Discontinuing Three Drugs-Is That Too Much? Long Post
Posted 26 March 2016 - 11:30 AM
I'm new here but got "referred" by another blog when searching for help with my symptoms.
I have PTSD from a college sexual assault and have struggled for years with the aftermath. I got so depressed, even having heard that Duloxetine was hard to wean off, I did not let that stop me. It wasn't the wrong decision at that time. I was hopeless and due to years of experiments with other meds with no effect, I was all in. Now, one and a half years later, the side effects of Duloxetine were getting worse over time. Mainly, I couldn't remember anything and was unable to utilize logical thinking, I was using bad judgment in decisions and was totally unaware of time passing. I had to set a timer for everything; to a point of absurdity. I was almost fired from my unpaid internship and was on probation. I was ready to quit graduate school with only 10 weeks left until graduation. I was sweating so profusely and so hot all the time I felt like a radiator. It caused me to look like a freak; going to work in the winter in a sleeveless summer dress.
I also have ADHD symptoms which were handled with adderall so when I complained about my problems with concentration, organization, time management, and memory, my doc increased Adderall. I was then on 90 mg Duloxetine, 60 mg/day Adderall, and took 7.5mg mirtazapine at night for sleep. The increase in Adderall didn't help. I was on probation by now at my internship and went back to doc. I was hopeless about my future and was convinced I could never work again and that it was probably signs of Alzheimer's or dementia. In addition, the news came out then about the impact of antihistamines on risk of Alzheimer's and having taken a lot of that as well as benzodiazepines, I decided it was just what was occurring from all that crap. Benzo's are also suspect in Alzheimer's and dementia.
So this time, my doc added Stratterra, which is a norepinephrine reuptake inhibitor used for ADHD. It was somewhat helpful but by week 6 or 7, I started getting sick; sweating even more, and the ability to think was shot. I sat down to write a paper and couldn't write because I couldn't remember the beginning of a sentence by the end of the sentence. The grammar I used was all over the map; my logic was missing entirely, and I would end sentences without closing them. For a grad student, that is not OK.
I went to class for the first time without a completed paper. I was devastated and started reading about the medications I was on. My doc was not helpful because his reactions were more to the effect of what you can read on the leaflet that comes with the medications. "10% experience nausea in the first week". etc. So, while reading, it looked like I might have been experiencing one of several potential adverse events but they all have the same symptoms; nausea, confusion, profuse sweating, agitation, etc. All I knew was something was very very wrong. If it was Alzheimer's, then it does not matter if I decide to go off the meds and it doesn't help since I won't be working anyway. If it's not Alzheimer's and it was the meds, I could go back to the despair and depression I had previously. But I was so sick literally, physically, it did not matter. My body ached, my back killed me and I could barely get out of bed. I was late for each and every thing I did. Nothing helped. So, I started reading and tapering off Duloxetine.
I got immediate help and relief. Immediately, I felt less tense; my body starting feeling different; I didn't realize how tense I was. I was beginning to think more clearly. I dropped to 60 mg/day for about a week, then called my doc and he said I could reduce to 30/day. I did that also. No severe side effects from that but the hot feeling; the sweating and exercise intolerance was still horrible. It was embarrassing and I didn't want to get dressed in the morning because it's winter and people are not wearing sandals to work yet.
Last Wednesday I began feeling nauseated and thew up. I thought maybe it was Strattera so I called my doc and he said it probably wasn't. So I continued with the same meds. On Saturday I was exposed to stomach virus and got extremely sick; nauseated and for the entire week was sleeping or vomiting and aching. I had a hard time drinking water and had to force myself and I stopped taking medications altogether except a couple times took the 30 mg Duloxetine. I skipped Duloxetine thursday and by Friday, last night, I was so nauseated and sick I felt like I was going to die like this. I hate being nauseated more than any other feeling. Last night I took the Duloxetine 30 mg. Today I feel pretty normal. I'm not sure what's up now.
I wanted to share my medication story to see if anyone else has experience with mutliple meds and not knowing what to do to wean off of them. Strattera also caused excessive heat and sweating and then, I think, nausea. Or maybe the nausea was from tapering off Duloxetine. I don't know! I just can't do any of this anymore. Spring is here and if I can get on the bicycle and ride for a couple hours, I know I'll start feeling more focused.
If anyone had the ability to read through this entire "essay", thank you so much! If not....
So, the actual question is... Does Duloxetine discontinuation cause nausea and how long does it last? Do I decrease from the 30 mg du. Down to nothing or start dumping out small amounts from the capsule? From 30 mg / day, how can I step off completely; like a couple weeks?
Posted 26 March 2016 - 12:12 PM
Well CCOD, that is quite a story. man you are in a pickle. First of all stomach concerns all the way up to vomiting is part of Cymbalta withdrawal. As far as weaning off Cymbalta we recommend a process called bead counting. You open a capsule each day and remove 2 to 3 beads more han the day before. If you get feeling too bad you just stay at that level til things settle down. It usually takes 3 to 5 months to wean off it. The withdrawal can be horrendous. In addition the Strattera (Atomoxetine) and Adderal (containing 2 versions of amphetamines)has significant withdrawal as well. Each is very difficult to come off of and it would be a bad decision if not dangerous to do all three at the same time.
In addition, thease drugs are not normally given together or only in low doses because....
Applies to: Adderall (amphetamine / dextroamphetamine), Cymbalta (duloxetine)
Talk to your doctor before using DULoxetine together with amphetamine. DULoxetine may increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Applies to: Adderall (amphetamine / dextroamphetamine), Cymbalta (duloxetine)
Talk to your doctor before using DULoxetine together with dextroamphetamine. DULoxetine may increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Applies to: Strattera (atomoxetine), Cymbalta (duloxetine)
DULoxetine may increase the blood levels and effects of atomoxetine. This can increase side effects such as dizziness, dry mouth, loss of appetite, sleep disturbances, and heart palpitations. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
NOTE 0 Seratonin Syndrome almost always causes a fever of 102 F or higher.
Posted 26 March 2016 - 12:35 PM
I don't understand why my doctor prescribes this stuff at this quantity with that combo! Psychiatrists are not necessarily users of these drugs so they don't believe us when we have a side effect from it.
I think I was experiencing the toxic effects of too much off all of it. I feel better today. I'm off Strattera altogether. I am now on 30 mg Duloxetine and 30 Adderall/day. I felt like I was dying a couple weeks ago; it's hard to explain. I looked up info and found serotonin syndrome and had those symptoms; then I found hyponatremia and I had those symptoms as well. This is what made me start weaning to begin with. It scared me and I had all the symptoms of withdrawal every one experiences when on all these drugs at their peak.
90 cymbalta + 80 Strattera + 45-60 Adderall + 7.5 mirtazapine= brain fog max, profuse sweating, nausea, profound exercise intolerance, loss of ability to manage my time, life, organization, hopelessness. It was as bad as the reason I went on it. Going off has been easier than those weeks of hell when on all of that.
I also think as you get older you need much lower doses due to metabolism issues. I am older. I think it was a combo. I'll do the 30 day for now then start the bead program in June when done with school.
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