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Consistent Weaning Help


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#1 Daricci

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Posted 10 December 2017 - 06:05 AM

Duloxetine 30 mgs weaning...

Stopped taking duloxetine for 4 days and vertigo was a scarey withdrawal symptom. I need to at least take half capsules until my rheumy responds to my email at his office Monday. Best way to split capsules anyone?

#2 fishinghat

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Posted 10 December 2017 - 09:10 AM

Welcome Daricci

 

Stopping Cymbalta cold turkey can be dangerous. The FDA and manufacturer warn that it can lead to seizures, suicidal thoughts, and much more. I recommend that you go back to 30 mg, stabilize and then start bead counting your way down. As far as a half capsule. Well the best approach is to open a capsule, poor out the beads, count them and then put half back. Empty capsules can be purchased from Amazon as well as a local compounding pharmacy in your area. Do not just guess at how many. Cymbalta has a short half life of 12 hours so if you are off it will cause your withdrawal to be erratic.


#3 gail

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Posted 10 December 2017 - 10:31 AM

Hello Daricci,

Same advice here, go back to 30mg or at least 15 or 20mg. And once stabilized, if you do stabilize at 15 or 20mg, bead counting is our way to taper.

FH, can you give us the percentage of people that have rough withdrawal, and people who don't?
My memory has been left on the surgery table(lol)! Thank you sir!

#4 fishinghat

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Posted 10 December 2017 - 11:28 AM

Around 20% have little to no withdrawal, about 60% have moderate withdrawal (6 to 8 months0 and about 20% have severe withdrawal (8 months to 2 years).  The numbers vary depending on what research you look at but that is about an average.


#5 gail

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Posted 11 December 2017 - 05:30 PM

Fishinghat, if you have time, can you give me the reference for this information?
Bad English, I'm sure that you know what I mean! Thank you sir.

#6 fishinghat

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Posted 11 December 2017 - 06:03 PM

It is sort of an average for a dozen different research articles. It is not written in concrete. I will post the articles.

http://neuro.psychia...ticleid=1828814
http://www.jad-journ...0286-7/abstract
44.3% have withdrawal

http://www.ncbi.nlm....pubmed/19337457
30% have withdrawal

http://www.ncbi.nlm....ubmed/15912562/
0% serious(?) withdrawal events

http://www.aafp.org/.../0801/p449.html
20% have withdrawal.

http://www.aafp.org/.../0801/p449.html
20%

Duloxetine Induced Discontinuation Syndrome:
http://www.jcdr.net/...1619_6_4_11.pdf
http://www.fda.gov/d..../UCM172866.pdf
http://www.fda.gov/d...e/UCM172866.pdf

http://www.fda.gov/d...e/UCM172866.pdf
FDA.gov. (2009, June 9). Cymbalta (Duloxetine) Discontinuation Syndrome Issues of Scope, Severity, Duration and Management.


UCM172866

Misc.
http://www.fsijourna...0495-7/abstract

SSRI Discontinuation syndrome.
http://www.ncbi.nlm....ith agoraphobia
45%
https://www.ncbi.nlm...pubmed/20478876

Paroxetine (Paxil) and venlafaxine (Effexor) seem to be particularly difficult to discontinue and prolonged withdrawal syndrome lasting over 18 months have been reported with paroxetine. (See the following 3 references)
https://www.ncbi.nlm...pubmed/11347722
https://www.ncbi.nlm...pubmed/12008858
Gartlehner G, Hansen RA, Morgan LC, et al. (December 2011). "Results". Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An Update of the 2007 Comparative Effectiveness Review (Report). Comparative Effectiveness Reviews. Rockville, MD: Agency for Healthcare Research and Quality – via NCBI Bookshelf.


#7 gail

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Posted 12 December 2017 - 09:16 AM

Thank you so much sir for this information.

I read it all. The tendency is a four week tapering!!!!!

I read a few cases with awful withdrawal, just a few.

And I learned that with cymbalta withdrawal, the switch to another SNRI with a longer half life is suggested. This, I think you wrote about recently, would be Trintallix. I need to check this out and will be back with the info.

#8 gail

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Posted 12 December 2017 - 09:39 AM

I was wrong about Trintallix, which is an SSRI.

In all of the SNRI's, the longest half life would be Effexor with 15 hours plus or minus 5 or 6 hours. Right?

And I learned that when getting off Paxil, a switch to fluoxetine would be of help.

Ah! The complexities of antidepressants! So sir, why Trintallix for Cymbalta's withdrawal?

And I read that even after stopping after 8 weeks, reinstating would take about 24 hours to make the symptoms go away!

#9 fishinghat

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Posted 12 December 2017 - 09:51 AM

Your right on your info Gail. The strange thing about Trintellix is that it has a minor withdrawal compared to other ssri for some reason. Drs are increasingly using it to replace someone's ssri/snri and then wean off the Trintellix over a 3 tom 7 week period. It seems to work well. When I get a little time I am going to look into that a little deeper as it hold much promise if true.





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