period of about 5 months. Now I'm coming down from 30 to 20 and looking for other people's advice and experiences

Posted 19 July 2010 - 04:13 PM

I'm 30, working full time as a secretary and studying part time for a degree. It's taken me a long time to build my life back up and I don't want to let withdrawal mess it up.

I am on 30mg, and looking to get down to 20. I have found a great GP who understands it all and I am swapping a 30mg capsule for a 20 every 5 days, so my routine is 30/30/30/30/20, 30/30 etc. I have been doin this for just over a month now. I am finding that I have lovely periods of euphoria a day or so after my dropped dose, but also the bad guts and especially the dizziness and nausea on about days 3 & 4 for periods of about 5 hours. I rang my GP to ask what she recommended I could take for the nausea and she said she thought I was tapering too quickly for me.

My question is, do these (relatively) mild withdrawal symptoms mean I am tapering too quickly if I am not having psychological symptoms of anxiety or depression (which I was originally prescribed duloxetine for)?

My next step down is to take increase the frequency of the dropped doses by one day. If I am getting symptoms at this stage will they get worse when I am taking 20mg every 4 days?

I am concerned not to waste time like I did last year, when I tapered far too quickly under bad advice, straight down from 60 to 40, and got quite poorly and had a lot of psych symptoms, and had to go back up and stabilise before tapering more slowly. Nevertheless I got down to 30mg from 60 in about 5 months, whereas the schedule I have this time is for 8 months.

Any comments? I'd like to be on a lower dose ASAP, I feel much more myself since the last drop.

Thanks

#2 sarah

sarah

    Member

  • Members
  • PipPip
  • 16 posts
  • LocationColorado
  • why_joining:
    I am in the process of getting of Cymbalta

Posted 22 July 2010 - 09:49 AM

Hello Lily,

I've never heard of a tapering schedule like the one you're on. From all the information I've gathered from here and from my doctor, the half-life of Cymbalta is much shorter than for many other drugs. This means that it's out of your system very quickly, which is why the advice that some doctors give to take a dose 'every other day' while tapering is not considered good advice. (Your body gets rid of the Cymbalta and you begin to go through withdrawal, only to take your next dose and reintroduce the drug into your system- it's like a rollercoaster as the amount of Cymbalta in your system jumps back & forth and you go through mini withdrawals every other day...)

That said, there is so much unknown about the tapering process of Cymbalta, so who am I to say that the approach your GP has suggested is incorrect? Though it doesn't make sense scientifically, neither does the fact that my symptoms don't hit until day 6 after dropping a dose, or that any of us are having the trouble we are getting off this stuff in the first place!

If you did want to try a more agreed-upon approach, it seems that most people feel the best method for a slow taper is to reduce the daily dose by about 10% of the current dose you're on, and then stick to that dose until you no longer feel symptoms of withdrawal before moving on to another drop. This means you'll have to be creative by splitting pills, counting beads, etc, but it gives you much greater control over the dosage you're taking every day.

I can sympathize with your desire to get off of this drug as quickly as possible, but in the long run it makes sense to take your time and do what you find works best for you. Personally, I find the psychological symptoms much worse than the physical ones, so if I found a way that eliminated the psychological symptoms I'd stick with it!

Good luck with your progress and definitely read through this site to see where you might find people have very similar experiences who you can connect with, and learn from.

Best,

Sarah

#3 Lily

Lily

    Member

  • Members
  • PipPip
  • 10 posts
  • why_joining:
    I came down from 60mg to 30mg last year over a period of about 5 months. Now I'm coming down from 30 to 20 and looking for other people's advice and experiences

Posted 22 July 2010 - 11:00 AM

Thank you Sarah, I thought it must be an odd one cos no one seemed to know what to say! Thought I'd set a real stumper!

I was confused, because I had done some reading here and elsewhere and neither for Cymbalta nor for any other SSRIs or SSNRIs could I find any evidence for my schedule. I think it does seem odd to take a drop of 33.3% (especialy of a short half-life drug) and spend 4 days recovering, thereby not allowing my body to really get used to a new dose or being able to assess the effects. I am also prone to getting w/d effects if I am even a few hours late taking my pills, so I would rather give it a bit of stability!

I will take the general advice of a 10% drop and I think I will allow myself to stabilise on that for a month each time, just to be sure.

I have been having some psych symptoms now, depression yesterday (a 20mg day) and a bit today and a lot of irritability, which I woud like to minimise as my boyfriend just can't cope with it and the consequential guilt and further irritation are not something I want to repeat, I threw the Yellow Pages at his head last year! Can't stand even having to repeat myself, or to be interrupted or made to jump! I would like things to be more consistent and I think an only-slightly-lower everyday dose would be the best way to achieve that.

Thanks again, I can't tell you how much of a relief it is, I get so confused as well!

#4 sarah

sarah

    Member

  • Members
  • PipPip
  • 16 posts
  • LocationColorado
  • why_joining:
    I am in the process of getting of Cymbalta

Posted 22 July 2010 - 12:05 PM

Thank you Sarah, I thought it must be an odd one cos no one seemed to know what to say! Thought I'd set a real stumper!

I was confused, because I had done some reading here and elsewhere and neither for Cymbalta nor for any other SSRIs or SSNRIs could I find any evidence for my schedule. I think it does seem odd to take a drop of 33.3% (especialy of a short half-life drug) and spend 4 days recovering, thereby not allowing my body to really get used to a new dose or being able to assess the effects. I am also prone to getting w/d effects if I am even a few hours late taking my pills, so I would rather give it a bit of stability!

I will take the general advice of a 10% drop and I think I will allow myself to stabilise on that for a month each time, just to be sure.

I have been having some psych symptoms now, depression yesterday (a 20mg day) and a bit today and a lot of irritability, which I woud like to minimise as my boyfriend just can't cope with it and the consequential guilt and further irritation are not something I want to repeat, I threw the Yellow Pages at his head last year! Can't stand even having to repeat myself, or to be interrupted or made to jump! I would like things to be more consistent and I think an only-slightly-lower everyday dose would be the best way to achieve that.

Thanks again, I can't tell you how much of a relief it is, I get so confused as well!

Hi Lily,

It's also good to recognize your triggers, which it seems like you do. I've noticed that I get super irritated when I can't find things and also when things are messy. I suppose it has something to do with the feeling of not being in control, but it's awful! I get frustrated and have to watch myself so I don't throw a tantrum! It just feels that my fuse is so much shorter while going through this withdrawal process. And it's not only triggers like misplaced keys or my boyfriend leaving coffee grounds in the sink- I find that my PMS is exaggerated ridiculously, and I am much more sensitive to sugar and caffeine... I try to use up some of the nervous energy by going for runs which can definitely help. Plus I've switched to green tea rather than coffee and I try to steer away from sugar if I have the discipline to do so... (which is easier after a few days of avoiding it- I find that a few sweets whet my appetite for more and then I'm constantly craving them!)

I think you're smart to rethink your tapering approach. You may find that you can make larger steps down than the 10%, or that can take the steps more frequently than every month- Everybody's different and I think this experience is forcing a lot of us to really try to listen to our bodies and minds in a way that we often don't. Finding an approach that works for you won't only help to minimize the symptoms, but could help give you a sense that you are not just a victim in this situation, and that you've managed to gain some control!

Good luck with your new approach- I would talk to your doctor about what you're doing to make sure that she knows your plan and so she can support you with it.

Keep us posted!

Best,

Sarah



0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users