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#1 jrudy

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Posted 05 September 2014 - 11:04 AM

Hi,

I'm new to this site in fact this is the first forum i've ever been on. I'm 48. Live in Philadelphia and have been on cymbalta and Lamictal for 5 years, which for me has been very effective. BUT

I don't want to be on it for the rest of my life.

I need a doc, local to me, who can help me get off this stuff. My last Pdoc retired with no recommendations of where to go.

 

I have to say I am nervous about trying to get off. Anyone out there have any recommendations?

 

Best,

Rudy


#2 fishinghat

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Posted 05 September 2014 - 11:15 AM

Welcome to the site jrudy.

 

No doubt about it bead counting is the best method. Bead counting, is where you open the cymbalta capsule each day and remove a few beads, usually 2 or 3. So the first day you remove 3 beads, the next day 6 beads, the next 9 beads etc. This provides for a slow steady withdrawal. If symptoms get too bad you just hold at that dosage for a while until you stabilize. Then start dropping again. Be aware that for most the last few beads give the worse withdrawal. Be prepared to slow down when you get to the very end. Now this is just an example. Some can only remove 1 bead a day and others 7 or 8 beads a day. You will have to play with it a little bit to find what works for you. This doesn't mean you won't have withdrawal but it will be lighter and you will have some control over it. Many of the brands have 200 plus beads inside but some of the generic only have 6 or 7 large pellets. If you find that to be the case just let us know and we have someone who is excellant at figuring out the withdrawal rate for those (ThisMoment).

 

Keep us posted and we hope it is an easy ride for you. 


#3 thismoment

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Posted 05 September 2014 - 11:36 AM

jrudy

Welcome! If the Cymbalta and Lamictal have been "very effective" for you for five years, getting off may open up a new world that is not so pleasant. Staying on might be better than getting off at this point, and you need to research this as much as you can while you are healthy, stable, and cognitively sound.

Withdrawing is as much a part of Informed Consent as starting, and often getting off is as much a crap-shoot as getting on. You have been exposed medium-long term, and the overall consequences associated with withdrawal and discontinuation are directly related to the length of exposure.

Nobody can say how your body will react when you come off, but I understand the desire to withdraw. Being drug-free, however, does not trump quality-of-life.

Consider a slow taper with no gaps or big steps. Let the symptoms be your guide-- if symptoms are unbearable, slow down the weaning and level off until you stabilize. Plan on a weaning regimen spanning approximately one year. If the symptoms are light, you can shorten the length of time as you go.

Bead-counting is pretty standard as a method of tapering the daily dosage. Some extra beads are removed from the capsule each day. There is a difference between brand name and generic. We can discuss that when you decide to withdraw.

Is the Lamictal for bi-polar or seizure?

Take care.

#4 brzghoff

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Posted 05 September 2014 - 11:53 AM

 

Jrudy:

 

i was on the same combo as you, cymbalta and lamictal - for bipolar 2. i weaned off C because i felt i didn't need it any longer, i had some side effects i didn't like, insurance wouldn't cover it or the generic anymore and i felt i was erroneously diagnosed as BP2. many years of therapy opened my eyes, as well as realizing i had a psychiatrist who relies on drug reps to be his advisors. i am still on lamictal and would like to be off it someday as well but for now will focus on the C. been off 16 weeks and am still struggling, although much better than the first 2 1/2 months. so… baby steps. i can wait. 

 

thismoment is right, if you are doing well and aren't having disagreeable side effects, you may want to think twice. however, we all understand if you want off. having a good therapist is also a good idea. i know many people who have taken psych drugs and never had a therapist - not a good idea. 

 

you may have a difficult time, but its not impossible to find a psych who will help you wean off. most think psych drugs are "for life" - if they don't have drugs to prescribe they have no need for you to be a customer. 


#5 TryinginFL

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Posted 06 September 2014 - 11:24 AM

Welcome jrudy!

 

How are you feeling today?  I'm so happy that you have found us - this is a great bunch of caring, supportive people!

 

Have you decided which way to go?

 

Should you decide to get off the C. everyone here offers their support - please keep us posted!

 

Liz :)


#6 jrudy

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Posted 13 September 2014 - 10:25 AM

Thank you for the response.
I am nervous about getting off and maybe I shouldn't but I worry about the long term consequences about that decision and I am in a much better place than I have ever been in my life.
The lamictal is for bipolar and I don't think I want to get off that but I need to figure that out with my psych. Just found a new one.

jrudy
Welcome! If the Cymbalta and Lamictal have been "very effective" for you for five years, getting off may open up a new world that is not so pleasant. Staying on might be better than getting off at this point, and you need to research this as much as you can while you are healthy, stable, and cognitively sound.
Withdrawing is as much a part of Informed Consent as starting, and often getting off is as much a crap-shoot as getting on. You have been exposed medium-long term, and the overall consequences associated with withdrawal and discontinuation are directly related to the length of exposure.
Nobody can say how your body will react when you come off, but I understand the desire to withdraw. Being drug-free, however, does not trump quality-of-life.
Consider a slow taper with no gaps or big steps. Let the symptoms be your guide-- if symptoms are unbearable, slow down the weaning and level off until you stabilize. Plan on a weaning regimen spanning approximately one year. If the symptoms are light, you can shorten the length of time as you go.
Bead-counting is pretty standard as a method of tapering the daily dosage. Some extra beads are removed from the capsule each day. There is a difference between brand name and generic. We can discuss that when you decide to withdraw.
Is the Lamictal for bi-polar or seizure?
Take care.


#7 joecinsf

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Posted 19 September 2014 - 06:35 PM

I have been on 120mg Cymbalta for nearly two years now. My doctor also prescribed Abilify 10mg along with Cymbalta. I had some really good results when I was on this combination therapy. Until recently, by that I mean within the last few months. I have noticed serious lethargy, fatigue, sweating, headaches, depression and almost no sex drive. (FYI the sex drive I did have was not enjoyable). And that’s just what I believe Cymbalta is doing to me.. The Abilify also has it's unmanageable side effects. I researched Abilify and found the same side effects I was experiencing. After telling my psychiatrist, he weaned me off the Abilify. After two months off of Abilify, I told him I wanted to taper Cymbalta. What he suggested was tapering 120mg to 90mg. The first day, I was so miserable. I had all sorts of dark thoughts. I was panicked and restless so much, I could not stand still. I was literally pacing around my apartment. After a day I gave in and took the whole 120mg. I went to see my doctor after this. I told him of my frightful experience. After I told him what I had read on the Cymbalta forums, I realized he had no clue. However, I was convincing enough to get him to write prescriptions for 30mg and 20mg to taper off. I have been on 110mg since September 2. He also advised me to use 2mg of Abilify as I taper. Does this sound right? I have never read anywhere abilify would help with tapering. Can Abilify be a subsitute such as Prozac during tapering?
 
Needless to say, I don’t know what to do from here. The time is coming to reduce 10% and I don’t have any idea how to do it. I tried counting the beads in the 20mg capsules along with using a scale I bought (Gemini-20 portable Milligram Scale that measures 20g x 0.001g). I weighed the capsule and decided to cut its weight in half. I opened the capsule and the beads spilled out all in the tray I had under it. I tried to count them. What a chore! I don’t have the patience to do this. Does anyone have any tips on how to do the weighing and filling easier? Should I use a bigger capsule? I have 60mg and 30mg. How do I figure the correct dosage if I use a bigger pill. In order to drop 10% I need to remove enough beads to equal 99mg. I’m overwhelmed at the precise math. Does anyone know how to do this? I have 20, 30, 60mg pills. I have lost all trust with my math skills, which were never that strong anyway. I’m in dire need of assistance. I know if I just stop taking the 20mg pill, thereby decreasing my dose to 90mg from 110mg could be disastrous for me.
 
Thanks. Any detailed help would be greatly appreciated.

#8 joecinsf

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Posted 19 September 2014 - 06:46 PM

Sorry. I posted this twice and can't find how to delete this duplicate

I have been on 120mg Cymbalta for nearly two years now. My doctor also prescribed Abilify 10mg along with Cymbalta. I had some really good results when I was on this combination therapy. Until recently, by that I mean within the last few months. I have noticed serious lethargy, fatigue, sweating, headaches, depression and almost no sex drive. (FYI the sex drive I did have was not enjoyable). And that’s just what I believe Cymbalta is doing to me.. The Abilify also has it's unmanageable side effects. I researched Abilify and found the same side effects I was experiencing. After telling my psychiatrist, he weaned me off the Abilify. After two months off of Abilify, I told him I wanted to taper Cymbalta. What he suggested was tapering 120mg to 90mg. The first day, I was so miserable. I had all sorts of dark thoughts. I was panicked and restless so much, I could not stand still. I was literally pacing the around my apartment. After a day I gave in and took the whole 120mg. I went to see my doctor after this. I told him of my frightful experience. After I told him what I had read on the Cymbalta forums, I realized he had no clue. However, I was convincing enough to get him to write prescriptions for 30mg and 20mg to taper off. I have been on 110mg since September 2. He also advised me to use 2mg of Abilify as I taper. Does this sound right? I have never read anywhere abilify would help with tapering. Can Abilify be a subsitute such as Prozac during tapering?
 
Needless to say, I don’t know what to do from here. The time is coming to reduce 10% and I don’t have any idea how to do it. I tried counting the beads in the 20mg capsules along with using a scale I bought (Gemini-20 portable Milligram Scale that measures 20g x 0.001g). I weighed the capsule and decided to cut its weight in half. I opened the capsule and the beads spilled out all in the tray I had under it. I tried to count them. What a chore! I don’t have the patience to do this. Does anyone have any tips on how to do the weighing and filling easier? Should I use a bigger capsule? I have 60mg and 30mg. How do I figure the correct dosage if I use a bigger pill. In order to drop 10% I need to remove enough beads to equal 99mg. I’m overwhelmed at the precise math. Does anyone know how to do this? I have 20, 30, 60mg pills. I have lost all trust with my math skills, which were never that strong anyway. I’m in dire need of assistance. I know if I just stop taking the 20mg pill, thereby decreasing my dose to 90mg from 110mg could be disastrous for me.
 
Thanks. Any detailed help would be greatly appreciated. sorry. I posted this twice and can't find how to delete this duplicate

#9 FiveNotions

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Posted 19 September 2014 - 07:02 PM

Hi Joe! Welcome to the forum!

The best approach to get off Cymbalta is bead counting. I can't speak to it, because I'm one of the ones who quit cold turkey ... definitely not the way to do it if you have a choice ... I didn't for insurance reasons...

The others will be arriving soon to great you and to explain the bead counting method.

In the meantime, look at the post by Fishinghat, on September 5th ... further up the page in this thread.

If you're going to use the scale method, I think our member CymSik has done it that way... I'll search the archives to see what I can find and post the link here for you.

I don't know anything about abilify, but we've got members here who do know. They'll be happy to share their knowledge and experiences with you.

Stay here with us, and we'll do everything we can to help you!

#10 TryinginFL

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Posted 19 September 2014 - 07:06 PM

Welcome joecinsf!  We're happy you found us  and have joined our helpful group!

 

When you say "it is time" to reduce again, the ONLY time is when you feel good and stable on the dosage you are currently taking or go up to where you do.  You can begin bead counting when you feel almost no symptoms.  You are currently in "cold turkey" withdrawal just in the jump down from 120 to 90 - that's a big drop!  I did the cold turkey thing from 60 mg to 0 - I DON'T RECOMMEND this method! 

 

You can control your weaning by doing the bead counting which I will let some others on here explain to you. I wish I could have had the knowledge before I found this site after 2 weeks of terrible suffering.  I kept on going with the cold turkey but you do not have to!  These knowledgeable people will be on here soon to welcome you and give you their advice...  please listen to them!

 

There is no way to rush this withdrawal as we are all different and our bodies will tell us when to do what.  Just listen and be kind to yourself - you will need much sleep, drink lots of water and if you are interested in any supplements we have a forum for "nutritional supplements" - you might like to check this out as many have found some of these to be of great help while going through this escape from the poison.

 

I have been off this crap for 8 1/2 months now, but I still have some sleep issues and occasional anxiety.  I never suffered anxiety until I got off this crap.  You will probably need a benzo to help with this - I did/do take Alprazolam which has been a great help - don't know how I could have done this without it!  You can do this - and do it much more easily than some of us here did -  good luck and please keep us updated on your progress!


#11 Carleeta

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Posted 19 September 2014 - 07:22 PM

Joeinsf...Welcome to the forum. Ambilify is used to treat depression and added to antidepressants when the antidepressent isn't enough, in treating depression. Many members here have had success in a method called bead counting. Fishinghat, will be popping in shortly to advise you on this meathod. Honestly, there was a member on this forum who used the weighing method, although I've had no success looking for their thread.

Hang in there, as other members will be popping in and offering knowledge, experience, support, and understand. We are here for you.

#12 FiveNotions

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Posted 19 September 2014 - 07:31 PM

Actually, I shouldn't have said I don't know anything about Abilify... I meant from an "I've used it" perspective. My old law firm (including me)represented the drug's developer, the Japanese company Otsuka, for purposes of getting visas for the global abilify project development managers and senior scientists to come to the US for the final stages of the drug's development, FDA approval process and move to market back in the early 2000's.

It was originally designed / intended as a treatment for bipolar disorder. If I recall, the use for depression came later, when they needed to "expand the market." I think depression may still be an "off label" use.

#13 fishinghat

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Posted 19 September 2014 - 07:46 PM

First of all I hope you did not start the abilify. It has as bad a withdrawal as Cymbalta if not worse. I will include my instructions on bead counting here but if you are in that bad shape you can't trust your math then weighting them may be better. I think Cymsik is the one who can help best with that.

 

bead counting, is where you open the cymbalta capsule each day and remove a few beads, usually 2 or 3. So the first day you remove 3 beads, the next day 6 beads, the next 9 beads etc. This provides for a slow steady withdrawal. If symptoms get to bad you just hold at that dosage for a while until you stabilize. Then start dropping again. Be aware that for most the last few beads give the worse withdrawal. Be prepared to slow down when you get to the very end. Now this is just an example. Some can only remove 1 bead a day and others 7 or 8 beads a day. You will have to play with it a little bit to find what works for you. This doesn't mean you won't have withdrawal but it will be lighter and you will have some control over it.


#14 ShadyLady

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Posted 19 September 2014 - 11:29 PM

Welcome, Joe...i ain't the one that knows about weighing;). There is a 'Search' bar at the top of the page and if you enter Weighing Dose Instead of Bead Counting, there is an excellent post written with the details of how to weigh the doses. It was posted by our member, Tria, the pro in that department, of using that scale and her method she fine tuned. I ordered the scale off Amazon. when it arrived three days later, I didn't even remember ordering it, and after opening the box I knew I was screwed trying to use it when I saw mathematical skills were involved..after trying to count those 'Mexican jumping beans' and spilling them everywhere as I had the shakes and couldn't even see the damn things as I was too far in to full blown withdrawal!! Ugly!

So, with that 'Instruction Manual' by Tria and the bead counting method from Fishinghat, you have a choice of which one would best suit you in slowly weaning of this shit drug. I did not prepare for weaning and became a tilt o' whirl with brain matter hurling everywhere as I had no idea stopping at 30mg would begin this epic nightmare! I had down dosed at 30mg intervals from 120 to 30mg for about two months without noticeable side effects or none that I remember:/

Why in hell would your doc put you back on 2mg of Abilify after you just went through two months of withdrawing off 10mg of that crap?! Oh, these idiots make me so mad! Where is the sense in that? You won't know what is Cymbalta withdrawal or side effects of adding back the Abilify or both, right?!

Read the post on 'Weighing the Dose' and then check back and give us your thoughts or questions on which way you think is better for you. Sounds like you have to take control of the weaning off without ol' doc's help which is assinine, imho!

We are here to support and encourage you to get through this and to the shore safely toward a new quality of life...this forum is the beacon of hope for us all as we help each other.

Be well

PS...Sorry this reply is a mess, typing & grammar sucks tonight along with brain sputters!

#15 joecinsf

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Posted 20 September 2014 - 10:10 PM

I think my head is all messed up. I'm on 110mg per day. (I know I said 120mg above. That was my dose for two years) How do I take out 2 beads one day, 3 the next, 4 the next day and so on.... I'm on 110mg right now. I don't get it. If I keep taking one bead out per day, at my dosage, I'll be doing nothing else but counting. What am I missing?

I began tapering on September 2, 2014, 120mg to 110mg (taking one 60mg capsule, 30mg capsule and a 20mg capsule per day) I am still feeing lethargic most of the day and my gut hurts. Could this be from the tapering of 10mg? It's been three weeks too. How could this still be going on for this long? I was hoping I would be stabilized by now. I feel like I am going nowhere. I hardly leave the house. What confuses me more is that I do have some days I feel well enough to go out walking and errands. But then the next day I feel sick again. Does this cycle sound familiar to anyone? I don’t know what I should do. I do not want increase my dosage but it sounds like the only solution.


#16 FiveNotions

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Posted 20 September 2014 - 10:39 PM

Yep, Joe, everything you're experiencing is from the Cymbalta leaving your system ..and yep, getting off this stuff takes quite a while for a lot of people ... those of us who are here on the forum are those people. Some are able to get off the drug quite easily, and in a short amount of time. But a lot of folks have a lot of trouble ... it's truly different for each and every individual. You're finding out, I think, that you're going to need to do this more slowly.... and yep, bead counting is the way to do it ...

 

All of these symptoms you've got are due to the big drop in Serotonin in your brain as you dose down. Believe it or not, coming down by just 10 mg. all at once constitutes a pretty big drop. Cymbalta artificially boosts the serotonin level, and when we start reducing our dose, our poor brain has to relearn how to manage serotonin by itself again. Your brain is essentially screaming at you for dropping down in dose ...

 

So, Let's see if I've got this straight ... you were on 120 for 2 years ... that's a really high dose, so my bet is your brain is really "hooked" on that big of a serotonin boost ... you dropped to 110 mg on September 2, and you've been at 110 for about 19 days ... almost a full 3 weeks ... and, you're still not feeling good all the time, but you are having some good days/periods of time ...

 

I'm thinking you've got several choices ...1)  hold at 110 mg, ride out the symptoms and wait until you get stable ... then go back to bead counting, by removing just a few beads every day ... or, every few days ... whatever number of beads and over whatever period of time your body will allow you to do without giving you unmanageable symptoms...

 

2) go back up to the full 120 and get stable there, then count down.... 

 

3) go back up to a dose somewhere between 120 and 110 ... by taking just a few beads out of the 120, then staying at that level until stable ... but for that approach, I need to let the others here who know bead counting really well help you figure out how many beads, etc. (I think I mentioned further up in this thread that I'm a cold turkey survivor ... the fast hard drop, and the long hard recovery. :blink:)

 

Hang in there ... the first few  weeks of this are the hardest in terms of symptoms, the most confusing in terms of trying to learn why this is happening, how to manage the weaning process, and how to listen to what our brain/body is telling us ...

 

Stay tuned... our resident bead-counters will be here soon!





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