Newbie
Posted 28 June 2016 - 07:23 PM
Hi Everyone,
I just joined this site. I want your opinion as to if the withdrawal schedule my Dr. recommended seems reasonable. I have been on 60 mg for probably 10 years. He wants me to drop to 50 mg for 3-4 weeks, then to 40 for the same amount of time, down to 30, then 20, and off. Thanks for your advice!! Amuy
God-like
Posted 28 June 2016 - 07:53 PM
Amy,
Welcome to our forum. You will find an abundance of support, love, understanding, and advice from all the wonderful members here.
To answer your questions, I feel this is way too fast of a taper. Most members here who have come off cymbalta use what we call the 'bead counting method". Fishinghat will be able to explain this method in detail to you. If he isn't popping in tonight he will be here tomorrow most likely. Other members should be dropping by one by one.
Please stay in touch with us and keep us posted....
Site Partners
Posted 29 June 2016 - 08:10 AM
Welcome Amy
Your dr has the right idea, better than most drs BUT still way too fast. We normally recommend bead counting. Open the capsule and count the beads (usually 200 to 300 depending on brand). Remove 2 to 3 beads each day. So remove 3 beads the first day and then 6 the second etc. This is the same principle as your dr but a lot slower. This method also gives you some control. You can drop slower if necessary or even go back up a few beads if necessary.
Advanced Member
Posted 29 June 2016 - 09:35 AM
Hi Amy and FH,
Comparing mg and beads has got me a bit confused. Amy's doctor's rate of 10 mg per month (4 weeks) seems a bit slower than the bead counting method. Here's what I came up with:
Bead Counting:
I'm assuming the 200-300 bead figure is for a 60 mg capsule. I could be wrong. I'll simplify by using the 300 bead number.
A 3 bead reduction every day means 1% per day (this also means 100 days to get to zero). Every day, you go down
by 0.6 mg.
Each week gets you down by 21 more beads. This gets you down by 4.2 mg per week.
On the other hand:
Dropping by 10 mg every 3-4 weeks comes out to 2.5-3.3 mg per week.
Bead counting is smoother, more gradual. It doesn't have the jumps every month that dropping 10 mg would have.
Just trying to understand.
Frank
Site Partners
Posted 29 June 2016 - 10:30 AM
You are exactly right Frank. Just smoother and those sudden drops really hit you hard. We have actually had members that were so sensitive to the drops that they were only able to handle a 1 bead a day drop with an occasional break. That is unusual though.
God-like
Posted 29 June 2016 - 11:47 AM
Hi Amy, welcome to the forum, so glad you found us !
I'm with Frank and FH on this ... the slower the better for getting off this stuff ... but at least your doc has a generally solid approach ... it's just that those sudden drops at the end of each "level" may give you sudden side-effects / symptoms ...
You could always try it according to your doc's plan, and then, if you do get slammed with symptoms, switch over to the even slower method that Frank details ... each of us reacts differently, so what's important is to develop a plan that suits you ... (I quit cold turkey, and that doesn't suit anyone)
Keep us posted on how you're doing !
Advanced Member
Posted 23 July 2016 - 03:01 AM
God-like
Posted 23 July 2016 - 06:39 AM
Anndi,
Welcome to the forum. We are happy to have you here and there are many members here which you will find to be very supportive, loving, caring, and eager to share their knowledge and experiences with you.
You asked about the bead counting method. Here I have added a quote from Fishinghat from another post:
"Let me start by recommending bead counting. If you open one of your capsules there should be around 300 little beads inside. Remove 2 or 3 beads more each day. If the withdrawal does rear its ugly head then you can go back up a few beads until you stabilize then start reducing again. Next, if you haven't taken the Lorazepam in a year I suggest you do everything you can to avoid taking it again. It is a highly addictive drug with a horrible withdrawal unless you take a year or so to come off. A once a week thing for a rough spot is Ok but not constant usage. I would consider using clonidine or hydroxyzine instead as they have nearly the same effect but no withdrawal. Like most drugs they work for some and not others. If needed they can be used daily."
You also asked stating the time difference from Australia to the USA. There could be anywhere from a 14 hour difference to a 17 hour difference depending on where in Australia to where in the USA. If I were you I would go back on your Australian time on your wrist watch and while naturally your cell phone and lap time will be the currently time you are in your current place. Therefore try and get on the Australian time and take your medication and bead counting method according to that time since you are only on vacation. Resulting in staying on this new schedule once you have arrived back home.
This is the best advice I can offer. Others will be chiming in later and adding more of their suggestions
God-like
Posted 23 July 2016 - 06:47 AM
Anndi,
Welcome to the forum. We are happy to have you here and there are many members here which you will find to be very supportive, loving, caring, and eager to share their knowledge and experiences with you.
You asked about the bead counting method. Here I have added a quote from Fishinghat from another post:
"Let me start by recommending bead counting. If you open one of your capsules there should be around 300 little beads inside. Remove 2 or 3 beads more each day. If the withdrawal does rear its ugly head then you can go back up a few beads until you stabilize then start reducing again. Next, if you haven't taken the Lorazepam in a year I suggest you do everything you can to avoid taking it again. It is a highly addictive drug with a horrible withdrawal unless you take a year or so to come off. A once a week thing for a rough spot is Ok but not constant usage. I would consider using clonidine or hydroxyzine instead as they have nearly the same effect but no withdrawal. Like most drugs they work for some and not others. If needed they can be used daily."
You also asked stating the time difference from Australia to the USA. There could be anywhere from a 14 hour difference to a 17 hour difference depending on where in Australia to where in the USA. If I were you I would go back on your Australian time on your wrist watch and while naturally your cell phone and lap time will be the currently time you are in your current place. Therefore try and get on the Australian time and take your medication and bead counting method according to that time since you are only on vacation. Resulting in staying on this new schedule once you have arrived back home.
This is the best advice I can offer. Others will be chiming in later and adding more of their suggestions
Ann,Please discard any referance to the quote from Fishinghat in regards to the sentence refering Lorazepam. It was an error on my part to include this part to you. I was unable to find the correct site and took this from another site where Fishinghat was explaining the bead counting methold.
It should read this from Fishinghat:Let me start by recommending bead counting. If you open one of your capsules there should be around 300 little beads inside. Remove 2 or 3 beads more each day. If the withdrawal does rear its ugly head then you can go back up a few beads until you stabilize then start reducing again."
Once again please take into consideration using your wrist watch with Australian time vs us time, due to the 14 to 17 hours difference.
God-like
Posted 23 July 2016 - 07:11 AM
Anndi
It's 8:10 where I am here where I am in NYS.........is it 10:10pm Australian time?
Advanced Member
Posted 23 July 2016 - 06:26 PM
God-like
Posted 23 July 2016 - 06:40 PM
Anndi
Glad to hear you are doing better. Sounds like you have done the math correctl, although I'm not sure if this might be a bit too fast. If I'm reading your message correctly it seems as though you are going to start your bead counting here in the US (with a prescription which is filled in the US). Do make sure you keep going to the rame pharmacy each time you get a refill. Some manufacturers are different. This could result in the number of beads inside the capsules changing. Example: one brand may have 200 or 300, and another brand may have large beads and resulting in 6 large. You are stating there are 565 beads in there. I will research somethings and get back to you shortly.
Site Partners
Posted 23 July 2016 - 06:48 PM
That is more than I have heard of but it is possible.
God-like
Posted 23 July 2016 - 06:52 PM
I do agree Fishinghat, although when I did the math to come off of it in 90 days and there being 565 beads in there the math is correct. I does come out to taking 6 out for the first day and then 12 the next, I do see Anndi is going to go a bit slower and start with 5 beads. Yes this brand does have many beads inside.
Advanced Member
Posted 23 July 2016 - 07:37 PM
God-like
Posted 23 July 2016 - 07:59 PM
Anndi, I'm happy to hear you have the three month supply with you. It makes it much easier knowing your prescriptions could possibly be all the same. Yet It's a good choice to check on the number of beads in tomorrows dose. You could go a bit slower and if you do, you will most likely not finish is the three months which you have planned. You could start with removing the 5 beads and then the 10 and so on....and when you start to feel any symptoms which are too uncomfortable to handle stay at the last number of removed beads and stabilize until you feel comfortable again to start removing the next set of beads. Do you have access to any physicians while in the US? Do you have any benzos with you? I'm asking these questions just in case you need something extra if you need them.
God-like
Posted 23 July 2016 - 08:24 PM
Anndi,
Your math is correct. You take the number of beads in your capsule and you stated you had 565. Now you wanted to come off in 90 days. Therefore you divide 565 by 90 which equals to 6.777. which indicated you would start at 6 beads the first day, then 12 the next then 18....and so on. You had decided to take 5 capsules out and to go a bit slower, which I agree with.
Therefore, your 90 days would change to a longer end date. You are doing the math correctly.
You asked why I asked you if you had benzo with you. Some individuals, not all, do have experience anxiety and to help ease the anxiety they may need to have some benzo to take this edge off. That is the only reason as to why I asked you. It doesn't necessarily mean you will experience this withdrawal symptom.
My concern is you are in another country trying to wean yourself from cymbalta and i don't know if you have a physician in the US where this would be more convenient if needed....
Please don't get nervous, They are many many individuals who have come off cymbalta with little to no symptoms and you may be one of them. The worse that can happen is if you start to feel uncomfortable with symptoms you just stay at the dosage you are at and remain there until you feel comfortable to start removing more. It's possible to stay at that dosage for a week or two.
Advanced Member
Posted 23 July 2016 - 08:32 PM
God-like
Posted 23 July 2016 - 08:41 PM
Honestly, I don't have any idea where you can purchase them. It's possible you can see if Ebay, or Amazon.com have them. I do agree not to waste them. Maybe others on here will be able to answer your question. Unfortunately, I'm sorry I'm unable to help in this area.
It's good you will have a physician to see while you are in the US if needed.
Wishing you the best. So far you are doing great.
Please keep us posted as there is always someone here to offer their support to you.
Advanced Member
Posted 23 July 2016 - 09:06 PM
Advanced Member
Posted 25 July 2016 - 08:29 PM
God-like
Posted 25 July 2016 - 09:07 PM
Anndi
Oh yes, it's very frustrating to count those beads, and you have many. Smile about that. You are doing great and happy you found those empty capsules. If you are going to encounter any discomforting symptoms it might take a while. The exact time you may feel them, I have to admit I don't have the answer to that. Fishinghat might be able to see this in the am and give you the answer to that. I wouldn't worry about this too much right now. Take day by day and be good to yourself. Just listen to what your body is telling you, for you know it best.
Very glad to hear from you as you keep us updated. Please continue to do so.
Site Partners
Posted 26 July 2016 - 01:19 PM
It really varies Anndi. Many start getting synmptoms after about 2 to 3 weeks after beginning to drop. There has been a few of us (me included) that did not get hit until they dropped down to just a few beads left. That last 1%.
I would just like to reinforce what Carleeta said. Just listen to your body. Sow down or stop if needed.
Advanced Member
Posted 26 July 2016 - 02:05 PM
I'm writing on behalf of my mother. She's 68 with Parkinson's and chronic pain from 5 slipped disks. She had horrible withdrawals last summer from stopping Lyrica, developed terrible anxiety, and was put on lorazepam. She has finally recovered from that and it has taken a year. She was on 60mg of Duloxetine and was increased to 120mg several months ago (at least 6), thinking it might help her pain and depression. It didn't seem to do that much.
...
She has been improving markedly each week for the last 2-3 months. Her new neurologist added one new Parkinson's med, and told us to drop her lorazepam dosage 1/2 milligram per week until she was just taking one at bedtime. Once we got to 2 & 1/2 a day, we hit a brick wall where she would have crying fits for hours the day after the drop. I then tried reducing 1/8 of a pill per week, which led to 2 hours of crying the next day. So finally we are reducing 1/16 of a pill each week, which seems to be working.
...
At our last appointment the new neurologist said he would like to switch her to nortriptyline from duloxetine, saying it is better tolerated for Parkinson's patience and may help more with her pain. Our schedule is:
The first week we degreased the duloxetine from 120 to 90, started nortriptyline 25mg.
Second week 60 duloxetine, 50mg nortriptyline.
Third week 30 duloxetine, 75mg nortriptyline.
Forth week stop duloxetine, continue 75 mg nortriptyline.
She has mostly done fine so far. She cried for 10 minutes the first day of 90 duloxetine/25 nortriptyline, but has improved steadily during her waking hours. The second week, she had some nights of nightmares, talking and screaming (which she has had before, and which is related to her Parkinson's, but she hasn't had it this bad in a long time). We started week three Sunday. Monday night she talked off and on in her sleep from 11:00 PM to 4:00, which ended in a blood curdling scream. She told me it was a pretty terrible nightmare.
So I looked up nortriptyline and nightmares may be a side effect. But I also looked up duloxetine withdrawal, and that also lists nightmares. And we are continuing to reduce the lorazepam 1/16 each week also (which I think is the main reason for her improvement the last 2-3 months).
I'm getting extremely anxious about this, probably irrationally so, but we spent the entire previous year dealing with the after effects of stopping the Lyrica. Does this weaning schedule off duloxetine and onto nortriptyline sound reasonable? Next week we are supposed to stop the duloxetine altogether.
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