36 replies to this topic

[kwannop]

Hi My name is Tan and I'm 20. I have been taking cymbalta 60 mg for 4-5 month and edronax 4 mg for 10 days and I decided to QUIT on cymbalta !! This is my second day cold turkey and the withdrawal effect is really awful. I have nausea, dizziness, extremely mood swing (crying, raging !!), 

 

Question

1.Which way of quiting is better ? cold turkey or gradually off ?

2.Which supplement should I take so the symptom can be managable ?

 

I'm feeling pretty great that I'm not alone Any advice for me : ))

 

Thank you very much and sorry for my bad English : )

[TryinginFL]

Welcome Tan!

 

You have found  a great place filled with wonderful people who want to help you!  First, your English is fine...

 

 I suggest that since it has only been 2 days, take your usual dosage NOW!  Then please read the topic "Bead Counting - How To Do It" under the "Are You New Here" where you just posted.  This is the easiest on your body and brain and since you are young and have not been on the drug very long, you should be able to drop a rather large amount of beads at intervals.  Just give your body time to stabilize before you drop more beads.  If you have questions, please come back and ask! 

 

Cymbalta only has a half life of 12 hours so you are in cold turkey withdrawal right now.  By bead counting, you should be able to avoid these symptoms (or at least keep them to a minimum).

 

There is also info on supplements under "Nutritional Support" - just look on the home page! 

 

I wish you the best and we are here if you need us!

 

Liz

[FiveNotions]

Tan, welcome to the forum, so glad you found us! Congratulations on your decision to get off this drug !!! ...... And your English is just fine, so don't worry a bit about it. We're here to help each other get off of Cymbalta, not to correct each other's English .... another one of our members is a native French speaker, and we've had members from a number of other countries ...
 
I agree with TryingInFlorida, definitely use the gradual bead-counting method to get off ... your having some strong symptoms from just 2 days of "cold turkey" ... get right back on your 60 mg dose, wait a few days until all the cold turkey symptoms have stopped ... then, start bead counting ...
 
Here's the link to the information on how to bead count ...

https://www.cymbalta...ng-how-to-do-it
 
TFL and I, and several others here, quit cold turkey. We made it, but it was hard, very hard. Like TFL said, you're young, you haven't been on the drug very long, and 60 mg isn't a really high dose .... all of those factors are definitely in your favor ...
 
Use the time while you get stable on your 60 mg dose to read up on bead counting, ask us any questions that you have, and make a plan for yourself ... and keep posting to let us know how you're doing ...

[kwannop]

My psychiatrist suggests that I should withdraw to 30 mg once per week and if it's okay I can do it twice and then all week 30 mg(like you take 60 for the rest of the week and you take 30 mg for only one day then increase the frequency of 30 mg) because my psychiatrist said that bead counting is hard to control. Any advice : ))

Thank you for all your generosity and advice : ))

[thismoment]

Hi Tan

 

The point of bead counting is to be able to finely control the rate of reduction. It's not difficult to do.

 

Why control the rate of reduction? The half-life of Duloxetine (Cymbalta) is 12 hours-- meaning that in 12 hours the effective drug has degraded to half its original strength, and in 24 hours it has degraded to one quarter of its original strength. At some point along the time/strength line of degradation, withdrawal symptoms will emerge. 

 

When you count the beads you are able to reduce the dosage slowly, consistently, and in a linear fashion (a gentle slope with no big steps). 

 

The ad-hoc method your psychiatrist is proposing will drop you in-and-out of some level of withdrawal over the entire time: you will be withdrawing-then reinstating-then withdrawing-then reinstating; it makes no sense. That process will promote stress, upset your emotional equilibrium, and unnecessarily burden your organs.

 

Your exposure to the drug is relatively short and there is some correlation between the length of exposure and the severity of discontinuation; this should go relatively smoothly for you with minimal symptoms if you taper off over 6-8 weeks with NO BIG STEPS in the process. 60 mg to 30 mg is a 50% reduction-- a huge step! Consider reducing by a just few percent each day.

 

If I had to choose between what your psychiatrist recommended and Cold Turkey, I would choose Cold Turkey!!

[FiveNotions]

kwan, I'm with ThisMoment ... your doctor clearly doesn't know much about how to get off of SSRI's in general, and Cymbalta in particular (very few doctors do, they know/believe only what the drug company sales reps tell them)... the method he or she proposed is going to put you into a roller coaster of cold turkey ... on and off ... don't do it, please!

 

Just use the bead counting method ... you do not even need to tell your doctor that's what you're doing ... just get your Rx filled, and use it to bead count your way down and off this stuff .... slowly and gradually ...

 

I went cold turkey, and it was awful. I don't want you to have to go through it ... and, using your doctor's approach, you'll be going through it repeatedly .... bead count, please.

[kwannop]

Thank you all you guys : ))

I have decided to bead counting but don't know how and where to start. I count my first capsule. It has 578 beads !! I don't know that I count it wrong or not(I guess I miscount some). I think it's too much to count. What should I do   Thank youu 

[TryinginFL]

Hi Tan!

 

How are you feeling?  Don't start any bead counting until you have no more withdrawal feelings!  You will need empty capsules that you can get at a Pharmacy or Health Food Store (these are for the beads you are removing).

 

You can start by removing whatever number you are comfortable with - such as 3 beads the first day, 6 the next, 9 the next and so on...

Should you start to feel any symptoms, stop reducing until you feel stable again and then pick up where you left off and continue tapering down.  There is no time line here - you can continue down dosing as long as you feel OK.  You may find that you will be able to remove more beads each time as you are young and have not been on the drug that long.  We have one member who was able to only reduce by 1 bead each day, but she made it and has been free of the poison for over 6 months now!

 

You can do this - and you should have minimal withdrawal symptoms using this method!  Good luck and please keep us posted..

 

Liz  

[FiveNotions]

Tan, neither TFL nor I used the bead counting method, so what we tell you is just what we've learned from others here who did ... hopefull they'll arrive her soon to comment and to correct anything TFL and I have said that isn't accurate ...

 

That said, TFL has the basic plan for you... first get completely stable on the 60 mg...

 

Read the info on bead counting in the thread I posted (well, follow the link I posted and read) ....

 

Also, while you're getting stable again, see if you can buy some empty gelatin capsules at a health food store or pharmacy ... if not, you can order them online ... I know for sure that Amazon.com sells them ... and I'm sure that many other sources do as well ...

 

That's great that you counted how many beads in one of your capsules ... and it's not essentially that you know the absolute "exact" number ... 578 is a fine number to work with ....

 

Save the beads that you remove ... a small bowl or even a small "baggie" or plastic bag would work ... you can use those beads later on, with the empty gel caps, to make the smaller doses for yourself as you've reduced quite far in dose ...

 

but remember, DO NOT take the beads unless they are in a capsule ... they all hit your bloodstream at the same time, and that's not a good thing ... they must be in a gel cap ... and keep them somewhere safe and secure ... you don't want any children or pets (dogs, cats, etc) to somehow get them and eat them ...

 

Like TFL says, start by removing just a small number of beads ... say 3 ... then the next day, 6 beads ... and so forth ... pay very careful attention to how you feel each day ... what is your body "telling" you ...

 

if you have symptoms that are bad, more than you feel you can handle, just slow down the bead removal process ... either stay at the level you are at for a few days until the symptoms fade / stop, or even go back up a few beads ... that is, remove fewer beads to increase your dose a bit ...

 

You can also control the process by waiting for a day, or 2 or 3 or 4 etc. days between removing beads ...

 

While there is a basic method for bead counting, it's actually a very individualized process ... because each of us is unique in how our brain reacts to Cymbalta ... both being on it, and especially while getting off of it ... you'll learn what you can handle, and you'll get a sense of what works best for you, very rapidly ...

 

Do not be afraid of this ... bead counting will give you control of the process ... you can stop / start anytime you want to ....and you can most definitely do this!!

 

And keep posting right here to let us know how you're doing!

[thismoment]

Hi Tan

 

I see you have the brand name Cymbalta by Eli Lilly.

 

I agree with TFL and FN. Get stable first (no withdrawal symptoms- feeling okay) on the 60 mg; that might take a few days or a week.

 

Here's a suggestion: 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 capsules. 2% of 578 is 11.56, but round that down to 11. 

 

Day 1- 

Take 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-

Take 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-

Take 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".

 

You can see how this works. You'll have a few extra beads left over at the end.

 

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 hope this helps.

[FiveNotions]

Great post / bead counting instructions, TM !
 
If you get a chance, would you cross-post this ... add it to the "Bead Counting - How to Do It" thread I started while you and FH were on "vacay" .. it's definitely "a keeper" ....
 
Here's the link to that thread ...

https://www.cymbalta...ng-how-to-do-it

[kwannop]

Thank you very much you guys are amazing !! Now I have symptoms like weak mental strength, laziness, fear(more than usual), lot of negative thought flooding in my brain, lost of concentration and can't spell the word "happy". I feel like I'm worthless because I couldn't control myself and have no motivation in doing anything  What should I do in this state ? Thank you : ))

[thismoment]

Tan

 

The weakness and tiredness is part of where you are in the process. I know it feels awful; there's a sense of permanence that yields droplets of anxiety. 

 

One of the most difficult mind states to accept is when we fail our own standards. For the moment (or at least for part of the day), this is your world and different standards apply: if tomorrow you woke up with an arm missing, would you be justified to feel responsible for its disappearance? No. Accept it.

 

To deal with your current mind state, first-- accept it: for the moment, this is who you are (but remember-- you are transforming). Second-- acknowledge that you have no guilt to bear for that mind state (you neither planned it nor caused it). Third-- happiness manufactures happiness: do ONE thing today that you could not do yesterday. Just one thing that made you feel "worthless because I couldn't control myself . . . "

 

Change the "I'm worthless" to "sometimes I feel I am less worthy". Do you see the difference in that self-talk? Much of the fabric of the future is woven from the threads of self-talk from the past.

 

The lethargy and brain-fog will slowly go away. One of the most pro-active things you can do to feel less out-of-control is to foster your dignity, which is surely the foundation of humanity. Shower, wash your hair, put on your usual makeup, get dressed; impose a bit of order on the chaos. 

 

Try this little thing and tell me how it goes.

 

Hang in there!

[kwannop]

Thank you Thismoment!!, I'm really glad I found this forum )

[FiveNotions]

And we, too, are very glad you found us, Tan!

[kwannop]

Should I stop edronax(ruboxetine) before withdraw Cymbalta because I intend to be drug-free after all ?

[FiveNotions]

Hi Tan, I don't know anything about this drug ... I'll research it and learn, and hopefully others here have some knowledge ..

 

What I can say, for sure, is don't quit more than one drug at a time! 

 

What is the edronax for? Also, why did you start the Cymbalta? Was it for depression / anxiety, fibromyalgia, etc?

 

Is the edronax helping you?

 

My thought, subject to what others here wiser than me have to say, is that you've embarked on getting off the Cymbalta ... do that first, and do it slowly ... yes, you want to be "drug free," but doing it all at once will only set you up for failure, and quite possibly put you back on drugs again, and more of them ...

 

The goal is to get off of the drug(s) slowly and gently ... one at a time ... don't rush yourself or set unreasonable goals ...

[FiveNotions]

Interesting ... I just read the Wikipedia article ... http://en.wikipedia....wiki/Reboxetine
  
Edronax (reboxetine is the generic name) is made by Pfizer. It's also marketed under the name "Prolift. BUT it's not available in the US, only overseas.

It's an SNRI (norepinephrine reuptake inhibitor), so Edronax works on just norepinephrine. It's not an SSRI (serotonin reuptake inhibitor)like Prozac and Zoloft.

Cymbalta is an SSNRI, meaning it inhibits reuptake of both norepinephrine and serotonin -- however, it's primary action is on serotonin.

The Wikipedia article indicates that there's a lot of discussion as to whether this drug is even effective. I think it said that in at least one study, Edronax didn't perform as well as the placebo....
 
It's got a short half life -- 12 hours -- just like Cymbalta. So could be a tough one to get off of as well. ... The longer the half-life, Tan, the easier it is to gently dose down without the symptoms hitting. For example, Prozac has a half life of approx. 36 hrs (can be longer).

 

It also has some very ugly possible side effects ... that list alone makes the Wiki article worth reading ... it's at the bottom of the page ...

[FiveNotions]

Tan, you're young, and you have a whole wonderful life ahead of you. Getting tangled up with psych drugs this early in your life has the capacity to alter your future in ways that may not be very positive. Taking meds puts the control of your life in the hands of the drugs, their manufacturers, and the doctors who write the prescriptions.

I speak from experience, once you give the control of your life over to a drug (be it cocaine, heroin, or an antidepressant), you lose yourself, moment by moment ... and it becomes harder and harder to take your life back as time goes by ...

I think it may be wise to ask yourself now why you are on these drugs, and what alternatives you can use to deal with the reasons that you've been taking them.... non-drug alternatives, like cognitive behavioral therapy, yoga, meditation, diet, exercise, acupuncture, acupressure ... just a few that come to mind ...


 

[kwannop]

Ohh Thank you very much Fivenotions for your generosity and kind advise I really appretiate it. I think I will start with cymbalta then. Can I ask you something ?What's your symptoms ? Are you drug-free now ? If so, Do you still have symptoms ? What do you do about it ? 

Thank you very much : ))

[FiveNotions]

Here's an article on reboxetine from the British Medical Journal ...
 
It's been around for over a decade, but was never approved in the US, as it was deemed insufficiently effective and potentially harmful ... Germany declined to approve as well ...
 
Only the abstract of the BMJ article is available, but it says enough to give me serious concerns about this drug ...

-----------------------------
Finding studies on reboxetine: a tale of hide and seek
British Medical Journal (Oct. 2010)
http://www.bmj.com/c...j.c4942.extract

The antidepressant reboxetine, a selective noradrenaline (norepinephrine) reuptake inhibitor, has been approved in several European countries (including the United Kingdom and Germany) since 1997. However, approval was declined in the United States in 2001. The German Institute for Quality and Efficiency in Health Care (IQWiG) report on the benefit and harm of newer antidepressants concluded in 2009 that, overall, reboxetine was both ineffective and potentially harmful. . . [emphasis added]

An additional analysis of published versus both published and unpublished evidence shows that published evidence overestimates the benefit of reboxetine, while underestimating harm. These typical effects of publication bias have been identified (and in part quantified) not only in other research on antidepressants4 5 but in a wide range of treatments. [emphasis added]

Biased evidence may form part of a marketing strategy. Analyses of litigation documents, which are available at the Drug Industry Document Archive (http://dida.library.ucsf.edu), have shown how trials and journal publications are used as marketing tools to promote drug use.

--------------------------

[FiveNotions]

Hi Tan !

 

I was on Cymbalta 60 mg. for 7-8 years. I quit, cold turkey, last year -- 12/4/2013. It was a very dumb thing to do, quitting cold turkey, but at the time I had no choice ... I'd lost my health insurance and was unemployed, so had no money to pay for the full price of the drug (approx. $600 a month here in the US).

 

I'm much older than you -- early 60s. I was also (still am) in lousy general physical condition -- virtually no exercise other than walking.

 

Those factors, plus having been on it for so many years, likely made my CT withdrawal even harder than it would typically be. I won't go into all the scary details, but here's a summary ... I was pretty much confined to bed for a 4 weeks, during which time I could not eat any solid food, other than a cracker or two ... I drank only liquids like chicken broth and herb tea, and apple juice. I had almost constant vertigo (extreme dizziness and nausea) ...

 

In other words, I was sick. Really sick. I was an extreme example of Cymbalta withdrawal.

 

Now, here's the important thing ... I did not need to be on this drug !!! I ended up on it only because I had a horrid "adverse reaction" to the generic form of Wellbutrin, another antidepressant that I'd been taking for almost 10 years ... the generic Wellbutrin caused me to have a major psychotic episode, and I was hospitalized ... in a locked mental ward....

 

The Cymbalta was given to me to "glue me back together," so to speak, after the psychotic episode ...

 

Another important thing ... I did not need to be on the Wellbutrin that caused me to have the psychotic break.

 

I was put on Wellbutrin to help me with depression/anxiety related to the ending of a very bad marriage in the mid-late 1990s. All I needed was good therapy .... but these drugs had become readily available and were all the latest "rage" ... a pill ... "easier" than working on issues in therapy ...

 

And, I was young and naïve... and I took the easy way out ... I took the pill...

 

This is why I'm saying these things to you, Tan ... I look back and see what happened to me ... what was done to me ... through no fault or intention of my own ... I needed help, and I reached out for it ... and instead of a "hand" to hold mine, and therapy to talk through what was hurting me, I was given a little white "magic pill" ... and then, over the years, came other "magic pills" ...

 

I have lost a lot of years of my life to these drugs, Tan ... I don't want that to happen to you, Tan ... or anyone else ....

[FiveNotions]

PS ... and there is a happy ending to the story ... life after Cymbalta is good, very good!

[thismoment]

Tan

I think you should work with a psychologist to help you address this.

[stasia]

Hi all..

So there has to be a different percentage reduction on the TYPES of cymbalta available? *breathes*. I'm on a Generic brand (just straight up Duloextine) and I have 410 beads per 60mg cap. I apologize for being incredibly slow.. But due to my current head space and fear of mathematics I'm struggling to figure out what I need to remove and when! The list made sense but I am not on the official cymbalta brand.

Does anyone here know about transitioning from one anti depressant to the next? Because I think I would really like to get back on my first medication (lovan) just so I can feel some friggin relief from this anxiety and depression.

[TryinginFL]

Stevie,

 

There is also info in the Bead Counting section regarding the generic.  I'm sorry, but I cannot be of much help here as I am a cold turkey survivor - have never bead counted!  Hopefully someone will hop on here soon to help you out.

 

I suggest you talk w/your Dr. regarding cross-tapering if you want to go back on another med while down-dosing the C.

[thismoment]

Stasia

 

Hi. How long have you been taking duloxetine (Cymbalta), and always at 60 mg?

 

If you've been on for more than a year you might consider tapering off over 100 days at the rate of 1% per day. Your 410 beads is good to work with. Get 50 caps of your generic duloxetine and 50 empty gel caps from the health food store. 

 

I know it's sometimes difficult for us to search archives when we're struggling, so here's the general outline of weaning off the C. 

 

Using 410 beads-

Day 1 take out 4 beads, reassemble the cap and take it.

Put the 4 beads into an empty gel cap and label it "Day 100".

Day 2 take out 8 beads, reassemble the cap and take it.

Put the 8 beads into an empty gel cap and label it "Day 99".  And so on down to day 50.

 

You take out 4 extra beads each day and you're half way at day 50. You've got the last 50 capsules all labelled and ready to go. Simple.

 

Cross-Training-

As for cross-training to Lovan, that should be pretty straightforward. Lovan is generic fluoxetine, which is Prozac-- the very first SSRI. The transition from duloxetine to fluoxetine is generally very successful: Start taking the Lovan right now along with your Cymbalta. After a month begin tapering off the Cymbalta in a gentle slope with no steps in it. Consider weaning off the C over about 2 months.

 

Benzo for anxiety-

You might consider a benzodiazepine on an as-needed basis to keep the anxiety down. Perhaps the Lovan will work for anxiety and you can forget the benzo. 

 

You can do this. Get the doctor on board with the cross-training to Lovan. The doc will suggest you just drop the Cymbalta when you start the Lovan, but that will bring on withdrawal symptoms for a number of weeks until the fluoxetine comes on stream at 4-6 weeks.

 

Best wishes. Hope this helps.

[fishinghat]

TM is totally correct. I would like to add that hydroxyzine (a antihistamine) and clonidine both work fairly well on anxiety. Like all medicines there are drawbacks as well. Benzo is addictive with also a wicked withdrawal, although there are ways to deal with that as well. Both hydroxyzine and clonidine can (but not always) make you sleepy and both can lower blood pressure some.

 

But certainly Prozac is easier to wean off of than Cymbalta.

[stasia]

Ah! Thank you so much guys. I have only been on 60mg for 4 months (thankfully) - I wrote a post explaining my situation under "are you new here" sorry if I am not posting in the right threads, I keep finding updates on bead counting in different posts. My mother mentioned asking for a low dose benzo to help with the anxiety, I'm just a little warey of putting more possibly addictive substances in me while I already have the cymbalta. But I will see my doctor first thing tomorrow and discuss it with him.
I'm just in disbelief as to how much I don't feel like myself at all any more.

Thanks again guys

[kwannop]

Hey guys just wondering that if I use tip of my finger to seperate the beat and store it in the new capsule. Does the humidity decrease the potential of the drug
P.s. I don't use saliva to stick the pellet just press it hard and it just comes up
Thank you very much )