11 replies to this topic

[jessielee]

Hello,

I started this topic telling my back story of depression & my Cymbalta history, but then I realized, you are suffering, you don't want to read about more suffering, you just want HELP!

I want to try to help. I am not a doctor or pharmacist, although I have consulted many through my trials, as well as read many books & consider myself very educated in this subject. In the past 6 years or so, I have tried to free myself of Cymbalta unsuccessfully, but here I sit, finally Cymbalta-free and with very little to no withdrawal effects. I don't lie about this, this is gospel.

I am what they call a "poor" metabolizer, meaning that I don't need a high dose at all to feel the effects of a drug, so I never got higher than 30 mg in the whole time I took Cymbalta, so keep that in mind.

I had been halving 60 mg capsules for years because it saved me another $130 every other month. I would halve them just by eyeballing it, but when I finally decided to begin weaning off Cymbalta completely, I started to count granules. Now, counting granules is no small feat--you have to set aside time, have decent eyesight or a strong pair of magnifying glasses & feel ok looking kind of like you are conducting a major drug operation. But this is your health, people.

According to my cousin who holds a doctorates in pharmacy, there is an acknowledged and acceptable variation in the amount of granules from capsule to capsule. Say one 30 mg capsule contains 155 granules (this is just a random number). Another 30 mg capsule from the same bottle could contain 145 granules or even 162. So even while maintaining a normal dose, you are going to have variations in granule amounts from day to day anyway, and hardly notice a thing.

While we all kind of hate on Cymbalta on this forum, it is here that I want to express my gratitude that Cymbalta is in granule form! Had it been a tablet, I would probably still be on it. And while Cymbalta did what it needed to do for me, it was time for us to part ways.

Anyway, here is how I did it & I know that you can, too.

1. You will have to do this slowly, over the course of a few months.

2. I suppose one should contact their doctor regarding this tapering, but from what I've read & experienced firsthand, many such doctors are hesitant & suspicious when the patient tries to take control of their own dosing. If your doctor is like this, try to get another doctor! You should be respected by your physician, not condescended to. In my case, I started my gentle tapering and was well into it when I had a normally scheduled appointment in which I informed my doctor as to what I was in the midst of. She fully supported it and was interested in hearing about how I did. She had also rarely or almost never heard of someone taking the time to count granules, which I think everyone should know about!.

3. You will need a bag of empty capsules, which you can get from a health food store or probably a head shop, but you'll look and feel less suspicious getting them from a health food store. You will also need a good light, a pair of reading glasses if your eyesight is poor, and, this is important, a bead mat or soft crafting mat. It is basically a small piece of soft blanketing material. You can get them at bead stores or likely any hobby store such as Michael's or Hobby Lobby. This is very important so that the granules don't pop about and scatter. A normal hand towel will not do, & neither will a paper towel. You will also need a business card or some such sturdy paper card to count out the granules. Probably also a notepad to keep tally.

4. THIS IS VERY IMPORTANT! Make sure the pills you are using to wean from are all of the same dose! Halfway through my taper, I received a sample bottle of 30 mg pills, whose granules were significantly smaller than those of my typical 60 mg capsules I had been using to taper. I consulted my cousin the pharmacist and he provided me with an equation in which I had to solve for X. I got the equation all wrong (no surprise there) and ended up taking a dose that made me feel super duper weird. So I just trashed those 30 mg and went back to tapering from the 60 mg capsules.

*I apologize here for not providing the exact #s of granules in my explanation. I did not keep a tally of the granule amounts & whatever I did write down as a little reminder to myself, I have since thrown out.

5. Now I wasn't so very painstaking at the beginning of my taper. I went from halving 60 mg capsules by eyeballing the amount poured inside the empty gelatin capsules, to then counting out the amount in thirds. I did this by emptying a 60 mg capsule onto the bead mat, counting out the granules & then dividing them into thirds. This was the first start of my taper, and I took 1/3 of 60 mg a day for about 2 months. I felt a little different, but not anything terrible and after about a week or so into the aforementioned 2 months, I felt completely fine and adjusted to the lower dose. If you feel too "off" and this taper is too quick, then perhaps another method that I describe later, that I used at the very very end of my taper, will work for you. Anyhow, after those 2 months, I decided I was doing well and wanted to taper even further.

6. As an aside, I think the reason this time I was able to get off Cymbalta with any success as opposed to times in the past, is due not only to the nature of the sloooow taper, but also to the fact that I made many changes in my lifestyle. I am not a preachy person at all, BUT I BELIEVE THIS IS VITAL. It is my belief that the medication, even if it works wonders for you, is not addressing much deeper issues that are likely contributing greatly to the initial problems of anxiety and depression. For me, instilling a reliable exercise routine in a not-too-early morning hour each week, as well as ceasing or at least cutting down SIGNIFICANTLY drinking alcohol, journaling and finding a hobby you can throw yourself into, especially one such as gardening/landscaping helped me immeasurably. The quitting drinking was especially important as I found A.) it didn't make sense to be detoxing off one medication while filling my body with toxins from another source and, B.) hangovers were worse/unbearable and brought back nearly all of my anxiety issues. Also, eating healthy foods/juices, taking vitamins (which I will list later), getting PLENTY of water/gatorade and enough sleep are important, as is having support from your significant other/family/friends, etc. If your friends can't accept the fact that you have to cut down/out of drinking because you are trying to get off medication/change your life, then they need to chill. Also, educate yourself and uplift yourself. I found the book, "Anatomy of an Epidemic" by Robert Whitaker to be helpful, also funny movies, spiritual readings/practices, yoga & meditation. In general, be gentle to yourself, respect yourself, reinforce the idea that you are SO STRONG. You have made it through SO MUCH, and you DESERVE a place in this world.

7. OK, back to the taper.
After 2 months of taking 1/3 of 60 mg, I decided to go further. I dumped out a 60 mg capsule, counted the granules, then divided them into fourths (effectively taking 1/2 of 1/2 of 60 mg, so approximately 15 mg.). I did this for another 2 months or so. Again, I felt a bit odd for the first few days of the new taper, but eventually acclimated.

8. After those two months, I decided to go even lower. This is where the granule counting gets painstakingly minute. What I did was count out the 60 mg capsules as I had been into 4ths, making my approximately 15 mg doses. Let's say each 15 mg dose contained 50 granules (again I apologize for not keeping my original tally sheets). For my next taper-down, I removed 10 granules from each capsule. Thus, each dose now contained 40 granules, and I had 40 granules left over from removing 10 granules each from 4 capsules, so I had an additional dose already counted out. But you could even take out 5 granules or 15, whatever taper schedule you feel comfortable with. For me, at this point I was effectively splitting the doses into 1/5th of 60 mg. Now, I had to set aside time and sit and count, but for each sitting and counting session I would get a good few weeks of doses.
Again, I stayed on this dose for about 1 1/2 months.

9. After this, since the amount is so low and dividing the original capsules into 1/5th so painstaking, what I did was then just count out my aforementioned 40 granules from the original 60 mg "mama" pill as a dose. As I said, I did this for about 1 1/2 months. When I was ready for my next taper, I just started taking out 5 granules from that 40 granule dose and decreased every few weeks. To put it another way, at this point I was taking one 35-granule capsule a day. I did this for a few weeks. Then I counted out 30 granules from the "mama" pill & took one 30-granule capsule for a few weeks. I would taper down 5 granules or so every few weeks until I was on the meager dose of one 10-granule capsule a day.

10. At this point, I decided to just get off the Cymbalta completely, because I was taking a dose that was actually nearly nothing & was also the same number of granules that I mentioned before was an acceptable margin of error to be within for pharmaceutical companies.

It has been one week since I stopped taking my miniscule doses completely, and I have to report that I am doing so much better than I expected & that I ever have in the past when I tried to taper too quickly. Of course I have a few side effects but they are very manageable. Vitamins and whole fruit & vegetable juices help immensely, as well as allowing myself to be gentle to myself and give myself what I need such as more sleep. I also am making sure that I stick to my commitments at work and in the world at large, to reinforce the idea that I am a fully functional person, and not someone sitting around waiting for the other shoe to drop.

I was telling my husband that this time in my life feels a bit like when you were learning to ride a bike & someone you trusted was holding on to the back of it as you pedaled. As you picked up speed, that person would let go & there would be those few moments when you were riding by yourself and you didn't know it. The moment you realize that that person is no longer holding onto the back of the bike, you can either panic and fall off or realize that you've been riding the bike successfully by yourself the whole time & you are free to enjoy the ups and downs that come along with it. I feel more equipped this time & ready.

Please be kind and gentle and patient with yourself. You can get off this medication if you want to. Give yourself time & nutrition & respect & forgiveness.

Here are some vitamins & other things that are helping me.

*Standard Process Vitamins: Min-Chex (9/day) & Cataplex G (6/day)
*Life Extension (Brand): Thymic Immune Factors (2-3/day)
*Premier Research Labs (Brand): Max Stress B in liquid form (2 doses of 1/2 tsp./day)

These can be pricey depending on where you get them (I think they are all available on the internet), but compared to the price of Cymbalta, you know...
BTW, I get no compensation from any of this stuff.

*Motion-sickness pills or Benadryl. These help me in the evening times if I start to feel a bit off. I don't have to take them every night, by any means. And I don't think they should be taken together.
*Gatorade and water. Lots.
*Having a bit of sweets here and there. Even just a little Starburst chew intermittently throughout the day helps.

I know this is a long post, but I just wanted to share. I hope it helps someone, somewhere.

All my love to you guys.

[cookie]

Dear JessieLee:

The other day I was thinking exactly the same thing. That it is better that cymbalta comes in granule form than a tablet. I totally agree with you on that granules are better to make a certain dosage.

I have a question for you. I´ve been weaning very slowly from 60mg to 12mg. I´ve had symptoms but they have been “manageable”. Does weaning really guarantee that I am not going to suffer withdrawal once I get to 0mg???? Or withdrawals are going to hit hard anyways once I am off the med???

Totally agree on changes of lifestyle (nutrition and exercise)

Love your story on learning to ride a bike!!!! Due to my severe Depression I think I will need a little support once I quit cymbalta. Do you have any suggestions on alternative medicine/natural alternatives to treat Depression and anxiety???? Are you going to take any other medicine now?? Or are you going to be on your own???

Hugs
cookie

[jessielee]

Hey cookie,

In my humble experience, I haven't been totally withdrawal-symptom free, they've just been very mild compared to what I experienced when I tried to wean more quickly in the past. For example, I haven't experienced any full body lightning-strike force brain zaps or shivers, but every so often I will get a little start. I've learned that being able to accept the fact that things are going to be a bit uncomfortable here and there throughout the day is half the battle. I was always so afraid of feeling any little side-effect because I thought that would signal the return of all my depression and anxiety. But if I just tell myself that things are going to be a bit wonky for a little while, that this phase will pass like so many other phases in my life, then I think I can get through them. Like I said, I'm only 1 week out, but due to the very low dose I was on at the end & the fact that I've read that Cymbalta seems to leave your system quickly, I'm pretty sure it's all out of my system. And I haven't felt any of the huge, scary side-effects I've experienced in the past and have read horror stories about. I'm sure you can tell I'm trying to be optimistic about everything, but I'm also realistic & I don't want to gloss over anything, but in all honesty things have been much more smoother than in the past. Perhaps this is due to things I have learned, perhaps its timing, perhaps it was the slow taper. Or maybe everything all in one. And there is no guarantee I won't have to get back on them at some later time, which is something I would like to avoid, but am not completely opposed to if my mental health and well-being are at risk. The main reason I got off Cymbalta in the first place is because I want to prepare my body for the possibility of having a child, although I know many people who have had healthy children while being on a low dose of medication and I wouldn't judge someone for a moment for that, I just would like to try to be medication-free before my husband and I think about going down that road. As far as suggestions I have, I am big on bibliotherapy seeing as I can't afford actual talk therapy right now! Knowledge is power! There are tons of great books out there with more information than I could ever give; one of my favorites over the years has been "The Chemistry of Joy" by Henry Emmons and Rachel Kranz. If there is any spiritual path you follow, I think reading more books on that would be good. Buddhist texts and guides on meditation are good for me. I think exercise and a good sleep schedule are keys, as well. But I'm not perfect; I'm sitting here eating a pint of Rocky Road Ice Cream. But that's part of treating myself gently right now. If I feel a bit odd and I think a bit of ice cream might help, then I have some!

It sounds like you've already got a good thing going with your tapering off! I wish you luck! Keep me posted if you like; I think these online Cymbalta support groups are great--otherwise we're just kind of thrown out into the ocean without even a hint of support.

-jessielee

[cookie]

Dear JessieLee
I totally agree on your phrase "Knowledge is power!" Thank you for all the advice and please keep in touch, reporting how you feel.
One of my biggest fears is that depression will return when I am off the med. If something guaranteed me that everything I am feeling it´s just withdrawal I wouldn´t mind suffering for a period of time.
It is so exciting that you want to have a baby and I think it´s great that you want to stay healthy.

hugs
Cookie

[jessielee]

Thanks! I know; I'm scared, too. But at least I always know medication is there if I really truly need it...

Thanks for the kind words--I will definitely keep in touch!

-jessielee

[cookie]

Yes, I want to experience how to feel to be off the med, to remember what it feels to be myself, to feel. I totally agree on that we can always go back on medication if we need it.

Keep on posting your progress.
Hugs
Cookie

[jessielee]

Hey Cookie,

Been meaning to check in and write this for some time now. I want to report that I am still Cymbalta-free and doing well! There are ups and downs, but the downs are very very manageable and nothing outside of typical human experience. I am so thankful that there are forums like these and I am so thankful that I finally found a weaning schedule that worked for me. I also have to remark that I think timing has a lot to do with getting off any drug. For me, at least, the time seemed to be right. Just wanted to let you know that so far my story is hopeful! I hope you are doing very well!

Sincerely,

jessica

[cookie]

Dear Jessica:
Thank you so much for writing and giving us hope. I am so glad you are doing fine and that your ups and downs, are nothing outside typical human experience. I am down to 8mg, and it is getting tougher at lower dosages.
How long did it take you after you quit, for your body to get back to balance????
hugs
Cookie

[jessielee]

vannie,

i am glad to hear that you found my post helpful. i agree that cymbalta can be exactly what a person might need at that moment in time; it has its benefits, indeed. i feel fortunate that i was able to wean down successfully. i completely hear you about wanting instant gratification, but with getting off the meds, that is definitely a concept to be abandoned. weaning slowly, for me at least, took the fear and anxiety quotient away because i felt in control and not at the mercy of the drug. and, again, i have to reinforce the idea of being gentle with yourself. if you feel you're tapering too quickly, dial it back a bit until you feel you are ready to proceed. or maybe one can find a good place at a miniscule dose, even if it's just a placebo effect! (i have much faith in the placebo effect, btw. just knowing i can always get back on the medication [even though i completely don't want to] is always a good reinforcement.) all i want to say is that i'm just so glad that these forums exist and that there is a place to have real discussions about this very important issue. also, i gotta reiterate that i am not a doctor nor do i pretend to be one, so please seek medical help if needed!

you can do it!

xoxox - jessielee

[amie815]

I am going to wean myself off Cymbalta the same way....counting granuales. Tonight was the first night. I am on a 30mg dose once a day so tonight I counted the granuales and removed 10% or 20 of them out of 194. (I know slightly more then 10%, but I couldn't remove .6 granuale.) I am hoping to decrease by 20 weekly but it is good to know that if that is too quick I can take it slower and still get off this medication.

[ECMJ]

Jessie
Thank you for posting this it makes me feel better that there is an easier way to go through this. I have been decreasing my dosage for 6 days now and started feeling the effects. My question is. Do you think that it is necessary to use a capsule to take the medication? I have just been counting the beads and taking 10mgs at a time. I was on a 20mg dosage initially so I just cut it in 1/2. I have moments when I feel very confused but mostly sick to my stomach did you feel any of this? I am trying to get off of cymbalta to start a family as well...I'm just so nervous about the side effects and how my job is going to be effected as well.

Thank you for sharing your story and how are you feeling not having been on the meds for a while?

Lisa

Lisa,

I have been wondering the same thing. I am pretty sure that the capsule is just a convenient way to handle the tiny beads and keep them together. The main problem would be to figure out how to count, say 38 beads, and keep them all together so you could take them all at once. Perhaps coating a spoon with a little bit of peanut butter and dropping the granules onto the pb?

Good luck!
Em

[cookie]

Lisa,

I have been wondering the same thing. I am pretty sure that the capsule is just a convenient way to handle the tiny beads and keep them together. The main problem would be to figure out how to count, say 38 beads, and keep them all together so you could take them all at once. Perhaps coating a spoon with a little bit of peanut butter and dropping the granules onto the pb?

Good luck!
Em

ECMJ and Lisa:
I am not a doctor. But have been reading this site for a while, and remember reading of the importance to take the product in its original capsule. It seems that the capsule is not only a convenient way to handle the tiny beads. The capsule protects the beads from acids of the stomach and guarantee they get to the intestine safely. It seems that not all capsules sold in the market are the same, they vary in specifications (moisture content, etc).