Where To Withdraw
Posted 04 April 2016 - 08:29 AM
That is a tough question to answer. It really depends on the two friends and how patient and supportive they are. It also depends on how well you do when being alone. Some (like me) don't need people around all the time but others suffer if they don't have people around. I am sorry I couldn't give you a clear cut answer but I hope this helps some.
Posted 10 April 2016 - 09:12 AM
regarding the racing heart at night and the lack of sleep due to that reason - can you or anyone who reads this recomend a drug or a supplement?
and - is there something that can help with the amxiety that follows the withdrawal process?
Posted 10 April 2016 - 09:47 AM
Best supplement for the heart issues and is chelated magnesium. There are other forms of magnesium that work but they can be hard on the stomach. It is not expensive and most of my drs recommend starting at 100 mg one a day for 4 or 5 days and if that is not enough they go to 100 mg twice per day. Then, if needed, up to 300 mg per day. Usually it takes around 300 mg and after 2 or 3 days you start seeing the relief.
What to take for anxiety during withdrawal. We have all tried to deal with that at some point. A brief outline of my opinion is below.
Ativan (lorazepam) or any other benzo. Addictive, you develop tolerance to it in a few weeks and the dose needs to be raised. I wouldn't recommend unless no other choice.
An AD like Zoloft, Lexapro or Prozac. Many have went this route. It not only helps the withdrawal but is easier to wean off of. So you go on one of the three for several months (to give your body a chance to recover from the lack of Cymbalta and then you start weaning off the new AD.
Not Addictive/No Withdrawal
Clonidine or hydroxyzine. Start up slow because they can make you a little sleepy at first. They will also lower blood pressure some. Of the two Clonidine is the most recommended for anxiety unless there is severe sleep issues then the drs often go with hydroxyzine.
Over the counter
No Withdrawal but Tolerance
Benadryl - Many have success with 50 mg of Benadryl which contains diphenhydramine, an antihistamine, like the over the counter sleep aide. Some sleep aides use different anti-histamines as well. The work decent for most on anxiety but you build up tolerance over time and in a couple weeks it has no effect. If you stop taking it for a few weeks it will once again work for a while.
Some have good success with Melatonin, a chemical that your body produces to help us get sleepy at night.
There are also many other herbal/natural products which can be beneficial BUT many of them can have serious interactions with prescription meds and should be used very carefully.
As with any medicine, prescription or not, remember the old 'teaspoon/teacup rule'. Start with a small amount first and then build up the dosage slowly. This way if you are going to have a reaction it is less likely to hit you like a brick.
I am sure many of the others have suggestions as well and will be chipping in.
Posted 19 May 2016 - 08:21 AM
That is an excellent question. Unluckily there is no clear cut answer at this time. Mostly drs choose one based on there experience and instincts. Not real scientific. What works for one may not work for the next 5!! There are efforts underway to develop tests to determine which AD would work best for an individual based on DNA and/or medical history. A couple of these are discussed below.
As far as I am concerned, well, I really don't have an answer for you except don't give up.
Posted 19 May 2016 - 01:41 PM
Well I made a mistake. I decided to do some searching of the medical journals on how a dr should make a decision on which AD to try for their patients. A lot of articles (50 to 100?0 which normally say a lot but have little meaning. They are filled with 'but', maybes and ontheotherhand' type comments.
I did find a few interesting ones that I have listed below.
Effectiveness of a smartphone app for guiding antidepressant drug selection.
Choosing appropriate antidepressant therapy in the elderly. A risk-benefit assessment of available agents.
Biomarkers to Predict Antidepressant Response
Functional Biomarkers of Depression: Diagnosis, Treatment, and Pathophysiology
Update and Critique of Natural Remedies as Antidepressant Treatments
Posted 03 June 2016 - 12:33 PM
man what a bummer.
just got back from my dr. he recommendef that i will stop with the cymbalta (currently im on 25 mg) and move straight to fluvoxamine (25 -> 50 -> 100. few days in 25 and then in 50). he thinks that i must take another AD to be less obssesive\perfectionalist.
he didnt want to give me clonidine. said it will make me too sleepy and that it will not help. after i told him i have read about it and i think it will be good for me (especially for my anxiety night bursts), he gave me clonidine 0.025 mg. he said to start at one a day and move up to 2 in the morning and 2 in the evening.
i dont think that changing from c to fluvoxamine sharply is a good idea. you people agree?
and regardign clonidine - even if ill take 2X2 a day of 0.025 clonidine, its sums up to 0.1 mg a day - which i think it might still not be a therapuatic dosage for me. what do you people think?
Posted 03 June 2016 - 05:00 PM
First of all I believe there is a change over taper from Cymbalta to fluvoxamine but I will check on that but I think your dr is a little fast on his feet. You can suffer a lot of withdrawal before the 4 to 6 weeks for fluvoxamine to kick in.
On the other hand I do agree with his clonidine approach. It does lower blood pressure so go on it slow and come off it slow. My dose is only 0.1 mg/day (0.05 in the AM and the same at bedtime). That is an average therapeutic dose for anxiety/panic.It does a good job for me. If your bp doesn't drop significantly they can put you on more later.
I like that second post. We are not trying to develop a perfect mental health. It is only natural to be a little compulsive, anxious, depressed or whatever. We just don't want to be consumed by it. If you feel that your level of OCD is tolerable and just part of who you are then don't worry about it.
Posted 03 June 2016 - 05:14 PM
There is a cross over taper when the patient is on higher dosage than you but I am more concerned that it takes 2 to 3 weeks for the fluvoxamine to begin to kick in and 4 to 6 weeks to reach full effect. It is worth noting that he is going from the minimum effective dose of 30 on C to the minimum effective dose of 100 fluvoxamine. Many do a change like this and about half way through the change the withdrawal symptoms disappear yet the patient will continue to increase the dose up to the drs recommended dose. I have always chosen to maintain my dosage when I reach a comfort level. Usually that turns out to be sufficient and the less I pump in my body the better. Anyway, just my opinion. Not an MD but makes sense to me.
Posted 06 June 2016 - 02:09 PM
thank you so much for your answer. a question: what do you mean by "cross over taper"?
I decided tp continue with tapering C and for the meanwhile, not to take the fluvoxamine. ive been on medication for 10 years. i would like to see if i can do without them. Ive been very anxious for the last one and a half years but perhaps it is also because i was on C. i mean, can it be possible that low dosage of cymbalta causes anxiety?
Posted 06 June 2016 - 02:43 PM
A cross over taper or sometimes called cross taper is to slowly come off one ssri/snri while slowly building concentration up on the new ssri/snri. In the case of a patient being on a low dosage the drs sometimes just switch directly.
I would say that the anxiety at 20 mg of Cymbalta may be from decreasing the Cymbalta (withdrawal). My suggestion would to be to hold at the dosage you are now at on the Cymbalta until things clear up and then continue dropping. Slow is the word. very slow.
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