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Withdrawal Question


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#1 grungerock

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Posted 15 August 2015 - 02:37 AM

Thanks to this great website I learn something.

I just reduced my 60mg to 30 mg of Cymbalta last week after 10 months usage.
Suffered some withdrawal symptoms but so far manageable. 

I would say I keep 30 mg Cymbalta until everything stabilizes.

Now if I want to reduce the 30 mg, I have 2 approaches:

 

1) Bead counting.

 

or

 

2) Withdraw my 30 mg Cymbalta by using cross taper.

What is the equivalent dosage for Lexapro as well as the equivalent dosage for Prozac.  I am thinking of choosing either one.
And what is the procedure and process?

 

 

 

What do you recommend?

 

Thank you.


#2 thismoment

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Posted 15 August 2015 - 05:23 AM

grungerock

 

Hi and welcome!

 

Is your primary purpose to come off the med completely, or transfer to something else?

 

Bead-counting to zero--

If you plan to come off completely, then yes get feeling stable at 30 mg and then bead-count from there. It might take a week or two to feel like you're ready to start counting beads. Perhaps consider setting your bead-counting timeline at about 10 weeks and step down 3 mg per week (3 mg the first week; 6 mg the second week; 9 mg the third week etc). Count the beads in a capsule and figure out how many beads equals 3 mg. Get some empty gel caps from the pharmacy or health-food store. Adjust the timeline to keep the symptoms manageable.

 

Cross-tapering--

Your exposure to Cymbalta (duloxetine SNRI) would be considered low at just under a year, but nevertheless, some withdrawal symptoms are to be expected even when you transfer to another drug like Prozac (fluoxetine) or Lexapro (escitalopram)-- both SSRIs.  As the new drug comes on-stream you will begin to stabilize.

 

It's prudent to taper off the Cymbalta and taper on the Lexapro; it takes 4-6 weeks to fully upload these drugs, so consider taking 4-6 weeks to make the switch, weaning one up and the other down. Talk to the doc about this. I don't know what dosage would be equivalent to 30 mg of Cymbalta-- I think that would be a try-it-and-see thing.

 

Prozac vs Lexapro? Here's a website that compares the two: http://www.healthlin...xapro#Overview1

 

One of the major concerns taking two of these kinds of drugs is serotonin toxicity (also called serotonin syndrome). Read about that here: http://www.mayoclini...on/con-20028946

 

Another consideration is the interaction this new drug may have with other meds you are taking. You can check drug interactions here: http://www.drugs.com...teractions.html

 

This transfer is fairly common and I hope it goes well for you. Give it some time to work. If you plan to completely wean off the SSRI thereafter, consider doing that over 8-10 weeks also.

 

If you are having anxiety, you might consider having a benzodiazepine on the shelf for AS-NEEDED. Non-addictive alternatives to benzos are hydroxyzine and clonidine. Again, talk to the doc and keep him or her in the loop.

 

There are many smart and compassionate folks that will add to what I've said and correct any errors I've made. You've found a great place here-- we all work together.

 

Take care.


#3 grungerock

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Posted 16 August 2015 - 08:15 AM

Thanks for the reply.

The reason is I want to get off Cymbalta completely.
So based on my understanding, counting beads will be the first choice?​


#4 fishinghat

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Posted 16 August 2015 - 08:31 AM

TM is absolutely right.


#5 thismoment

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Posted 16 August 2015 - 11:48 AM

grungerock

If you want to be free of all psychiatric drugs-- and based on your relatively low exposure-- perhaps bead-count over something like 10 weeks and see how it goes. If difficult symptoms emerge, stay at the dosage you're at until you stabilize, and then start bead-counting again-- but at a reduced dosage with an extended timeline.

It's all trial-and-error: Eli Lilly doesn't have a withdrawal protocol, and we can only give you general guidelines-- a place to start. Also, there are no facilities in North America set up to help those withdrawing from addictions to psychiatric meds (remember, they're not addictive-- lol). However there are countless facilities set up to help you withdraw from heroin, meth, and coke-- I wonder why that is.

Anyway, you can do this-- just go slow and let the symptoms dictate the rate of withdrawal, the timeline. It has been demonstrated that if you wean super-slow (12-16 months), you can be virtually symptom-free. But that timeline is not practical for everyone-- it's a steady job preparing daily meds, and short-term users like yourself probably don't need it.

Don't leave any gaps (missed days), and wean off in one of two ways: First, consider utilizing a linear strategy (a constant slope in dosage reduction-- like 2% per day over 50 days) or second-- do a multi-day step-down (say a reduction of 10% each week over 10 weeks). Walk an hour or two every day, stay hydrated, and find distractions that engage you and keep your brain from listening to itself criticize itself all day long.

When your mind settles down after a couple of months, look into Mindfulness and Mindfulness Meditation which will offer strategies to help you cope at first, and then enable you to flourish in your new reality as the future unfolds.

Keep us in the loop as you go. Best wishes!

Take care.

#6 grungerock

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Posted 17 August 2015 - 07:06 AM

Thank you very much for all the kind reply


#7 Carleeta

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    Read so many painful stories on here and offering others support while trying to heal myself from cymbalta and other antidepressents.

Posted 17 August 2015 - 09:13 PM

Grungerock. Stay positive. Listen to what your body is telling you. TM is giving good advice. Best of luck to you.

#8 Sleepyhead

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Posted 20 August 2015 - 06:04 PM

Hi. I've been slowly tapering 1 to 2 balls whenever I feel I can. I am curious about reducing by 2 percent. Would that be 2 percent of 30mg each reduction or do you calculate the new 2% of total milligrams after each reduction ?

#9 fishinghat

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Posted 20 August 2015 - 06:25 PM

2% of your last dose. Example; if your last dose was 160 beads then you would reduce 3.2 beads. As the beads can not/should not be cut that means you would reduce 3 beads.





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