4 replies to this topic

[thismoment]

We taper off these drugs slowly in order to keep withdrawal symptoms to a minimum. That way we can function-- go to work, drive the car safely, and not alienate everybody in the household.

 

Tapering off slowly, however, keeps you exposed to this neurotoxin for a longer period of time, and there is a greater risk of encountering medication toxicity. Even though the drug is being gradually reduced, your organs are still being exposed; therefore, it's important to monitor your symptoms throughout the weaning program.

 

Cross-tapering (uploading a second drug while reducing the first one) can exacerbate medication toxicity if the second drug is of a similar type, like another serotonin-related med. Physicians would normally be aware of negative drug interactions, but you can check it yourself by going to www.drugs.com and see Interactions.

 

Should symptoms of toxicity emerge, it's time to consider quitting immediately-- Cold Turkey! Areas of concern would include (but are not limited to) the following: liver, kidney, signs of tariff dyskinesia, skin rash, Serotonin Syndrome, heart arrhythmia, suicide planning, self-harm, and mania. Of course it's recommended that you have your physician in the loop while you are withdrawing.

[Ramona80]

Interesting, because I have tried to find information online about cross-tapering Cymbalta with another antidepressant, and there really isn't much information. I take it cross-tapering isn't done very often when you're reducing Cymbalta?

[thismoment]

Hi Ramona

 

Actually cross-tapering is fairly common when withdrawing from Cymbalta, and a long half-life SSRI like Prozac (flouxetine) is often used. Because there is a risk of Serotonin Syndrome and other complications, the process is closely monitored by the physician.

[Ramona80]

Is Prozac ever started before the patient starts the Cymbalta wean? All I've ever read is where people use it as a "bridge" near the end of their Cymbalta taper.

[thismoment]

Ramona

 

My understanding is that the cross-tapering drug should be started before the Cymbalta is tapered off. But also, the cross-tapering drug (say Prozac) is weaned in slowly for a few weeks before the Cymbalta is slowly weaned off. 

 

The Prozac might reach full dosage after 6 weeks or so while the Cymbalta is weaned off over 8-12 weeks.

 

Then after a period of time, the Prozac is weaned off. There may be need for a benzodiazepine on an as-needed basis for anxiety. As you know, the benzo is as dependency-forming as the serotonin meds and they need to be weaned off too if taken regularly.

 

This is arrived at via anecdotal examples; I have no scientific data to support this, and all comments are requested.