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Weaning Off Cymbalta Before Getting Pregnant


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#1 deadbirddiary

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Posted 12 August 2015 - 09:16 AM

Hi everyone! I'm new here and I was looking for some advice/support for the journey I am about to go on. About 8 years ago I suffered from two major panic attacks that sent me to the hospital. After these panic attacks I was put on Paxil. I was on Paxil for about 2 years when I was changed to Cymbalta. 

I have been on 30mg of Cymbalta for 6 years now. My husband and I would like to begin trying to start a family soon. I went to my doctor (physicians assistant) and told him that I had heard that being on Cymbalta is not safe for a pregnant woman. I don't really like my doctor (physicians assistant), but he was the only one I could find in a jiffy. Where I live doctors accepting new patients are about 2 months out on appointments. He spent the entire time of my appointment Googling on his phone. He finally was like, "Hmmm, yeah... I mean. There are risks with any drug you take. You'll probably be fine". I then told him about my Hulk-Smash PMS rage to which he said, "Yeah, that happens. I usually give woman Cymbalta to women with those problems but you're already on it". So I left that appointment feeling helpless.

 

I decided that I want to be off all prescription drugs during my pregnancy. I know quitting Cymbalta is going to be bad. I have missed days and I get crippling depression and anxiety. I always say it is like I am Chicken Little mixed with Eeyore. The sky is falling and there is nothing we can do about it so let's cry and take a nap. I would consult a doctor on this issue, but you see how well it went before. 

 

I thought about increasing the hours between my dosage, but it looks like bead counting is the best method. I'm hoping to go see a therapist during this time to help. I am looking for suggestions on how many beads to cut back on every week.

 

Thanks and I look forward to being a part of this community.


#2 thismoment

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Posted 12 August 2015 - 09:51 AM

deadbirddiary

Hi and welcome!

The FDA has rated Duloxetine (Cymbalta) as a Category C: "Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks."

There is much information online about Cymbalta and pregnancy that ranges from good to bad-- therefore, one must scrutinize the source of the information: This 'study', for example shows that there is no deviation in fetal defects when compared to the national average http://www.ncbi.nlm....les/PMC3590601/ You must look closely, however, to see that the 'study' was paid for by Eli Lilly and the researchers were hired, or are on the Eli Lilly payroll-- click on the names of the researchers to see who's paying them.

Avoid WebMD as that is an Eli Lilly site.

Drugs.com is a useful site. Here is a note on Cymbalta and pregnancy from their site: http://www.drugs.com...duloxetine.html

http://www.cymbaltap...ncyregistry.com This is the website of the Eli Lilly (Cymbalta manufacturer) Pregnancy Registry-- you can register and participate in their study of babies born to mothers taking Cymbalta. It's been online for many years, but still looks active.

The child will be born with its body modified when compared to having been born without Cymbalta present in the mother. Is this bad? Eli Lilly says it's okay; the FDA merely cautions. Can the baby be weaned off successfully without injury being caused by withdrawal itself? After withdrawal, will the baby be the same as if it had never had Duloxetine in its system? All unknown.

Six years is considered long-term exposure, and withdrawing needs to be done slowly to keep the symptoms manageable-- the slower you wean off, the fewer and easier the symptoms. Of course there are variables, and you could possibly have an easy time of withdrawal, and you could perhaps withdraw in a shorter time-- you will have to experiment.

Rage? Yes, you are one of us. The rage will fade as you wean off, as will the unusual craving for alcohol one experiences when on Cymbalta.

After 6 years at 30 mg, I would consider setting the timeline to be wean off at 9-12 months. How many beads are in your capsules (pull apart 3 of them and calculate the average number of beads)? If you have any questions please ask; there are others on this forum far more knowledgeable than I.

Be your own medical advocate: Do your own research online, and note the source of the research: if it's the manufacturer (Eli Lilly), take the information with a grain of salt-- their prime responsibility is to the shareholder; therefore, their moral guide is profits.

Take care.

#3 lady2882Nancy

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Posted 12 August 2015 - 12:41 PM

Hi deadbirddiary

 

Glad you found us.

The first thing I would do would be to open one of those capsules and find out how many beads are in each capsule.

Then take the number of beads and divide by 30 to get the number of beads per mg

You really don't want to decrease more than about one mg at a time.

If you get symptoms while decreasing by that amount then change you decrease to 1/2 a mg at a time.

 

That is one way to do it or you can just decrease by 3 to 5 beads a day depending on the number of beads that are in the capsule.

 

If at any time you start to get symptoms then stop the decrease until you are feeling stable again.

 

Also makes sure you drink lots of water and get a good prenatal vitamin. The prenatal vitamin has all the vitamins and minerals you will need to help your body detox itself from this med.

 

Take care of you and let us know how you are doing.

 

Nancy


#4 fishinghat

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Posted 12 August 2015 - 05:04 PM

Looks like you have already got some good advice. I am going to attach a few links on Cymbalta during pregnancy. Just some light reading.  lol

http://www.ncbi.nlm....pubmed/23471302
No significant effect on fetus.

http://www.ncbi.nlm....pubmed/21359876
Low amount of cymbalta across placenta and in lactation.

http://www.ncbi.nlm....pubmed/23218163
Text not available.

http://www.ncbi.nlm....pubmed/23873363
No effects on new born health.

http://www.ncbi.nlm....pubmed/19809008
No effect on fetus, newborn at birth or during lactation.

http://www.ncbi.nlm....les/PMC3590601/
List what the negative out comes are.

http://www.ncbi.nlm....pubmed/25171134
Increase risk of club foot with ssri.

http://www.bmj.com/c.../bmj.g4835.long
SSRI increase risk of autism in new borns.

https://www.ncbi.nlm...pubmed/25551238
Little transferred to infant.

Duloxetine withdrawal syndrome in a newborn
http://cpj.sagepub.c...52/10/976.short
Clinical presentation and management of neonatal abstinence syndrome
http://www.dovepress...hp?fileID=19621

Use of selective serotonin reuptake inhibitors during pregnancy
http://contemporaryo...nancy?page=full

Neonatal paroxetine withdrawal syndrome
http://www.ncbi.nlm....les/PMC1721229/
Four term neonates presented with symptoms such as jitteriness and necrotising enterocolitis after paroxetine exposure in utero.

The use of psychotropic medication during pregnancy: how about the newborn?
http://www.ncbi.nlm....les/PMC3770341/

#5 Ramona80

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Posted 12 August 2015 - 06:55 PM

Hello and welcome! I was like you (although I was on Celexa at the time), and I wanted to be off it when I got pregnant, so I weaned off it beforehand. I think it's wise of you to be going off Cymbalta at this point. You will get good info on this forum to support you through the process. Good luck to you! 


#6 deadbirddiary

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Posted 14 August 2015 - 08:26 AM

Thank you every one! I have been reading a lot on the forum. I believe there are 150 beads in one of my capsules (I lost count plenty of times). Today I took out 5. We will see how it goes. I missed my pill the other day and I had so much anxiety. It felt like my insides were electric. I haven't been off anti anxiety medication in 8 years. Right before I went on I had two panic attacks that sent me to the hospital. I keep telling myself that that isn't going to happen again and that I need to stay strong if I want to have a healthy baby. Thank you.


#7 thismoment

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Posted 14 August 2015 - 09:44 AM

DBD

Good work!

Here is a withdrawal regimen you might consider:

If you take out 5 beads per week you'll be done in 30 weeks, or 7.5 months. That's 5 beads taken out each day of the first week; 10 beads taken out each day of the second week; and 15 beads taken out each day of the third week etc. For 30 mg, each 5 beads=1 mg.

You'll need to carefully count beads (yes, each one matters). Don't just swallow the beads-- put them in gel caps. You can get empty gel caps at the pharmacy or a health food store.

Should the symptoms become difficult you will have to slow down by either taking out fewer beads, or waiting a longer period of time before the next reduction, or some combination of the two.

Consider having a medication on the shelf to be taken AS-NEEDED for anxiety-- a benzodiazepine, or perhaps hydroxyzine or clonodine.

Toward the end of the weaning program you may find that symptoms will begin to emerge and you'll have to extend the timeline and/or level off the dosage for a week or two. As the symptoms ease, you can continue reducing-- but at a slower rate.

Let the symptoms dictate the rate of dosage reduction-- if it hurts too much, slow down-- also note that if you choose to wean off super-slow (12-14 months), it's possible to be virtually symptom-free. It's a diabolical choice between time and discomfort.

Good luck in your endeavour! I know you know this: the best way to have a healthy baby is to start with a healthy and happy mom.

Take care.


#8 deadbirddiary

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Posted 23 August 2015 - 03:54 PM

Right now I'm at -25 beads. Today has been really rough but I want to get off this medication so I can start my family.


#9 FiveNotions

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Posted 23 August 2015 - 08:13 PM

DBD, take it easy on yourself ... if you don't feel well at the rate at which you're decreasing, slow it down ... pushing yourself to get off too fast isn't going to help you with the baby ... your baby (waiting to be) needs a mom who's healthy and happy ... not one who's depleted herself by getting off Cymbalta too fast ...

 

We have quite a few discussion here in the archives about pregnancy and Cymbalta ... go to the main page, and type in "pregnancy" or "pregnant" (without quotes) and you'll pull up a long list of them ...

 

Your doc is an idiot ... if a mother is on Cymbalta while pregnant, the baby is receiving the drug also ... when the baby is born, he / she no longer gets the drug ... and is thus put into cold turkey drug withdrawal ... that is an evil thing to do to a baby ... there have been a couple of cases where the baby has died as a result of the post-partum drug withdrawal ....

 

You're doing a wonderful thing to get yourself drug free and healthy for your baby !! Be patient with yourself and this process ... you're young, and you're going to get through this just fine ... listen to what your body is telling you, and if you don't feel well, as I said, slow down your weaning process.

 

You, your husband, and your baby, will be glad you did ! :)

 

Keep us posted, we care about you ! :hug:


#10 deadbirddiary

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Posted 14 September 2015 - 06:04 PM

Just an update! I wanted to let you all know that as of today I am halfway through weaning of Cymbalta. 75 beads out, 75 beads left. Some days have been really hard and I've had to stay on a certain dosage for a few days. The worst days are the weekends. Like most people with anxiety, I function best on a schedule. I like when I dedicated all my thoughts to work. I teach elementary school so I am answering a million questions a day and I don't really have time to think about my feelings. So when the weekend rolls around I feel freaked out by all alone time without my thoughts. 

 

I hear a lot of negative stuff about coming off the drug, but I wanted to tell you some good thing good about coming off Cymbalta. I feel WAY more motivated. I'm getting so much work done. I know part of that is anxiety driven (I need to get this done or I'm going to freak out) but I'm feeling a lot more accomplished. Feeling accomplished makes me feel better about myself. Thanks for your support!


#11 fishinghat

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Posted 14 September 2015 - 06:26 PM

Hi DBD

 

That is great. You really made my day!! It is just a matter of time now.

 

God Bless


#12 gail

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Posted 14 September 2015 - 06:28 PM

DBD,

Thanks for the update, a positive one. More motivated, more accomplished, that is so good to hear.

With time, the week ends will get better. At the beginning, you may have to force yourself to make a small schedule during that time. Like they say, the first step is the hardest. Again, bravo for your enthusiasm.

Keep updating, it is good for all of us and for you, of course.
To the pleasure of reading you again.

#13 TryinginFL

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Posted 14 September 2015 - 06:42 PM

DBD,

 

 

Thank you for keeping us updated!  You are making great progress - half way now! :)

 

Things will continue to get better - hang in there!


#14 sandinafh

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Posted 15 October 2015 - 09:33 AM

Hello, when I saw your post I instantly knew I'd be replying - I'm 42 years old, my hubs and I have been together for 26 years, and we're hoping that now that we've finally decided to have a baby, we'll be able to. When I was praying about it, God told me to quit the Cymbalta, which I intend to do. I have been on it for 10 years and I've tried numerous times to quit, but not with the bead method. I would really love and appreciate hearing how you're doing... I definitely need to hear some good news! I don't have time to spend a year trying to get off this horrific drug.

 

Many thanks - Sandina


#15 fishinghat

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Posted 15 October 2015 - 01:58 PM

Hi Sandinath

 

I have been an active member of this site for nearly 5 years now. I have read nearly all the posts. Good news is hard to come by. I can tell you this....

About 20% of the people suffer little or no withdrawal.

Taking 3000 mg Omega 3 and 500 mg of vitamin C per day helps some.

Weaning sllooowwllyy  by bead counting is longer but generally less hell.

Many on this site have successfully quit but it does take time and patience.

 

You can do this. We are here to help and you are not alone.


#16 lady2882Nancy

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Posted 15 October 2015 - 06:11 PM

Hello and Welcome

 

Fishinghat knows his stuff and all I can add is that staying well hydrated (and I'm talking more than the 8 cups of water normally recommended) and staying as active as possible helps too.

 

Here's hoping you are in the lucky 20%

 

Take care of you and be well.

 

Nancy





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