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Bead Counting Advice Doesn't Jive With My Capsule Contents


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#1 Vinpin

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Posted 04 September 2016 - 02:39 AM

Hi everyone,

 

I'm a newbie to the forum. Like many others on this forum in the past, I'm having withdrawal symptoms coming off of Duloxetine. In part, I have caused my own problems, because I decided to come off my daily 30mg dosage cold turkey about 10 days ago. Over this time, I've experienced worsening brain zaps and electric-like brain flashes, plus: severe tinnitus, nervousness, diarrhea and insomnia (the insomnia being the reason this post is being posted at 3:30am my time.....).  I still cannot believe withdrawal symptoms from any of these depression medicines can be so severe and debilitating - very scary stuff. I'm wondering if/when I will again get some decent sleep......

 

Additionally, 10 days ago I started on Bupropion XL 150mg, because the Duloxetine wasn't helping my depression at all, which has gotten pretty out of hand. I think I may have heard my psychiatrist incorrectly, and will give him a call after the holiday weekend - I think he meant for me to stay on the Duloxetine when I started the Buproprion, instead of coming off. 

 

In any event ... I think I need to start back on the 30mg of Duloxetine, and wean myself off accordingly via bead counting.

 

I've read over the bead counting instructions in various posts on this site, and I thought I understood them well enough. However, when I opened my first Duloxetine capsule (which was fairly small), I only see six beads in the capsule! I thought maybe this was a manufacturing mishap, but I opened two other capsule, and again found just six beads in each. So, what would you guys suggest I do to wean myself off of the six bead capsules? The beads aren't overly tiny and look like then can be ground down to powder ..... so should I try to smash up one of the beads into half bead "doses", and just go down in half-bead increments (6 to 5.5 to 5 to 4.5, etc. over time, and ultimately down to 0)?

 

Thanks in advance for helping out a poor soul that underestimated withdrawal effects.....

 

-Vinpin 


#2 fishinghat

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Posted 04 September 2016 - 08:33 AM

Welcome Vinpin. I think that is a new record. I heard of 7 beads but not six. Grinding them is not a good idea as they are suppose to be coated. One member just dropped one bead every 2 weeks as his method and he had a lot of ups and downs but it was better than cold turkey.


#3 Vinpin

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Posted 04 September 2016 - 09:22 AM

Hi fishinghat,

 

Thanks for your response!

 

Yes, I was surprised to first hear so many forum members talk about 100, 200 or 300 something beads, and then I opened my capsule and found six! Very interesting what you said about the coating - I didn't think of that since they look like "powdery-prone"  tablets. I won't grind them, but what I'm thinking of doing is what you said another member did - one bead less every 2 weeks, and see how that goes. I will post my results on this thread, for others to read and consider my experience in deciding what they should do.

 

Right now, I'm most concerned about two things - if you or any other forum member have thoughts or experiences on these issues, please reply back:

 

1) whether the brain zaps/swooshes could become an actual convulsion or seizure. It almost feels like it could, especially when I'm trying to fall asleep the last three nights. I was so frightened at times last night that I almost asked my spouse to drive me to the ER. I'm also worried about this because the Bupropion has seizures as a documented side effect (albeit very low incidence at my dosage, around 0.1% (1 in 1,000) chance.

 

2) how long I can function on so little sleep. I've probably average 4-5 hours per night the last three nights, and last night I got about 3. I'm exhausted and washed out this morning, and wondering how many more days of this little sleep I can endure before not being functional at all during the day. I plan on taking a Xanax to calm down some of the nervousness (caused by the Bupropion, I think) around dinner time, and then a Unisom (over the counter) sleeping aid before bed.

 

To any reader of this post: Thanks for reading my posts! I'm already finding this forum helpful and encouraging, and plan to return the favor by continuing participation, even after I find my resolution to my Cymbalta withdrawal.

 

-Vinpin


#4 gail

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Posted 04 September 2016 - 03:05 PM

Hello Vinpin,

Welcome to our family! Great move to reinstate the 30mg. And reducing one bead every two weeks. See how this goes and you can stay put to stabilize if problems should point it's noise.

I cannot answer your first question, never had brain zaps.

As for insomnia, I think that reinstating Cymbalta should improve your sleep. Surely a withdrawal symptom. Should not take too long. A day or two from what I have read.

I am real sensitive to meds and when I tried the wellbutrin, I had no serious side effects. All unique here.

So, stabilize on the 30mg, then bead count(not too arduous with 6 beads)lol!

Keep us posted Vinpin, and any time you feel like it for whatever the reasons, post!

#5 PtldFrank

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Posted 04 September 2016 - 03:51 PM

Vinraim,

 

At least one brand of generic duloxitine uses what I call "pellets" of 5 mg each.  Therre are six in a 30 mg capsule and 12 in a 60 mg capsule.  I've been working with these since February.  I'm a bit slower in the taper than others -- reducing by 1 pellet every 4 weeks.  This means at least a six month withdrawal from 30 mg.  Here are some important considerations:

 

1.  Stepping down by 5 mg in a jump can be a problem with side effects.  Gradual is better.

 

2.  Each pellet is individually coated, I presume to pass through the stomach.  Splitting one may render it useless, or at least

     less than 100% effective, depending on how quickly it dissolves.

 

3.  That being said, I take the risk and reduce by 1/2 pellet every two weeks.  Jumping 2.5mg every two weeks seems to go better

     than 5mg every 4 weeks, though the everage is the same.  I bought a bag of #3 capsules so I could use the pellets I removed.

 

My main symptoms are anxiety, coninued depressions and, as they say, distress in the lower tract.


#6 fishinghat

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Posted 04 September 2016 - 04:00 PM

Actually Vinpin the researchers actually think there is a link between the cause of the brain zaps and seizures. They have noted that seizures only occur in cold turkey withdrawal and if tapered instead the patient usually gets brain zaps. They say that they both originate in the same area of the brain.

 

I survived on less sleep than that for around 4 to 6 weeks before I was finally put on hydroxyzine which took care of the issue.

Your choice of Unisom is an excellent one. Its active ingredient is diphenhydramine which is the active ingredient in Benadryl. It not only induces sleep but also helps with anxiety (as does most antihistamines, like hydroxyzine). One caution, you develop tolerance to it quickly. If used every night then it will soon get where it has no effect. So a couple nights on and a couple nights off.


#7 Vinpin

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Posted 04 September 2016 - 04:18 PM

Hi Gail,

 

Thanks for your response! Its nice to have a new (additional) family ......

 

Great confirmatory news about the Wellbutrin! What you say is precisely the reason I wanted to try it in the first place - a close neighbor and I got into a confidential discussion about Wellbutrin, and he also said he usually is supersensitive to all "brain" meds. But with Wellbutrin, he says he had no side effects at all and is feeling like there's many reasons to wake up in the morning. I guess we all want to feel that way ideally, right???

 

Thanks for all the other recommendations and encouragement:

 

 

Update for everyone:

 

I took my first 30mg of Duloxetine (generic Cymbalta, for this unfamiliar), after 10 days of going without, late this morning ..... and the brain zaps subsided about two hours after I took it. We will see how it goes tonight, but that's fairly substantial proof that the Duloxetine is the cause of my brain zaps and swooshes. I was able to get in a much needed two hour nap as well this afternoon. So things are on the upswing!

 

I hope all the first-time readers of this forum (like me.....) pay close attention to the seriousness of Cymbalta's withdrawal effects. In my eyes, it's now very plausible that prescribing doctors really are biased and negligent in their opinions about the frequency and severity of the withdrawal side effects. Let's face it: as patients, withdrawal symptoms and a proposed "weaning off" regimen are not the first questions that come to mind when we are excited to try out a new depression medicine, especially when we know someone who's had success with it.

 

It's a hard lesson learned, but it shows that it wouldn't hurt to familiarize ourselves with withdrawal symptoms before we try a new medicine (and in my case, not be nonchalant about coming off it). If I was more aware, I would have stumbled on this avalanche of evidence about the harmful effects of this medicine back in the beginning, instead of now.....

 

Will keep everyone updated,

 

-Vinpin

 

 


#8 Vinpin

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Posted 04 September 2016 - 04:33 PM

Hi PtldFrank,

 

Your post is super-helpful - thanks so much for it!

 

I'm going to consider what you say about 1/2 pellets, although I was figuring the splitting of a tablet may reduce its efficacy dramatically. But I may try what you say, since it seems you've had success. I'd rather do this slowly, and it could be coming off over six months is better for me than over three. I'm still grateful for only having been on 30mg for the 4 years I've been on - I can't imagine how folks coming off higher dosages must feel....)-:

 

Can you provide a little more detail as to how it went cutting the pellets in halves? Did you use a tablet cutter, and just slice them in half? Do they hold together when slicing, or do they crumble a bit (or a lot .....)???

 

I wonder if our Duloxetine is from the same manufacturer? Mine is "Lupin" {you know, "Lupin" can make you "loopy".....(-:..... I have a nerdy sense of humor, but at least I still have it .....}

 

Thanks again,

 

-Vinpin

 


#9 Vinpin

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Posted 04 September 2016 - 04:52 PM

fishingchat,

 

Thanks for the additional info. It's all starting to make sense now......

 

I really felt as if I was going to seizure last night. When the brain zaps are most severe (when closing my eyes trying to fall asleep), it is very scary - my eyes jerk behind my eyelids, I see a flash of bright light instead of the darkness behind my eyelids, the tinnitus alarm goes super-loud and my body jolts. The zaps are more severe than what I've heard others call "brain swooshes", which occur ongoing throughout the day. The "swooshes" cause the tinnitus alarm to sound, and immediately disorient me, with a loss of balance if I am up and around. 

 

Just knowing that the zaps are attributed to the Duloxetine makes me 100% sure I need to come off of it in the long run - and I most certainly will. Even if I still had positive results on it (which I don't anymore), I wouldn't stay on this ultra-dangerous, super-addictive drug - no drug is worth this. 

 

I hope the brain zaps stay away - makes me scared to fall asleep. My understanding is that even if a seizure/convulsion occurred, in only very rare instances would it be fatal. Do you know if that's correct?

 

Thanks,

 

-Vinpin 


#10 PtldFrank

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Posted 04 September 2016 - 05:12 PM

Vinpin

 

Yes, my manufacturer is lupin also.  I use a pill cutter that has a nice 'V' shaped pill holder.  In mine, the little pellets just fit in the end of the 'V'.  So it cuts sort of close to the middle -- I figure it averages out.  But my pill cutter doesn't cut all the way through, and I hav to finish with my (cleaned) pocket knife on a cutting board. 

 

I don't see much powder fall out when I cut.  The half pellets seem to hold together OK.


#11 fishinghat

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Posted 04 September 2016 - 05:40 PM

You are right Vinpin. Seldom fatal. Now that you are back on the Cymbalta and will be weaning there shouldn't be an issue.


#12 PtldFrank

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Posted 04 September 2016 - 05:44 PM

Vinpin,

 

Regarding seizures, that's a subject I do have personal experience with.  The good news is that I'm seizure free for more than 10 years.  The bad news is that I had half a dozen gran mal seizures in the 12 years prior, starting with wellbutrin.  I tend to believe the seizures all came from the various meds (15-20 combinations) I went through.  The only thing that seems to have stopped the seizures is the anti seizure medicine Keppra.

 

I haven't had brain zaps while withdrawing from Cymbalta, but maybe that's because of the Keppra.

 

One thing my psychiatrist says over and over again is "ALL antidepressants lower seizure threshold."


#13 fishinghat

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Posted 04 September 2016 - 05:46 PM

Frank, I fully agree with your dr. These meds have soooo many effects.


#14 PtldFrank

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Posted 04 September 2016 - 05:53 PM

Regarding seizure fatalties,

 

Fully involvedtonic/clonic seizures (the kind I get) have three major risks:

 

    - The seizure itself lasting more than a minute or so (oxygen deprivation)

 

    - Injury from falling down (hitting your head)

 

    - Aspiration (choking on your own vomit - yuck)

 

None of the above have happened to me, but it's no fun anyway. 


#15 fishinghat

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Posted 04 September 2016 - 06:00 PM

Thanks for sharing. That's how we learn on here. Thanks again.


#16 Vinpin

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Posted 04 September 2016 - 06:43 PM

Thanks fishinghat and PtldFrank for sharing your wisdom. It is so great to have folks like you helping inform others.

 

I will be posting my weaning off progress occasionally, so you guys and everyone else can follow along and compare to his/her own experience.

 

-Vinpin


#17 Carleeta

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Posted 05 September 2016 - 09:49 AM

Vin, Welcome,

 

I do see others have answered most of your concerns here and it seems as though you will be taking the route to wean yourself slowly off this medication. This is a good choice.  As far as your brain zaps are concerned, I wouldn't worry about them too much.  They will eventually stop and not be so bothersome.  I too had the brain zapps when I discontinued anti depressants.  They were mostly annoying to me once I realized they were not life threatening.  They did become farther and farther apart for me and then before I knew it they were gone. I'm sure you will be just fine now knowing they are a normal part of withdrawal from medications (not all are anti depressants).  

 

You keep us posted ok?


#18 TryinginFL

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Posted 05 September 2016 - 03:04 PM

Welcome Vinpin!

 

I'm sorry I'm a bit late to communicate here - I was rather computer-free yesterday!

 

I would just like to share my experience - I was on 60mg of the crap drug for 4 1/2 yrs - my Dr. told me it would help as I was terribly depressed after I lost my daughter.  At that point in time, silly me still considered my Dr. a god, so was happy for the help.  And it did help, but now that I look back I realize that I had very little emotion which I was not aware of at the time.

 

I was also on generic Lyrica due to fibromyalgia pain.  In Jan. of 2014, I decided that neither one was helping any more, so just jumped off of both cold turkey.  I DON'T RECOMMEND THIS TO ANYONE!

 

Unfortunately I did not find this forum until it was too late to go back on the poison and am most grateful to the wonderful, knowledgeable people here that helped me during one year of absolute hell.

 

After almost 1 1/2 yrs off, I still couldn't keep myself together very well and my 3rd Dr. (yes, I had switched twice - they were total asshats) gave me Bupropion to try.  It helped in a very short time and I am now on 300mg/day.  We have a dear member here who always said it is all about the quality of life, not being able to say that you are med-free.  How right he was.. Unfortunately, some of just need more help than others.

 

I never had brain zaps or tinnitus but sure had plenty of other stuff!  I have now been off for over 2 1/2 yrs and am finally aware that I must check every medication before I would take it.

 

Sorry to be so long winded here, but hope that I have been of some help!

 

Please come back to keep up updated - we are here for you!

 

Liz :)


#19 Vinpin

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Posted 05 September 2016 - 07:33 PM

Hi Carleeta,

 

Thanks for your response and insight. This forum has been a wonderful experience thus far, and its great to correspond with all the super members of this support community!

 

That is good to know about the brain zaps. I mentioned in another post they stopped just two hours after I took my first 30mg dose of Crapalta after 10 days of going cold turkey. Can you believe that?

 

The plan is to wean off according to the instructions fishinghat provided. I just wrote up a planned schedule for myself, which should have me off the drug completely April 2017. That sounds like a long way off, but I am in no big rush. And of course, fishinghat's warning to "stabilize" and suspend the weaning drops if I experience withdrawal symptoms will be heeded if required, so the April 2017 date is flexible.

 

I will keep you and everyone posted.

 

-Vinpin 


#20 Vinpin

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Posted 05 September 2016 - 07:46 PM

Hi Liz,

 

It is great to hear from you! I've seen all your great responses on other forum threads - so it is a pleasure! You can be as long winded as you want (-;..........

 

Wow, your experience is sad (so sorry to hear about your daughter.....), but at the same time encouraging. It is good to know that, even if it is a long road, you can get off the crapalta.

 

Even though I've been somewhat blinded by the withdrawal symptoms of the crapalta ..... I actually think the Bupropion might already be helping. The reason I think so is that my overall outlook and mood doesn't seem so downtrodden and "oh woe is me".  But, fishinghat did provide insight into a "cross-taper" I should consider with the Buproprion/crapalta exchange - ramping up more slowly on the Buproprion, while coming down off of the crapalta. I'm going to talk to my doctor about that this week; in the meantime, I decided to cut my Bupropion dosage from 150mg to 75mg, and stabilize on that for a while. I will keep the thread posted on how that goes.

 

In the meantime, count me in as a bigtime fan of cymbaltawithdrawal.com! I feel like a made a bunch of new friends!!!

 

-Vinpin 


#21 Vinpin

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Posted 07 September 2016 - 03:40 PM

Hi everyone,

 

Just a quick update for everyone - today is my 4th day of being back on Crapalta after my 10 day "cold turkey" hiatus off of it. Needless to say, I am feeling much better - even my constant headache is gone. But of course, I can't help but feel at the mercy of this drug.

 

I met with my Psychologist yesterday - she couldn't believe I even tried to come off cold turkey. She thought I was well aware of Cymbalta Discontinuation Syndrome. She said the most dangerous issue with CSD, especially coming off cold turkey, is feeling suicidal. Luckily I did not experience that. Does anyone have any insight on how often (or how many) suicides are attributed to CSD??? 

 

Hopefully the weaning off will go well. It will start next week, with 5.5 (27.5mg) pellets per daily dosage instead of 6 (30 mg), for the first week. I will report back!

 

-Vinpin


#22 fishinghat

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Posted 07 September 2016 - 04:49 PM

Hi Vinpin

 

Sounds like you are stabilizing nicely. You should be able to start bead counting soon.

 

As far as the suicides from CSD...well I only know of one attempted (not by a member here) but if you do a search for 'suicide ideation' on this forum you will find quite a few hits.


#23 Vinpin

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Posted 11 September 2016 - 09:07 PM

Hi all,

 

Just a quick update for those interested in my status:

 

I decided not to start my weaning off of Cymbalta today. Earlier in the week, after three days resumption of 30mg of Duloxetine while staying on 75mg of Wellbutrin, I started experiencing some dizziness, lightheadness, chills and a constant headache. These symptoms persisted up till Friday.  I called my doctor, and he advised me to discontinue the Wellbutrin. I'm disappointed that I'm not able to make the Wellbutrin work, but I need to be rid myself of the head and chill issues.

 

Yesterday (Saturday), I felt mostly better, but today I again experienced the aforementioned head and chill symptoms. I think my brain "chemistry" just needs a chance to stabilize - this is another reason I've decided to heed my doctor's advice, and pull off the Wellbutrin for now. Taking the 30mg Duloxetine daily with no Wellbutrin now puts me back where I was medicine-wise before this mess started.....

 

I have an appointment with my doctor this Friday, and I plan to discuss weaning off the Cymbalta. I'm hopeful to postpone the weaning one week, starting next Sunday instead of today - I expect that he will not have any issues with my wishes. In the long run, my hope is to wean off of the Duloxetine over the next 3-6 months. Once I am fully recovered and stable from the discontinuation, I'd like to try the Wellbutrin again - this time, without any potential interaction from the Duloxetine. My mood really did improve on the Wellbutrin - its just the resulting, confounding side effects of one or both of the medicines that make it difficult to stay on it. 

 

If anyone has any thoughts, advice, opinions or encouragement..... I am all ears!!

 

Thank you friends,

 

-Vinpin


#24 fishinghat

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Posted 12 September 2016 - 07:57 AM

I don't see anything wrong with your approach. One step at a time. Evaluate and then the next step. Slower but sure.


#25 gail

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Posted 12 September 2016 - 03:38 PM

Hi Vinpin,

Good move for reinstating the C. And waiting a bit longer for bead counting.

Regarding Wellbutrin, it seemed to do you good from what I read. I would stick with it, so I think, 75 mg is low. It will serve you as a piggy back when you bead count. My thought this morning and still is. Keep posting as you go on this unique pathway!



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