32 replies to this topic

[Armywife]

I have been sick with nauseation and dirreah for 5 weeks now. I have seen my GP and he has ran every test possible from pregnancy to Crohns, everything has come back negative. I have gone on gluten free foods, thought it could be my nerves, did food diary, now I am only doing saltines and water but there is no pattern. I have been keeping journal of each day and today while looking at my planner it just dawned on me. I saw my doctor 6 weeks ago and he increased Cymbalta from 90mg (Been on that dose for 3 years) to 120mg.
My husband is currently deployed overseas for a year. I am severely stressed with being a single mom of 2 small kids, 1 which has special needs. Then on top of that I have my own health issues, Lupus, Fibro & Rheumatoid Arthritis. I don't have the time or engery to be suffering so severely.
I have been reading stuff online and wondering if my issues could be side effects of the increased dose. Or being that half life is 12 hours, could it be from talking all 120mg around 8am and I need to break it up?
Please please give me suggestions. I am so sick I can't take care of kids and scared I might end up in hospital then who would take care of kids. I have to figure this out because I am out of options but I can't live like this. Then last 4-6 days I have been having headaches and severe insomnia and Ambien isn't even working..

I do want to wean off this medication especially after everything I am reading.but what Is the safest way to wean ?

PLEASE PLEASE HELP ME! I cannot keep living like this.

[buntbean2]

Sorry to hear you're suffering Armywife.  I wanted to respond because I understand how anxious you are feeling.  I haven't researched like others on this site but I did find a few things relating to cymbalta and diarrhea:

http://www.drugs.com...hea-751280.html

http://www.depressio...oes-it-go-away/

 

Your body is different from anyone else's so just because something isn't the "norm" for most people, doesn't mean it isn't the norm for you.  Don't let anyone convince you otherwise.  There are MANY stories about side effects that people have had and doctors/pharmacists/etc will tell you that doesn't happen and well...it does!

 

Being Saturday it may take alittle while for the 'experts' on here to get back to you...but they will!  This group has been very helpful in my distress.  The advice offered has gotten me thru some really tough spots.  I couldn't read thru the other topics and I had a learning curve for maneuvering this site but ask and they'll answer.

 

I'm sure there are other medicines that may work better for you.  Maybe adding a different med in addition to 60mg for awhile would be a better idea.  An anti-anxiety medication (clonazepam or lorazepam) at bedtime might help.  Don't let it go.  Keep going back or at least calling your doctor.

 

I wish I could be more helpful.  I pray you'll get the help you need and quickly.  

[buntbean2]

https://www.cymbalta...ty/?hl=diarrhea

[fishinghat]

Hello AW and welcome to the site. There is no way to be sure but it is possible that the GI problems are from the increase dose of Cymbalta. That is a very high dose.

 

There shouldn't be any reason to split your dose as with time it builds up in the body. If the GI problems were during the first 4 or 5 hours after taking your 8 AM dose then faded it would indicate that splitting yoour dose might help. If it is all day long then splitting yoour dose would not help.

 

As far as the best way to come off the Cymbalta...Bead counting, this 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. Now there is a complication to this. Since the new generic version has come out it has been discovered that they normally contain 4 to 7 big pellets in the capsule. "Bead counting" with them is a little different. Usually you remove one more bead every week to 10 days depending on how hard it hits you. Again, you will have to adjust your drop rate depending on how yoour body reacts. I can not stress enough the patience that you should have with this process.

 

I know others will be weighting in on this matter. There are some great people here to help you along. Don't hesitate to come here and ask for help or just to blow off some steam.

 

In addition, I would like to thank you and yoour husband for the sacrifices you are making to support our country. It is appreciated.

 

God Bless

[TryinginFL]

Welcome, AW!

 

We're so happy that you have found us - you will get help, support and much caring from the wonderful people on this site.  Is your plan to get off the C.?

 

The bead counting method outlined by one of our most knowledgeable members above would definitely be the way to go - especially since you have a family to care for and have your own health issues.  With your husband currently being deployed, I'm certain that things are very difficult for you.  If you decide to bead count, you will keep your side effects to a minimum and still be able to function.

 

I am so sorry that I didn't do that, as I, along with several others on the site, dove right in Cold Turkey and I DO NOT recommend that approach!  I didn't find this site until I was 2 weeks into it, so just kept going on my own trip to Hell.  Others here will come on soon to welcome you and tell you of their experiences.

 

Please keep posting and let us know of your progress...We want to help you!

 

Liz  

[Armywife]

Thanks so much everyone.

I do want to get off Cymbalta if possible. I am just gonna have to be patients which I am not very good at doing.

I will keep everyone updated along my journey.
Normally 120 mgs
DAY 1: As of right now I took 1 60mg pill and the 2nd pill I opted to open and took half of 60mg. If I see that is too drastic I will take more beads.

[TryinginFL]

AW...

 

I think that is too drastic - dropping that much will put you into cold turkey withdrawal....   I suggest you take it slooooooww....

 

Please start with only 1-3 beads each time - per FH's directions.  If you need more info, please ask!

[Armywife]

Ok. I know I am not suppose to just swallow beads. How can I take more beads without having capsule?

[TryinginFL]

You can purchase empty capsules at either your pharmacy or a health food store - this should solve your problem - and be careful!  Those little suckers jump all over the place!

 

One of our members called them "Mexican jumping beans"!

[FiveNotions]

AW, thank God you found us! You sound sick as a dog, and I'm so very sorry!

Hang in there, you can and will get through this! We'll do everything we can to help! I'm ready to place all the blame on the increase in crapalta (our "pet name" for the shit) dose ..but I'm not sure ... I had these symptoms when I was in withdrawal from it, but I've got to do some research for you on this connected with dose increases...

But first, you need some help with the immediate issues you're dealing with...

Do you have anyone who can help you with your children as a "back up" if/when you need some extra rest and a day or two "off duty"? Do you have a support network of friends, other army spouses? If possible, share what you're going through with at least a couple of close, trusted friends and family ... if not, don't worry, you've got us!

The nausea ... home remedies ... ginger ... ginger ale, ginger root slices (like they serve with sushi), ginger tea, candied ginger, and, in a pinch, just lick the ginger spice from your kitchen cabinet off the palm of your hand or make tea using a tablespoon per cup of water ... stopped the nausea I had during crapalta withdrawal almost completely ...

The other thing that worked for me was ice packs, placed on the area between my solar plexus and stomach, or over the stomach itself. Move it around to see if there's spot where it seems to feel good.

Also, do you have any of these OTC meds at home, or can you get to the store (or have someone else) to buy them? (I didn't have them / use them ... I was so sick at first I hadn't found this forum, and I had no one to help me. I just crawled on hands and knees to the bathroom to puke, finally gave up and took a pillow and blanket in there and just slept/napped on the floor.)

Antivert
Bonine
Dramamine
Benadryl

Another "trick" ... self-acupressure ....

Lie down on your back, with your hands over your abdomen, head slightly elevated. Do your best to breath slowly, and fully, not shallow breathing, which we go into when we're sick / stressed. Put the tip of your right index finger on the underside of your left wrist, about 1 1/2 inches from your hand. (You may need to adjust this, the acupressure points are really small, but your "spot" is somewhere right around there.) Press gently/firmly for several minutes.

-------------------------------
Okay, now we need a bit more information ... a couple of questions that will help us help you ...

For what condition were you put on the poison in the first place? Was it for pain related to the fibro and / or rheumatoid arthritis?
 
What other meds are you taking, in addition to the ambien and Cymbalta? In the time that you've been having these current issues, has your dosage of any other meds been changes? Any other meds added or stopped?
 
How long has your husband been deployed? Have you told him about this, or are you not telling him in order to shield him from more stress than he already has?

-------------------
Keep posting here, AW ... stay right here with us, you are not alone, and you are going to make it through this.
 

[FiveNotions]

AW, if you don't have patience at the start of this process, I assure you that you'll acquire it as you move forward ...

 

FH is exactly right about doing it with bead counting, and TFL is right, that's way to big a drop in dose ... you're already sick and feeling like dog poop on a platter ... so there's no need to add more poop to the pile by reducing dose too fast ...

 

Remove just a few beads at a time, even one at a time. (EquusWoman, one of our "success stories" got off the stuff one bead at a time ... she's back to riding her horse and building fences now!! She checks in regularly to give us encouragement, so you'll get to know her pretty soon.)

 

I defer to FishingHat and the others here who are experts at bead counting ... I did it cold turkey, like TFL ... I describe it as skydiving, but without a parachute ... the landing is very hard ... 

 

If you can't find the empty gel caps that TFL mentioned at your pharmacy or health / vitamin store, you can also order them online from Amazon.com.... in the meantime, until you get them, you could put the beads you remove into a small baggie ... save them, and use them in the gel caps later on ...

 

Also, as TFL mentioned, those beads can be buggers to deal with ... others who've done it have figured out different ways to deal with them ... use a plate, with elevated edges ... a piece of felt, which seems to keep 'em from rolling around ... a bead tray, like is used to hold beads for making jewelry ... a couple of us (CymSik?) have even bought scales calibrated to weigh out exactly the right amount of beads (that one would be waaay beyond my skill level, even now that I'm off the stuff)....

 

Just to confirm, you're taking the brand, not the generic, of the poison? Also, am I correct to assume that your health care/doc/Rxs etc come through the VA?

[Armywife]

I am on it for Fibro/depression. In the time I have Been sick I also have stopped taking my pain medication (morphine) bc I cannot function as sole parent, drive kids being on it. I did tapper off it and everything I read says 10-12 days which it's been well pass. Husband has been gone 3 months and Doctor has considered it might be my nerves. He recently started Xanax .25mg to help if stomach issues are related to nerves but when I have taken it does not help.

[Armywife]

How do I know if generic or not?
No VA I use TriCare but through civilian doctor.

[Vision]

Hi Armywife

 

Sorry to hear you are going through all this.  

I was on cymbalta for 4 years to manage fybromyalgia pain.

The good news is it really really really works for fybro pain. The bad news is I was suffering with withdrawal while on it!!!

I was thankfully only on 60mg.

I am now 2 weeks without cymbalta. It took 4 months to get off of it. Im still bothered with a few symptoms and they appear to be depression. (Imagine becoming depressed by taking an anti depressant)

The fybromyagia is as active as it ever was.  

 

To me it does sound like you are going through withdrawal..if you can call it that while still on it. 

Unfortunately coming off of it may not be the best thing for you at this time with all that is going on in your life.

 

Best wishes

[fishinghat]

The prescription bottle will have the manufacturer's name. The brand name is manufactured by Eli Lilley, all other brands are generic.

[FiveNotions]

FH, could her morphine dose reduction play into this?

[Armywife]

Ok now that you mention I did switch to new pharmacy since husband deployed. Walgreens no longer take military insurance. the pills I got there look different than ones I get now at new pharmacy. Could that be it? Walgreens pills use to come in the sealed Cymbalta bottle from manufactured not in a Walgreen bottle.

[FiveNotions]

AW, in what way do they look different? Different colors? Are they still the capsule that can be opened? Still, check the bottle of the current rx ... label should say the manufacturer name ... for example, Teva is a company that makes a generic version...

Also, what was your original morphine dose and how long were you on it ... that seems like way too rapid a weaning period for the stuff ..

How are you feeling right now?

[Armywife]

Yes these say generic name on pharmacy bottle. Yes I can open them.

MS Cotin ER 60mg less than year. Took 1 pill in am on average 5 out of 7 days.

Extreme nauseated, feverish, rumble stomach and lethargic. Lethargic might be from not being able to eat and drink correctly.

[FiveNotions]

Holy crapalta !  before we even deal with the generic ...

here's the first issue I see ... you are/were skipping doses ... Cymbalta (generic name, duloxetine) ... has a very short half-life ... 12 hours approx.... so, every time you skip a dose, within 12 hours your brain/body goes into hard, cold-turkey withdrawal ...

So, what you've been doing is what I did ... skydiving with no 'chute, hard landing ... about once a week ... so, you've essentially been in off/on hard withdrawal for the entire time you were taking the stuff... man, you are one tough broad, and a glutton for punishment to have been doing this for so long ...

Seriously, no telling what effects this has had on your over-all health and your other health issues ... likely a contributing factor to them and how difficult they've been / are to manage ...

Stop skipping doses immediately !! ... take the shit every single day, get yourself stable, and then start bead counting ...

 

CORRECTION: I apologize ... I misread what you said, AW ... you were taking the MS Contin ER 5 out of 7 days ... not the Cymbalta .... whew ...

Edited by FiveNotions, 13 September 2014 - 01:14 PM.

[Armywife]

Thanks!

[FiveNotions]

AW, I'm doing some research now on the morphine thing ... I'm finding comments on other online forums from others who were prescribed it for pain, such as fibro etc.... and, while on it, their bodies built up "tolerance" ... they obviously weren't using the stuff "recreationally," but when they decided / needed to get off it, their brains/bodies, as would be expected, went through withdrawal ...some of them report having an "extended" withdrawal period, much longer than their doctors had told them they would have ... and, when they told their docs about it, the docs told them it wasn't possible, must be some other "condition" etc... (this is exactly what those of us here have experienced with Cymbalta) ...

 

We'll need FishingHat to weigh in on this, but I'm seriously wondering if you've also been dealing with an extended morphine withdrawal ...

[FiveNotions]

AW, the MS Contin ER you were on is interesting stuff ... I haven't found research articles on this (likely they don't exist), but lots more comments on other online forums ...

Many people report that 1) they had extended withdrawal symptoms, lasting for several months, 2) they experienced depression while on it(either for the first time, or if they had depression prior to the MS Contin ER that it made the depression worse), and 3) several commenters said they believed it caused anxiety and/or panic attacks ....

How's your pain level / management now without it?

[thismoment]

Armywife

 

You're in a challenging situation to be sure. You are in duloxetine AND morphine withdrawal simultaneously and intermittently. The newly-acquired benzodiazepine Xanax will surely help with the anxiety, but won't touch the bulk of your withdrawal symptoms.

 

I agree with FH, FN, and TFL. You need to get stable (stable= having no, or few easily-managed withdrawal symptoms) before formulating a plan to withdraw-- just dumping out half a capsule of 60 mg is rash and unsafe considering your current responsibilities. You've got to address that desperate behaviour head-on and just get stable on the Cymbalta right now. We will talk about withdrawing after that. Forgive my frankness my dear, but this is what you need to do.

 

The morphine is surely an issue, and if it's needed for the pain of lupus, fibro, and arthritis to enable you to cope-- then that has to be considered too.  You should probably get stable on both the duloxetine and the morphine before tapering off. You will have to find help with the children.

 

My heart hurts just thinking about your situation. Slow down. Get stable. Get assistance for the children. Once stable (a number of weeks, perhaps a month)-- consider weaning off the morphine first as it is a serious hypnotic and affects driving especially. 

 

You have thrown yourself under the bus of withdrawal all-at-once. Back up and put yourself in a position where you can think.

 

I deeply thank you and your husband for your sacrifice, as it isn't just the soldier who is put in harm's way. Take care.

[fishinghat]

AW

 

Can't really add anything to what Tm and FN said. They gave you the straight scoop. One thing for sure....you don't want to go through morphine withdrawal at the same time as Cymbalta withdrawal. Youwill need to get back to some level on the Cymbalta until you are stable. Once you stabilize we can see where you are at and take it from there.

[TryinginFL]

AW

 

Ditto to all of the above - excellent advice from our most excellent members!  Good luck and please do as they advise.

 

I, too, thank both you and your husband for your contribution to our country's service.

[FiveNotions]

AW, I'm reading up some more on the MS Contin ER, and just found something on one of the NIH drug info. pages about it ... getting off this is serious business ... doing it wrong, too fast has caused seizures, convulsions and even death ... Don't meant to scare you, or come on too strong, but this is really important.

 

Did you tell your doc you were quitting this stuff?

Did he put you on something else to replace it?

Were you on any other opioids prior to being put on this stuff?

Was 60 mg. your starting dose of it?

 

The reason I ask is that 60 mg of it is the recommended dose for individuals whose bodies are already "opioid tolerant" (body is addicted to it) due to having been on other opioids. If the individual hasn't been on an opioid immediately prior, and thus isn't "tolerant", they are put on 15 mg.

 

60 mg is a very high dose ... and the body becomes tolerant (addicted) to it after just 1 month ...

 

If you've been on other opioids prior to MS Contin ER and were switched to it without withdrawing from the previous opioids, you are definitely going to have withdrawal issues ... likely over a period of months ....

 

Even if you haven't been on an opioid previously, just one month on the 60 mg of the MS Contin ER got your brain/body hooked ...

 

Also, from what the NIH web page for this drug said, skipping doses is NOT GOOD ... it does to you what I described the skipping of Cymbalta doses as doing, in my post above ... in and out of withdrawal ...

 

You must get stable on the Cymbalta... and I'm thinking the MS Contin ER as well.... but I just don't know enuf about it to dare try to give you more detailed advice ...

 

Two withdrawals at once are two too many.

 

You need to do one at a time. My thought would be to focus on the morphine first ...

 

Either way, you went off way too fast ... like TM said

[FiveNotions]

Sorry, forgot to post the link to the NIH information source ...
http://dailymed.nlm....75-37b2e9ff65f6
 
All the symptoms you're describing are listed as possible side effects of MS Contin ER.

Other websites I've been reading indicate that they are also withdrawal symptoms of the drug.
 
NIH recommends getting off it only by the "titration" method. I don't know anything about that, but FH has used it for getting off benzos.

[Vision]

Hey everyone.

I'm not an expert by any means.

I have been living with fybromyalgia for 15 years I chose not to take anything for it for 10 years.

The diagnosis and symptoms have been extreme since day one of the first symptoms. 

I eventually caved into taking Cymbalta as the doctor was getting amazing feedback from others with fybro. on cymbalta.

I was not on cymbalta for depression.

I gave it a try and was on it for about 5 years... we know the rest.

Here I am barely able to sit here to type this. I'm in tears and ready to vomit from the pain of fybromyalgia.

Exactly the same as I was *before* Cymbalta.

 

My concern for you Armywife is that you might be adding one more thing to deal with when you wean off of the drug(s).  The reason you chose to take them. The pain.

 

 

Thanks for your courage and support everyone 

[thismoment]

Vision

You are right. You have illustrated the need for truly "informed" Informed Consent before starting antidepressants. Somebody should put up an Informed Consent Website that tells it all-- maybe that's the role of national health agencies like the FDA, I don't know.

People need to know that while antidepressants help some people for some time, a plan to 'manage' the the drug has to be part of the prescription-- scheduled reviews, dosage management, and when and how to withdraw.

Every aspect of taking antidepressants includes a gamble (it's a crap-shoot right across the board)-- getting on/ symptoms/ how long it might help/ how it interacts with other medications/ symptoms that will affect your quality of life/ symptoms regularly become permanent/ when the drug becomes ineffective and what to do/ getting off the drug/ the fact that some people cannot get off ever/ the fact that getting off could be worse than staying on/ the fact that long-term exposure can alter your brain beyond its ability to self-restore/ the fact that re-instating after quitting cold turkey may not stop symptoms created by quitting-- you could be worse off/ the fact that emotional flat-lining and sexual dysfunction are common and could be permanent etc etc. All this needs to be fully briefed before starting-- and of course all alternative treatments like therapy and alternative, less-devastating drugs must be discussed.