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Bead Counting -- How To Do It


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#31 Neesee

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Posted 16 October 2014 - 09:32 AM

I've had a horrible headache and high feeling all week since tapering to 30 mg Sunday. I think I'm gonna gulp down a few extra beads.  I didn't know of the bead count method. I just found this site yesterday. Thank you, thank you, thank you for your advice!!


#32 ThisBetterPass

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Posted 17 October 2014 - 07:35 AM

I'm glad you found it useful, Hopeful2014.  :D

 

Yesterday and today are horrible, no good, very bad days. My stomach already played 'catch' with the sink this morning. Even with slowing down the taper near the end, I'm finding myself really ticked-off with the high and low bead counts per capsule. It makes me confirm the benefits of the linear reduction approach.  

 

The total number of beads per 20 mg capsule yesterday was 157, while today's was 169.  (Maker is Actavis; the number on the capsule is 2890.)


#33 Hopeful2014

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Posted 17 October 2014 - 07:38 PM

Im sorry to hear your having a bad time ThisBetterPass :( How are things today? Im afraid I don't know your story other than you have been on this journey 6 months. Im sure it's on here somewhere but am still finding my way around the forums. What dosage was you on to begin with etc... Hope your feeling bit better today.

#34 ThisBetterPass

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Posted 18 October 2014 - 09:59 AM

I was on 60 mg for about 8 years for depression. It did help for about the first two years. My son was diagnosed with severe autism and my daughter was 14 months. Needless to say, I just wanted to be able to function. How ironic, now that I'm getting off of the drug, eh?

Both kids are considerably stable at the moment, considering that each of them have special needs. The worst weeks were back in May when my daughter had severe psychiatric issues that required a 4-day stay at an institution...poorly timed with my drop from 30 mg to 20 mg. The main lesson we both took away from it was the importance of the mind-body connection. Understandably, I was a mess during that time. In the flip side though, that time made me remember how strong we can be to endure hard times. That alone is what gets me through the bad days with this taper; it's a temporary blip in the long game of tapering from Cymbalta.

Last night was rough as I endured a bad bout of the shakes and muscle tightness in my ribcage. It abated and I got a good night of sleep. Today is much better and I feel at about 80%.

#35 Carleeta

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Posted 18 October 2014 - 10:29 AM

I've had a horrible headache and high feeling all week since tapering to 30 mg Sunday. I think I'm gonna gulp down a few extra beads.  I didn't know of the bead count method. I just found this site yesterday. Thank you, thank you, thank you for your advice!!

Neesee, would you then consider the bead counting method.  It might help a bit more with a more stable taper....


#36 Carleeta

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Posted 18 October 2014 - 10:33 AM

You're referring to the working out of the average number of beads, by averaging the low # and the high #, yes?

Yes.  this is probably most helpful when there are capsules with different number beads inside of them.  It will probably help to get the exact number when bead counting and using the 10% or 5% method.


#37 FiveNotions

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Posted 18 October 2014 - 11:27 AM

Neesee and everyone else who reads this thread ... please, please please consider bead counting ... unless you've been off the stuff for so long that going back on it isn't worth it, and you think your symptoms are manageable, or you absolutely can't for insurance/financial reasons. (That was my reason for doing cold turkey... if I'd known then what I learned during hard withdrawal, I would have begged/borrowed/stole the money needed to buy enuf of the brand poison to bead count down.)


#38 thismoment

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Posted 03 January 2015 - 07:42 PM

More on Bead Counting-- January 2015.

 

Up to 1 year on Cymbalta might be considered short-term exposure, 2-5 years moderate exposure, and 5 years and above long-term exposure. Anecdotal data shows us that difficulty in discontinuation is related to (a) how you withdraw (cold turkey, ad-hoc methods with gaps and steps, or patient slow weaning by bead counting), and ( B) the length of exposure-- the longer the exposure the more difficult the discontinuation, and the more likelihood there is of long-term (or chronic) discontinuation symptoms.

 

Therefore, one should relate the weaning-off timetable to the length of exposure: If you were only on the drug 5 or 6 months you might consider weaning off over 5 or 6 weeks; if you were exposed for 2 or 3 years you might consider weaning off over 5 or 6 months; if you were exposed for 7 or 8 years you might consider weaning off over 10 or 12 months.

 

Here's a suggestion for a 50-day weaning from 60 mg by bead counting: plan to reduce by 2% per day and you'll be at 0 in 50 days. You will need 25 60mg Cymbalta capsules and 25 empty gel capsules (get them at the pharmacy or health food store). If your 60 mg capsule contains (say) 578 beads, 2% of 578 is 11.56, but round that down to 11. 

 

Note- generic capsules contain fewer beads than the brand name. Therefore a modified tapering system must be used-- you simply can't plan a 2% per-day reduction if your generic capsule only contains 14 beads. I will write something on this later.

 

Day 1- 

Pull a Cymbalta capsule apart and remove 11 beads.

Reassemble the Cymbalta capsule and swallow it. 

Put the 11 beads in an empty gel cap and label it "Day 50".

Day 2-

Pull a Cymbalta capsule apart and remove 22 beads.

Reassemble the Cymbalta capsule and swallow it.

Put the 22 beads in an empty gel cap and label it "Day 49"

Day 3-

Pull a Cymbalta capsule apart and remove 33 beads.

Reassemble the Cymbalta capsule and swallow it.

Put the 33 beads in an empty gel cap and label it "Day 48".

 

Continue.

 

On Day 26 you will start to consume the gel caps you have been filling. You're done at Day 50. Some folks have difficulty in the last week or two of weaning off, and you may have to slow down some and stop reducing for a few days until symptoms abate. In general, let the severity of the discontinuation symptoms be your guide. If you're hurting-- you're reducing the drug too fast: slow down and level off at your current dosage for a while or even add some back until you stabilize. Then continue even slower!

 

If you taper off quickly, many disturbing discontinuation symptoms could appear, and both you and your physician will want to quell the symptoms with a new prescription; this happens a lot, and the game is over. NOTE-- You have to make it through about 6 months before the horizon really opens up and you know you can make it. Hang in there!

 

If after a couple of weeks of bead counting you are symptom-free, you could consider speeding up the process. But there is no rush, there is only quality of life.

 

I did this and I have been Cymbalta-free for 28 months and I'm doing fine! You can do it too.


#39 TryinginFL

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Posted 03 January 2015 - 07:50 PM

TM,

 

I have been wondering..

 

Do you still have those headaches?  If not, I'm so happy for you!!  When I first joined this forum, you said that you were experiencing a headache 24/7.  Sure hope this stage has ended! :)


#40 thismoment

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Posted 03 January 2015 - 08:12 PM

Liz

 

Thank you for asking.

 

The headache is still there but has reduced significantly in the last 4 months. It was full-on 24/7 for the first 2 years of discontinuation, about a 7-8 on the pain scale. I would say it's a steady 3 now, which is at the threshold of not noticing it for most of the day! 

 

I am confident that the headache is not chronic, and one day it will be gone. I still have the tinnitus in my right ear though, but that gets forgotten when not focussed upon. I'm satisfied with this.

 

I view discontinuation to be life after antidepressants. If one is looking for a clear-cut line at the end of discontinuation, I fear he or she will be disappointed; it's a long slow fade like an Icelandic sunset. And it doesn't spook me if some familiar discontinuation symptom emerges for a day or two even now-- odd aches and pains in muscles and joints; a little unsteady balance; misremembering. The waves are now tiny ripples few and far between-- you might call it normal.

 

I can't control it and I don't think about it. I'm too overwhelmed with gratitude to nit-pick the little anomalies that are most likely the result of aging.

 

Take care.


#41 brzghoff

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Posted 03 January 2015 - 08:43 PM

glad to hear it TM. i have had chronic headaches and tinnitus, but i can't blame the C. the headaches started in childhood and the tinnitus, well, i had a rock and roll career and lifestyle for over 20 years and that has a lot to do with it. <sigh> the aches and pains since ditching the C while - well painful, i can deal with. i just want to see the anxiety continue to fade. it is slowly, slowly - but then every couple of weeks it jumps up and says BOO!


#42 thismoment

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Posted 04 January 2015 - 06:20 AM

Generic Cymbalta usually contains fewer beads in each capsule, so a very slow gently-sloped taper is not possible. Therefore, will have to reduce in steps, and you stay on that step for a period of time until the withdrawal symptoms arrive (might be a few days or a week), and then wait until they wane and you feel stable once again.

 

If your generic capsule only contains 10 beads, then 1 bead contains 10% of the full dosage. WOW! That's a HUGE last step, and it will surely be a moderate-sized cold turkey. You can see why tapering off from the brand name gives you more options for less pain.

 

With 10 beads, of course the best you can do is remove one bead at a time. Here's an example for a 10-bead generic over 10 months:

 

Day 1-

Remove 1 bead.

Day 30-

Remove 2 beads.

Day 60-

Remove 3 beads.

 

And so on to month 10 when you are done.

 

That last step will be a big one, and I'll post something later to explain why the last reductions are always the most impactful. 


#43 thismoment

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Posted 04 January 2015 - 06:26 AM

Here is a great link to a well-respected Administration poster named Altostrata from Surviving Antidepressants forum (16000 posts). 

 

This link deals with the 10% reduction method, whereby your dosage is reduced by 10% of the previous dosage. It involves more dedicated and complicated computations, but has good results; it's the method recommended by Dr. Shipko from Mad In America.

 

There a very good section on why the last reduction (however small) is so profound. It's why we have to slow down the tapering to a crawl toward the end.

 

http://survivinganti...0-of-my-dosage/


#44 Flossy

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Posted 29 January 2015 - 10:21 PM

Hi thismoment
I was taking 180 of cymbalta when I started tapering very quickly. I went from 180 to 45 in 4 months and I was having a lot of trouble adjusting so went to see an addiction specialist whereby I was advised to return to 60mg which I did. That was in October and I think I'm ready to start bead counting now to try to get off this drug for good. I have been on cymbalta for 5 years, I would be really interested in your opinion on how I should go about it? I tolerated my large drops pretty well considering I was dropping 30mg every 2/3 weeks at a time but after a tumultuous time since oct ( obviously paying for those large drops) I am more cautious now. Any advice would be very appreciated! Scary 😬

#45 thismoment

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Posted 30 January 2015 - 01:40 AM

Flossy

 

Yes, it's scary. 

 

If you are stable at 60 mg, and considering your 5-year exposure, you need to go slowly and be patient; I know you know that. Before we begin, can you fill me in regarding your current status?

 

Brand name or generic duloxetine?

How many beads in your 60 mg capsule?

Do you have anxiety-- and if so-- what meds do you have for that?

What other mood-related medications are you taking?

 

You are right to be cautious; after 5 years on, a slow and consistent withdrawal is necessary. You might also consider piggybacking off Cymbalta by uploading a longer half-life SSRI like fluoxetine (Prozac) before weaning off the Cymbalta. You could talk to your physician about that when the time comes to start the process. 

 

Glenys's post "A Trick I Found That Worked" is one way of doing this piggyback strategy where she blended both drugs in the capsules-- uploading the fluoxetine and reducing the duloxetine. It proved successful for her, and I was very impressed by her ingenuity!  Or you can simply upload the fluoxetine (Prozac) and after a few weeks begin weaning off the duloxetine (Cymbalta).

 

Take care.


#46 Flossy

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Posted 30 January 2015 - 02:31 AM

Hi, thanks :)
I am on the cymbalta brand, Cymbalta duloxetine HCI 60mg is what my box says! I haven't actually counted how many beads are in the 60mg capsule, I probably need to do that. I was originally diagnosed with panic disorder.....however, at the time(9 years ago) I was taking cipramil for depression. I had been seeing a chiro/kinesiologist to consider coming off the cipramil. So I started to reduce on my own, and that was when panic attacks started. To try to condense a long story, I was admitted to hospital after several ER visits thinking I was dying and them not picking up on it being panic attacks. I had every test under the sun and nothing, however after google searching myself, in my irrational state I concluded I had seretonin syndrome so stopped the cipramil completely, hence worse panic. Finally a psychiatrist was brought in and I was diagnosed with " spontaneous panic disorder". No connection was made that the withdrawals from cipramil was what was likely causing the panic! I was very vulnerable and trusting and so began 9 years of benzos, many different anti depressants, beta blockers, mood stabilizers, you name it! The thing is that I now have virtually no anxiety or panic as it is slowly waning as I reduce the cymbalta. I also am following a new treatment for mental illness founded by William J Walsh, it's called nutrient therapy and I have vitamins compounded to combat the high copper in my body and pyrrole disease which I was diagnosed with after having my biology tested. It has been incredible. It all makes me wonder now though, did I ever have "spontaneous panic disorder"??? Other than 60mg of cymbalta, I take my compound vitamins, .25mg xanax and 5mg Valium, as my dr has had me on them for 9 years and I am unable to not take them. I also take gaba, melatonin and mega magnesium. I don't know what the future holds with regards to my mental health, however all I know is that the less of that shit I put in my mouth, the clearer and healthier minded I am. I was originally put up to 180mg and was also taking valdoxan, another anti depressant, seems so crazy that I allowed myself to be guided in this direction, but as I said, before nutrient therapy came along I was only able to make decisions with a very trusting and drugged out mind. I obviously want this next 60 to be over with, but I know it's going to take time. I appreciate you taking the time to read this. 😊

#47 Flossy

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Posted 30 January 2015 - 02:50 AM

Also, I am definitely going to check with my dr to see about switching my shortfall of cymbalta with Prozac, thanks for that tip. I was put on Prozac in my early 20s, for mild depression, I'm 43 now, and I don't remember having any adverse effects when going off it. I had a baby at 20 and apparently through big hormonal events, some people(me) retain copper and it builds up, which would explain me having a little depression then!

#48 lady2882Nancy

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Posted 10 February 2015 - 10:59 PM

Posting to move this up the post list


#49 lady2882Nancy

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Posted 16 May 2015 - 03:38 AM

Bump


#50 Solauerbach

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Posted 16 October 2015 - 10:16 PM

ah here it is.
im bumping it up so other can have an easier time finding it


#51 lady2882Nancy

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Posted 17 November 2015 - 11:00 PM

This should bring it to the top for a bit.

How do you get a topic pinned to the top anyway? I know there is a way to do it but maybe you have to be an admin.


#52 fishinghat

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Posted 18 November 2015 - 06:50 AM

I think you are right Lady Nancy. Ken would have to do that.

 

I must be blind I just couldn't find it. Thanks


#53 sk8mom

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Posted 05 December 2015 - 11:35 AM

Helllo everyone...

omg I can't believe I still am familiar with some usernames on here, fishingthat, great to see you are still here helping people out :)

I was on this site in 2013.... I was then on 60mg of Cymbalta and had just weaned off remeron (15mg).... I am glad I did the bead counting, and went down from 60mg to 30 mg.... but it took me about a year. (patience is the key)...I had NO withdrawal symptoms at this slow pace.  Although in January 2014, my husband announced me he was leaving.... that put a stop to my weaning, I even got back on the remeron to handle the crisis and get good sleep.... now almost 2 years later... I can stay I am a divorced, full time mommy of 2 girls (14&11), the girls chose to live with mommy and visit their dad every other weekend.... that full time mommy responsibility and my full time job takes a lot of time and energy but I am coping quite well... so I think I am ready to start weaning my 30mg of Cymbalta to hopefully ZERO....even if it takes another year...  then I will tackle the remeron.  I think I am doing it the other way around this time because I need my sleep.

I am also on synthroid since 2010... so that nice combo of remeron, Cymbalta and hypothyroism made me gain a good 40 lbs in 8 years :(

I also notice that I have a lot more difficulty concentrating.... almost like a light ADD.... never had that before the meds.... I'm sure they don't help my memory either....

 

so, I will sure be back to keep getting support and answers from you guys :)


#54 fishinghat

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Posted 05 December 2015 - 12:47 PM

WOW!!!

 

Great to hear from you Sk8. It has been a long time. I am glad you have come so far and it sounds like you did exactly as you should have. Great job. Now the 30 mg, slow and patient. We can have a forum party when you get to zero!!   lol

 

Sorry about the divorce but sometimes that happens. Hold tight to your children and we are here when ever you need us.


#55 umopepisdn

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Posted 01 March 2016 - 04:39 PM

Oh man.  this is super helpful.  I'm on generic 60mg "prasco labs (ohio) / aurobindo (india) capsules.  Guess my boyfriend and I have a math project for tonight. 





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