40 replies to this topic

[Pups4Life]

Well, I'm 31 days off of Cymbalta and while the dizziness and brain zaps and gastro issues (finally!) have subsided, I am an emotional wreck!  I have tried to will myself out of this dark hole, but that hasn't helped either.  The anxiety is brutal and the depression is pretty dark.  I hate to admit it, but I'm having a lot of suicidal thoughts (will never do anything) cuz it seems pretty hopeless.  My head spins negative thoughts over and over, I'm barely sleeping and nothing is enjoyable.  I still have pretty severe shakes and shivers at times and the nightmares make it pretty scary to go to bed at night.  I have a new therapist who is AMAZING (I'd like to start calling her "mom") and yesterday I called her in crisis mode and she met me within a couple of hours.  I walked into her office and she met me at the door and said "you need a big hug" and she wouldn't let go.  I definitely feel blessed to find her!!  She happens to also have a nursing background and tells me I'm in the midst of withdrawal.  We talked about maybe going on some other kind of medication and while I'm feeling resistant to that (there's a sense of failure and moving backwards) I also need to be able to find some kind of quality of life as this isn't quality...at all. She works with some hypnosis and while I leave her office feeling better, the anxiety creeps back in an wreaks havoc.  I refuse to ever go on Cymbalta again, but am open to going onto something else in order to get out of this hole.  My doctor is not very helpful and difficult to get into and I have an appointment with a psychiatrist (that I was really trying to avoid going to) in three weeks, but was feeling I needed some medical advice, so I just got back from a walk-in clinic.  The doctor there insists that this is NOT withdrawal and there's no such thing as the "brain needing to rewire".  She is pretty adamant that this is because I have an illness called anxiety and depression and will need to be on medication to manage that...for life.  Wow.  I don't own what she says, but why oh why is it so hard to find a doctor with common sense?  We talked about various drugs and she suggested Effexor or Pristiq.  I said no way Jose, I won't go on a drug similar to Cymbalta and she again argued that they are not even in the same family of drugs.  (aren't they all SNRI's?)  I asked if she's had patients with difficulty coming of Cymbalta and she said she's never heard of people struggling to come off.  Knowing we weren't going to see eye to eye, I just asked what I can do between now and when I see the psychiatrist.  I asked about Zoloft and she said is doesn't work for anxiety and panic at all.  As our conversation went on, she suggested sertraline as it does help with anxiety.  I asked what the brand name was and she said she didn't know.  Zoloft.  It's Zoloft.  So, I politely took the prescription for ZOLOFT and am sitting here thinking, WTF do I do now?  If someone could guarantee me that this is temporary and if I stick it out I will start seeing light, I might be able to push through.  Unfortunately, there are no such guarantees and I'm afraid of how much darker this will get.  I'm exhausted beyond measure, feeling pretty hopeless and too tired to cry right now.  This anxiety gets me to the point of feeling hysteria...can't think straight, dread getting through the day, feel shaky and want to crawl out of my skin.  Can anyone relate?  

 

[thismoment]

P4L

 

I can totally relate! And so can the rest of the good people who come to this forum every day to try to find new words to say the same things: hold on; it slowly gets better; there will be light at the end of the tunnel; you can do this; try to find something to distract your attention; walk-- get tired each day; accept the thoughts-- even the suicidal thoughts-- you can't think them away; be patient; listen to your body; be patient; be patient.

 

Here's a timeline you've seen before: 6-8 weeks of struggle; another 6-8 weeks with intermittent breaks that give you hope-- there's a light at the end of the tunnel. After 6 months you are over the hump and dusting yourself off and walking away from the whole thing. There will be small waves from time to time, but it's clear you are out.

 

It's never wrong to take medication when you need it, but in discontinuation it's hard to tell IF you need it-- the doctor doesn't want to see you suffer so he or she will be quick with the pen and prescription pad. I think the therapist is the best hedge against getting into a med unnecessarily, but it so hard to know-- I understand how difficult it is to know. But if you can manage to put in a few months you will know.

 

I wish I had the words or the magic or the divine grace to give you peace; I don't-- I can only wish it for you.

 

Take care.

[fishinghat]

listen to TM. He knows what he is talking about. You have already seen improvements (brain zaps, GI issues...). It will be slow but it will get there.

 

If you really get where you feel you need something I would not recommend another ssri/snri (the family of drugs which include Cymbalta and Zoloft) or a benzo (like Ativan, Valium, Xanax) as they are very addictive, loss effect after a few months and have a wicked withdrawal too.  I would start with clonidine or hydroxyzine. Although they can have side effects like lower blood pressure or sleepiness (esp at first) but have little or no discontinuation symptoms. THEN if they don't work you go to something like the Zoloft. While similar to Cymbalta is has a much longer half-life and a less severe withdrawal. That should be a drug of last resort.  Now with that said I think you can work your way through this, probably without any other med. It will be tough but can be done.

[lady2882Nancy]

Hey Pups4Life

 

You sure are right that sertraline is Zoloft and I know that for me it worked wonders to get rid of my anxiety and panic.

I was given it about 12 weeks off Cymbalta and was amazed at how quickly it worked for me.

It was my then new Psychiatrist's drug of choice when she saw just how anxious and panicky I was.

I really resisted taking it as I didn't want the terrible agony of discontinuing another antidepressant but good news there too as this was so easy to discontinue when I did decide to 6 weeks later of course I was on a very low dose.

What dose were you give?

Most don't advocate taking another antidepressant at this far off but it worked for me and I know that it is worth a try. If it doesn't work you will know that your symptoms are not related to the antidepressants

 

Hang in there, it will get better

[Pups4Life]

Thanks for all the words of wisdom and encouragement. It's so frustrating that the medical professionals can't see past the nose on their face and just don't listen to the people they are giving these drugs to....and are simply so uninformed. Why os it that everyone into support system OTHER than physicians can agree that there is indeed a process of withdrawal and discontinuation from these meds. I have some clonidine and whole I took some last night, I took a small dose (.05 mg). I also have BusPar that was prescribed a while ago but I never took it because of the drug interaction with Cymbalta...anyone tried it? I took some clonazepam this morning as well but hate to use the benzodiazepines. I will try some of the suggestions here before jumping to the Zoloft.

[thismoment]

P4L

The caution for mixing BusPar and Cymbalta is considered 'Major'.


http://www.drugs.com...1690-0,949-2273

[Pups4Life]

Oops...the dose I was given is 25mg. What I find hard with all these drugs is many can CAUSE anxiety and depression...the very thing they're supposedly treating, so if it doesn't work, is that actually indicative of it not working or causing side effects? I only ask because many of the SSRIs have worsened anxiety for me.

[Pups4Life]

Thismoment...that's why I didn't take it. And I specifically asked the doctor if it was ok to take them together and he said yes. When I got to the pharmacy they told me not to take it. I explained I was only on 20 mg of Cymbalta but that didn't make them any happier to fill it. And this is why I have very little faith in doctors.

[lady2882Nancy]

Hey Pups4Life

 

I took Buspar for anxiety and might as well have taken nothing, but the my anxiety wasn't run of the mill anxiety.

 

My dose of Zoloft was only 10mg. I wouldn't have taken much more than that LOL.

 

Who me? have a trust issue? I can't imagine why.

[thismoment]

P4L

 

When in doubt about medications or the interaction of medications I speak only with the pharmacist, not the doctor.

[Pups4Life]

You and me both, TM! Yet the pharmacists know diddly squat about coming off this stuff too. I just find it maddening that doctors are so incredibly brainwashed and narrow minded. I swear there's something in the water at med school that makes them stop listening to people and common sense. (I say this because I worked for a doctor who was SOOOO closed minded)

[thismoment]

Pups

 

The doctors learn about the drugs via schmoozing with the Drug Sales Reps.

[Pups4Life]

Hey Pups4Life

 

I took Buspar for anxiety and might as well have taken nothing, but the my anxiety wasn't run of the mill anxiety.

 

My dose of Zoloft was only 10mg. I wouldn't have taken much more than that LOL.

 

Who me? have a trust issue? I can't imagine why.

I just looked it up and can only find Zoloft in 25, 50 or 100 mg...maybe cuz I'm in Canada?  (I know we can't get Cymbalta in anything other than 30 or 60 mg)  

[lady2882Nancy]

That can't be why Pups4Life as I am in Canada too

[fishinghat]

P4L

 

I have taken buspar for 13 years concurrently with an ssri or snri. The drs tell me not to exceed 20 mg per day with 10 mg being recommended. Above these doses there is an increase risk of seratonin syndrome. It is one of the weakest anxiety drugs there is but has little to no withdrawal. It tend to give me a little bit of a more positive attitude about life and that is all (God knows I need a more positive attitude!!  lol).

[Pups4Life]

So, yesterday I had a better day...I got to the gym (I haven't been in over a month) and worked for a few hours.  I've been taking the clonidine which helps with the anxiety, but man, it's knocking me off my feet.  I can't believe how tired and lethargic I am.  Today I'm having trouble concentrating too so I stopped by the drug store and checked my blood pressure...121/57...which I believe is a bit low.  The anxiety isn't horrible, but I'm not sure if it's the exhaustion that's getting me down or if it's depression worsening, but I feel pretty low today.  I really, really don't want to go back on meds and am working with a fantastic therapist right now, so when do I know if this is withdrawal and will improve, or if it's time to try another med?  I'm doing some research on ways to increase serotonin through diet and supplements and exercise (and I'm already on a bunch of supplements), but I'm feeling pretty vulnerable to all this right now.  I have no desire to do anything at all and being home and resting is so anxiety producing because it just gives me time to think and think and think.  Any advice?

[thismoment]

P4L

Glad to hear you had a better day yesterday. If the clonidine is sedating you, reduce the dosage and/or take it at the end of the day.

The tired and lethargic feelings are par for the course for many of us in discontinuation.

It's very good that you are happy with your therapist-- but note that very often the therapist will chant the same mantra as the physician: "At five weeks you are long past the withdrawal and discontinuation". This chatter has a way of discounting the suffering and symptoms of the patient in discontinuation, and it often leads quickly to another prescription you may not need.

It's not over in 5 weeks. Often the sole and relentless topic of the thought-storm is all about getting another drug on board to ease the pain-- this is a normal self-preservation mind-state when coming off any drug.

". . . when do I know If this is withdrawal and will improve, or if it's time to try another med"? You will know within 6 months of weaning off (based on anecdotal data).

 

This is from my post of Feb. 10:
"Here's a timeline you've seen before: 6-8 weeks of struggle; another 6-8 weeks with intermittent breaks that give you hope-- there's a light at the end of the tunnel. After 6 months you are over the hump and dusting yourself off and walking away from the whole thing. There will be small waves from time to time, but it's clear you are out."

Pups, discontinuation is an exercise in tolerance and finding distraction. But if symptoms are intolerable, of course it's prudent to start another medication to stop the pain of discontinuation. Only you can determine where that line is.

I can't say what to do. I assign no moral importance to being on or off drugs of any kind-- it's simply irrelevant in my view. The most important thing you can do for your future is imagine where (and who) you would like to be in a year or so, and articulate that to your therapist. The therapist will help you move toward it-- if being drug-free is part of that image, say so. If not, that's okay too.

 

Quality of life is all that matters, and only you can define that abstraction.

Right now the best you can do is find ways to distract yourself as you pass through this period of agitation.

Take care.

[fishinghat]

P4L

 

Been on clonidine a long time. That sedation effect will slowly taper over several months. Just like TM said, the drs around here typically prescribe if to be taken in the evening and when the patient has been on it several months they may then prescript some more for daytime use.

[Pups4Life]

Thanks for the response. My therapist is different in many many ways...she's the one who told me I was in the throes of withdrawal (she's a nurse as well) and we've been doing some hypnosis to get me to where I want to be. I want nothing more than to be drug free...I see some differences in my personality already being off of them for the 5 weeks...and I want to discover who I am without the chemicals. I guess it comes down to trusting myself, trusting that I've made the right decision to come off of them....and that's a huge work in progress. What concerns me is just how dark the days can get...and my fear gets caught up in the wondering of how much darker can they get. I am having a hard time working and having no other ways to obtain an income, I need to keep working. I do take the clonidine at night...I was taking .01 and reduced it down to 3/4 of a tablet (I'm not doing the math). Is clonidine something that can be taken as needed or do I need to keep on it?

[fishinghat]

P4L

 

You need to keep on it as scheduled. It is also used to stabilize blood pressure so if stopped suddenly your bp will jump up and you will become physically jumpy for a 2 or 3 week period. Nothing like Cymbalta but you don't need to jack up your blood pressure. By the way I would imagine your dose is 0.1 mg not 0.01 mg.

 

Hang in there my freind.

[Pups4Life]

Yes, you're right...it's 0.1mg.  I quit taking it and had a better day yesterday...today the anxiety is pretty bad again so I'm not sure what's best...to take it and feel stoned or feel so anxious.  There are so many faces to anxiety and this is quite different from how I've felt before.  I was visiting with my sister and brother and their spouses today and wanted nothing more than to just go home...but knew that if I did, as soon as I got home I'd not want to be there either.  Home is a hard place to be as it's just me there and being in my own company is the hardest.  I was feeling quite jittery and shaky while visiting and was constantly looking at the people around me and wanting to be able to live life through their eyes.  And in that I mean not analyzing every thought and feeling and fighting to stay put together.  Right now I enjoy nothing...I was once a very sociable person and now my world is so small.  Mostly because I feel so much shame...shame for struggling with this horrible depression and anxiety.  I don't want anyone's pity (so I hide it from most people) and at the same time it feels like admitting I am going through this puts me on a lower level of humanity than my friends and family.  And I don't feel that way for one second about anyone else who struggles with depression and anxiety...a big double standard, I know.  Just where my head is at.  (This isn't just withdrawal...I've felt that way the whole way through this).  This anxiety causes me to shake and shiver and at times I feel like I'm going completely crazy and on the verge of hysteria.  Is this what other people's anxiety is like?  I've dealt with anxiety my entire life, but used to be able to push through it and continue to enjoy doing my day to day activities.  I'm working hard at getting some exercise as a way of raising serotonin levels, but I'm finding after 1/2 hour of any type of cardio, my legs shake and I spend the rest of the day trying to recover.  Anyone else feel that way?  (I used to be a gym rat and a runner...until Cymbalta)

[TryinginFL]

Awww Pups,

 

You expressed your feelings so well, I can identify with all of it.  Especially the not wanting to spend time with yourself at home.  I did that most of the time when the anxiety was actually "freezing" me.  I took/take Alprazolam (Xanax) but have been able to cut the amount in half at this time.  I couldn't have made it otherwise.  That was absolutely the worst for me.

 

I had a slight recurrence of that yesterday and today as a DVD that was sent to me brought back a time that provoked the worst anxiety I have ever experienced in my life.  I had never had it before this lousy crap drug.  When you hear that this whole discontinuation thing is cyclic, that is for sure - times in between grow longer and hopefully they will fade into nothingness, but I still get them 13 months off the crap.

 

No, you are definitely not alone - not that it helps much, but at least you have company!  I still feel at times that I am somehow beneath others because of what I have (and sometimes still do have) going on with me.  I hate it, but can't do anything about it.  The best we can do is just accept it - and you should feel no shame - you didn't choose this any more than any of us did.  It happened and we will do our best until it suddenly fades.  That's what happened with the anxiety - one day I realized that it just wasn't hanging around any more.

 

You will be OK - hang on!

 

Liz

[gail]

Pups,

Just know how you feel.

I think that you would render a great service to yourself and others by telling them that you are going through a tough time with anxiety and depression. No need of details.

Trying to hide it or make believe that you are fine is a hard task and asks a lot of energy, while making you feel worse and ashamed.

I do think that it would liberate you, it did for me!

[Pups4Life]

Thanks ladies.  Those who are close to me do know what's been going on...it's just that I've been in crisis mode for 2 1/2 years and I'm afraid people are getting sick of me.  I've been doing a lot of reading on discontinuation syndrome but can't find much stating that it lasts longer than a couple of weeks.  Today is a hard day.  I'm super agitated and depressed and not seeing a way out.  My thoughts are dark and are sending me into a tailspin.  My prayers have been that God would strike me dead or make this stop...and I'm not getting an answer either way.  I can't even explain how I feel, really...agitated, anxious, angry, sad, hopeless...those are just a few.  I don't have any bad relationships or situations in my life driving this...I really have a lot going for me...lots to be grateful for.  I have a family who loves me, a few great supportive friends, my own home, two little dogs who are like my children...and yet I am unable to enjoy any of it.  I know my journey is taking me down the path of learning to love my self...and that seems unsurmountable right now.  I don't know how to love me when I hate my own existence and feel like every hour of each day is something I need to survive rather than just live.  I feel stuck between a rock and a hard place as there's a part of me that wants to try another medication just to make this stop, but I've tried so many drugs and they simply don't work and in fact, make things worse.  I just don't know what else to do.  Sorry for the negativity...it's just truly where I'm at today.  

[thismoment]

Here are a couple of articles and forum discussions that may be of interest to all. Dr. Stuart Shipko has been observing discontinuation from antidepressants for some time.

http://www.madinamer...n-acknowledged/

http://www.madinamer...odds-revisited/

[DoneWithCrap]

Sorry I can't offer any positive words of wisdom for you as I feel the same way about myself and my life.

I can tell you that I do have some breaks from this depression when I can enjoy at least part of the day.
It is getting slowly better with time for me. I'm sure you will start to feel this weight lift for you too. It takes time and it is inconsistent

[jimmcg]

I went off Cymbalta August 25 after being on it for about 6 years. I was on various anti-depressants for 22 years. It was a rough fall, and I'm sorry to say that after 6 months completely clean of any drugs it's still rough. Clearly I'm dealing with an anxiety disorder and it harkens me back to me teens when I used illegal drugs to self-medicate, not knowing what was going on. I went on the anti-depressants a couple of years after coming out of a 28-day program.

 

So now, after 6 months I'm thinking, okay, is it really going to get much better than this? I have a lot of anxiety. Things get blown out of proportion. I ruminate endlessly on things that don't deserve the worry. Currently, no matter what time I go to bed -- 9 pm or midnight -- I wake up at 4:30 and don't sleep any more. That's making it pretty difficult to handle the anxiety, and for the first time today I started thinking if this doesn't get better in the next two months I'd better resign myself to some kind of medication because I don't want to live like this. I'm seeing a very good analyst once, sometimes twice a week, I'm meditating, I'm reading books on dealing with anxiety and rumination, but it's just not getting much better and I'm getting pretty discouraged.

 

Read reviews of any anti-depressants or anti-anxiety drugs and you see some don't work for some people, but Prozac seems to get the least bad reviews and seems to have a reputation for dealing with anxiety.

 

Anyway, I'm sure this report won't cheer you up, but this is where I am exactly 6 months after Cymbalta and working my butt off to get better.

 

JM

[thismoment]

Hi Jim

Nobody likes to hear that their case is 'typical' for fear of it not being taken seriously. I do, however, take it seriously-- and your case IS typical. It happened to me and many others just as you described it.

The "hump month" for discontinuation is month 6. After 6 months the waves of anxiety, sleeplessness, and chronic self-focus get smaller and further and further apart.

The fact that you are pro-active with a therapist, meditation, and research is very positive. Find a way to get the anxiety down because it is the consummate destabilizer, and it will therefore dictate your next move.

It won't be done in two months from now, and to assign a timeline on your healing is to doom the process; it's done when you no longer focus on the symptoms-- it all slowly fades and fades. Find distractions that capture mental bandwidth-- something exciting-- and get the anxiety down with a benzodiazepine, or perhaps hydroxyzine.

Take care.

[jimmcg]

Thanks for the good words, thismoment. That helps give me some hope. Unfortunately 19 years of addiction problems many years ago precludes use of any kind of benzos or even sleeping meds. That's a slippery slope for me and my kind, so I just have to gut it out. Trying melatonin for sleep. Seems to get my 5-6 good hours, but the alarm in my head still goes off at 4:30 am! Getting enough sleep to survive but not enough to be cheerful!

 

Anyway, I'll be patient. Bit of a stressful time at work right now and that seems to exacerbate the anxiety. I get a break in another week.

 

JM

[thismoment]

Repositioned to "The Fade".