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#1 crbach

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Posted 21 November 2016 - 12:30 PM

Hello ALL..!!

 

First off, after reading MANY threads here, I wanted to say how amazed I am with all the wonderful people that provide support and encouragement on this forum...what a blessing for so many souls..!!  A big "THANK YOU" to you ALL..!!

 

My name is Colin and I'm looking for more specific (if there's such a thing) information in regards to planning and executing the tapering off of Cymbalta for my Mom who is 73 yrs young.

 

She has been on Cymbalta now for just about 8 weeks and the side effects are more than she bargained for, hence the reason why she is wanting to stop this medication as soon as possible.

 

After doing my research, it appears she is on the threshold, and maybe a bit beyond, in regards to a steep reduction leading to quick stoppage of this medication, BUT I'm hesitant to allow it after reading so much on the withdrawal symptoms in which so many have experienced.

 

I know that everyone is different and this medication is one that surely doesn't fall under the guise of the "one size fits all", so I'm reaching out to all of you that might be able to help me make that first step for my Mom.

 

Her dosage has been worked up to 90 mg (first week at 30 mg, second 60 mg, third 90 mg) and has remained at the 90 mg up until this day, which brings her usage time to just under 8 weeks.  To make up that total dosage of 90 mg, the doctor has her on 60 mg in the mornings and 30 mg in the evening.

 

Question: 

Do you see a 30 mg immediate deduction as being possible (her doctor has suggested she just stop the evening dose) OR is a slow taper (bead counting) more worthy at this time?

 

30 mg immediate deduction from 90 mg:

If 30 mg straight deduction, should I stop the 30 mg evening dosage OR should I cut the morning 60 mg dosage to 30 mg and continue to keep two separate 30 mg doses per day..one for the morning and the one at night?

After the 30 mg cut, should she stay at this cut for 2 weeks and remain until she "stabilizes"?

AND should the next step be the "bead counting" from 60 mg or should we cut another large percentage of her dose?

 

If taper and bead counting from 90 mg:

If taper, should we taper from both dosage times OR should we get her to where she is taking it only once per day?

If we taper from both dosages, then is right in assuming that (and using 300 beads as a rough estimate for the 60 mg dose) the deduction would something like...removing 6 beads/dose from the morning AND THEN 3 beads/dose from the evening...until the dosage has been cut by half and she is now around 45 mg combined..AND at that time to readjust and take 10% reduction for the new dosage total of 45 mg and continue to bead count from there..?

 

Any suggestions, questions and/or confirmation from the above mumbo jumbo that you have just read would be GREATLY appreciated.

 

Again, thanks for all that you do and I will continue to pray not only for you and your wonderful works, but for all those that have been touched by them, and by the Grace of God, may we ALL find that road to recovery and health..

 

God Bless You All.

 

Kindest Regards,

 

Colin 

 

 

 


#2 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 21 November 2016 - 01:32 PM

Hi Colin and welcome to the forum,

You will have different point of views here. Be prepared.

My thinking here is no bead counting from 90 mg. Straight to 60mg. This will probably go real smooth. Stabilise if need should be. 30 in am and 30 in the evening.

Keep in mind that between 20% to 30% have rough withdrawal. Others can stop just like that. In what category your mom is, you will find out.

Now, if that goes well and it will, drop to 30mg. Bead counting from there. I just hate to see your mom on that Cymbalta for a long time.

What is the reason your mom went on this med? Is she anxiety prone?

By the way, I want to mention that many go from 60 to 30 with no problem at all.

On that, Fishinghat will come by soon to answer your post. Stand by!

#3 fishinghat

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Posted 21 November 2016 - 01:34 PM

Hi Colin

 

Thank for the very kind words Colin.

 

Well lets hope your mother is one of the lucky ones. If this was my mom I would cut out one of the 30 mg in the morning and wait 2 weeks like you said. If no issues I would then cut another 30 mg (the one in the evening) and wait another 2 weeks. If at anytime she develops even small withdrawal symptoms I would wait until she has stabilized and then start bead counting from there. Keep in mind that studies have shown that the elderly tend to be more sensitive to antidepressants in general.

 

I just say Gail post and it looks like her and I are on the same page.


#4 Runni

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Posted 21 November 2016 - 03:19 PM

Hi Colin 
My doctor was my best port of call as she know me for 20 years adn I stopped letting teh psychiatrist prescribes for me as he was just so disinterested in me as a person.
 
Cymbalta was not easy to come offs but over a few  weeks I have come from 120 to 30. It has been difficult but I am in the better of it.
Thing is ...are there other meds your mom is on? also...what is underlying her need for cymbalta? Sometimes there is a deeper adn more heart felt need emanating for a person where they may be experiencing mood/emotional symptoms but recovery is more complicated than medication 
 
My experience here is that bead counting was problematic and continued my dependence on my family. I went from 120 (had been on for 8 years) to 90 mg, to 60 and finished 30 last week. First two months were real smooth. But this last moth was hard.
 
Your mom is, you will find out or know, her own person. I am 54, a mom and when I was very ill used my illness as a way pf not being responsible for me and wanting to be dependant as then I would be loved...hence why I was on therapy &drugs.
I go to a clinical psychologist every two weeks adn also more valuable now I am getting better is that I am working with a coaching psychologist.
 
Also my family sought help...maybe an idea..
 
Remember your mom needs to be the one to decide adn the carer also needs to be cared for..good luck 
 
 
 

 


#5 crbach

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Posted 21 November 2016 - 03:23 PM

Hi Gail & Fishinghat..!!

 

Thanks for the quick and reassuring words of support and guidance AND what a nice surprise to hear from two of the GREATS..!!  Tag-Team at it's best.

 

It looks like my thoughts were right in line with your post(s), I guess ALL that reading paid off.

 

The Plan for Cymbalta Withdrawal For My Mom..(starting tomorrow 11/22)

90 mg straight to 60mg..(cutting morning dosage by 30 mg, resulting in 30 mg morning AND 30 mg evening)...and will hold and monitor for two weeks.

If no issues..with first 30 mg cut from 90--> 60 mg:

Proceed to another 30 mg cut (cutting the entire 30 mg evening dose)...and then hold and monitor an additional two weeks..

If no issues with second 30 mg cut from 60--> 30 mg:

Could cold turkey BUT smartest/safest choice would to "bead count" to zero by removing 2-3 beads per dosage (using 150 beads in 30 mg) until done..

 

Sounds and looks great, but more importantly.. it looks very do-able.

 

Back to Gail's question..if you can offer some additional help that would be greatly appreciated.

"What is the reason your mom went on this med? Is she anxiety prone?"

 

To make a long story short (if even possible), my Mom was diagnosed with Fibromyalgia way back in 1998, and after the clinics went from manual pressure point therapy, which was helping her tremendously, to ONLY using machines (and machines of ALL kinds "short her out") my Mom was introduced to Valium and Tylenol 3 as a last resort for dealing with her debilitating pain.  After 15 plus years of "using" these medication for treatment, this past Fall she stopped using both cold turkey.  Everything was going fine with no issues whatsoever, and then after one bad fall 6 months later...things went downhill very fast which pushed her into a MASS sensory overload resulting in an Emergency Room trip AND a 4 week stay at a Geriatric "Facility".   Very SAD to say the least, but there is NO place for this kind of person with that kind of traumatic emergency situation.  This has lead to the current road we're on of mood altering/stabilizing, antidepressants, and anti-psychotic medications..prescribed by a ambulance chasing psychiatrist.  Before I knew anything about all of these medications (including her Valium and Tylenol 3 usage) it was far too late for me to do much..this is where I'm coming from today.

 

Don't get me wrong, because without these medicines I'm almost positive my Mom wouldn't have this second chance, but there has to be a better way around treating benzo withdrawals syndrome(s) other than subjecting patients to more harsh medications and withdrawals nightmares..right?  And now, with all that reading about the hell that Big Pharma has "pushed" onto society, as you can see, I'm taking a much more proactive step in helping my Mom get well. 

 

They have also prescribed other medication (and I'm sure you picked up on this from above) and those are...Lithium, Seroquel, Ativan, and Inderal LA (high blood pressure medication).  I didn't want to bring these up in my first post because I didn't want to make things more confusing (for me and for you) when trying to discuss the drug that is making things much worse with side effects for my Mom...and that is the Cymbalta.  What a mess..???

 

Here is her list of medicine and dosages:

Lithium    (600 mg)  300 mg morning.....300 mg evening.

Seroquel (150 mg)  25 mg morning.......125 mg evening.

Ativan      (.5 mg)      .5 mg morning..........1 mg evening.  (OR as needed)

Inderal La(120 mg)  120 mg morning

 

Our Goal:

Cymbalta first...Lithium second...Seroquel third..and then Ativan.

 

Cymbalta..Plan is laid out starting tomorrow.

 

Lithium..   Plan on paper, won't begin until after Cymbalta done..but this is how I understand stopping Lithium for a "short term use".  Any advice?

                 600 mg---> 300 mg...hold for 1 week, maybe 2 weeks.

                 300 mg--->OFF

                 QUESTION...What dose to stop first..morning OR evening?

 

Seroquel. .. Plan looks very similar as Cymbalta..AND won't begin until off Cymbalta & Lithium...Any advice??

Inderal LA...Should be adjusted as soon as the medication are removed seeing they increase blood pressure..(how stupid, right?)

Ativan....... .Another benzo of high addictive properties, BUT she is going to need it to get through all the rest...then we'll worry about that one.

 

I feel a bit overwhelmed by all this, but I'm going to show no FEAR for her sake.  One day at a time and that's ONLY accomplished by placing one foot in front of the other.

 

Any extra advice or suggestions would be greatly appreciated..but what you've done this far has eased my concerns greatly and I thank you both for that..!!

I look forward to keeping you posted as well as seeing what you have to say on such posts like this one.

 

Much Thanks Given today and ALL this week!!

 

In the fight.....

 

Colin


#6 crbach

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Posted 21 November 2016 - 03:28 PM

Hi Colin and welcome to the forum,

You will have different point of views here. Be prepared.

My thinking here is no bead counting from 90 mg. Straight to 60mg. This will probably go real smooth. Stabilise if need should be. 30 in am and 30 in the evening.

Keep in mind that between 20% to 30% have rough withdrawal. Others can stop just like that. In what category your mom is, you will find out.

Now, if that goes well and it will, drop to 30mg. Bead counting from there. I just hate to see your mom on that Cymbalta for a long time.

What is the reason your mom went on this med? Is she anxiety prone?

By the way, I want to mention that many go from 60 to 30 with no problem at all.

On that, Fishinghat will come by soon to answer your post. Stand by!

 

 

Hi Colin

 

Thank for the very kind words Colin.

 

Well lets hope your mother is one of the lucky ones. If this was my mom I would cut out one of the 30 mg in the morning and wait 2 weeks like you said. If no issues I would then cut another 30 mg (the one in the evening) and wait another 2 weeks. If at anytime she develops even small withdrawal symptoms I would wait until she has stabilized and then start bead counting from there. Keep in mind that studies have shown that the elderly tend to be more sensitive to antidepressants in general.

 

I just say Gail post and it looks like her and I are on the same page.

Hi Gail & Fishinghat..!!

 

Thanks for the quick and reassuring words of support and guidance AND what a nice surprise to hear from two of the GREATS..!!  Tag-Team at it's best.

 

It looks like my thoughts were right in line with your post(s), I guess ALL that reading paid off.

 

The Plan for Cymbalta Withdrawal For My Mom..(starting tomorrow 11/22)

90 mg straight to 60mg..(cutting morning dosage by 30 mg, resulting in 30 mg morning AND 30 mg evening)...and will hold and monitor for two weeks.

If no issues..with first 30 mg cut from 90--> 60 mg:

Proceed to another 30 mg cut (cutting the entire 30 mg evening dose)...and then hold and monitor an additional two weeks..

If no issues with second 30 mg cut from 60--> 30 mg:

Could cold turkey BUT smartest/safest choice would to "bead count" to zero by removing 2-3 beads per dosage (using 150 beads in 30 mg) until done..

 

Sounds and looks great, but more importantly.. it looks very do-able.

 

Back to Gail's question..if you can offer some additional help that would be greatly appreciated.

"What is the reason your mom went on this med? Is she anxiety prone?"

 

To make a long story short (if even possible), my Mom was diagnosed with Fibromyalgia way back in 1998, and after the clinics went from manual pressure point therapy, which was helping her tremendously, to ONLY using machines (and machines of ALL kinds "short her out") my Mom was introduced to Valium and Tylenol 3 as a last resort for dealing with her debilitating pain.  After 15 plus years of "using" these medication for treatment, this past Fall she stopped using both cold turkey.  Everything was going fine with no issues whatsoever, and then after one bad fall 6 months later...things went downhill very fast which pushed her into a MASS sensory overload resulting in an Emergency Room trip AND a 4 week stay at a Geriatric "Facility".   Very SAD to say the least, but there is NO place for this kind of person with that kind of traumatic emergency situation.  This has lead to the current road we're on of mood altering/stabilizing, antidepressants, and anti-psychotic medications..prescribed by a ambulance chasing psychiatrist.  Before I knew anything about all of these medications (including her Valium and Tylenol 3 usage) it was far too late for me to do much..this is where I'm coming from today.

 

Don't get me wrong, because without these medicines I'm almost positive my Mom wouldn't have this second chance, but there has to be a better way around treating benzo withdrawals syndrome(s) other than subjecting patients to more harsh medications and withdrawals nightmares..right?  And now, with all that reading about the hell that Big Pharma has "pushed" onto society, as you can see, I'm taking a much more proactive step in helping my Mom get well. 

 

They have also prescribed other medication (and I'm sure you picked up on this from above) and those are...Lithium, Seroquel, Ativan, and Inderal LA (high blood pressure medication).  I didn't want to bring these up in my first post because I didn't want to make things more confusing (for me and for you) when trying to discuss the drug that is making things much worse with side effects for my Mom...and that is the Cymbalta.  What a mess..???

 

Here is her list of medicine and dosages:

Lithium    (600 mg)  300 mg morning.....300 mg evening.

Seroquel (150 mg)  25 mg morning.......125 mg evening.

Ativan      (.5 mg)      .5 mg morning..........1 mg evening.  (OR as needed)

Inderal La(120 mg)  120 mg morning

 

Our Goal:

Cymbalta first...Lithium second...Seroquel third..and then Ativan.

 

Cymbalta..Plan is laid out starting tomorrow.

 

Lithium..   Plan on paper, won't begin until after Cymbalta done..but this is how I understand stopping Lithium for a "short term use".  Any advice?

                 600 mg---> 300 mg...hold for 1 week, maybe 2 weeks.

                 300 mg--->OFF

                 QUESTION...What dose to stop first..morning OR evening?

 

Seroquel. .. Plan looks very similar as Cymbalta..AND won't begin until off Cymbalta & Lithium...Any advice??

Inderal LA...Should be adjusted as soon as the medication are removed seeing they increase blood pressure..(how stupid, right?)

Ativan....... .Another benzo of high addictive properties, BUT she is going to need it to get through all the rest...then we'll worry about that one.

 

I feel a bit overwhelmed by all this, but I'm going to show no FEAR for her sake.  One day at a time and that's ONLY accomplished by placing one foot in front of the other.

 

Any extra advice or suggestions would be greatly appreciated..but what you've done this far has eased my concerns greatly and I thank you both for that..!!

I look forward to keeping you posted as well as seeing what you have to say on such posts like this one.

 

Much Thanks Given today and ALL this week!!

 

In the fight.....

 

Colin


#7 crbach

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Posted 21 November 2016 - 04:18 PM

 

Hi Colin 
My doctor was my best port of call as she know me for 20 years adn I stopped letting teh psychiatrist prescribes for me as he was just so disinterested in me as a person.
 
Cymbalta was not easy to come offs but over a few  weeks I have come from 120 to 30. It has been difficult but I am in the better of it.
Thing is ...are there other meds your mom is on? also...what is underlying her need for cymbalta? Sometimes there is a deeper adn more heart felt need emanating for a person where they may be experiencing mood/emotional symptoms but recovery is more complicated than medication 
 
My experience here is that bead counting was problematic and continued my dependence on my family. I went from 120 (had been on for 8 years) to 90 mg, to 60 and finished 30 last week. First two months were real smooth. But this last moth was hard.
 
Your mom is, you will find out or know, her own person. I am 54, a mom and when I was very ill used my illness as a way pf not being responsible for me and wanting to be dependant as then I would be loved...hence why I was on therapy &drugs.
I go to a clinical psychologist every two weeks adn also more valuable now I am getting better is that I am working with a coaching psychologist.
 
Also my family sought help...maybe an idea..
 
Remember your mom needs to be the one to decide adn the carer also needs to be cared for..good luck 
 
 
 

 

Hi Runni..

 

Thanks for the reply and words of support..greatly appreciated.

 

Also...Congratulations to YOU on your 120------> 0..!!  What a wonderful and inspirational accomplishment.  I hope you celebrated in style..maybe an ice cream sundae or two :)..

 

IF you read the comment I left Gail and fishinghat you'll see that my Mom was prescribed these types of medications for a temporary medical emergency situation..we'll call it a "late in life" crisis and unfortunately, she just happened to fall into the trough and was scooped up by the system.. UGH!

 

And yes, a doctor of many years should be the first person we turn to in times of medical emergencies, but my Mom's physician of 12 years just left her high and dry to deal with withdrawals of long term benzo use.  It's a sad thing and another story all together, but she was abandoned and left to fend for herself.

 

We have a new physician and he is working with us to get her all the support that he can offer...Also, as much as I have disdain for her "prescribed" psychiatrist, I have shown him the respect he deserves and he too will be helping to guide her with support and desired dosage of prescriptions.  A little bit of politics are in order when dealing with them new doctors, but I feel I'm handling them pretty well, especially with all the information that is available from this forum and others like it.

 

As to family support.  She has it.!!  I'm here unconditionally until this venture is finished...and yes, we will finish it together.  My Mom is one tough cookie who has been through a great deal in her 73 years and IF I had the extra time I would proudly lay it out for the world to see because I'm proud of her and love her much..!!

 

I'll be here on this forum until things are over...and God willing, I'll have a success story like yours that I can come back from time and time to share and to help support others fighting the good fight.

 

Much Thanks and many blessing to you Runni..

 

Regards,

 

Colin


#8 fishinghat

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Posted 21 November 2016 - 05:25 PM

CRBach

 

Sounds good.

 

As far as the Lithium, that seems a little fast but I will dig into the medical journals and let you know what I find out.

 

Seroquel I quit cold turkey with only a few days of mild irritation. I will also look into this as well. Been there done that.

 

Inderal is easy it is in the bp control family with clonidine, atenolol, nadolol....  It only has a rebound effect for the blood pressure. If you cut the dose by 1/3 every week for 3 weeks. That will minimize the bp spike.  Been there, done that.

 

Ativan, nasty bugger. Highly recommend the use of water titration. That gives you very fine control of your dose and can be done slowly enough to avoid withdrawal symptoms.

 

I look forward to helping you and your mom deal with these problems. One step at a time. Time and patience.


#9 crbach

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Posted 21 November 2016 - 06:14 PM

CRBach

 

Sounds good.

 

As far as the Lithium, that seems a little fast but I will dig into the medical journals and let you know what I find out.

 

Seroquel I quit cold turkey with only a few days of mild irritation. I will also look into this as well. Been there done that.

 

Inderal is easy it is in the bp control family with clonidine, atenolol, nadolol....  It only has a rebound effect for the blood pressure. If you cut the dose by 1/3 every week for 3 weeks. That will minimize the bp spike.  Been there, done that.

 

Ativan, nasty bugger. Highly recommend the use of water titration. That gives you very fine control of your dose and can be done slowly enough to avoid withdrawal symptoms.

 

I look forward to helping you and your mom deal with these problems. One step at a time. Time and patience.

 

Can you hear that?  It's a huge sigh of relief....

 

When I started reading your posts 2 weeks ago, I knew that having someone like you in my corner would be a key variable in the support plan I envisioned for my Mom..and me by association... SO..I'm honored and stoked that you're part of this vision.  

 

Thanks so much fishinghat..!!!

 

Have a great day.

 

Colin


#10 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 21 November 2016 - 06:23 PM

Hi Colin,

I, personally, think that some of these medications should be left as is. Your mom is not 25 years old, and perhaps she does need some of the meds.

Ok for Cymbalta, nasty side effects for her. Ativan, if she is still 1.50mg, I would let that be. If it's still working. If not, another benzo. Lithium, mood stabilizer, nothing wrong here. Inderal, blood pressure, nothing wrong here if needed.

I would just worry about the Cymbalta. My point of view only. Good p!an for withdrawing from, that, we all agree on the method to be used, great minds think alike.(lol)

#11 crbach

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Posted 21 November 2016 - 06:36 PM

Hi Colin,

I, personally, think that some of these medications should be left as is. Your mom is not 25 years old, and perhaps she does need some of the meds.

Ok for Cymbalta, nasty side effects for her. Ativan, if she is still 1.50mg, I would let that be. If it's still working. If not, another benzo. Lithium, mood stabilizer, nothing wrong here. Inderal, blood pressure, nothing wrong here if needed.

I would just worry about the Cymbalta. My point of view only. Good p!an for withdrawing from, that, we all agree on the method to be used, great minds think alike.(lol)

Thanks Gail..you're the tops.  It must be the name because my Mom's name is Gail too!

 

Our main focus is the Cymbalta because the side effects are really messing with my Mom.  She can't stand not having control of her limbs anymore..that and the harsh sweats and tremors/shaking are driving her bonkers...not to mention the spikes in blood glucose levels which is firing up her hyperglycemia.  My oh my how the domino's fall..

 

As to the other medication outside of Cymbalta, we're not worried about these yet...just thought I put those out there so you know the full story.

 

You guys have taken a load off my mind.

 

Thanks MUCH for caring..

 

Have a nice week!

 

Colin


#12 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 22 November 2016 - 04:16 PM

Hi Colin,

We would appreciate it if you can update us concerning the drops your mom makes with the Cymbalta. Thank you in advance!

Updating is always a lesson more that we can learn for the others that will come by.
Ah, what a funny phrase here, my name might be Gail but I am French(Canadian).

#13 crbach

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Posted 22 November 2016 - 06:23 PM

Hi Colin,

We would appreciate it if you can update us concerning the drops your mom makes with the Cymbalta. Thank you in advance!

Updating is always a lesson more that we can learn for the others that will come by.
Ah, what a funny phrase here, my name might be Gail but I am French(Canadian).

Sure thing gail..

 

As things move forward, I'll be posting progress and if, God forbid anything negative develops, I'll sure be looking for your support and guidance.

Might be "​Gail", BUT IS a French Canadian....are you from Quebec? 


#14 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 22 November 2016 - 07:06 PM

Hi Colin,

Thank you. I live in the Province of Quebec. Sherbrooke, Eastern township's. A beautiful touristic region. Although I do prefer rural zones. Are you from Canada?

Looking forward to or for the updates.

#15 crbach

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Posted 22 November 2016 - 07:27 PM

Hi Colin,

Thank you. I live in the Province of Quebec. Sherbrooke, Eastern township's. A beautiful touristic region. Although I do prefer rural zones. Are you from Canada?

Looking forward to or for the updates.

Not from Canada.  Born and raised in Massachusetts and, for the past 28 years, I reside in Southern California. 

​But..back when I was young, I took 3 trips to Quebec and surrounding areas including a trip to Montreal.  Super nice indeed!  During high school, our French class took a week trip to Quebec City and stayed at the The Château Frontenac..  What fun we had there.   Do they still have that "ice slide" along the boardwalk during the winters?  That is one sweet set up.


#16 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 23 November 2016 - 07:53 AM

Chateau Frontenac! Not for the poor for sure.

Last time I was there, 25 years ago, so I don't know. The area that I am familiar with in the Province is the Gaspe coast.

#17 crbach

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Posted 30 November 2016 - 08:07 PM

Hi Gail & Fishinghat..

​I thought I would give you a quick update as to my Mom's progress with Cymbalta reduction. 

 

Well, it's been just over a week of reducing her total dosage from 90 mg to 60 mg (30 mg in morning and 30 mg in evening), and things couldn't be better..!! 

 

Many of the horrible side effects at the 90 mg dosage have either been greatly reduced or have completely disappeared.

*Her nightly sweats are gone after 3 days reduction.

​*The tremors or feelings of being hypoglycemic are almost completely gone.

​*The muscle jerks or spasms happen only a few times a day compared to dozens per day.

​*And best of all she seems to be coming back to her self again..with much less fear.

As to withdrawal side effects (from 90 mg--->60 mg)..you were right, so far she has been doing great with very little or none.  What a blessing..!!​

​We plan on taking that next step (60 mg----> 30 mg) on Monday, and doing like you suggested by cutting the 30 mg dosage in the evening, and keeping it here for another 2 weeks...

​Thanks for all the advice and support so far and I will keep you up to speed as things progress.

​Hope things are as well as can be with you both.

​Your friend,

​Colin


#18 gail

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Posted 01 December 2016 - 07:40 AM

Hi Colin,

Thank you for updating. Sure glad that things are so much better for your mom.

Hope to see you back soon to know how she is doing on 30mg. If things are tough, come back sooner, we will suggest something else.

#19 crbach

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Posted 12 December 2016 - 05:23 PM

Hi Gail & Fishinghat..

 

A little over a week ago I stated that things were going fine and Mom and I would be taking the next step in the reduction of Cymbalta..I think I spoke a bit too soon because before we made that step, she started to feel effects of the drop in dosage..or at least that's how the symptoms showed themselves..(dizziness, nauseousness, some head aches, muscle aches, etc.) and because of these symptoms we have remained at the same dosage this extra week..and in doing so, things have stabilized as of today and she is feeling much better.

 

But a question has surfaced during this time and I'm hoping one of you can help..

 

With Seroquel and Cymbalta..there is a "moderate" drug interaction between and with these two medications...especially for the elderly...link below.

https://www.drugs.co...html?consumer=1

 

QUESTION:  Could the interaction of these two medications be a main contributor to these "symptoms" my Mom could be experiencing instead of withdrawal symptoms?

IF so..since she is taking BOTH (Cymbalta/Seroquel) in the morning and BOTH (Cymbalta/Seroquel) in the evening..

Would it be better (before we continue with reduction of medications) if we were to get her Cymbalta dose combined for the morning and the Seroquel dose combined for the evening dose..?

 

Her dosage for Cymbalta again is 30 mg (morning)..30 mg (evening)

Her dosage for Seroquel again is 25 mg (morning)..125mg (evening)

 

Can we or should we combine these..Putting all Cymbalta at 60 mg (morning) & Putting all Seroquel at 150 mg (evening).

 

Is there any harm in doing this...

 

Any help/advice would be greatly appreciated.

 

Hope you both are well and are staying warm..

 

Regards and thanks,

Colin


#20 fishinghat

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Posted 12 December 2016 - 06:05 PM

Hi Colin
 
I guess the first thing that comes to mind is that Cymbalta has a half life of 12 hours and Seroquel 6 hours. That means that is takes over 3 days to process one dose of Cymbalta and of course by that time (no matter when you take it) you have taken more doses and your blood chemistry levels have stayed high. Changing it to all at one time will have little effect on how much is in your system.
 
Seroquel on the other hand at 6 hour half-life takes about a day and a half to mostly be eliminated from your body, and again, of course you have already taken 2 or 3 more doses.  I don't think changing schedules would really make a difference.
 
Secondly, your mother's symptoms seem to be a reflection of the drop in dose and with the extra week she has improved. This sounds like withdrawal. If the symptoms had been from a combination of the two meds then it would remain fairly stable in its occurrence. In addition the symptoms your mom has (dizziness, nauseousness, some head aches, muscle aches, etc) seems more like withdrawal symptoms than the symptoms of the drug interaction (impairment in thinking, judgment, and motor coordination). With the drug interaction the person appears more confused, hard to focus, stumbles a lot, etc. In addition this drug interaction will cause bp to drop whereas withdrawal (of any type) increases bp. Also, the digestive issues is classic for any ssri or snri (such as Cymbalta)as it controls serotonin which is the controlling neurotransmitter for the digestive tract.


#21 crbach

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Posted 12 December 2016 - 06:18 PM

Thanks for that quick reply fishinghat. 

 

I understand about the half life of these meds and as a result, changing up the medication schedule wouldn't have any extra added benefit because the meds are already up in running in the body and there would always be an overlap..

 

I'll stick to the next step as discussed and will work diligently in getting her off this poison.

 

Thanks again for being there!!

 

Have a nice week..!


#22 gail

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Posted 13 December 2016 - 04:38 PM

Hi Colin,

So glad that your mother has stabilized. Fishinghat is the one that has knowledge about meds,i would put my faith in his answer.

Of course, you are welcomed anytime, we are here for you! Updating is really appreciated by all of us. Wishing you and your mom well.

#23 crbach

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Posted 14 December 2016 - 12:52 PM

​It's nice to know that both you and fishinghat care as much as you do.  Thanks Gail..!!


#24 crbach

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Posted 15 December 2016 - 02:04 PM

​Hey fishinghat.. A few questions for you.

​-I just read the post about generic vs non-generic Cymbalta tapering.  Well, my Mom is on the generic and I'm wondering what the best way to taper from her 30mg in two weeks with all those different size beads.  Any suggestions on this?

​-Also..We should just focus in on one medication tapering at a time, right? 

 

​-After we get off the Cymbalta, how long until we should start the taper on the next medication?

​-Lastly..what medication should we taper next...Lithium or Seroquel?  If we waited on the Lithium and taper Seroquel first, would the Lithium add extra stabilization with the taper of the Seroquel?

​So you know...last night (12/14) I reduced my Mom's Cymbalta dosage by removing the 30 mg evening dosage per our prior discussion(s).  We'll keep the final dose of 30 mg in the morning going for the next two weeks...and if things go smoothly, then we'll begin that bead count until off.

 

​Ok..that's it from here.  Take it easy.

​Colin


#25 fishinghat

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Posted 15 December 2016 - 05:39 PM

First item. Are the bead sizes in your generic vary in size? Some generics do vary a lot and others don't.  If the bead sizes do vary then you are better off getting off the generic and on the Cymbalta so the drop will be a little smoother.

 

Item two, absolutely yes. Focus on one medicine at a time.

 

After coming off the Cymbalta I would wait 1 to 2 months and give your nerves a chance to adjust and not be so sensitive.

 

Fourth, I would do the Seroquel next. It is a relatively easy withdrawal. It normally takes 2 to 4 weeks, for me anyway.  lol

 

I hope you and your mom success with the drop to 30 mg. You are right, you will know in a couple weeks.

 

Keep us posted. It sounds like you have a solid plan.


#26 crbach

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Posted 15 December 2016 - 06:08 PM

​Yes fishinghat, beads in the generic Cymbalta vary quite a bit..SO I'll take your advice and ask the doctor to prescribe non generic when the time gets close...

Will this non generic Cymbalta make much of a difference as far as the strength of the medication...??  Should I even worry about that..??

​As for Seroquel..Do you have a plan for a Seroquel taper AND will her being on Seroquel an additional 1-2 months (waiting for quieting of the nerves) make it any harder for her to come off of a total of 150 mg dose (and at that time it will be right around 4.5 - 5 months)..? 

​One more thing..(sorry)..Do you see any issue with us combining her Seroquel dosages (25 mg in the morning and 125 mg in the evening) for "convenience" sake only...?? 

​Thanks for ALL the help and support..


#27 fishinghat

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Posted 15 December 2016 - 07:30 PM

It makes no difference on the strength but the bead size is consistent and will help with the withdrawal less erratic.

 

Most people drop 50 mg every week until at zero and the length of time on it seems to matter little.

 

I assume she is taking it for sleep which is common. Seroquel has a half life of 6 hours. I doubt if you would have much issue with taking the 150 at the same time. If you do just divide the dose over the day, say 50 mg every 8 hours and then taper from there. That will provide a more even blood level and less up and down on the withdrawal. Do expect some difficulty sleeping during this time, That is one of the main rebound effects.


#28 crbach

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Posted 15 December 2016 - 08:15 PM

Thank you fishinghat.. Stay warm and have a nice weekend.. :D  ​


#29 crbach

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Posted 23 December 2016 - 03:57 PM

Question for you fishinghat...(or for Gail if you would like to add something..)

​First..things have gone pretty smoothly over the past 10 days making the transition from 60 mg down to 30 mg..not to much discomfort and things are keeping relatively stable.

​BUT..as we discussed with using the Name Brand Cymbalta for a more consistent bead taper during the last 30 mg dosage...My Mom's insurance will NOT cover the name brand Cymbalta (at a cost of $475.00)... SO we are stuck (on Tuesday next week 12/27) with trying to bead count the last 30 mg dosage with the non proportional sized beads in the generic Cymbalta.  Is there a way to deal with the multiple sized "beads" (if you can call them that) when doing the bead counting taper with the generic Cymbalta?  

​Any thoughts or suggestions that you might have with this would be greatly appreciated...

​Thanks again.  Colin.. :rolleyes:


#30 fishinghat

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Posted 23 December 2016 - 04:07 PM

There is a weight (pun intended) to deal with it and that is to weight the beads. You will need to open two or three capsules and weight the beads. From that you can determine the average weight of beads in the capsules. Lets say 900 mg. A 1% drop would be a 9 mg drop each day. You will have to purchase a high quality mg scale from maybe Amazon. Something that weights from 0 to 3 grams lets say and its accuracy is +/- 1 or 2 mg. If you have trouble finding something you are comfortable with please let me know and I will look into them. I am also going to do a little research on the weight of full capsules of Cymbalta. I will let you know what I find out.





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