21 replies to this topic

[rootbeer]

Hello, thanks for this forum. I've been reading a lot about cymbalta withdrawal and finding it all very difficult and a bit confusing.

I'm a 26 year old woman. I was on 20mg of cymbalta for around six months, prescribed for depression, when I felt it was time to try living without antidepressants (had been on citalopram for several years prior) and my doctor advised me to take it every second day, then every third. It has been around three weeks of taking it every third day and I'm finding it very difficult. Constant mood swings, insomnia old anxieties rising to the surface, finding it very difficult to get out of the house, etc. Can anyone tell me if this strategy of every third day (then whatever the doctor advises next) is a good idea? Has anyone done this and had it work or is there a reason it won't, or should I try capsule splitting?

Thanks.

[truckprincess]

There is a post on here where someone did the same thing and it worked for them. I can't remember the title of the post or how long this person had been on it but seemed to have milder side effects. If you can't tolerate the every 3 days try going back to every 2 days for a couple of weeks then try again and see if it helps or not. It's different for everyone on what works and what doesn't. You almost have to play around with it a bit. My doctor told me to alternate the 60mg/30mg every other day for a week, then take 30mg for a week, then take the 30 every other day then just quit. Based on history I on my own decided I would do the 60/30 alternating for two weeks instead of one. Once I tried to do just the 30mg I couldn't handle it. Then I tried taking out 7 beads a day as someone suggested. Once I got to a certain amount I couldn't do that either. So I went back to my reg dose for a few days and thought I would try just taking out 10 beads of the 60 for a week and work my way down each week. But tonight I decided I would try the 30mg dose to see how I do. Good luck and keep us posted!

[windupbird]

Hello, thanks for this forum. I've been reading a lot about cymbalta withdrawal and finding it all very difficult and a bit confusing.

I'm a 26 year old woman. I was on 20mg of cymbalta for around six months, prescribed for depression, when I felt it was time to try living without antidepressants (had been on citalopram for several years prior) and my doctor advised me to take it every second day, then every third. It has been around three weeks of taking it every third day and I'm finding it very difficult. Constant mood swings, insomnia old anxieties rising to the surface, finding it very difficult to get out of the house, etc. Can anyone tell me if this strategy of every third day (then whatever the doctor advises next) is a good idea? Has anyone done this and had it work or is there a reason it won't, or should I try capsule splitting?

Thanks.

You were on 20mg thats it? The recommended dose for depression is 60mg. Just quit cold turkey. Forget the every other day things as thats probably making it worse. I went from taken 60mg for 8months to nothing and felt really dizzy for a week and then I was fine.

[rootbeer]

You were on 20mg thats it? The recommended dose for depression is 60mg. Just quit cold turkey. Forget the every other day things as thats probably making it worse. I went from taken 60mg for 8months to nothing and felt really dizzy for a week and then I was fine.

I was previously on 60mg of Celexa. The Cymbalta I intended to take to the therapeutic dosage but felt fine on 20mg which made me realise I wouldn't up it from the starting dosage and I'd like to try going without anti depressants for a while.

I've decided to take the 20mg daily for a couple of weeks again (it has been a relief just taking it like this two days in a row after the few weeks of skipping hell) and will reduce by ten beads or so every week until I'm off.

[shotzy]

Cymbalta caps have some fillers in them correct, when one removes beads, how do you know if they are Rx or filler?

[thismoment]

Shotzy- I did read about that on the net, but I could only find speculative notes about it. Nothing from Eli Lilly I could find. Do you have anything definitive on it as it would be good to know.  Thank you.

[sk8mom]

Hi

What do you mean by filler ?  does it means some beads have nothing in them and some are Cymbalta ?  Why would they put fillers ???

[Heartfeathers]

You CANNOT take cymbalta every other day!!  The half life is way too short and you will be thrown into continual cold turkey withdrawals!  The ONLY safe way to get off of this poison is to wean slowly!   Look up "bead counting".   

[equuswoman]

What is sad is that physicians tell us to do it like that...I found out the hard way that it can't be done!

Thank God I found t his forum and learned about bead counting. When I was scanning the topic list and saw "bead counting" I thought WTH is 'bead counting' having never opened a Cymbalta capsule before. But I read about it and decided it was the ONLY way to get off this stuff. That is what I am doing now and it is a very very slow go in my case but I will make it 'til the end, I have 2.

Thanks to everyone here who has assisted me in my bead counting, given me encouragement etc.

May God bless you all!

Much love & prayers,

TheEquusWoman

[equuswoman]

gosh now 'fillers' to be concerned about,

good golly, what next?!?!?!

thx U Eli Lilly~ NOT    

[Ape]

What are the fillers?

[thismoment]

I found nothing definitive on fillers (beads that don't contain the drug). Therefore I don't think about it.

 

It would be nice if every fourth bead was chocolate, though.

[equuswoman]

I found nothing definitive on fillers (beads that don't contain the drug). Therefore I don't think about it.

 

It would be nice if every fourth bead was chocolate, though.

 

hum, chocolate YUM...I so LOVE that stuff!

[AaronSD]

I found nothing definitive on fillers (beads that don't contain the drug). Therefore I don't think about it.

 

It would be nice if every fourth bead was chocolate, though.

Although I don't know 100% for sure because I never worked in a drug formulation dept. (worked in pharma drug discovery, basic R&D), the filler should be in each individual bead mixed with the cymbalta.  Each bead is likely composed of cymbalta mixed with filler and a substance (or substances) which affect the drug release rate (because it's an extended release formulation).  Sometimes beads in capsules are coated as well.  There is no rationale that I can think of for having beads that are just filler, but formulations is a complex science and I am by no means an expert in that field.  If there are beads that are just filler, however, bead counting is probably not a good idea.

[AaronSD]

Although I don't know 100% for sure because I never worked in a drug formulation dept. (worked in pharma drug discovery, basic R&D), the filler should be in each individual bead mixed with the cymbalta.  Each bead is likely composed of cymbalta mixed with filler and a substance (or substances) which affect the drug release rate (because it's an extended release formulation).  Sometimes beads in capsules are coated as well.  There is no rationale that I can think of for having beads that are just filler, but formulations is a complex science and I am by no means an expert in that field.  If there are beads that are just filler, however, bead counting is probably not a good idea.

 

Correction...cymbalta is a delayed release formulation (DR) not extended release (ER) one.  Here is the abstract of the patent covering formulation:

 

"A duloxetine pellet formulation comprises: (i) a core including a desired amount of duloxetine; (ii) an enteric coating comprising hydroxypropylmethylcellulose phthalate (HPMCP) as an enteric polymer; and, optionally, (iii) a separating layer located between the core and the enteric coating, the separating layer including polyvinyl alcohol and a low molecular weight hydroxypropylmethylcellulose (HPMC)."

Read more: http://www.faqs.org/...5#ixzz2oBE6pEn9

 

Enteric coating implies delayed release by the way.

[fishinghat]

Well the more I read about eli lilley and cymbalta the more confused I become. This description IS for a DR pellet BUT Cymbalta is not a pellet. This same description may be found for Prozac and Zoloft which are pellets . Pellets are hard solid medicine sometimes with multiple layers (as you described) but Cymbalta is a capsule. I am going to check something out!!

[fishinghat]

First of a;; I am surprised to see the Eli Lilley website has totally changed and all info was expressed in a Kindle format. The Cymbalta.com website is gone and only the generic Eli Lilley website pops up.

[fishinghat]

The hard copy PDR sheets refer to it as a delayed release capsule with  "an opaque green body and opaque blue end". I am wondering if the pellet form is how it was first made in the 80's and was switched to a capsule later. I am going to do some more digging later.

[fishinghat]

Well I finally found this info which I think explains my confusion (and I am probablt the only one confused, lol).

 

"Each capsule contains enteric-coated pellets of 22.4, 33.7, or 67.3 mg of duloxetine hydrochloride equivalent to 20, 30, or 60 mg of duloxetine, respectively. These enteric-coated pellets are designed to prevent degradation of the drug in the acidic environment of the stomach. Inactive ingredients include FD&C Blue No. 2, gelatin, hypromellose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate. The 20 and 60 mg capsules also contain iron oxide yellow."

 

So the enteric coated pellets are pertaining to the little beads inside. It is interesting to note a couple things. First, you are getting a slightly greater dose than on the label (a 60 mg is actually 67.3 mg). This is supposedly to compensate for what is not absorbed by the body.

 

Secondly, note that the inactive ingredients list sucrose and sugar spheres which are sugars and I beleive that hypromellose is also a sugar if I remember right. At one time a long time ago I spent sevveral days searching the web for the number of calories in each med I was taking. It came out to be over 500 calories a day!! Many tablets not only contain sugars but are made with rice, potato or other starches (binders). That just makes it a little harder to control weight. Anyway that is probably worthless info but what the heck. Off to church I go. May all my freinds have a great day.

[AaronSD]

Well I finally found this info which I think explains my confusion (and I am probablt the only one confused, lol).

 

"Each capsule contains enteric-coated pellets of 22.4, 33.7, or 67.3 mg of duloxetine hydrochloride equivalent to 20, 30, or 60 mg of duloxetine, respectively. These enteric-coated pellets are designed to prevent degradation of the drug in the acidic environment of the stomach. Inactive ingredients include FD&C Blue No. 2, gelatin, hypromellose, hydroxypropyl methylcellulose acetate succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate. The 20 and 60 mg capsules also contain iron oxide yellow."

 

So the enteric coated pellets are pertaining to the little beads inside. It is interesting to note a couple things. First, you are getting a slightly greater dose than on the label (a 60 mg is actually 67.3 mg). This is supposedly to compensate for what is not absorbed by the body.

 

Secondly, note that the inactive ingredients list sucrose and sugar spheres which are sugars and I beleive that hypromellose is also a sugar if I remember right. At one time a long time ago I spent sevveral days searching the web for the number of calories in each med I was taking. It came out to be over 500 calories a day!! Many tablets not only contain sugars but are made with rice, potato or other starches (binders). That just makes it a little harder to control weight. Anyway that is probably worthless info but what the heck. Off to church I go. May all my freinds have a great day.

 

The extra mg (7.3 mg for the 60 mg dose) is due to the presence of salt in the formulation (usually referred to as the "salt form"), which in this case is HCl (i.e. hydrochloride).  Thus 67.3 mg duloxetine HCl is equivalent to 60 mg duloxetine (i.e. active drug molecules) and 7.3 mg HCl (i.e. hydrogen and chlorine atoms that are associated with the duloxetine molecules).  One of a list of several salts may be included in a drug formulation.

 

From http://www.spectrosc...date=&pageID=3:

 

"The selection of an appropriate salt form for a potential drug candidate is an opportunity to modulate its characteristics to improve bioavailability, stability, manufacturability, and patient compliance."

[fishinghat]

You are completely right AaronSD. Good catch!!!