17 replies to this topic

[brzghoff]

when folks talk about how long it takes to get off cymbalta, are they talking about the time they spent  tapering off, the amount of time for symptoms of withdrawal to go away during and after the taper - or just after going off in full?

 

i have a diagnosis of bipolar disorder. i take 200 mgs of lamictal and am weaning off cymbalta. for me, the major side effects of taking cymbalta since 2004 are high blood pressure and an inability for me to empty my bladder, which means lots of infections and constant blood in my urine. in the past when i have forgotten to take it, the withdrawal kicks in about 2-4 hours later. after 6 hours i would be too sick to work. fortunately i have a great husband who would rush my meds out to me if i didn't have spares stashed in my desk drawer. i have been through almost ten years of rational behavioral therapy and recognize the thought patterns that have perpetuated depression. as a result, i don't think i need cymbalta and don't want to take it anymore.

 

i decided to get off this stuff. my p-doc is totally cool with my taper strategy. however, he thinks i'll always have to be on lamictal or some type of mood stabilizer for life. i used to be on depakote and gained 30 pounds. i lost all that within 6 months of switching to lamictal. 

 

i was on 90 mgs of cymbalta for about 8 years. last year i went down to 60 and went further down to 30 in the fall of 2013. in march of this year i started doing 30 mgs every other day. so far so good, certainly some discomfort - mostly fluish symptoms. about four weeks ago i began splitting open the 30 mg caps and swallowing half the "beads" and putting the other half back in the caps, which i would take two days later, effectively 15 mgs every other day. thats when the trouble started. my primary withdrawal symptom is severe anxiety. it is mentally paralyzing. the fear is disabling. i have the crawling skin symptoms in my legs - its as though razors are shredding my shins - i don't feel pain just a sensation, hard to describe but i think many of you "get it". its dreadful. i have a hard time focusing. i don't hear people talking to me. my short term memory is shot. i am constantly distracted and can't hold a thought. i can't find the right word and forget what i am talking about in midsentence. for me no brain zaps, although for the ten years i've been on the drug its not uncommon to get "jolts" throughout my body - usually as i fall asleep. mostly annoying, not painful. wakes up my husband when my body jerks. 

 

i don't have the luxury of "counting beads" - i don't have enough med to waste it like that and my new insurance won't cover cymbalta so i can't have extra to pour out a few more beads each day - hence i eyeball a half and half split. i've got enough to do 15 mgs every other day til mid june. then i'm out. i would not have been able to get this far if i was employed, so thank god for that.  given the level and length of my taper i am curious as to what will happen when i step off completely. is that when all hell breaks loose? i fel like it already has, s when i see posts about what people are going through after "x" number of days off cymbalta i wonder if they mean after they did a taper or if it was from going cold turkey?

 

i've wondered about benadryl, knowing its chemical makeup is similar to early antidepressants - and then i saw references to it here. i'm gonna take some tonight before bed. don't like the drowsy but its better than having a 24 hour panic attack. i can't do the prozac assist therapy - a big no no for bipolar folk. i've found that doing yardwork  in the heat actually helps a lot. as soon as i walk inside and start to cool down and relax, the fear and anxiety come right back. very strange.

 

i guess my big question is... will the next step down be any tougher than the step from 30 every other day to 15 every other day?

[thismoment]

Hi Brzghoff

Welcome!

The time off Cymbalta means the time since your last dosing, whether that was a 60 mg capsule or just 2 beads.

Tapering off regimens vary a lot, and some are clearly better (fewer and/or weaker side effects) than others.

We here (and the manufacturer Eli Lilly) recommend a slow and gradual taper with NO STEPS or interruptions. A stepped method like 15 mg every other day (as you are doing) will bounce you in and out of withdrawal due to the short half-life of duloxetine (12hrs). It could make for an unnecessary and unpleasant ride, compared to a gradual gently sloped taper.

Regarding bead counting, no beads are wasted. Here's an example of a slow, gently sloped tapering off regimen:
EXAMPLE- let's say your 30 mg capsule contains 180 beads. You plan a slow taper over 90 days. 180 beads divided by 90 days is 2 beads per day (2 additional beads taken out each day). You will need 45 capsules of 30 mg capsules, and 45 empty gel caps (get them at a pharmacy or health food store) to cover the 90 days. Also pick up 45 little envelopes, each to hold a capsule.

Day one take out 2 beads from a full capsule- swallow the capsule and put the 2 beads in an empty gel cap and into an envelope labelled "DAY 90". Day two take out 4 beads from a full capsule- swallow the capsule and put the 4 beads into an empty gel cap and into an envelope labelled "DAY 89". Day three take out 6 beads from a full capsule and swallow the capsule- put the 6 beads into an empty gel cap and into an envelope labelled "DAY 88", and so on. No waste.

Should symptoms get rough, stop reducing for a few days and stay at the last dosage until you stabilize, then continue counting beads. On DAY 90 the capsule has just 2 beads and you're done. There will still be some weeks of annoying side effects, but nowhere near as acute as the cold turkey or step-down methods.

Your symptoms sound pretty standard.

If you go to a slow taper the anxiety should diminish. You may also consider a benzodiazepine to have as a standby AS NEEDED for anxiety.

You're active, you have support, and you sound determined; you can do this!

Best wishes!

[gail]

Hello Brzghoff,

 

Thismoment has given you the best advice. It is the best way to do it. You've come a long way, from 90 to 30 with little discomfort.

 

Remember, beads are to be swallowed in a capsule. Be gentle to yourself, go back to 30 and start the bead counting.

 

And, yes, for anxiety, dont hesitate for a benzo. I could not have done it without it.

 

Dont hesitate to visit us anytime you have a question or simply to say hello, a lot of experienced and loving people here who have walked the walk.

[FiveNotions]

Welcome, Brzghoff! I'm glad you found us!

 

The jolts/zaps are a common withdrawal effect .... as are the skin/muscle tingling and burning sensations ... one thing that helped me was chelated magnesium, as well as taking hot baths with Epsom salts....

 

Also, are you taking any vitamins or supplements? (see the "nutritional support" and "what's helping me" forums) .... vitamins, b-complex, chelated magnesium and omega 3 are a good basic group to take ....

 

I'm not sure if I read your message correctly, but it sounds like you might be swallowing the beads themselves, without having them in a capsule....if so, not a good thing to do .... get some empty gel caps at the health food store and put them in one of those before you swallow them .... you can also portion out the beads more accurately and reduce any wastage that way ....

 

Keep us posted, it sounds like you've got a solid plan!

[brzghoff]

thanks to all of you for your quick responses and support. i sure wish i had found this place a couple months ago i think i am too far gone to get much out of the bead counting strategy, although that sounds like a real winner. i only have four 30 mg caps left. i think that will carry me to may 30 on my current strategy. since my insurance won't cover cymbalta/duloxetine -  nope, not even generic - i am pretty well tapped out. i was shocked when i learned the generic was still over $200 for a 30 day supply. i understand that only one manufacturer is allowed to make the generic for the first 6 months - and it will still take a little while longer for the marketplace to determine the final cost even after the competition from additional manufacturers kicks in. my p-doc doesn't get samples anymore due to the generic status. i left my job for a number of reasons, but getting off cymbalta was high on the list. i knew i couldn't do it employed.

 

i think i am somewhat fortunate in that the lamictal (actually the generic lamotrigine, just easier to spell) helps moderate the withdrawal symptoms, which is why i felt very minor impact once i started the every other day therapy with 30 mg. even when i stepped it down to ~15 mg every other day, it took a week for the rough stuff to kick in.  yes, i figured that its better to keep the beads in the cap for a more even absorption but didn't know i could get empty ones at the drug store. it made me realize i can empty out the beads in benadryl or some other OTC capsule i have around the house and use that cap. what is interesting though is that my best days are the "capless" bead days, 2nd best are the the no med days after the capless bead day. the worst is the day i take the other half still in the cap. that's today. however its been mostly physical symptoms tody, sometimes its the head, other days its the body. the best i felt today was when we rode our bikes to the polls to vote - special referendum.

 

as with every day, doing something physical is the best thing i've found if i can overcome the morning resistance to doing anything. as a result the yard is looking pretty good! i take a good B complex suppliment as well as vitamin C and liquid calcium with vitamin D and magnesium in it. i'm a little concered about overdoing the mag - due to its laxative effect. withdrawal already means "the runs". lost ten pounds in two months. not too much of a big deal, but i'm 5' 4" and 130 lbs now. i like losing the weight, i could stand to lose 10 more but it seems that was a little fast for my size. omega 3 isn't a bad idea, although i get a lot in my diet naurally.

 

it is just incredible that there is such great support on a web site like this. much appreciation to you all. my husband and i are planning a backbacking trip in a couple weeks up in new england, i'm hoping the exercise benefits will keep my symptoms to a minimum. and if i see a bear, i'd have an anxiety attack anyway ;-) i'll let you know what happens when i "step off the cliff" and keep lurking around in case i can offer someone else support as you all ahve shown me

 

much gratitude

[FiveNotions]

Holy Crapalta, you're in withdrawal and you can ride a bike! And you're planning on going hiking/camping! How wonderful!

 

When I was at your point in time in withdrawal I was pretty much bed-bound, living on broth and tea, and suffering vertigo and brain zaps beyond description....my Parish priest friend actually came twice in the same month to give me the sacrament of the sick, formerly known as "Last Rites"...and boy, I sure felt like I was dying ...

 

You must not be an "old fart" like me .... which makes it even more wonderful that you're getting off the poison now...

[brzghoff]

wow! five notions, that sounds really rough. i am sorry to hear what a struggle that was.  last rites???? 

 

i have to really make myself do some activities, depending on the day.  if i had climbed on the bike and my head started spinning - which happens - i would have climbed off, looked at my husband and say "you drive". i am happy to have made the decision to get off "the C" - i've been on it for ten years now, that's way too long. i've been on one SSRI/SSNRI since 1996 and i am afraid  that i might discover i've suffered some permanent brain damage as a result. however i don't want to project something about which i know nothing. hence, my decision that its okay to plan a backpacking trip. if it ends up being too much to take up, we'll have a plan B - like car camping which i think i can handle no matter what.  i guess we'll find out ;-) the fear and anxiety is the worst part i and i pace a lot when i let it get out of control. hiking/backpacking is a lot like pacing, except you keep going in one direction ;-) 

[brzghoff]

to amend my post above, i meant to say, i've been on one anti depressant or another since 1996. 

[brzghoff]

 

today i am sick sick sick. all physical not mental. i have the runs and am weak and washed out. the worst part, i am having to scramble to finish getting the car packed for our trip north. we leave tomorrow at 0 dark thirty.... and my husband has invited his cousin and his wife to stay in our house while we're gone. the place is a wreck. so i'm mopping, dusting, vacuuming all day. my husband is teaching today so i am on my own to get this done. its not that he hasn't done his part, he's been doing stuff left and right in and around his work schedule - he's been all the he-man stuff done, like fixing an underground pipe, ripping out rotten steps on the porch and replacing the decking, mowing mowing mowing (we live on acreage there is  a lot to do).

 

just venting - thanks for being here. back to work.

[FiveNotions]

Whoa, brzghoff!

Slow down, immediately......and stop with the crazily activity level....

This is just family ...a cousin and his wife.... no perfect housekeeping required or even needed.... give them clean sheets and towels....at the most, change the bed linens for them.... Oh yeah....flush the toilet ("floaters" really are a "no-no") ....

You are sick...genuinely ill.....tell them that you are just not feeling well...no need even to tell them why....and just say that you haven't been able to do all you'd normally do to prepare.....

Hand them a dust cloth and the Pledge and let them dust the place themselves.....I doubt they even care....

Take a nap if you can...or just sit still with a cup of tea....

Throw a few things in the car....let your husband help you....this is a vacation, not a Death March.....and why start at zero dark thirty? What's wrong with getting a good night's sleep, driving as far as you can in a reasonable amount of time, staying overnight on the road and arriving the next day.....rested and relaxed rather than at each other's throats and exhausted....

Again, not a death march....stop whistling "bridge over the river Kwai" and start humming "why worry, be happy"!

[fishinghat]

FN is right. This is very destructive to yoour withdrawal. If they love you they will understand what you are going through. There is an old German saying....You have to make yourself happy to be able to make someone else happy. Please take care of yourself.

[brzghoff]

hey there,

 

thanks again for all your support and guidance. you all are right about not pushing myself. as of now, its all good. i hung low for awhile on thursday, felt a bit better towards the end of the day and paced myself, not worrying about cleaning every detail. 0 dark thirty became 9 am and i felt much better as a result. as a matter of fact i have now gone two days in a row without the c'balta and am doing well. my energy and clarity are good! of course, one day at a time and i am not setting expectations that tomorrow will be the same or different - just gonna let happen what happens and go from there. i have 3 30's left and prepared to use them if needed. i got some empty caps to do the split without swallowing beads w/out a cap. the road trip went very well. rhododendrens and azaleas are in bloom. won't take off to new england for another week. that's when we plan to do the back packing trip - but again, only if it feels like i can handle it.

[FiveNotions]

Good plan, brzghoff!

Take it slow and easy....even keel....and have a wonderful trip!

I'm so glad you checked back in to let us know you're ok!

[brzghoff]

i've been under the radar on this board but the struggle continues. big changes to plans. circumstances have all but derailed our trip further north. as is often the case in renovations, unforseen problems are keeping us here until we drive back home. the scenery is lovely - short range mountain views of peaceful pastureland and long range mountain views. at night the fireflies are so brilliant and plentiful. and me? im falling apart. its been two weeks since i went totaly cymbalta free. ittle things totally stress me ot and i think everything is hopeless. i really feel sorry for my husband.

 

there have been some very good days followed by very bad ones. i think the ne thing that helps more than naything else is getting involved in serious exercise - not getting overheated, but mowing the lawn, biking, hiking and tilling and raking bare soil and planting grass seed

well thats it for now

[Kat1523]

Hang in there! Take it one day at a time!

[FiveNotions]

So happy to hear from you, brzghoff!

That bungalow sounds like my dream house....

Just think of the mud slick in the yard as a little bit of Woodstock ....sorry, I'm "dating" myself..... Hehe

[brzghoff]

just saw this... only 3 weeks late ;-)

 

yeah, i should have been singing "Long Time Gone" while sliding through the mud. i absolutely love the film, sound track and era of music. i was only 9 when the festival ocurred. now my daughter, son in law and family live about 20 minutes from there. 

[buntbean2]

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